The Petzine

Ear infections, most often known in the medical world as “otitis externa”, are extremely common in all breeds of dogs. Cats and dogs with small, stand-up ears are less likely to deal with ear infections, but it can happen. As someone with a cocker spaniel mix, I know all about the pains of dealing with long, floppy ears and the chronic ear problems that come with them. The good news is that there are a number of inexpensive ways of keeping it under control.

Understanding The Problem
First, it’s important to understand the difference between a true infection and ear mites (also known as Otodectes cynotis). Ear mites are extremely common in cats, yet you very rarely see them in dogs. The mites will cause intense itching, to the point where lacerations around the ear from frantic scratching are frequently observed, and will sometimes need treatment as a secondary infection. Ear mites are too small to see with the naked eye, but can be detected under close magnification or under a microscope (the latter is how veterinarians will diagnose them). What you will notice is a discharge that looks similar to coffee grounds — Black, grainy substances that accumulate very fast inside of the ear canal. Otitis externa, an ear infection, will present as more of a waxy or pus-like (also known as “purulent”) discharge that is usually accompanied by a very foul smell. You will likely notice scratching with an ear infection, although it is usually accompanied by shaking the of the head, whimpering, and the external ear canal may look very red and irritated.

Whatever you think might be bothering your pet’s ears, it is important to schedule a visit with your veterinarian to accurately diagnose the problem and receive effective treatment. Ear mite treatment is fairly straight forward, but otitis externa can develop into otitis media, which is an infection of the middle ear. This is a much more dangerous and more painful problem, and can require a round of oral antibiotics to treat.

Understanding Your Vet Visit
When it comes time to see the veterinarian, many owners worry about the procedure and what will happen during the visit. You can expect to receive a full physical exam with each visit, as this is common practice. The veterinarian will most likely check your pet’s heart, lungs, ears, eyes, nose and throat, as well as palpate (feel) the abdomen and sometimes check the skeletal system by palpating the vertebrae on the back, moving the legs around, etc. A thorough inspection of the ears should take place, including the use of an “otoscope” (usually a cone-shaped instrument with a light on it) to examine deep into the ear canal. They may take a swab of the discharge for testing. If ear mites are suspected, the sample will be placed under a microscope to look for the mites. If the test is positive, you can ask to see what it looks like — most clinics will allow this, and ear mites look very gross, but very interesting when magnified to 10x their normal size. However, if the veterinarian suspects otitis, they will need to run a cytology. This is a similar test to that of the Pap smear, where they use a special stain that causes cells to appear under the microscope. This will help them determine what type of bacteria is growing in your pet’s ear, and how to treat it. It’s not as interesting to look at under the microscope as ear mites are, but you can still ask if you’re interested. Some clinics will need to send their cytology testing to the lab, and you won’t get the results for a few days.

Treatment for otitis externa is often going to be a topical ointment that you apply once or twice daily. Mometamax is a very common treatment, and it is only applied once a day, which is very convenient for forgetful people like me. The active ingredients in Mometamax are gentamicin, mometasone, and clotrimazole. Gentamicin is an aminoglycoside antibiotic used to treat lots of different types of bacterial infections. Mometasone is a glucocorticoid steroid, and as a topical treatment, it is used for many types of skin disorders and allergies. And finally clotrimazole, which is an antifungal used in treatments for yeast infections, ringworm and athlete’s foot.

Another very common treatment is a product called Otomax, although many clinics now carry one of the generic brands like Vetromax, Tri-Otic, or Mal-Otic. This is a twice daily treatment. The ingredients are gentamicin, clotrimazole, and betamethasone. As you can see the ingredients are very similar, the only difference being betamethasone: a similar glucocorticoid steroid to the mometasone in the Mometamax. The differences between the two ointments are slight, and you should look for your veterinarian to prescribe a drug that more efficiently kills the bacteria found on cytology. Be aware, though, that Otomax and it’s generics are often substantially cheaper than Mometamax. While Mometamax is slightly more potent and has the once-daily convenience factor, Otomax is still a great product and you should not hesitate to ask for it if cost is a factor for you.

If your dog has a more serious otitis media infection, your veterinarian may need to prescribe a round of oral antibiotics, and your pet may need a follow-up visit. At this point, it’s important to listen to what your vet recommends, as otitis media is a very serious infection and needs fast and effective treatment. Don’t mess around with this one.

Ear mites are typically treated with a parasiticide, of which there are dozens of different kinds. A common and effective treatment is with a product called Acarexx, a one-time dose of ivermectin. This product is currently only approved for cats, so a rare case of canine ear mites would be treated with one of the other parasite treatments on the market.

Once your pet finishes their course of treatment, symptoms should clear up quickly. It’s important, however, to closely monitor your pet’s behavior in order to catch a recurrence. If otitis is the culprit, recurrence is very likely. Any symptoms should be reported to your veterinarian as soon as possible. However, there are some things you can do at home to prevent recurrence from becoming a frequent problem.

Home Remedies
Cleaning your pet’s ears is relatively simple, and can go a very long way towards preventing infection. It’s also a great way to monitor the area for any changes that might indicate an infection. Cats are typically very sensitive in this area, and you would be smart to enlist the help of a “holder”, or someone who can wrap your kitty in a towel or blanket to stabilize them while you clean the ears. Dogs are usually more receptive, but having a trusty holder around can make a huge difference.

Purchasing a good ear cleanser from the veterinarian is a great idea, and you can usually pick one up for fairly cheap. You can buy cleaners over the counter, but you must be sure to pick the correct formula — nothing medicated or containing too many additives. My favorite OTC cleaner is called Epi-Otic, and can be purchased at most pet stores, online, or through your vet. It can be used on both dogs and cats. You will also need some q-tips and cotton balls or cotton pads.

You should apply the cleaner first, by using a small squirt in each ear and then massaging it in for 10-15 seconds. Your pet will probably want to shake their head, so go ahead and let them, but stand back. Using q-tips, you can then begin to swab out any discharge or debris in the external part of the ear. Never let the q-tip go too far into the ear canal, especially on cats. Just get what you can see, and leave the deep cleans for the veterinary staff. After using the q-tips for all the little cracks and crevices, you can wipe any residual cleaner out with a cotton ball or cotton pad. Let your pet shake their head again, if they want to.

Ear cleaning is safe to do about once a week, as a preventative measure. Your veterinarian may have you do it more often when treating for an infection. Bacteria and yeast tend to thrive in warm, damp environments, so performing a thorough cleaning after your pet has been in the swimming pool, in the lake, or after a bath is very important.

Finally, one of the biggest causes of otitis, especially in smaller dogs, is hair growing in the external ear canal. This can be pulled out with minimal discomfort, and your groomer should be able to help you with this. If your pet doesn’t visit the groomer, or if the groomer is unwilling to perform this procedure, a veterinarian will be able to do it whenever necessary. It’s up to you, as the owner, to monitor the hair growth and keep track of when it’s time for another visit.

Tagged as acarexx, cytology, ear cleaning, ear mites, malotic, mometamax, otitis, otomax, triotc, veterinarian + Categorized as Medical