Original Question: 6 months ago my dog started scratching her right ear constantly. I noticed a tar build up and cleaned her ear with natural products but she is still scratching and the build up is still happening so we are cleaning weekly. The vet said it’s not infected but to keep her ear hairs trimmed and not to pull the hairs out but months later and she’s still scratching constantly. Sometimes if we touch that area she will yelp. Her ears have a slight smell but they are not red. - Stuart
We need to first think about why the dog is scratching and getting a wax build-up and there can be a number of causes of itching and that can include parasites to start with and that could be fleas, mites and ear mites in particular. There could be allergic skin disease such as allergic dermatitis which is an allergy to fleas and it also be caused by an allergy to pollens and other things within the environment which is called atopy and there could also be a food allergy which causes itchy skin. It could also be caused by local ear problems so that can be just ears that have had chronic long-term infection that’s caused a narrowing of the actual ear canals, which makes a subsequent infection more likely. Hairy ears can certainly increase the risk of infection, the big flappy ears dogs like Spaniels have. Water in the ears is another potential cause, so a dog who likes to swim and also any masses as well. If there’s a mass within the ear canal, then that can make an irritation much more likely.
So when we’re thinking about treating itchy ears and ear disease in general, we need to address the underlying causes. So it shouldn’t simply be a case of popping ear medication down there and leaving it at that and doing nothing else, especially if we’ve got a repeat problem and it’s something that keeps flaring up or is poorly controlled with that initial treatment. So as I already said, long-term ear inflammation can cause scarring, which makes future problems more likely and we also need to address the underlying cause because at the end of the day being itchy all the time is absolutely miserable for a dog. I liken it to being in constant pain all the time and being itchy has the same effect on quality of life.
So there’s a number of things we can do to try and diagnose the problem. So we can take samples from within the ear. We can do ear smears looking at whether there’s yeast or bacterial infection and whether there’s any resistant infection. So we can send off a culture and sensitivity as well, take a swab and send that off to the lab. We might also want to be taking X-rays to look at the middle ear if we suspect that there is a middle ear infection or a mass in the middle ear that’s underlying all of these problems. We might want to do a trial treatment and give an anti-allergy medication. We might want to do a diet trial such as changing to a skin diet or an exclusion diet to try and rule out a food allergy.
And then once we’ve done all of those treatments really it’s going to depend on the underlying cause and controlling this if at all possible. So we might be using a cleaner to help mobilize wax and create an environment that doesn’t favor the growth of bugs and there are some great cleaners out there that do just that. They’re not antibiotics but they’re antibacterial. They dry the ear and they help reduce the build-up of debris within the ear and provide an environment that isn’t favorable for the bacteria or for the yeast to grow in. When we’re cleaning the ears as well we don’t want to actually poke a Q-tip or a cotton bud down the ear to clean them because that can just push the wax deeper and compact it down making the problem much worse. We want to be using the cleaner to mobilize that wax and then we just want to be taking a cloth or a tissue and wiping the outside surface of the canal that we can see. So just removing the wax and debris that way. And then something to mention and I say to the vast majority of my clients who have pets with skin problems is that skin conditions and that includes ear disease, they can be incredibly frustrating and they can take some time to settle and to decide on the best treatment and prevention strategy for each individual. So it’s often a case of working through a little bit of a process, seeing what works, seeing what the pet doesn’t seem to respond to and coming up with a tailored individual treatment plan. So it’s not a one size fits all strategy that will be appropriate for every individual dog but we need to be thinking about tackling any infection that’s present, addressing any underlying causes and then managing the condition ongoing.
I hope this helps.
Dr. Alex Avery