Tuesday, July 23, 2013

The Ear Ache That Wasn't Going Away: Tottsie's Story

by  Krista Magnifico, DVM

We see endless cases of skin and ear problems. It is our bread and butter, but goodness it can get frustrating.

Yes, it is frustrating for us, and I know that it is frustrating to my clients but, most importantly, it is painful for our patients.

Here is my hope that I can educate my clients with all of the tricks of the trade to avoid these frequent recurrent problems.

I know that most people don't look for more reasons to visit my office nor do they want their pet to be ill or in pain and not know how to relieve this.

So here is my first piece of advice; if your dog has had one ear infection, bout of allergies, or other skin problem, it is very likely to have it again. 

Talk to your vet about how to identify the problem in its fledgling stages, how to prevent it, and what you can do to minimize any future episodes.

Today's story is about Tootsie.

A cuddle-bug kissing rotund little Yorkie. Her charm is instant and lasting. But, alas, she is a dog with allergies.

Tootsie, like many of my patients with allergies, starts to show her first signs of impending irritation via her ears flaring up.

Truth is that in many cases what my clients perceive as an "ear infection" is in some cases just ear 'inflammation." Whether that ear is infected or inflamed, the long term consequences of both are the same.

Chronic irritation creates chronic inflammation. 

Think of it like a wound that never heals. That wound will become raised and the tissue that makes up that wound will get larger as a scar starts to form. Scar tissue has an irregular, raised, almost cauliflower look to it.

If scar tissue forms around the tunnel of the ear canal then the only place it has to grow is into the tube. 

The ear canal tube thus gets narrower and narrower. A narrowed ear canal is called stenotic. Unfortunately, over time and repeated inflammation the canal closes off from the outside world.

Ears benefit from a few key things.

  • Ideally, the ear should be open to air flow. Dogs with erect open ears have fewer ear problems than those dogs with big floppy pendulous ear flaps. Like for instance the difference between shepherd and a spaniel. The erect ears get to breathe because an floppy ear flap shuts out sunlight, keeps in moisture and keeps in dirt and debris. I call this the "fire triangle." Remember when we were in elementary school and we were taught that a fire needs fuel (debris, wax, and dirt), oxygen (darkness), and a source of the heat (inflammation or allergies). With some dogs their ears remind me of the fire triangle.
  • The size of the ear canal should be large and open. The brachycephalic dogs have short narrow tortuous tubes..much harder to let air flow through.
  • Excessive ear hair is commonly seen in smaller breed dogs, like poodles. The hair keeps humidity, dirt, debris, and wax in the ear and precludes it from leaving the ear.
  • A dirty, waxy, or parasite filled ear is an invitation to a problem.

Many pets with allergies have ear problems. 

You will have a difficult time keeping the ears under control if you cannot keep the allergies under control.

In an effort to keep ears happy and healthy basic ear maintenance and intervention is key. 

For any dog with excessive hair around and in the ears I advise it to be removed, (remember never use scissors, either pluck or clip), ask your groomer or veterinarian for tips to keep the ears clean and hair-free. Any ear that is red and itchy should be kept impeccably clean with a good veterinary recommended ear cleaner, (read the directions for use, NEVER stick q-tips or swabs in the ear!). Also see your vet about how to distinguish inflammation from infection. If you do have an infection use the appropriate bug specific medication.

Tootsie has had allergies and ear problems for most of her 4 years.

She finally has her allergies (mostly) under control. But that right ear, well, it shut its doors to company (medical or otherwise) a long time ago. We have tried every possible concoction to get medicine to the inside of her ear. All with no luck. That right ear was a closed brewing vat of inflammation and infection that was unable to let any kind of medication penetrate into the closed canal of chronic disease.

When Tootsie came to see me I tried once again to treat her proliferative stenotic ear. 

For weeks we tried to get her infection back under control. With reluctance, and bit of optimism for resolve, we decided it was finally time to surgically open up Tootsies' ear canal.

We hoped that this surgery would provide her the ability to still hear but no longer suffer from infection.

For any real chance of keeping a functioning hearing ear we had to re-open her ear canal.

There is much that you can do, but of paramount importance is keeping your pet disease, pain and discomfort free.

For more information on how to clean ears please see Ears, Everyone has 'em, no one treats 'em right.

Ears are a common ailment for our pets but, in almost all cases, having a correct diagnosis, specific treatment plan, and diligent effort to prevent any of the predisposing factors is the key.


Krista Magnifico, DVM owns a small animal hospital in northern Maryland, where she practices everyday. She wants to make quality veterinary care available to everyone, everywhere at any time; trying to save the world 1 wet nose @ a time.  Her blog is a diary of he day-to-day life & the animals and people she meets.

To contact her, you may leave a comment on her blog, email her or catch her on Twitter or Facebook.

Articles by Dr. Magnifico:
Don't Make This Mistake: Ruby's Death To Heat Stroke 
Parvo: Cora's Story 
Jake's Laryngeal Paralysis
The Tip Of The Iceberg: The Unexpected Dental Dilemma


  1. Great article! Still struggling with a chronic infection here that comes and goes and we're running out of options!
    One question I have is that I thought plucking the ears was not recommended as it can cause inflammation and irritation in the ear? We have always been told to advise to trim the hair but not pluck

    1. Good question about the plucking. I've seen a vet to do that but it came out quite easily ... I guess it depends on the hair and on how loose it may or may not be. What breed is he? Did you look into the possibility of allergies? What food is he on?

  2. I have a Cairn Terrier/Maltipoo mix who has been plagued with left ear winter allergies her whole life. It's very sad when she has an issue and she looks to me for help! I have become very proficient in cleaning and medicating, but I do wish I could stop the problem all together...

    1. What you want to do is to get to the bottom of it, the original cause. You might want to look at the diet, do some environmental allergies testing (and there is an immunotherapy treatment), look at the anatomy of the ear ...

      Finding and addressing the cause is the way to get rid of the infections.