The microscopic presence of bacteria and yeast can easily be determined by taking a swab of the ear canal. Topical ear drops or ointments routinely prescribed are basically combo cocktails of antibiotics (to kill bacteria), antifungals (to kill yeast), and anti-inflammatory drugs like cortisone (necessary to dampen inflammation, stop the itch and reduce pain).
I rely on several Zymox OticÂ® products made by PKB Animal Health. This unique drug-free formulation contains highly effective enzymes that are both antibacterial and antifungal. Zymox products work best in a “dirtyâ€ environment – NO pre-cleaning is required. For ongoing control and prevention of flare-ups, use daily for 7-14 days, then apply to affected ear(s) 3 times per week for maintenance. I recommend Zymox with hydrocortisone 1.0% for dogs diagnosed with allergic otitis externa. A fancy medical term for inflamed ear canals due to an allergic response.
Systemic antibiotics (given by mouth or injection) are surely indicated if the eardrum is ruptured – most of the time they are not needed, but remain mysteriously prescribed. Systemic anti-inflammatories such as corticosteroids are often employed in the first week or two of a flare-up, and then tapered off.
Okay, now think itchy dogs. Environmental allergies (referred to as atopy – the human equivalent of hay fever) carry a presumptive diagnosis when symptoms look like this itchy trio: 1) excessive paw licking; 2) red bellies and armpits; 3) hot inflamed ears. When patients with red ears show up with additional skin zones (paws, belly, and armpits) affected by inflammation and hair loss, a broader treatment plan beyond topical ear meds is called for. Low dose oral corticosteroids may need to be part of the treatment plan during high allergy seasons. Also helpful in these patients is frequent bathing with antibacterial and antifungal shampoos followed with a leave-on lotion that contains cortisone – I like ResiCORTÂ® by Virbac.
Less common itchy ear culprits are food sensitivities. Possible food allergies fall under suspicion when your dog shows year around itchiness – as opposed to an intermittent seasonal pattern like hay fever. When food allergy pops up on my list of possibilities, a selective food trial begins for the next 6-8 weeks. Typically, a new protein source (not commonly found in pet foods) is chosen, like duck, rabbit, venison, or kangaroo. This diet must also be grain-free, so potatoes are often added. And no treats! Home cooked veggies or baby carrots will have to do for all you treat addicts. Vet alert: blood allergy tests have proven to be unreliable for the detection of food allergies – don’t waste your money. Blood testing can, however, confirm the diagnosis of an environmental allergic response (atopy) to plants, pollen, dust mites, fleas and other external factors. In general practice, a thorough examination alone will often confirm the diagnosis of atopy and treatment can begin. Based on my experience, costly allergy testing is needed for the sole purpose of desensitization and should fall into the trained hands of dermatologists, not your vet.
Failure to properly treat smoldering ear inflammation will result in progressive trauma that could rupture the eardrum and or narrowing of the ear canal, making any treatment more difficult and less successful. The Cocker Spaniel and similar floppy eared breeds have the highest incidence of these problems requiring surgical intervention in cases where patients suffer from advanced disease beyond the reach of medications. Don’t wait – get help now to put out this inflammatory inferno!