Have you ever noticed your pet shaking his/her head vigorously, pawing their ear, tilting head to one side and walking?

Well, all these are signs of ear discomfort or ear infection. It is a very common condition that can affect any breed of dog, at any age. There is no dog that has not come across this condition at least once in their life time.

As a pet owner, it is important to take care of this condition before it moves to the next level.

PREDISPOSING FACTORS

Certain breeds are more prone to ear infections such as cocker spaniels, poodles, basset hound, lhasa apso, terriers etc it is mainly because of their furry nature and long floppy ears.

The other factor is when there is moisture build up, there is good chance that opportunistic pathogen invading the ear which leads to infection.

ETIOLOGY/CAUSE

Dogs and cats have vertical ear canal which makes them more prone to ear infections. The ear is mainly divided into three parts external ear, middle ear and inner ear. Inflammation of the external ear, middle ear, and inner ear are known as otitis externa, otitis media, and otitis interna respectively. Often inflammation of the external ear goes unnoticed by the owner, in such cases the severity of infection increases along with the pain. This infection will spread to middle ear followed by the inner ear. Once inner ear is affected it could end in deafness, facial nerve paralysis, circling and lack of coordination.

Common causes include:

• Primarily bacteria
• Mites, ticks
• Yeast infection
• Moisture
• Ear wax build up
• Allergies
• Thyroid disorders
• Foreign bodies
• Injury
• Tumours

SYMPTOMS

• Pawing of the affected painful ear
• Swelling or redness
• Malodour
• Dark colored discharges from the ear
• Head shaking
• Tilting of the head to the affected side
• Whining while itching the ear
• In appetence
• Rubbing of the affected ear to walls or any other objects

What should be done by the owner?

As a first aid, carefully wash the ear with clean cold water, remove all the debris, wipe with a clean cloth. Do not press or try to squeeze out the discharges. Take the pet to a veterinary clinic as soon as possible.

DIAGNOSIS

Anamnesis/ history collection

Since the patients cannot directly communicate with the veterinarians, it would be helpful in pertaining better diagnosis if the following questions are clearly answered

• What are the symptoms?
• How long is it persisting?
• How often is ear cleaning done?
• Grooming history?
• Feeding history?
• Any known allergic conditions?
• History of any trauma, ectoparasite?

CLINICAL EXAMINATION

• Determination of the severity of pain – can be done by palpation. If the animal is in too much pain, sedation is recommended.
• Gentle manipulation of the ear pinna is required for the examination of crusts, scabs, swelling, fibrosis, redness, and discharges.
• Signs of self-trauma, lesions on the ear should be ruled out.
• Consistent head shaking signifies chronic otic discomfort. If the condition is unilateral there will be head lowering to one side.
• Otoscopic examination

In simple terms, it is a device used for ear examination. It potentially gives a clear view of the ear canal and the tympanic membrane (ear drum). Basically, it has a light source, magnifying lens, and a speculum or ear cone. Most have a working channel through which biopsy instruments, catheters for flushing and laser tips can be passed. It allows visualization through saline and water to determine the integrity of tympanic membrane and to facilitate sampling of culture from the ear.

When there is cerumen (ear wax) build up and excessive swelling, an otoscopic examination can be really difficult. In such conditions, the animal can be sedated or started with corticosteroids for few days so that the swelling can be reduced then otoscopic examination can be reconsidered.

TREATMENT AND CARE

• The animal will be in great discomfort and pain so the first step to treatment should be the management of pain. Analgesic (pain killer) should be given.
• Corticosteroids like (inj. Prednisolone, inj.triamcinolone) can be given to resolve to swell.
• The ear should be thoroughly cleaned with topical ear drops.  If the discharges are thick and dry waxy, cerumenolytic solutions ( a solution which will help in dissolving the wax) should be used such as soln.carbamide peroxide, dioctyl sodium sulfosuccinate (DSS). Pour the solution into the ear with the help of the filler or syringe, gently massage the base of the ear and wash it with warm water to remove the cleaning solution.
• If the tympanic membrane is ruptured usage of the DSS Solution and other detergents are contraindicated. In such cases saline, saline with povidone iodine can be used to flush the ear.
• For effective therapy it requires

• Topical ear drops: mostly combinations with antibiotic /antifungal and  corticoids are recommended it should be instilled twice daily
• Systemic antimicrobials: (ear swab should be taken and send for antibiotic sensitivity test (ABST) then only  the antibiotic  should be decided)
• Analgesic /NSAID’s
• Corticosteroids

This regime should be continued for at least 5-10 days for effective results.

If it is a fungal infection- anti fungal like ketoconazole tablets should be started, it should be continued for at least 2-3 weeks.

PREVENTION

If the animal is maintained well the chance of getting an infection is very lean. In order to prevent the infection following steps should be followed:

• Periodic ear cleaning: ear should be cleaned once in every 2-3 weeks. Need not use any antibiotic topical solutions in the absence of infection. It is advised to use normal topical drops like otocare, epi-otic.

• Check whether you are cleaning it right:

Step 1: if your pet is very furry, clip the hair surrounding the ear canal

Step2: take a dry towel and wipe the ear pinna and the passage to remove all the dust and sand particles.

Step 3: pour 5-8 drops of the topical drops carefully into the ear canal, massage the base of the ear for about 2-3 minutes

Step 4: Wipe the excess discharges with a clean towel. Do not use cotton as its fibers can stick on to the ear canal while wiping.

Step 5: use ear buds to clean the ear folds.

• While giving a bath to your pet makes sure you keep an ear plug so that water will not enter the ear canal. If water enters the ear canal there is a good chance for infection and maggots. Maggot infestation can complicate the infections as the larvae keep on feeding on the tissue.
• Always keep the ear dry.

Few simple precautions can make a huge difference to your pet’s health. Always remember “prevention is better than cure”.