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Ear Infections In Dogs

Ear infections are a very common malady for our canine companions. There are three types of infection all defined by the location in the ear. Otitis externa is an infection involving the ear canal to an intact ear drum. Otitis media is an ear infection involving the middle ear between the ear drum and the inner ear. And Otitis interna is an infection involving the inner ear. The most common is otitis externa.  If the ear drum ruptures then the pet has both otitis externa and otitis media.

Ear infections are very frustrating issue with our human clients. The reason they are both frustrating and common is (sit down before you read the rest) ear infections are not curable. Ear infections can be treated and managed, but they are not curable. The reason for their incurableness is the underlying causes for the ear infection.

There are many underlying reasons the ear canal will get infected. The infection is just the result of the underlying causes, not the cause itself.  For example, you have a swollen red infected finger. The finger swelling and infection could have been by the cat bite, the splinter, or a cut and the infection was the result.  Same goes for an ear infection. Identifying the underlying causes and managing them will make for happy pet and owner.

DogEarAnatomyThe first underlying reason is the anatomy of the ear canal. We all have a hole at the beginning of the ear canal. A human ear canal continues horizontally to the ear drum. A dog’s ear canal travels down (vertical ear canal) about ¾ inch then turns horizontal about ½ inch to the ear drum.  Any wax, water, dirt, or whatever will drop down the canal. The second anatomical problem is hairy ear canals. Certain breeds like Poodles and Schnauzers have exceptionally hairy ear canals trapping any wax, dirt, or moisture. Certain breeds like Spaniels and Bassets have floppy ears that cover the opening allowing body heat and  moisture to aid the bacteria and yeast to flourish. Certain breeds like Shar Peis have extremely small ear canals making it harder to thoroughly cleanse the ear.

The second underlying reason is moisture. Baths, swimming, ear licking, rain and humidity will cause moisture to build up in the ear canal. In people we commonly call this condition swimmer’s ear. And we know of the consequences if we do not remove the moisture. In our pets, the moisture and body heat create the perfect environment for an infection to fester.

The third most common underlying reason for ear infections is allergies. Pets that have allergies have common symptoms. Those symptoms are itchy skin and the most common areas are the feet and ears. The constant head rubbing, scratching and shaking abrades and inflames the skin causing swelling and redness.  That swelling and redness creates a perfect environment for infection. Why do you think people with nasal allergies get sinusitis? The environment of inflamed mucous membranes and surface bacteria create the infection.

The lesser common underlying reasons are parasites like ear ticks and ear mites. Another underlying reason can be foreign objects stuck in the ear like toys and grass awns.

How do veterinarians approach ear infections? First and foremost is the gathering of history.  Historical questions of reoccurrences, baths, and or swimming help narrow down some of the underlying reasons.  Next step is the examination. Most ear infections are painful, so a decision needs to be made on how to examine a painful ear. A lot of times, the pet will need to be sedated to thoroughly examine the ear. Under sedation and/or anesthesia we first take a sample of the exudates (the accumulated debris in the ear canal) to examine under the microscope. Then the ear can be cleansed by gentle flushing with warm betadine solution.  Once cleansed, we look at the entire ear canal down to the ear drum.

The material examined under the microscope will tell us if our infection is bacterial and/or yeast. This information helps us pick which medication we need to treat the secondary infection.

Treatment plan:

  1. Identify underlying causes for the ear infection.
    • Allergies need long term systemic medications of prednisone or antihistamines to control the allergy.
    • Moisture from baths, swimming, or humidity need to be controlled with ear cleansers that dry the ear canal.
    • The pet’s anatomical problems will need to be addressed. Hair ear canals need to be plucked. Floppy ears need to be cleansed with a cleanser that will dry the ear canal. Small ear canals may have to have a surgery.
    • Ear parasites need to be treated and prevented.
  2. Identify the infection. If the infection is yeast called Malassezia then an antifungal will be prescribed topically and/or systemically. If the infection is a bacterium then the appropriate antibiotic will be prescribed topically and/or systemically.
  3. Treat the pain. Most ear pain is caused by inflammation. It is very common to give the pet an anti-inflammatory drug, usually a steroid.
  4. Show the owner how to flush the ears at home and administer the medication.
  5. Recheck, recheck, and recheck.

The very serious ears will need surgery. Serious ear problems are extremely painful ears, dogs that are head shy from constant treatment, and/or small ear canals from chronic infection or breed related. This particular surgery is called a lateral ear resection. Very chronic ear infections may have the ear canal so swollen with scar tissue and inflammation that the only option is to remove the entire ear canal, called an ear ablation.

Question: I get a call from a client, “Hey Doc, I need a refill of Buster’s ear medicine you prescribed several months ago.” What is wrong with this scenario? Obviously I did not do a very good job of telling the owner about controlling the underlying conditions; the infection is just a result of those conditions and not the cause.

There are two important considerations with repeated ear infections:

  1. Scar tissue is laid down in the canal narrowing the canal like calcium in water lines. Making it harder to clean out the canal and treat. Eventually the ear drum will rupture and surgery becomes the only options. Ruptured ear drums cause the infection deeper into the ear. If the infection reaches the inner ear, hearing and balance are greatly affected.
  2. Constant antimicrobial treatment makes for resistance to the microbes you are treating. Soon, there are no medications effective against the super-bugs.

All ears can be treated and helped. Identify the underlying reasons and all ear infections will be held at bay. Or ignore the underlying reasons and the ear will be infected again. All that time and money spent treating the last infection will be lost as if you did not do anything at all.  Helping you control your pet’s ear problem makes for a happy pet.

Vaccinations for Dogs and Cats

Vaccines have been around for a long time. The term “vaccine” comes from the Latin word “vacca” which means cow. It was discovered that cowpox virus protected people from small pox infections. The first experimental vaccine was taking cowpox pustules and rubbing them onto people to prevent small pox.Boy have we come a long way in preventing diseases. When it comes to vaccinating our pets, there has to be several considerations taken into account.

  1. Is the disease endemic or epidemic in the pet’s area? Is the disease prevalent?
  2. How is the disease transmitted?
  3. Is the vaccine safe? Are there any side effects?
  4. What is the efficacy of the vaccine? Are most vaccinated pets protected after the vaccine?
  5. How dangerous is the disease?
  6. How is the vaccine administered?
  7. What is the frequency for boosters?

This is basically called a risk assessment. Each pet has their own unique environment and considerations. There is a big difference between a pet that lives completely indoors versus a pet that lives outdoors all the time. There is a difference between the multi-pet households and the single pet households. The pets that go to grooming, boarding, day care, or shows have a higher exposure to diseases. Pets in shelters probably have the highest risk of all. All the circumstances must be taken into consideration.

The American Veterinary Medical Association, American Animal Hospital Association, and American Association of Feline Practitioners have vaccine recommendations. The vaccines are broken down into core and noncore.

Dog core vaccinations are canine distemper, parvovirus, and rabies. The noncore canine vaccines are leptospirosis, giardia, cornavirus, bordetella, and Lyme’s.

Cat core vaccinations are panleukopenia (distemper), feline viral respiratory disease complex (rhinotracheitis and calicivirus), and rabies. The noncore vaccines for cats are feline leukemia, feline immunodificiency virus, chlamydia, and bordetella,

The core vaccinations are for all pets, no matter their living circomstances. The noncore vaccines require a risk assessment. For example, canine bordetella vaccine is highly recommend for grooming, boarding, show, and/or shelters situations. Feline leukemia vaccine is highly recommended for outside cats and catteries.

In summary, pet vaccines have been around for many years. I have vaccinated many pets since 1979. And I have had some reactions with vaccines. I have also seen a lot of disease during that time that could have been prevented. I’ll take the low probability of a vaccine problems versus the diseases they prevent anytime. Talk with your veterinarian about your pet’s risk.

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Dr. Bob

Dr. Bob

The patient behind my left shoulder is on an extreme diet.

Vomiting and/or Diarrhea in Dogs

What a glamorous first blog article, but this time a year I daily talk to at least 10 people concerning this symptom. Dogs are scavengers, constantly searching for that next tasty morsel. Their motto, ” Eat first, question later”. Luckily dogs have a safety valve, a hair-trigger vomit/diarrhea reaction. If that consumed substance does not belong down there, then the gut’s reaction is to get it out and either end will do. Nearly 100% of all vomiting and/or diarrhea cases involves ingestion of something that did not react well with the pet’s digestive system.

 Why this time of year for so many cases of gastroenteritis? The temperatures are getting warmer, the plants are growing, varmints are scurrying about, why it is a food pantry out there.

The are numerous symptoms to be on the lookout. The dog’s appetite is off or gone. The owner may here the pet’s intestines gurgling. The pet may have excessive gas. And, the obvious signs are vomiting and/or diarrhea. Vomiting is the worse symptom, it can lead to dehydration.

What to do with your sick pet?

  1. Take off all food for a minimum of 24 hours, your pet will not want to eat if he/she feels sick and nauseated. Trying to feed them makes the problem worse.
  2. Give your pet liquid Pepto-bismol or Kaopectate. 1 teaspoon per 10lbs every 4-6 hours. Continue for two to three days.
  3. After the fasting period, try a small amount of cooked rice or pasta. If your pet eats the meal, hold off for 12 hours before trying a little more.
  4. Feed the rice/pasta for 5 days.
  5. After 5 days mix the pet’s regular food in with the rice/pasta.

This is a general treatment for most pet’s gastroenteritis. Here are the exceptions:

  1. Older compromised patients, take them to your veterinarian the first day.
  2. Very young small breed puppies, take them to your veterinarian the first day.
  3. If the vomiting persists more than 36 hours, take them to your veterinarian.
  4. Known ingestion of large object that could obstruct your pet’s bowels.
  5. If in doubt, take your pet to their veterinarian.

Lastly, try to figure out what caused the gastroenteritis and eliminate it. Dogs are very intelligent, but for some reason that do not learn from their gastric conquests and will become repeat offenders.

Thanks for reading,

Dr. Bob