Ear Infections in Dogs
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.
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 Ear Care and Disease (starting on page 11) for in depth information about various causes of ear problems, both chronic and acute. Also see Treating Ear Problems in Cats, Dogs, and Other Pets for an easy-to-read overview, and Strategies for Battling Cat & Dog Ear Infections for an article about veterinary products.
See photos of normal infected ear canals: Vidoe Otoscope
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 antibiotid 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 supplements that may help with yeast include Probiotics, Vitamin C with bioflavonoids, fresh crushed garlic, olive leaf extract, and salmon oil. 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.
|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:
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:
|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:
- adding organic apple cider vinegar to their food (anywhere from 1/2 teaspoon to 1 tablespoon, depending on the size of the dog)
- cleaning with olive oil (just on the cotton ball, not instilled in the ear)
- treating the ear with acidophilus powder (just break open the capsule and sprinkle the powder in the ear after cleaning),
- Lavender essential oil can be effective against yeast, but should not be used straight, it is better to mix it with witch hazel or a carrier oil, and should not be used at all on cats, toy breed dogs, or very young puppies.
- A fellow Shar-Pei owner was successful using Colloidal Silver to treat yeasty ears.
- Another person added Ascorbic Acid (a form of vitamin C) to acidify the body and it helped clear up a yeast problem in the ears. If you try this, be sure to use Ascorbic Acid, and not one of the ascorbate forms of vitamin C, which are not acidifying. Also, increase vitamin C slowly, as too much will cause loose stools.
- A combination of topical Monistat 1-Day (miconazole, an anti-yeast medication) in the ears daily for 10 days and oral cephalexin (antibiotic that is used to treat staph infections) for 14 days worked to solve one St. Bernard's chronic ear infections.
See the following articles for a number of other natural suggestions for ear problems:
- Ear Problems
- Herbal Help for Ear Infections under Health/Herbal Info
- Otitis Externa Good conventional overview of causes of ear problems
- Surolan Ear Drops -- this is a medicinal product that contains Miconazole nitrate for yeast (malassezia), polymyxin B sulfate for bacteria, and prednisolone for inflammation. Click here for a little more info. One person whose dog had a long term problem with her dog's ears was able to clear them using this product combined with flushing the ears.
- Canyon Meadow Natural Ear Wash -- contains tea tree oil, so use with caution
- Herbal Ear Rinse from Animals' Apawthecary
- Halo Herbal Ear Wash
- Ear Fresh Medicated Ear Powder
- Animal Dermatology Laboratories Foaming Ear Cleaner and Ear Flushing Drying Lotion (available only from your vet)
- Ear Wash with Tea Tree Oil (do not use tea tree oil for cats or toy breed dogs)
- DermaPet Ear/Skin Cleanser for Pets
- Epi-Otic Ear Cleanser
- Natural Ear Comfort
- Pooch Calming Ear Remedy
- Zymox Otic (see above)
- Hy-Otic Ear Rinse contains hyaluronic acid to help with healing if the eardrum is injured (common with severe infections)
- BNT Otic is a prescription compounded ointment, made by BCP Vetrinary Pharmacy, and used to treat pseudomonas-resistant infections. It is applied one time, then stays in the ear for two weeks. Includes enrofloxacin to treat the bacterial infection, ketoconazole to help prevent fungal growth secondary to antibiotic treatment, and triamcinolone to help reduce inflammation. Ask your vet to order it for you if your dog has a persistent bacterial ear infection that is not responding to normal treatment. It's usually applied by your veterinarian, using a syringe. Because it's so thick, it is warmed first with hot water to make it liquid.
- Thornit Ear Powder contains zinc oxide (an ingredient in Pellitol ointment, above), boric acid, and iodoform, which is used in other ear products, so I think it should be relatively safe to use. One person reported success controlling chronic yeast infections in the ears with the use of this product. Sold in the UK, but also available in the U.S. under different names, or you can make it yourself. See Ear Powder for more information.
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).