Palm Beach Veterinary Society Members Meet to Discuss Advances in Ear Treatments
Michael W. Stephan, D.V.M.
Juno Beach Animal Hospital
On Thursday, June 8, the members of the Palm Beach Veterinary Society met for a continuing education seminar on new treatments for ear infections in dogs. The meeting was sponsored by Pfizer Animal Health and featured Dr. Ken Kwochka, a veterinary dermatologist from The Ohio State University.
Most of Dr. Kwochkas discussion focused on the treatment of dogs with chronic ear infections. Many of these ears are infected with bacteria with wide resistance to antibiotics, and in the past most of these patients were sent to surgery, often for removal of the entire ear canal! The focus now is for early and aggressive treatment of these infections with the goal of avoiding surgery and saving the ear.
The two most important factors in treating chronic ear problems are proper cleaning of the ear and the selection of the correct antibiotic. A badly infected ear needs to be flushed in order to remove the accumulated wax and debris from the ear canal and allow inspection of the ear drum and middle ear. In many cases of chronic infection the ear drum has been either partially or completely destroyed. With proper treatment, many ear drums will regrow over a six to twelve week period and hearing will return. All of the infection must be cleared from the external ear canal and the middle ear before this can occur. A proper deep flushing of the ear can only be done under heavy sedation or anesthesia. In some cases a short course of steroids, either topical or oral will be given before the flushing to decrease the swelling in the ear prior to flushing.
Many of the bacteria we find in heavily infected ears are highly resistant to antibiotics. It is recommended that a sample of the material from the ear be cultured in order to determine which antibiotic should be used. If your dogs ears have been treated frequently in the past with ear drops and antibiotics, there may be very few medications which will still kill the bacteria causing the infection. Only a culture and sensitivity can determine which is the correct antibiotic to use.
Some of the cases will still require surgery. This may involve removing part of the wall of the ear canal to allow better treatment and drainage of the ear, or, as a last resort, removal of the entire ear canal. This latter procedure leaves the patient with permanent deafness , but the reduction of pain by removing the ear improves their quality of life considerably.
The keys to successful treatment of ear infections include treatment early in the course of the infection, culture and sensitivity to determine the proper antibiotic, and a thorough cleaning of the ear canal and middle ear. Your veterinarian will also be able to give you some guidelines to follow to help prevent the recurrence of the infection and keep your dogs ears healthy and his hearing intact.