what could be hiding under that ear infection

what could be hiding under that ear infection
Posted by Dr. Ernie Ward on Dec 19 2014

One of the leading reasons pet owners schedule veterinary visits is for “ear infections.” For almost 25 years, I’ve been besieged with cases of dogs ceaselessly shaking their heads, cats constantly clawing their ears and pet parents who feel utterly helpless to ease their friend’s pain. While it’s true it may take another 25 years before these cases cease to cross my exam table, I’d like to share some info and updates on ear problems.

The root of the cause

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Outer ear inflammation, or otitis externa in fancy doctor-speak, is any redness, swelling and discomfort in the part of the ear exterior to the eardrum. Pets afflicted with otitis externa rub, shake, scratch and experience varying degrees of misery. Make no mistake about it ― ear infections hurt, and they make pets and their owners very unhappy. One of the challenges with most ear infections is that they’re not really infections.

Most ear problems are actually the result of inflammation followed by bacterial infection, then complicated by excessive yeast growth. By the time you get to the vet, it’s easy to miss the true inflammatory cause because of the existing infection. In other words, bugs or fungi end up getting blamed for an allergic or inflammatory condition. So what are the common causes of ear problems in pets?

Pets most at risk

The shape, size and hairiness of your pet’s ears often have a lot to do with the risk of ear problems. Dogs and cats with drooping, flat, low and furry ear tubes have a higher incidence of ear issues than those with upright, wide, clean canals. American Cocker Spaniels have lousy ear shapes worsened by an often-inherited anomaly known as congenital cornification defects. Ouch! Mix in water, parasites, debris and allergies, and you’ve got a recipe for auricular adversity.

Diagnosing ear infections

My standard supposition when confronted with an angry ear is to bet on inflammation. When I’m sussing out the source of the ear agony, I ask a few questions:

  • How long has this been going on? Greater than a week or two often tips the scale toward allergy.
  • How often do these occur? More than one “ear infection” per year suggests inflammation as the true trigger.
  • What was the sequence of symptoms? Shaking or rubbing first followed by discharge and stinky smells tells me there’s more than bacteria or yeast to blame

Because food allergies account for 15% to 20% of all chronic ear problems, you can bet I’ll also spend time quizzing the owner about dietary habits. The best diagnosis always begins with a thorough conversation.


Treating otitis externa depends on the exact cause and severity, but the key is to get beyond simply pouring medication in the ear and crossing your fingers. If your pet repeatedly suffers from “ear infections,” demand a reassessment. Something else is likely to blame (most likely inflammation). I’ve seen too many pets over the years that were prescribed the same old tube of antibiotic and anti-inflammatory ointment year after year, never solving the riddle of the red ears.

I’ll be the first to admit quick fixes for ears are rare. Treatment requires a bit of work at first, but once you get an accurate diagnosis and treatment regimen dialed in, your pet is on his way to a better, happier, pain-free life. Most cases can be managed by altering ear cleaning techniques and diet with occasional meds during allergy season. Severe cases may require surgery, hyposensitization injections or lifelong medical therapy.

My best advice is don’t accept “ear infections” as the diagnosis month after month, year after year. Demand diagnostic diligence, explore the latest treatments and never, ever forget that conformation and inflammation may be the covert culprits.

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