11 Reasons Why Your Dog May Be Struggling With Ear Issues
Ear infections have become nearly epidemic in dogs, partly because of how the canine ear is constructed. Because they are a very common reason for veterinary visits, know what you can do to help your pup's ears stay healthy and avoid chronic inflammation and infection.
Reviewed by Dr. Becker
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STORY AT-A-GLANCE
- Ear inflammation is an extremely common problem in dogs; inflamed ears often progress to a stubborn or recurring ear infection
- Signs of a problem include a dog who shakes his head a lot and scratches at his ears; his ear canals may appear red and have an unpleasant odor as well
- There are many potential causes for ear problems in dogs, for example, allergies, moisture in the ears, wax buildup, and foreign material in the ear canal
- Ear infections in dogs are commonly bacterial rather than fungal, though fungal infections (e.g., yeast) do occur
- Preventing ear infections involves checking the ears daily, cleaning them as often as necessary and addressing any changes in the ears as soon as you notice them
Ear infections are so common in dogs they’re nearly an epidemic, due in part to the way the canine ear canal is constructed. Unlike human ears in which the internal canal is straight and horizontal, your dog’s ear canal is formed like an “L”. There are wax-secreting glands lining the canal, along with hair that moves the wax up and out, but the gunk must execute a 90° degree turn before making its way to the outer canal.
Signs to Watch For
A normal, clean canine ear canal is a healthy pink color with no unpleasant odor. When inflammation or infection is present, you may notice your dog shaking her head more than usual, scratching at her ears, or rubbing her head against the floor. When you go in for a closer look, you’ll probably notice the ear canal is red rather than pink, and there can be an unpleasant smell as well.
Chronic ear issues in dogs are a very common reason for veterinary visits. Inflammation or infection of the outer canal of the ear (called otitis externa) can be a frustrating, sometimes painful condition that almost always has an underlying cause (e.g., allergies).
In my experience, many chronic ear infections are ineffectively treated, and as a result, what seems to be repeated infections is actually a single infection that persists because it hasn’t been fully resolved.
There are two basic types of ear problems in dogs: chronic inflammation and infection. Untreated inflammation can lead to infection. If your dog's ears are warm to the touch, red, swollen, or itchy, but there's little to no discharge, chances are the problem is inflammation. However, if one or more of those symptoms is present along with obvious discharge, it's usually a sign of infection.
Causes of Inflammation and Infection of the Ears
- Moisture in the ear — A common cause of ear inflammation is moisture, also known as “swimmer’s ear.” We see this primarily during the summer months when dogs are outdoors playing in lakes. Wet ear canals and a warm body temperature are the perfect environment for inflammation and/or infection to occur.
That’s why it’s important to thoroughly dry your dog’s ears each time he comes out of the water, has been outdoors in the rain or snow, and after baths. - Allergies — Allergies are by far the most common reason for ear inflammation in dogs. An allergic response to food (usually year-round ear issues) or something in the environment (usually seasonal ear issues) can cause inflammation throughout your pet’s body, including the ear canals and pinna.
A dog with ear inflammation caused by an allergy will sometimes push his head along furniture or the carpet trying to relieve the misery. He may also scratch at his ears or shake his head a lot. If you see any of these behaviors, check his ears for redness and swelling. - Wax buildup — A major reason for ear problems in dogs is wax accumulation. The presence of earwax is normal, but dogs produce varying amounts. Some dogs need their ears cleaned daily, while others never develop a buildup. Certain breeds produce more wax than others, such as Labradors and other retrievers who tend to love the water.
If you have one of these breeds, you should get your dog accustomed to having her ears cleaned while she’s a puppy. Other breeds that also tend to produce an abundance of wax are Bulldogs, Cocker Spaniels, and Poodles.
- Ear mites
- Foreign body such as foxtails, polyps, or a tumor
- Excess wax-producing glands or excess hair in the ear canal
- Anatomic changes such as narrowing of the ear canal
- Heavy, hanging ears
- Systemic inflammation from pro-inflammatory foods/diet
- Excessive cleaning of the ears
- Immune-mediated and endocrine diseases1
Other causes of ear inflammation in dogs include:
When inflammation in a dog’s ear progresses to an infection, it typically involves the outer canal, which your vet can see using a speculum. If the infection recurs or never really goes away, the condition progresses from otitis externa (problems outside the ear drum) to chronic otitis or an inner ear infection (behind the ear drum). It’s very important that your veterinarian identifies the infection as bacterial or fungal — or both — in order to successfully treat the problem.
Bacterial Ear Infections
Bacterial infections of the ear are more common than fungal infections. Bacteria are either pathogenic or nonpathogenic. Pathogenic bacteria are abnormal inhabitants of your pet's body, picked up from an outside source, for example, contaminated pond water.
Nonpathogenic bacteria are typically staph bacteria that are normal inhabitants of your dog's body. Occasionally these bacteria can overgrow and overwhelm the ear canal. Any normal, helpful bacteria can grow out of control and cause an infection in a dog with an underperforming immune system.
An accurate diagnosis of a long standing ear infection requires an ear culture to know what type of bacteria is causing the problem. This is especially necessary if you’ve been using a variety of medications to treat the issue, but none have worked.
A simple in-clinic cytology sample (looking at stained debris from the ear) will allow your vet to differentiate fungus from bacteria but will not allow her or him to know what antibiotic will work best to treat the infection.
If you’ve been dealing with ongoing ear problems, your veterinarian will suggest collecting your dog's ear debris with a sterile swab and sending it to a lab to determine what type of organism(s) are present, and what medication will most effectively resolve the infection.
If your vet does not think the infection is severe enough to warrant culture and sensitivity testing, then there’s a potential that antibiotic-free treatments may work to clear up the infection. If your vet deems it necessary to culture, then prescribe oral antibiotics, it's very important to finish the medication even if the infection seems to clear up before it’s gone. Stopping the medication early can lead to regrowth of resistant organisms.
In addition, while your dog is being treated for an ear infection, be sure to keep his ears clean and clear of gunk so the topical medication you put into the ears can reach the infected tissue. Removing daily ear build-up is important. Always use probiotics during and after antibiotic therapy to help rebalance the gut and skin microbiome.
Unfortunately, these days more and more ear infection culture results are showing the presence of bacteria that are resistant to most conventional medications. These are cases in which complementary therapies are not only a last hope, but can provide highly effective, nontoxic relief.
A 2016 study tested the effectiveness of manuka honey to treat bacterial ear infections in 15 dogs.2 Researchers applied 1 milliliter (mL) of medical grade honey in the dogs’ ears for 21 days. The results showed the honey "promoted rapid clinical progress," with 70% of the dogs achieving a "clinical cure" between 7 and 14 days, and 90% by day 21.
In addition, the bacteria-killing activity of the honey worked against all bacteria species tested, including multiple strains of drug-resistant bacteria.
It's important to note that it doesn't appear the antimicrobial activity of honey is enough on its own to resolve every ear infection. Most of the dogs in the study had complete symptom relief by day 21; however, several still had bacterial infections. I also believe the extent to which I’ve seen resolution using manuka honey depends on the potency of the honey: the higher the potency, the more effective the antimicrobial effects.
Another remedy for resistant ear infections is medicinal clay. Green clay has been shown to effectively treat a variety of bacteria that have been implicated in chronic ear infections, including pseudomonas and MRSA.3
Fungal Ear Infections
By far, the most common cause of canine fungal ear infections is yeast, which is always present on the bodies of animals. However, when the immune system isn't in prime condition, there’s excessive starch in the diet, or environmental conditions are right, the fungus can grow out of control and cause an infection.
Most dogs prone to yeast infections should have their ears cleaned and dried daily. If the problem seems chronic or there's a persistent infection that just won't clear up, there's probably an underlying immunological cause that should be investigated. For more information, including how to treat yeasty ears:
Veterinarians diagnose yeast infections with cytology, which means we look at a smear of the ear debris under a microscope.
How to Avoid Ear Problems in Your Dog
If your dog is prone to issues with her ears or you want to make sure she doesn’t ever have to deal with them, develop the habit of checking the ears daily or every other day for wax, moisture, or other debris that has accumulated in the outer ear canal.
If you’re consistent with your inspections, you’ll know soon enough how often she needs to be checked to keep her ears clean, dry, and clear of debris. The cleaning itself is simple, as long as you do it whenever the ears need it. If they collect a lot of wax every day, they need to be cleaned every day.
If they don't produce much wax or other gunk you can clean them less often, but you should still check them every day and take action as soon as you see the ear canal isn't 100% clean and dry.
If you think your dog might already have an ear infection, it's important to make an appointment with your veterinarian before you begin a cleaning protocol. In some cases, a long-standing infection leads to rupture of the eardrum, which requires special cleaning solutions and medications. For healthy canine ears, a few of my favorite DIY home cleaning agents include:
- Witch hazel
- Organic apple cider vinegar mixed with an equal amount of purified water
- Hydrogen peroxide, a few drops on a cotton round dabbed in coconut oil
- Green tea or calendula infusion (using cooled tea)
- One drop of tea tree oil mixed with 1 tablespoon coconut oil (for dogs only — never cats)
- Colloidal silver
You should never use rubbing alcohol to clean your dog's ears. It can cause burning and irritation, especially if the skin is inflamed. Use cotton balls or cotton rounds only to clean the inside of the ear canal. You can use cotton swabs to clean the outer area of the ear, but never inside the canal, as they can damage your dog's eardrums.
The best method for cleaning most dogs' ears is to saturate a cotton ball with cleaning solution and swab out the inside of the ear. Use as many cotton balls as necessary to remove all the dirt and debris. Just a few minutes spent cleaning and drying your pet's ears as often as necessary can make a big difference in the frequency and severity of ear infections, especially in dogs who are prone to them.
Sources and References
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