[Dailydrool] Ear problems (sorry it's so long)

[Pamela McQuade]

I believe the key to dealing with ear problems is to catch the problem early and treat the ears religiously. Unhappily, many dogs who come into rescue have not had humans who wanted to see to their comfort, so you often get a dog who is in dire straits because of a human's inaction.
 
Six years ago we went through ear problems with our foster/adoptee Alexis, and we are dealing with them today with our current foster Holly. Alexis came to us with a terrible pseudomonas infection. Immediately we started treating her with the antibiotics prescribed by the vet. The infection went on and on as we changed antibiotics several times. 
 
As I understand it, the antibiotics that work best are those placed directly in the ears. I had hoped the vet would have an injectable form that would do the job, but unless things have changed in the past few years, that's not the way things are. 
 
If you do not see a fairly quick response when you treat the ears daily according to the regimen prescribed by your vet, go back to the vet. Unless you let a vet know that the problem is not solved, it will be assumed the dog is doing well. It may take a few changes to get the right antibiotic. It's like when you get a cold--the doc may give you one antibiotic, but if you're not feeling well after a few days, he'll give you a broad-spectrum antibiotic that works on more kinds of bacteria. In a short time you will probably be feeling better. Baytril is a broad-spectrum antibiotic and an appropriate second drug to try, I believe. but if it doesn't solve the problem, don't give up. Dog ears aren't quite like human colds.
 
As much as possible, give the antibiotics without interruption, because the bacteria can build up a resistance to a drug if it is not given at a level that is really optimal. When given less frequently, the drug is not strong enough to kill the bacteria off, so they sort of get used to it, and it can no longer kill them. I think this had happened to Alexis, because by the time we got her, the bacteria critters in her ears were resistant to so many drugs.
 
Also be aware that secondary infections can occur because of the damage caused by the bacteria. This may be why your vet is hitting the problem with so many drugs at the same time. The injectables may treat those other infections.
 
If after you have tried two or three drugs for the ears, the problem is not solved, your vet should do a test that will show what drugs the bacteria will not be resistant to. Again, give the new drug religiously. Your vet may also want to do a deep ear cleaning to reduce the bacteria in the ears. They will knock the dog out and clean as far as they can into the dog's L-shaped ear canal. Ear infections are so dicey to get a handle on because you cannot get into the lower part of the L to eradicate them.
 
The surgery you mentioned is called a total ear canal ablation (TECA). It can bring healing to a dog that has no other options and is experiencing extreme pain. Alexis's vet described this pain as the dog feeling as if it had a constant migraine. But the surgery is painful and the dog will lose much of the hearing in that ear, so it's not to be done lightly. Our Alexis had a TECA in her right ear, and it did help her, but at a cost. She pretty much lost hearing in that ear. What they do is take out the lining of the ear and sew everything closed. The dog can hear lound thumps or maybe really loud noises, but not much else.
 
I would also recommend that if you have the surgery done, it should be done by a board-certified surgeon. This is not the kind of surgery I'd leave to just any vet, since it is very delicate.
 
Our current foster, Holly, who seems to be Alexis's stunt double, came to us with ear problems. As it turns out, her left and right ears are responding to different drugs and cleansers. On the left, where she has a yeast infection, she gets Epi-Otic cleaner and Mometamax antibiotic. The right ear, which seems to have a bacterial infection, gets Pharmaseb cleaner and Posatex. But I have noticed that since the weather has begun to turn, both ears have gotten worse. Literally, it happened in one day. We went to the vet's, who approved of her improvement, and the next day Holly had goop coming out of her right ear and more yeasty stuff in the left. I have continued with these drugs, and she has finally seemed to improve again, but if it takes another downturn, I would visit the vet.
 
My guess is that Holly's ear trouble is allergy related. Allergies show up in dogs by making them itch, but ear problems can occur at the same time. We took Holly and our Jane to a picnic a couple of weeks ago, and Holly's itchy paw got all red and aggravated. I suspect she's allergic to grass and maybe some other things. As more pollen gets into the air, perhaps inhaled allergies are causing the increase in the ear problem. (But remember, I am not a vet, and this is just a guess.)
 
After the TECA, Alexis had no more trouble with her right ear. I treated her left ear daily with the Blue Power ear treatment, and it never declined to the level of that right ear, but before you use the Blue Power treatment, you must be sure that the ear has no open lesions or a perforated ear drum. You don't want to cause more trouble by using such a treatment, so check with your vet first. I think the vets approved of the Blue Power treatment for Alexis because they had no other drug options for her. It kept her comfortable for another year and a half, the rest of her life.
 
I hope this helps. Drop me a line if I can help in any other way.
Pam, food slave to the Dashing Bassets