Symptoms and treatment of ear infections in dogs

Ear infection in dogs is one of the most common health problems that we treats at our animal clinic. In fact, up to 20 to 50% of all Norwegian dogs are affected by ear infections one or more times during their lives. Fortunately, there is a solid treatment for ear infections in dogs. In this article, you will find an overview of the symptoms and causes of ear infections, as well as a description of what a course of treatment looks like with us. Also get tips on what to look for if you suspect that your four-legged friend has an ear infection.

Table of contents

Written by our vet

What is ear infection in dogs? 

Otitis is a normal health challenge for several dogs, as a result of the accumulation of wax and moisture in the ear canal. Earwax is part of the immune system. The ear has its own microflora of fungi and bacteria. The microflora is transported out by means of "epithelial migration", which is a complicated mechanism that can easily be disturbed by frequent ear cleaning. The dog's ear canal is vertical and therefore available for inflammation. A healthy ear canal is basically self-cleansing, but in case of an ear infection, this mechanism can be delayed or stopped completely.

Anatomy of the ear 

The dog's ear consists of the outer ear, the middle ear and the inner ear. The outer ear includes the ear lobe and the ear canal, which is L-shaped and is on average 8 cm long. Deep inside the ear canal, the tympanic membrane lies at a 45 degree angle, and it cannot therefore be viewed in its entirety with an otoscope. It is worth noting that the ear is considered part of the skin.

Close-up of what a dog's ear looks like
Dog's ear

Acute or chronic ear infection?

The dog can have both an acute ear infection and develop a more chronic inflammatory condition. 

Acute ear infection in dogs 

In acute cases, the dog usually shows signs of itching and redness in the ear canal. An increased amount of earwax or brownish discharge in the ear canal is also not unusual. As the owner, you may notice that the ear smells different, often sour and musty.

Chronic ear infection 

If acute conditions in the ears are not treated satisfactorily, the condition can become chronic. Chronic ear infections are usually more painful than itchy, and secretion changes are often more obvious. The ear can become very swollen and irritated and it is not uncommon for the pain to be so intense that it disturbs sleep at night and leads to a greatly reduced quality of life.

List of symptoms of ear infections in dogs 

One or more of the following symptoms may indicate that your dog has an ear infection: 

  • Frequent shaking of the head
  • Excessive earwax
  • The dog scratches the ear area or rubs the ears against the ground
  • Abnormal smell from the ears
  • Yellow to brown discharge from the ears
  • Redness and irritation of the skin inside the ears
  • Swelling in the ears
  • Pain on palpation of the ears
  • Reduced hearing
  • Balance disorders and or crooked head posture
  • Blood ear
  • Facial paralysis
  • Horner's syndrome with prolapse of the third eyelid

When should I see a vet? 

Ear infections are usually an acute and painful disorder that should be treated quickly with pain and anti-inflammatory medication. Therefore, visit a vet as soon as you notice that your dog is suffering from pain or irritation in the ear. At the same time, you want to avoid the ear infection becoming serious and perhaps eventually permanent.

Causes of ear infections in dogs 

The symptoms of the ear infection are usually due to an overgrowth of bacteria or fungi in the dog's ears. This is related to direct and underlying causes. 

Direct causes 

  • Underlying presensitivity, preallergy
  • Underlying environmental allergy (atopy)
  • Foreign body in the ear canal
  • Ear mites
  • Polyps or tumors in the ear canal
  • Immune-mediated disease
  • The skin disease seborrhea

Predisposing causes 

  • Excessive napping and cleaning of an otherwise healthy ear
  • High humidity
  • Frequent bathing
  • Ear anatomy, e.g. narrow ear canals
  • Hormonal diseases such as low metabolism

Also read: What do I do if my dog ​​scratches his ear?

A veterinarian checks the ear of the dog under control.
Veterinarian checks the dog's ear.

Treatment of ear infections in dogs 

Before the ear infection can be treated, it is crucial to clarify the cause of the ear infection. The vet therefore has an important task in finding the underlying causes of the ear infection. At A-Vet, we go through the causal conditions and if the ear infection is recurrent, which means that it repeats itself, we often take blood tests to rule out, among other things, low metabolism and allergies. If we do not find the cause, there is a high probability that the ear infection will return.

In the next section, we take you through what a typical course of treatment looks like after we have clarified the cause of the ear infection. 

A typical course of treatment at A-Vet Small Animal Clinic 

When we treat ear infections here at A-Vet, we have a procedure for how we proceed. We start with a thorough examination of the dog's health, confirm the cause of the ear infection and implement the correct treatment. Ear rinsing is a typical and effective tool for treating ear infections. After the treatment, we always carry out frequent and regular checks on your four-legged friend, so that we can be sure that the inflammation does not return. 

Day 1 at the clinic: Thorough health examination and anti-inflammatory treatment 

We carry out a thorough health examination of your dog and check the ears with an otoscope.

Sometimes it is not possible to see the entire ear canal or the eardrum. As we know that 50% of all dogs with ear infections also have otitis media, we are restrained with ear cleaning at this stage of the investigation, among other things so as not to damage the middle ear.

We then take samples of the ear secretions and look at the cells under a microscope. Depending on what we find, the dog is put on a pain and anti-inflammatory treatment for 2–4 days. Since the ear forms part of the skin, the likelihood of sensitivity is high. That is why most dogs are put on a leash allergy-free feed for a period of 8 weeks and then provocation with other treats/treats afterwards. You will receive written information about this.

Day 2 at the clinic: Gentle ear rinsing 

We perform ear irrigation in a video otoscope 2–4 days after the initial treatment. Here at A-Vet, we have a special ear irrigation instrument, which is called the Storz video otoscope. This is connected to a camera that helps us "see" the entire ear canal, including the eardrum. This instrument brings tempered physiological salt water into the ear canal and sucks the liquid back up in a gentle way from the ear canal. The ear canal and eardrum are cleaned well without disturbing the ear's own immune mechanisms. The ear videoscope is incredibly gentle on the ear canal and eardrum. In addition, we can assess the eardrum in a completely different way than with a normal otoscope.

If your dog has fungus in the ear 

If the dog has fungus in the ears, we use medicine that is inserted into the ear canal immediately after treatment and which should have an effect for 3 weeks afterwards. We have very good experiences with this treatment. It seems that most dogs with ear fungus recover completely without any further ear treatment, while others also need preventive treatment at home 2 days a week, which often becomes lifelong treatment.

Control at the clinic after ear rinsing

7, 14 and 21 days after the ear rinse, we check the ear with an otoscope, and take samples for examination under a microscope. Based on the findings in the microscope, we assess whether the treatment is still working. If the result is successful, we see inactive fungi in the microscope. It is important to include the assessment in the further treatment.

Do you not want an ear rinse, but only a manual ear cleaner?

In order to give your dog the best treatment, we will examine and treat the ears manually at the clinic once a week, 1-2 times in total depending on the severity. Treating a more serious ear infection at home with daily rinses will rarely produce lasting results, and in some cases may even worsen the condition by adding moisture to the ear canals.

Veterinarian uses otoscope to check dog's ear.
Veterinarian checks the dog's ear with an otoscope.

Prolonged ear infection 

If your dog has had an ear infection for more than 12-14 days, there is a risk of developing an angry bacteria called Pseudomonas. This is a bacteria that is resistant to most antibiotics. It is slimy to the touch and has a greenish colour. In case of pseudomonas infection, we use a separate treatment regimen. 

Ear problems should be taken seriously, as long-term ear infections that are not treated can lead to permanent ear damage. The most common cause of chronic conditions is that acute problems are not investigated early in the course of the disease.

What happens if the ear infection is not adequately treated? 

If an ear infection is left untreated for a long time, there is an increased risk of the eardrum rupturing and the infection spreading to the middle ear. It can also lead to permanent damage to the ear canal, which in turn will cause the dog to have bigger and bigger problems over time. In spaniel breeds, secondary changes with scar tissue in the ears and narrow ear canals can quickly occur. The ear's normal functions will eventually no longer function and long-term measures or extensive operations will be necessary to bring the situation under control.

How to prevent ear infections in dogs  

  • Avoid picking the hair from the ear canal. 
  • Do not clean the ears too frequently. Regular cleaning 1–2 times a month is recommended.
  • Use a soft cloth and a mild ear cleaner
  • Avoid too much water in the ears when washing your dog. 
  • Check the skin and ears frequently!

Learn more about ear rinsing in the treatment of ear infections 

Ear rinsing with a video otoscope is a particularly effective and gentle way of cleaning the ears, because we eliminate all debris and quickly without damaging the skin in the ear canal. In the following video with associated images, we use our ear irrigation instrument, the Storz video otoscope.

In the video you can see how we use flushing, suction and angling of the instrument in the ear canal to remove a lump of old earwax. In addition, we remove debris and debris that lie along the canal and hair that grows deep inside or that enters the ear canal from the outside. This is done with a gentle brush. We also have the option of using pliers if we need to grip something with precision.

This dog has otitis externa, an inflammation of the skin in the external ear canal. In dogs, parasites, foreign bodies or allergies can often cause the inflammation. To make things more complicated, the shape of the ear can make a dog prone to ear infections. A narrower ear canal with or without an unnatural amount of hair in the outer and/or inner part of the ear canal provides less ventilation and creates persistent humidity. This weakens the skin's barrier and makes it more susceptible to inflammation. The inflammation can lead to the production of larger amounts of earwax and ear secretions. This provides little to no ventilation of the ear and can create a chronic ear infection. 

A-Vet helps your dog 

Your four-legged friend deserves only the best when it comes to care. Dog treatments always takes place with a focus on quality, and at A-Vet we always prioritize the dog's health and well-being. We understand how important your dog is and help with everything from routine health examinations to complex treatment courses. Contact us if you need help and advice.

A lady playing with a dog and giving the dog a high five with her paw.