Ear Infections (Otitis Externa) In Dogs And Cats
- Dr Suné Olivier, BVSc
- Mar 27
- 5 min read
Is your pet constantly shaking their head, scratching their ears or rubbing their face on the bedding? Perhaps there is a mysterious yeasty smell coming from your pet? If your pet is showing any of these signs, they may suffer from otitis externa, or an ear infection
What Otitis Externa?
Otitis externa refers to inflammation of the external ear canal (and sometimes the pinna, or ear flap). This inflammation may involve micro-organisms, and those cases will be known as ear infections. The inflammation can also be non-infectious (in other words, not involving any organisms). Inflammation of the middle ear is called otitis media and will not be discussed in this blog.
What Causes Otitis Externa?
There are several predisposing factors that can lead to inflammation and possible infection in the ear.
1) Breed predisposition
Some dog breeds are more prone to otitis externa than others due to having floppy ears, narrow ear canals, thick hair or being prone to allergies. Cocker spaniels, golden retrievers, Italian water dogs and many many other breeds are prone to this disease.
2) Swimming or bathing
Moisture in the ear canals may create a favorable environment for germs to grow in.
3) Skin allergies
Otitis often goes hand-in-hand with skin allergies, and getting the allergies under control will help to reduce the frequency of ear problems in most pets.
4) Ear mites
External parasites like ear mites can also cause inflammation of the ear. Always ensure your pet’s tick and flea preventive is up to date.
5) Objects in the ear
Small objects like seeds, insects etc. or can get lodged in the ear canal and cause inflammation
6) Masses in the ear canal
Tumours, growths or polyps can also create an environment that is favorable for germs.
7) Auto-immune and hormonal disorders
Some underlying diseases like Cushing’s syndrome, Diabetes, Hypothyroidism etc can have otitis externa as a symptom.
8) Bacteria or fungi
There are many species of bacteria and fungi that can cause ear infections. The most common is a fungus called Malassezia.
What Are The Symptoms of Otitis Externa?
· Head shaking
· Scratching of the ears
· Yeasty smell
· Rubbing of the head and face
· Swollen ear canals
· Red ear canals
· Fluid-filled pinnae (othematomas)
· Head tilt
· Sores and scabs on the ear flaps
How Is Otitis Externa Diagnosed?
You may have noticed by now that otitis is not always a straightforward condition, and it is important to find the underlying cause for treatment to be successful. It is very important to take your dog to a veterinarian if they show signs of otitis, as the condition will not go away on its own and can become very severe.
1) Physical exam
Your vet will do a full-body exam on your pet in order to find clues as to what the underlying cause of their ear infection might be.
2) Otoscope exam
Your vet will look into your pet’s ear to make sure there are no masses or objects in the ear. Some pets are extremely painful and will not allow such a close-up examination. In such cases, sedation may be required.
3) Ear smear
Every case of otitis should get an ear smear. This will tell your vet if the inflammation is due to organisms or not, and which kind of organisms are involved, so that the correct medication can be dispensed.
4) Culture
If bacteria or fungi are seen in the clinic microscope, your vet will likely recommend that a sample be sent to a lab for culture, especially if your pet has had previous ear infections that keep coming back. Culture will help identify the exact species of organism involved, and will tell us if the organisms are resistant to routine antibiotics. Resistant ear infections can be very challenging to treat, and culture is the first step to successful treatment.
5) Advanced testing
Some cases of complicated or recurring otitis may require more advanced testing such as video otoscopy, MRI, CT etc. These tests are usually performed by a specialist.
How To Treat Otitis Externa
The treatment of otitis externa is reliant both on treating the inflammation in the ears, as well as treating the underlying cause. Dogs with predisposing factors such as allergies or breed factors may occasionally get repeated infections, but the goal is to reduce the frequency and severity of the infections as much as possible. Below are some examples of what your vet may prescribe
1) Ear cleaning and flushing
Your vet will often do an initial ear clean in consult to ensure that any prescribed ear drops will go where it needs to go. Some severe cases may require ear flushes under sedation. There are several excellent over the counter ear cleaners available. We do not recommend using homemade solutions or preparations designed for humans except when directed to do so by your vet.
2) Prescription ear drops
Your vet may prescribe an ear drop with cortisone, antibiotics or antifungals in it. If a sample was sent for culture and resistance was picked up, your veterinarian may need to make up a unique combination for your pet. By law, a veterinarian may not give out prescription antimicrobials without an exam, even if your pet has been seen for ear infections before. It is also in your pet's best interest that a full exam and ear smear is made before any medication is prescribed, as the wrong medication can cause major problems down the line.
3) Allergy medication
If your pet suffers from underlying allergies, your vet may treat it with cortisone, cyclosporin, Apoquel, Cytopoint or other allergy medications.
4) Removal of foreign objects or masses if present
5) Treatment of underlying conditions if present
Why Are Follow-Ups So Important?
There are few conditions where follow-up exams are as important as with otitis externa. Even if the ear looks better at first glance, follow up smears (in the case of infectious otitis externa) are still extremely important. If there are any remaining organisms, your pet has a high chance of having a recurring infection, and these are often even more difficult to treat due to the build-up of resistant organisms.
Chronic, uncontrolled otitis can become very painful and some dogs may even become aggressive due to the pain. If not dealt with properly from the start, otitis can become an extremely expensive and frustrating condition to treat.
Do’s and Don’ts When Dealing With Otitis Externa
Do:
1) Seek veterinary attention as soon as you notice symptoms of otitis. Home remedies do not work and the condition will not go away on its own
2) Use Medications as prescribed
3) Dry ears thoroughly after bathing or swimming
4) Keep using your pet’s prescribed allergy medications.
5) Keep ears clean if dirty using an ear cleaner meant for pets
6) Keep up to date with tick and flea preventives to prevent ear mites.
7) Attend follow-up consultations if your pet was diagnosed with otitis externa
Don’t:
1) Put unregistered products in your pet’s ears.
2) Clean the ears too frequently, as it may cause skin damage that predisposes to infections.
3) Skip follow-up ear smears if the ear appears to be better
4) Pull hair from the ear canals – this can also cause skin damage.
Otitis externa can be difficult to treat in many pets, but if it is identified and approached correctly the first time, it carries a good prognosis.
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