Pets with external ear infections have inflammation of the vertical and horizontal ear canals. Pets will often shake their heads, scratch their ears and brown or yellow debris can be visualized when lifting up the ear flap. A foul odor may also be noted. The symptoms for middle and inner ear infections are often similar to external ear infections and include pain in the ear, head shaking, infected or bloody discharge, and scratching or pawing at the head or ear. As the infection in the middle ear progresses, the dog may also have facial paralysis on the infected side due to the inflammation of the facial nerve that runs adjacent to the middle ear. Signs of facial paralysis include difficulty swallowing, drooping eyelids and facial muscles, and a third eyelid that moves up and partially covers the eye. As the infection progresses to the inner ear, the symptoms will include a loss of balance, a downward head tilt and walking in circles. Any dog can develop ear infections during their lifetime. Dogs with narrow ear canals, such as dogs with chronic anatomical changes due to previous disease or dog breeds such as Shar Pei and Chow Chow, are prone to yeast and bacteria becoming trapped in the narrow canal. Dogs with long, droopy ears, such as hound breeds, are prone to developing ear infections due to their ear anatomy. Dogs that enjoy swimming may also be more susceptible to ear infections.
External ear infections are diagnosed based on otoscopic exam of the ear and ear cytology. For cytology, your veterinarian will take a sample of the debris in the ear and examine it under the microscope to look for yeast, bacteria and mites. Middle and inner ear infections are diagnosed with a thorough otoscopic exam and x-rays, CT scan or MRI of the head. Animals usually need to be anesthetized so that they can be properly examined and so that the ear can be flushed and treated. A ruptured eardrum or an eardrum that is discolored and bulging with fluid is an indicator of a middle and possibly inner ear infection. Most cases of middle and inner ear infections usually have signs of an external ear infection as well, but not always.
Ear infections are sometimes due to an underlying cause, like abnormal ear anatomy, which allows substances to become trapped in the ear. Other factors, such as food adverse response or environmental allergies, can allow dogs to develop ear infections because their skin is inflamed from the allergy, which is more conducive forming secondary infections.
Ear infections can also be caused by ear mites, grass awns or other foreign bodies embedding in the ear, growths in the ear and adverse reactions to substances applied to the ears. These infections usually begin in the horizontal and vertical canals, but can begin to move deeper if not treated. The middle and inner ear of dogs and cats is separated from the external ear by the tympanic membrane (eardrum). It is not possible to see the middle or inner ear unless the eardrum has been ruptured. The middle and inner ear coordinate hearing and control balance. Infections in this area may show up as hearing loss, loss of balance or other neurological problems.
Fortunately, if caught early, most middle and inner ear infections can be treated successfully. Most cases of middle and inner ear infections in dogs and cats are caused by an extension of an infection in the outer ear. Staphylococcus, streptococcus, and pseudomonas bacteria or malassezia and candida yeast are often isolated as the infectious agents. Less commonly, bacterial infections may ascend from the oral cavity through the auditory tube and into the ear.
Most cases of otitis can be treated for less than $150 per episode. Cases requiring surgery may cost $1500 or more per ear.
Many cases resolve within days to weeks of treatment. Pets that have severe infections and pets with middle and inner ear infections may be prone to recurrent ear infections.
Your veterinarian will let you know when they want to see your pet back after diagnosis. For severe infections, rechecks exams may happen every week.
Management of the underlying cause for many dogs can help prevent occurrence of ear infections. Dogs that are prone to ear infections after swimming should have their ears cleaned after getting out of the water.
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