Disease of the ear canal in dogs – Otitis Externa
Ear structure
The ear canals are lined by skin and so are affected by most of the problems that can affect the skin elsewhere on the body. But it is a special area. It is hidden away and out of sight. The skin of the ear canal is easily diseased and can be difficult to treat.
Also, the ear canal leads to the ear drum, through which is the middle ear and which in turn leads to the inner ear. Otitis externa often breaks through the ear drum so that the middle ear canal becomes infected. This then makes treatment of the ear canal disease itself difficult to manage.
The ear canals are lined by skin and so are affected by most of the problems that can affect the skin elsewhere on the body. But it is a special area. It is hidden away and out of sight. The skin of the ear canal is easily diseased and can be difficult to treat.
Also, the ear canal leads to the ear drum, through which is the middle ear and which in turn leads to the inner ear. Otitis externa often breaks through the ear drum so that the middle ear canal becomes infected. This then makes treatment of the ear canal disease itself difficult to manage.
Diagnosing and managing ear problems
Ear problems are very common in dogs but I will only usually get involved when either they have been going on for a long time or if they are part of a problem that is affecting the skin elsewhere. Ear disease causes pain and distress.
I use the PSPP system to try control and manage Otitis Externa:
P - Primary problem - what is the underlying problem which is causing recurring ear disease? Most commonly this is an allergy - atopic dermatitis, food allergy or both, but there are other causes. Once the current ear disease is under control this, ideally, is investigated.
S - Secondary infections with bacteria and yeasts, these need to be identified and have appropriate treatment to eliminate them and then often to prevent them reoccurring.
P - Perpetuating factors - changes that occur in the ear canals which increase the chances of them remaining diseased and infected. These factors need to be eliminated or controlled and then prevented from reoccurring (if they are reversible). These factors include swollen, inflamed skin in the ear canal which narrows the canal and produces more wax. The self-clean mechanism of the ear canal stops too. Sometimes the ear drum ruptures and there is disease in the middle ear too. Long term ear disease can lead to permanent changes in the ear canal such as scarring and calcification.
P - Predisposing factors - the things that increase the chance of a dog getting ear disease in the first place. These include lots of hair in the canals, swimming regularly so water getting down the canals, hair plucking, having pendulous ear pinnae and having long, narrow ear canals which is seen in certain breeds. Identifying these factors can help us make management changes and help us decide on the best options.
Many dogs with ear problems find them very painful and they are difficult to treat and some owners cannot afford all the treatment options. I understand this - we will discuss the potions and agree together what is best taking all circumstances into account.
Ear problems are very common in dogs but I will only usually get involved when either they have been going on for a long time or if they are part of a problem that is affecting the skin elsewhere. Ear disease causes pain and distress.
I use the PSPP system to try control and manage Otitis Externa:
P - Primary problem - what is the underlying problem which is causing recurring ear disease? Most commonly this is an allergy - atopic dermatitis, food allergy or both, but there are other causes. Once the current ear disease is under control this, ideally, is investigated.
S - Secondary infections with bacteria and yeasts, these need to be identified and have appropriate treatment to eliminate them and then often to prevent them reoccurring.
P - Perpetuating factors - changes that occur in the ear canals which increase the chances of them remaining diseased and infected. These factors need to be eliminated or controlled and then prevented from reoccurring (if they are reversible). These factors include swollen, inflamed skin in the ear canal which narrows the canal and produces more wax. The self-clean mechanism of the ear canal stops too. Sometimes the ear drum ruptures and there is disease in the middle ear too. Long term ear disease can lead to permanent changes in the ear canal such as scarring and calcification.
P - Predisposing factors - the things that increase the chance of a dog getting ear disease in the first place. These include lots of hair in the canals, swimming regularly so water getting down the canals, hair plucking, having pendulous ear pinnae and having long, narrow ear canals which is seen in certain breeds. Identifying these factors can help us make management changes and help us decide on the best options.
Many dogs with ear problems find them very painful and they are difficult to treat and some owners cannot afford all the treatment options. I understand this - we will discuss the potions and agree together what is best taking all circumstances into account.
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Long-term ear problems often lead to permanent deafness. Once a dog is deaf then medical treatment of the otitis externa may not be worthwhile: for dogs with long-term problems that are challenging to control it may be better to have surgery performed to remove the ear canals (called a TECA – Total Ear Canal Ablation [and lateral bulla osteotomy]). This surgery does not alter the external appearance of a dog unless the ear is closely examined. The best way to determine if a dog is deaf is to perform BAER hearing testing and this is part of the service that I offer to clients owning pet with ear problems. www.vethearingservice.co.uk Even if surgery is the best option for the ears, I may well need to help out in managing problems on the rest of the skin, especially the pinnae (ear flaps). |
Severe Otitis Externa
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