[Dailydrool] Lateral ear canal resection

[Elizabeth Lindsey]

Jan, for something like this, I suggest finding a veterinary  
dermatologist (sometimes they call themselves veterinary allergists)  
for a second opinion and also to figure out why Dexter's ear  
infection isn't improving on antibiotics.

Here's the story of our late Jane Basset and her persistent ear  
infections. For those who've heard it before ad nauseam, bear with  
me. Awhile back there was a Drool thread about sharing this kind of  
information on the Drool instead of e-mail off-list, so I'm going to  
do that.

Our Jane fought a six-month ear infection until we finally got smart  
and asked our regular vet for a referral to one of Purdue's vet  
school's specialists. The dermatologist there discovered a deep- 
seated and destructive infection our regular vet had missed.

Our regular vet had only a handheld otiscope to look in Jane's ear.  
This meant she couldn't see beyond the 90-degree bend in Jane's ear  
(all dog ear canals have a 90-degree bend). She missed seeing almost  
a full half of the rest of Jane's ear canal. The dermatologist had an  
endoscope, a flexible instrument with a camera on its tip, that  
allowed her to see way beyond the bend. She found a horrific  
infection that had raged unchecked for months. It looked like green  
cottage cheese sitting on the hinge of Jane's jaw. It explained why  
Jane no longer wanted to eat hard foods and why she drooled from that  
side of her mouth.

Why hadn't all the antibiotics our regular vet given Jane in those  
six months done the trick? Because the infection that the regular vet  
could see with her otiscope--infection that she could see to scrape  
and culture--was caused by an entirely different bacteria than the  
infection the regular vet couldn't see. So all those antibiotics were  
the wrong kind to kill that particular type of bacteria. With nothing  
to stop it, it raged out of control.

Jane wound up having to have a TECA (total ear canal aculusion)  
surgery to remove the entire inside of her right ear because that was  
the only way to get rid of the infection by that point. When her  
dermatologist got to the part of Jane's ear that was so infected, she  
discovered that the infection was softening Jane's skull. Basically,  
it was eating its way through her skull! If we hadn't asked for a  
referral finally, Jane would have died.

Another casualty of this long-term infection was Jane's thyroids. The  
continual infection damaged them, and so she had to take medication  
for underactive thyroid for the rest of her life. It wasn't expensive  
or onerous to treat the underactive thyroid, but it made us angry  
because it could have been prevented if the regular vet had admitted  
defeat much earlier in the game, been less sanguine about "all long- 
eared dogs have infections all the time," and if we'd only insisted  
on a referral much earlier.

The regular vet was merely treating Jane's symptoms (not very well),  
instead of finding out what exactly had caused the ear infection in  
the first place. After Jane had recovered from the surgery, the  
dermatologist tested Jane for both food and environmental allergies.  
She wasn't allergic to any food, but she was allergic to weeds,  
trees, pollens, grass, dust, cats, and feathers.

Allergens make dogs itch, so they scratch or lick to take care of the  
itch. Scratching and licking create tiny open wounds in the dog's  
skin, bacteria enters, and voila! an infection. Eliminate the reason  
for the scratching and the infections stop like magic. We put Jane on  
some supplements and allergy shots and her infections stopped. So her  
infections hadn't been caused by her physique but by allergies.  
Treating the infections did nothing for her. Treating the allergies-- 
the cause of the infections--was what worked.

Our regular vet also had us washing Jane's ears out with rubbing  
alcohol. It was cruel to do so because it was so painrful to Jane,  
and we only tried it a couple of times. With the infection Jane had  
going on in there, cleaning out her ears with anything by that point  
wouldn't have made any difference and only would have made it worse.

If your regular vet hasn't been able to clear up Dexter's ear  
infection after all this time, if your vet has tried doing a smear on  
a slide (to determine if the infection is bacterial or yeast, which  
determines which medications are used), if he's tried doing a culture  
so the right antibiotic can be aimed at the type of bacteria that's  
in Dexter's ear--if he's done all these things and the infection  
lingers, then it's time to see someone who specializes in dog  
allergies and/or skin problems (the inside of the ear is made of  
skin, so a dermatologist really does make sense for dog ear  
infections), someone who has better diagnostic equipment and more  
training and experience in hard-to-eradicate ear infections.

Like our own family doctors, regular vets are great for the  
commonplace injuries and illnesses. But sometimes the big guns, the  
specialists, are the only ones who can really fix a problem. Your  
regular vet can give you a referral, and don't worry about hurting  
his feelings by asking for one. We found that our regular vet  
actually sounded relieved to be "allowed" to pass our problem basset  
and her ears on to another vet. We're just sorry we took so long to  
ask for one. We were Jane's health care advocates, she depended on us  
to look out for her, and we failed her miserably by not insisting on  
a referral earlier.

The next time you take Dexter to a vet, ask that the entire ear canal  
be examined, even if that means seeing a specialist who has the  
equipment to do that. Dexter may have more than one kind of infection  
going on in his ear.

Elizabeth