Shasta is the sweetest 13-year-old Beagle dog you'll ever meet. He's up to date on his blood work, vaccines, and all recommended services, but he has one problem -- his ol' ears! Shasta has experienced frequent, minor ear infections for a while, but this one was different. In late January, he had an ear infection that was big, bad and ugly. Shasta's right ear was manageable, but his left ear -- shoo whee! It was definitely infected and painful.
Ear infections in dogs and cats usually involve a yeast organism or bacteria, or sometimes both. The reason animals get ear infections can be complicated to determine, but we know common causes include allergy, hypothyroidism, water in the canals (from swimming or bathing), or other unknown cause. Of course, itchy ears and buildup can be due to ear mites, but we see this far less commonly, especially in adult animals. In fact, pet owners will often assume their pet's symptoms are due to ear mites, try self-treating, and then call us when the treatment is ineffective.
Given his history, we were most suspicious of an allergic cause.
After examining Shasta's ear canals, I performed a cytology exam, or a microscopic look at a sample of the material in the ear, to better determine what type of organism was causing Shasta's infection. This would help me know which medications might be most effective at treating the ear. When I looked into the microscope at Shasta's right ear one that appeared normal, the sample contained a small amount of yeast. The left ear, however, contained a large number of bacteria. With the level of bacteria I was seeing, I was concerned that this infection could be difficult to treat.
After cleaning the ears with a medicated ear flush, I applied a topical treatment that remains effective for one month. I also prescribed an oral antibiotic because of the severity of the bacterial infection. This is a moderately aggressive approach to treatment, in my opinion. Shasta was to return at the end of the treatment course.
After one month, in late February, Shasta returned for a follow-up. Bad news: the infection had not cleared based on the result of the cytology exam. So, the next step for Shasta was to collect a sample from the left ear for culture. This test would tell us the name of the bacteria we were fighting, and which antibiotic would be most effective at treating that particular bacteria. Shasta's result identified three different bacteria causing his infection! So, I had to compare the lists of antibiotics to use for each one and find a drug that would be effective against all three bacteria. Shasta's mom picked up a new oral antibiotic and a new topical medication and set up another visit for two weeks later.
At the two-week recheck visit, now mid-March, our cytology test showed a 75% improvement in Shasta's ear infection. That was a good feeling for me and for Shasta. Now, our goal was a maintenance plan to finish out his treatment, and hopefully prevent another infection.
Shasta did pretty well for a few months, but in June, we checked in on his ear cytology and found evidence that an infection was threatening to develop. If you notice, Shasta's ear infections have now spanned different seasons, and we have fought this on a routine basis. This frequency, severity, and non-seasonality is suggestive of a food allergy. So, in June, Shasta began a prescription, hypoallergenic diet. This diet is very strict.
I wish I could tell you that Shasta never had another ear infection, but that's not the case. That's also not a reasonable goal. Our goal for Shasta is to limit the frequency and severity of his ear infections and to be able to treat and cure them more easily as they occur. In that regard, I would say we have been successful to this point.
Ear infections in dogs can be frustrating for pet owners and veterinarians alike. We want to cure disease, to prevent it. Sometimes, giving your sweet baby comfort and relief from a chronic, painful condition is the best medicine we can offer. It is so important to return for follow up visits until your vet releases your pet from treatment and to be patient and diligent in their care.