CANINE CHRONIC OTITIS

• Canine chronic otitis involves inflammation and possibly infection in one or both ears. If left untreated, scar tissue will form and further damage to structures of the ear may result in deafness.
• Inflammation often leads to an ear infection. Otitis is a painful condition; signs of otitis include a red ear (or ears), head shaking, and scratching at the ears. 
• Chronic otitis is generally not contagious to other dogs.
• A variety of ear medications and ear cleaners are available through your veterinarian for application into the ears. Sometimes antibiotics and/or anti-inflammatory oral medications are also required. Treatment may be long-term. It is also important to try and identify the underlying cause of the ear disease. Allergies are often implicated. 
• Prevention of chronic otitis may involve identification of specific allergies. When possible, avoidance of identified allergens may  help prevent recurrence. Regular ear cleaning with a good quality ear cleanser can also help prevent infections. 

What Is Canine Otitis?
Canine chronic otitis is recurrent or persistent inflammation of the ear. One or both ears may be affected. Inflammation of the ear often leads to secondary infection caused by yeast or bacterial overgrowth. This condition can be quite painful. 

Chronic otitis is most often caused by allergies to fleas, certain foods, or substances in the environment. Sometimes medical problems like thyroid disease can cause a dog to develop otitis. Certain breeds such as cocker spaniels and golden retrievers are more prone to ear infections.

Signs of Canine Chronic Otitis
Signs of otitis include head shaking, scratching, and even head rubbing against floors and furniture. The normally pink skin of the ear appears very red, and dark debris or yellow to brown discharge may be present, along with a foul odor. In dogs with dark pigmented skin, the redness may not be apparent, but debris, discharge, odor, and discomfort will be evident. This condition will persist or get progressively worse if left untreated.

Signs of Canine Chronic Otitis

• Head shaking
• Face/head rubbing
• Scratching at ears/head
• Redness inside the ear(s)
• Yellow to brown discharge from the ear(s)
• Foul odor
• Dark debris in the ear(s)
• Painful or uncomfortable ear(s)

Diagnosis and Treatment
Diagnosis is based on history, clinical signs, swabs of samples taken from inside the ear canal, and physical examination, including examination with an otoscope (a special tool with a light and a cone for viewing the inside of the ear canal). Your veterinarian may perform cytology, which is an examination of the swab sample from the ear specially prepared on a slide for evaluation under a microscope. The slide is examined for the presence of yeast, bacteria, and white blood cells (which fight infection). Ear mites (microscopic mites that can live inside the ear canal) can cause ear infections and also can be identified when your veterinarian looks under the microscope.

Another test commonly used to help diagnose chronic otitis is a bacterial culture and sensitivity test. For this test, your veterinarian will use  a sterile swab to obtain a sample of material from inside the ear. This swab is then placed in a special tube and sent to the lab for specific identification of bacteria and yeast.

The test result also lists the most effective antibiotics against the identified bacteria. 

Treatment of chronic otitis most commonly includes medicated ear-drops or cream along with a prescribed ear-cleaning regimen. Most ear medications contain a steroid to reduce inflammation, an anti-fungal medication, and an antibacterial medication. Sometimes your veterinarian will recommend pill or liquid medication to be given by mouth to help treat otitis. If your veterinarian performs a bacterial culture and sensitivity test, the results of this test will guide in the choice of antibacterial and/or anti-fungal medication. It is very important to follow the prescribed treatment, since failure to complete treatment may result in recurrence and even bacterial or fungal resistance to treatment.

Another important element of diagnosis and treatment is to identify underlying allergies. Common allergies in dogs include flea allergies, food allergies, and environmental allergies (allergy to dust, mold, pollen, and other common particles found in the environment). Your veterinarian can guide you through the identification process, which includes regular flea prevention, possibly a “hypoallergenic” food trial, and allergy-testing using specialized skin and blood tests.

Because medical problems, such as thyroid disease, can sometimes cause otitis, your veterinarian may recommend specific blood tests to look for evidence of underlying illness. 

Most cases of chronic otitis are treated or managed with medication. In some extreme cases, surgery may be recommended.

Prevention
Identification of underlying allergies is very important for successful long-term management and preventing “flare ups” in the future. If food allergies are identified, a special diet may be recommended to avoid offending foods. Sometimes this involves a prescription diet or a good quality store-bought diet that does not contain any of the identified allergens. If environmental allergies are identified using skin and blood tests, allergy shots may be recommended to help reduce sensitivity to the named allergens. In the case of flea allergies, regular flea prevention with a product recommended by your veterinarian is very important.

Other forms of prevention include regular ear cleaning with an ear cleanser that will help to inhibit fungal and bacterial overgrowth. Most ear cleansers also break up and flush out wax and debris that accumulate in the ear. Your veterinarian can guide you in the appropriate choice of ear cleanser, and discuss frequency of cleaning along with proper technique.