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Ear Infections in Dogs

Photo of vet checking dog's ears

Disclaimer: I am not a veterinarian, nor do I have any formal training in any medical field. The information presented here is not meant to replace your vet's advice or prescribed medications, but only to suggest additional options to explore, based on your dog's condition.


Introduction

Most chronic ear problems are related to allergies, so in order to control the ear problems, the allergies must also be controlled (see When is an Infection Not an Infection? for an explanation of the link between allergies and ear problems). Antihistamines can help with environmental allergies (and sometimes with food allergies) -- see this page for dosage info (be sure to use only plain antihistamines, as other ingredients in combination products can be dangerous). Natural anti-inflammatories, such as salmon oil (fish body oil), vitamin E, bromelain (given away from meals), quercetin (bioflavonoid) and yucca tincture can sometimes help. Frequent bathing with a gentle shampoo can remove allergens from the body and help many dogs, as can frequent vacuuming and the use of a HEPA air filter. Dogs should be kept flea-free as well. See Food Allergies Part I: Ear problems for more information on the relationship between allergies and ear problems. Also see How to treat pet with chronic ear infections and foot chewing with feeding trials for food allergies for more information about feeding an elimination diet to try to determine whether your dog might have food allergies that are contributing to the ear infections.

Hypothyroid dogs "often have ear infections and show ear pain, redness, and odor," and Cushing's Disease can also be associated with chronic ear problems, particularly in middle-aged dogs.

See the following articles for more information:

See photos of normal infected ear canals: Vidoe Otoscope

Yeast Infections

Many dogs suffer from chronic ear infections that are caused by a yeast overgrowth. Yeast infections are always secondary to some underlying cause, such as allergies. Topical antibiotic reatment can also encourage the growth of yeast (it's best to use products that include both antibiotic and antifungal medications when your dog has a bacterial ear infection).

Sometimes removing grains, yeast, and all sugary/starchy foods from the diet (including most fruit, potatoes, sweet potatoes, yams, corn, peas, and winter squashes) will help. See Malassezia Infections and Yeast Infections of the Skin for information on a specific yeast organism called Malassezia. Also see Feeding Grains to Dogs? for a good article on why grains are not necessary and some of the problems they can cause. It is helpful to give something to kill yeast as well, once you have switched to a yeast-free diet. One such product would be Azmira's Yeast & Fungal D'Tox. Olive leaf extract is also good for controlling yeast, such as Animals' Apawthecary's Ol-Immune.

Other things that can set off a yeast infection are vaccinations, anesthesia, topical flea killers, and autoimmune disorders. Allergies (environmental/inhalant/atopy, flea or food) and bacterial skin infections (pyoderma, folliculitis) may also be interrelated with yeast problems. In fact, recurrent yeast infections are usually related to allergies.

Two people have reported that their dog their dogs had terribly yeasty ears, and one began to lose his hearing. Both ended up discovering that the dogs were hypothyroid. Treating the hypothyroidism resolved the ear problems. Neither had other symptoms of hypothyroidism except a little lack of energy. See Hypothyroidism in Dogs for more information.

There are many topical treatments for yeast and other ear problems. Please keep in mind that almost anything other than sterile saline can cause ototoxicity (deafness) if used when the ear drum (tympanic membrane) is ruptured, which is not uncommon when a dog is having ear problems, but the ear drum will grow back when the infection is removed. These treatments may be useful for keeping a chronic problem under control, but it may be best to have your vet take a look first, to determine what is going on with the ear, and whether the ear drum is intact, before proceeding with home treatments -- it will not help to treat the ears for yeast infection if the real problem is bacteria or mites, for example. If the ear is very infected, it may also be necessary for your vet to flush it out before you will be able to use one of these methods for helping to keep the ear clean.

Moisture encourages the growth of yeast, so you want the ears to be dry. Some ear cleaners include drying agents such as alcohol that solve this problem.

Ear Cleaning Solutions
I've used the following solution with success: Mix 1 ounce witch hazel with 1 ounce aloe vera gel, then add a few drops of lavender oil. Use this mixture to clean the ears daily for three days, then weekly after that. Witch hazel is drying, which is good. Note that Preparation H Medicated Wipes use a combination of witch hazel and aloe, and can be used to clean ears (see the last item in Dr. Patrick’s Top Five Canine Holiday Gifts for more information).
Zymox Otic has been recommended by several people as helping when nothing else seemed to work. It is effective against both yeast and bacterial infections. You can get it with or without hydrocortisone (which helps control pain and itching). A newer product, Zymox Plus, was introduced in January 2012 for resistant ear infections. There is also an Ear Solution for regular cleaning. See A Quick Review of Otitis Products Old and New and Zymox Miracle Ear Cleaning Product for more information on Zymox products. Zymox is available from Amazon and VetAmerica.
Blue Power Ear Treatment is a mixture of alcohol, boric acid powder and gentian violet. I have used this solution in combination with the witch hazel/aloe vera mixture above with success in treating a long-term yeast infection, but I still hesitate to recommend it. Both alcohol and gentian violet are ototoxic (can cause deafness) if the eardrum is ruptured. The solution dries the ear out (probably due to the alcohol), which really seems to help stop the yeast from multiplying. It can be irritating to the ear, though, so I don't use it as frequently as recommended. It can also be very painful if ears are inflamed. Some people have used witch hazel or a combination of witch hazel and aloe in place of the alcohol in the recipe for a dog with very sensitive ears, or for long term use with a dog prone to yeast infections. 
K9 Ear Solutions from Liquid Health uses alcohol, boric acid and gentian violet, along with colloidal silver.
Gentian Ear Treatment from Urban Carnivore is a combination of witch hazel, boric acid and gentian violet.
Gentian violet "has the potential for severe damage" according to this article on ototoxicity.
Another recipe that is somewhat similar to the Blue Power Ear Treatment above combines 6 oz alcohol with 1/2 tablespoon boric acid powder, 2 oz white vinegar, and one teaspoon betadine. Boric acid is commonly used in ear medications. Vinegar is a source of acetic acid, which is often used in ear cleaning solutions to combat yeast. The combination of boric acid and acetic acid can also be effective against pseudomonas. Both of these ingredients appear to be safe even if the eardrum is ruptured (many other ingredients can cause ototoxicity/deafness if used when the eardrum is not intact). Betadine is an iodine solution that is antibacterial and may help to soften wax and loosen other debris. Alcohol is drying, but can be irritating if the ears are inflamed, and may be harmful if the eardrum is ruptured. It shouldn't be used frequently, or if the ears are inflamed or the eardrum is not intact. You could replace some or all of the alcohol with either sterile saline (which is not drying, so would leave the ear more moist, which could be a problem with yeast) or witch hazel, which is an astringent and has some drying properties. Another astringent is Burow's Solution/Domeboro, which contain aluminum acetate.
See the following web sites for more information:
http://www.zimfamilycockers.com/EarCleaner.html
MalAcetic Otic
Burow's Solution
Bur-Otic HC Ear Cleanser
Pellitol ointment was recommended by a vet in an article in the Whole Dog Journal (June 2004). She says to completely fill the ear canal with Pellitol, massage the ear, especially around the base, then leave it undisturbed for a week (this is one case where filling the ear is appropriate). The ointment will dry up and flake off, taking the ear's debris with it. You can then use cotton balls or Q-tips to remove whatever is left. If the ear is not ulcerated, bleeding or painful, you can put a pinch or two of boric acid powder in the ear first, using your finger or a Q-tip to work it in, before applying the Pellitol. Remember that boric acid is toxic, it is important to be sure that none gets in they eyes, mouth or nose if you use it. Sometimes a second treatment with Pellitol is necessary, or you may need to flush the ear to complete the therapy. Cleaning with a regular cleaning solution on an ongoing basis should be done to prevent problems from recurring. 
Pellitol appears to be no longer available as of October 2011. There is a similar product called Re-ca-litol Otic Ointment from SVPMeds (a compounding pharmacy).
Vinegar (acetic acid) in various combinations is often recommended. Vinegar helps to control yeast and fungus. Note that alcohol is drying, which can help with yeast, but it can also be painful if the ear is inflamed, so use with caution. I have seen a variety of recipes, including: 
  • Mix 2 tablespoons apple cider vinegar (acetic acid) with one cup of (warm) water. 
  • Mix equal parts of alcohol and white vinegar.
  • Mix 3/4 white vinegar with 1/4 water.
  • Mix 3/4 apple cider vinegar with 1/4 witch hazel. White vinegar may be the better choice for yeast.
Probiotic Powder or Acidophilus can be used both orally and in the ears to help clear up yeast infections.
For yeast infections, you can also use Monistat or Massengill Vinegar & Water Douche or other over-the-counter treatments for vaginal yeast infections in women. Apply creams gently using a Q-tip.
DermaPet® Ear/Skin Cleanser , which contains both Acetic Acid (vinegar) and Boric Acid, has been recommended for treating both yeast and bacterial infections of the ear.
Vodka/Boric Acid: Use an 8 oz bottle and fill with about 6-1/2 oz of vodka. Into the vodka put about a tablespoon of boric acid powder and shake vigorously. Make a saturated solution so keep adding the powder until it no longer dissolves. Squirt into the ear and massage, let them shake their heads, then wipe out with cotton pads. If there's a lot of gunk, do this twice a day. Works for sore ears and infection. Vodka is supposed to be less harsh than rubbing alcohol.
Mix Betadine and (warm) water half and half. Betadine, like alcohol, is drying but can be irritating, so use with caution.

You should warm any solution you use to body temperature by immersing the bottle in a bowl of warm water. This makes ear cleaning much less aversive to the dog. Put the solution on a  cotton ball, then use that to wipe the ear. You can also use a Q-Tip, but be careful not to go any further into the ear than you can see or you may cause damage. Clean daily for three days, then every other day for a week, then weekly after that.

See What's the Best Use of Ear Cleansers? for information on cleaning ears from a veterinary perspective.

Other things that have worked for some people include:

See the following articles for a number of other natural suggestions for ear problems:

Products I've seen recommended by people who have used them with success:

Therapeutic Laser Therapy

Low-level lasers are being used to treat pain from arthritis and wounds. Read Therapeutic Laser Fights Acute Otitis for an account of how this same therapy was used to reduce pain, swelling and edema caused by an acute ear infection. Note that the laser doesn't treat the infection itself, but makes the ear less painful and reduces swelling so that topical treatments can work. Also see Class IV Laser Therapy for Canine Ear Infections (written by someone who works for a company that sells the lasers).

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You can contact me if you have any comments, but I regret to say that I can no longer respond to questions about individual dogs. See my Contact page for more information. My name is Mary Straus and you can email me at either or

   


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