O(no)titis!

Persistent scratching and head shaking. A foul or yeasty odor. Redness and pain. We all know those tell-tale signs of this common dog and cat ailment. Otitis. This is a general term for inflammation of the ear canal, but can be diagnosed as many different forms: allergic, bacterial or fungal, traumatic. Even the location of otitis can be classified as external, middle or inner.

Dog and cat ear canals
Dog ear canal from VIN. Cat ear canal from catwatchnewsletter.com

Unfortunately, otitis is a very common issue that we see on a regular basis in the veterinary field, most of the otitis we see is external otitis, which means inflammation and/or infection of the external ear, more commonly called the ear canal. A thorough ear exam and ear cytology are the first line of defense when it comes to diagnosing and treating the problem. An otoscope and specula (see below) are MUSTS when it comes to examining the ear canal. Unlike humans, dogs and cats have both a vertical and horizontal component to their ear canals, so you can imagine that some light and magnification go a long way in viewing the entire ear canal. Sometimes foreign objects like blades of grass, foxtails, ticks (eek!) or hair/wax balls can get deep into the ear canal and be a source of otitis. If properly identified, these can be removed promptly and allows for much quicker healing.

Otitis blog
Otoscope (the long, silver part) and specula (the cone). 

An ear cytology is also extremely important in diagnosis. A cotton-tip-applicator (similar to a Q-Tip) is used to take a swab of the ear canal and this material is then examined under a microscope. An ear infection can be caused by yeast or fungus, bacteria or small parasites (mites), and determining which is present will allow us to pick the right medications for your pet!

Ear-Jayda
Using a cotton-tip-applicator

Now we wish it was always a simple answer for why otitis occurs – like the above foreign objects getting in the ear canal, a recent swim in the lake or maybe too zealous of a bathing, but sometimes there are factors that can lead to chronic otitis, and these cases can be much more difficult to manage. Conformation (anatomy of the ear canal), allergies (either food or environmental) and endocrine (hormonal) diseases are the top causes. Different clues, such as seasonality of infections, concurrent skin infections or itching and findings on otoscopic exam will help to guide us in the right direction, but often additional testing is required. Blood work, food trials, sedated ear flushes, cultures and even consultation with a veterinary dermatologist may be recommended to rule out chronic, underlying causes.

However, one of the biggest factors in chronic otitis, are ear infections themselves!!! Inflammation and irritation that occur during an ear infection can cause permanent changes to the skin and glands within the ear canal, predisposing that dog or cat to getting additional or more frequent infections. A smaller, more narrow ear canal, excessive wax production and abnormal skin barriers make yeast and bacterial overgrowth easier. Stopping or minimizing this snowball effect is critical, which brings us to treatment.

Ear
Ear 

Almost always, a topical medication is going to be applied to the ear canal. Daily or long-term medications are available, but their use depends on the type of infection present. If a large amount of pus or waxy debris is present, frequent at home flushes with an appropriate cleanser is usually going to be recommended. Steroids or non-steroidal anti-inflammatory medications are also routinely prescribed to decrease swelling and provide comfort. Occasionally, if a middle ear infection is suspected (the ear drum has been ruptured) oral antibiotics will also be prescribed, and possibly for a longer period of time. As you may imagine, it isn’t always easy or fun to clean and medicate ears in our pets, but compliance is critical. If you are having any difficulties, please don’t hesitate to call or schedule an appointment to get some tips on application!

Skin issues, including ear infections, are some of the most frustrating and difficult cases to “cure”, often impossible, but being aware of the signs, having them evaluated and treated as promptly as possible, and knowing a little about the disease process itself, improves our pet’s comfort and happiness. If you have any questions or feel like your pet may be one suffering from otitis, give us a call at (603) 437-1010 to schedule an appointment!

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