[Dailydrool] Need advice on chronic ear infections

[Elizabeth Lindsey]

If you've been to the vet numerous times, have done smears and  
cultures, and tried various antibiotics, creams, and washes, then  
it's past time to head to a specialist. I say this based on the  
experience we had with our late Jane Basset, who went through six  
months of debilitating ear infections with a regular vet who did  
smears, cultures, and antibiotics, while telling us that all long- 
eared dogs have ear infections and this was pretty much "normal" for  
bassets. It isn't.

It reached the point where our Jane's right ear hurt so much that she  
drooled constantly on the right side and couldn't chew any hard  
kibble or treats; we had to soak all her food. Our guts told us  
something was really wrong, but we erroneously trusted our regular  
vet, who's a really nice person, and kept taking Jane back to her for  
another culture, another antibiotic. I wound up taking Jane to see my  
parents' vet during a visit to their house, and that vet urged me to  
take Jane to our state's vet school. She said Jane's infection had  
gone on for too long, and its *cause* needed to be determined and  
treated, not merely its symptoms.

When I got home, I asked our vet for a referral to Purdue, and she  
gave it to me without any sign of offense being taken. I honestly  
don't think she cared that much, and maybe she even thought we were  
wasting our money by going to Purdue because in her world, long-eared  
dogs and ear infections are "normal." We weren't wasting our money,  
she was on useless antibiotics. What we found out when the veterinary  
dermatologist looked into Jane's ear with a flexible endoscope was  
that Jane had been suffering a raging infection that the regular vet  
couldn't possibly have seen or detected with her handheld otiscope  
and rigid swabs. A dog's ear canal makes a 90-degree bend, and an  
otiscope doesn't allow a vet to see beyond that bend. Swabs can't  
make that bend either to get samples for smears and cultures.

So for months the vet had been treating the symptoms of an infection  
she didn't even know existed, and she was throwing the wrong kind of  
antibiotics at the type of bacteria that was causing that infection.  
By the time the specialists at Purdue discovered it, it looked like a  
mess of green cottage cheese and it was eating through Jane's skull.  
Actually, it'd been allowed to rage for so long that the specialists  
worried it may have turned cancerous.

Jane had to have a TECA (total ear canal acclusion) surgery, which is  
extremely painful and should really only be done by a specialist;  
it's not a surgery that regular vets have much experience doing and  
it's tricky. She had to stay at the vet school for almost a week with  
a tube in her ear for drainage. The surgery left her with her ear  
flap but nothing inside that ear, not even a hole; it was sewn up.  
Her hearing wasn't terribly compromised, but her thyroids were.  
Because she'd had an infection for so long, she developed  
hypthyroidism and had to be on medication for that for the rest of  
her life.

After they got the infection cleared up, Jane's dermatologist worked  
to find the cause of her chronic ear infections. It turned out she  
had environmental allergies to molds, weeds, pollens, dust, feathers,  
and cats. We put her on twice-a-week allergy shots, fatty acid  
supplements, Tavist-1, and, when needed, oatmeal baths and limited  
prednisone to control flare-ups. She had only a few flare-ups within  
the first six months of treatment. Once we got her allergies under  
control, her ear infections stopped completely. Despite still being a  
long-eared dog.

If we hadn't taken Jane to Purdue, she would have died from that  
infection. Because of Jane, we take ear infections very seriously. We  
now operate under a "three strikes and you're out" rule with our  
regular vets--if a regular vet can't clear up an ear infection after  
three tries (tries that include smears and cultures), we ask to see a  
veterinary dermatologist or allergist. In my experience, regular vets  
tend to have great self-confidence in their abilities and sometimes  
don't know when they're in over their heads and should refer a  
customer on to a specialist who has access to better diagnostic tools  
and has had extensive training and experience in one area of medicine.

Don't ever hesitate to get a second opinion or ask for a referral to  
a specialist if you feel the vet you're seeing isn't treating  
something effectively. Our dogs depend on us to look out for them in  
this way.

Elizabeth