OTITIS EXTERNA

(outer ear infection)

Otitis externa is an inflammation of the external ear canal that begins at the outside opening of the ear and extends inward to the eardrum.  Causes include bacteria, fungi, ear mites, accumulation of wax, thick or matted hair in the ear canal, debris, impaired drainage of the ear, and infections from elsewhere in the body.    The ears of dogs (especially those with pendulous ears) and cats are ideal for the growth of bacteria and fungi because they are moist and warm, and contain wax and other debris.  The funnel shape of the ear canal effectively traps debris, further complicating treatment of infections.  Otitis at the least is irritating for your pet and can cause discomfort and severe pain for your dog.  Initially this can be detected by you because your pet may be shaking his head, scratching at the ears and/or rubbing the ears on the floor or lawn.  Initially the ears can become red and even ulcerated.  There may significant odor and/or slime or purulence.  Chronic irritation to the ears is detected by several changes; the tissues will thicken, becoming leathery, a dark pigment will develop, and the canals will start to narrow as the tissues thicken.  As the canal narrows, even less access to the ear is available, drainage is further hindered and airflow in and out is impeded.  Proper treatment will slowly reverse these processes.

Important Points in Treatment

1.       The longer the infection has been present, the more difficult it is to clear up.  In severe long-standing infections, surgery may be necessary to correct the problem.  We will continue treatment until the whole ear canal is healthy and an infection is unlikely to recur.  This usually requires a minimum of 4 weeks treatment.  In some cases, therapy will continue for several months.  You can reduce the time necessary by following the recommended method and schedule for cleaning and medication of the ear.  If you are not sure how to best handle your animal for treatment, please ask for help.  The ears are very tender at the start of therapy, and your pet may not be use to this kind of handling, but with a soft reassuring touch, and firm commitment, your task will become easier and more effective as treatment continues.

2.       To be effective, the medication must contact microorganisms or mites deep in the ear canal.  To achieve this contact, the canal must be kept clear of debris, and the medication must be placed deep within the canal.  Please call the doctor if you are having trouble treating your pet's ear.

3.       All animals that have had a yeast, or bacterial infection cleared, should regularly have their ears cleaned to prevent the reoccurrence of this disease.  The doctor will instruct you based on your pets individual needs as to how often regular cleaning should occur.  Proper grooming is a necessity for pets.  Long eared dogs should have the hair under the flap and around the outer canal kept shaved and clean at all times.  Dogs that swim should have ears flushed or cleaned and flushed within 12 hours of swimming.  Dogs that have canal hair must have the hair regularly removed by plucking (shaving is not possible inside the canal).  If the pet is taken to the groomer, the animal should not go home until you inspect the ears and insure the hair was plucked.  If plucking was not done, find out why not.  If pain is the reason, please visit the Veterinarian.  Regular plucking is a discomfort that these breeds come to accept, but is a necessity to prevent infections and pain.  Regular plucking and ear hygiene is less painful than neglect.

4.       Sedation or general anesthesia may be necessary initially to allow thorough cleansing and inspection of the ear canal and to obtain specimens for bacterial cultures.

5.       Cleaning the ear:

Hold the ear up, to slightly straighten the canal and allow your fingers to feel the funnel shaped cartilage of the outer ear.  Fill the canal with the cleanser.  While still holding the ear up with one hand, massage the lowest portion of the canal to gently squeeze the funnel shaped area repeatedly until the cleanser foams up and lifts the debris of the lower canal to the outer part of the ear.  Please try several positions on the canal to perform the massage.  You will find the canal is accessible around about 90% of its diameter.   The healthier the ear is, the more vigorous the massage.  Once the foam is no longer changing color (from blue or clear to brownish), it is time to take a clean tissue and wipe away the lather at the top of the ear.  Please use one finger swathed in tissue to gently clean as far down the canal as your finger can reach.  If the debris is thickening the foam, please repeat the procedure right away.

6.       Flush the ear:

We do not recommend flushing the ear with most flushes until the ear is significantly improved.  Most flushes have alcohol in them, and an infected ear is basically an open wound.  The pet will experience severe pain if alcohol is put on an open wound.  You should flush the ear when it is healthier, and Dr. Bennett has given the okay to use a flush, this is usually 5-7 days after starting treatment.  If your pet reacts to the flush, contact us.  To flush:  Apply ample amount to rinse the remaining cleanser and loose debris from the ear canal. 

7.       Apply medication as deeply as possible, then massage canal to help spread/distribute the medication to the deepest parts.

8.       Be sure to continue on this routine until the scheduled recheck visit, and the doctor changes the instructions.

9.       Notify the Doctor if Any of the Following Occur:

* You cannot medicate your pet's ear(s).

* Your pet's ears turn bright red after cleaning or medication.

* Your pet continually rubs, paws or scratches its ear(s).

* Your pet shows other signs of illness during treatment.

* Your pet's infection recurs after apparent recovery.

Clean the ears the night before the recheck appointment, but do not apply medication.