Outer Ear Inflammation (Otitis Externa)

Our guide has been authored by qualified veterinarians, but should not be taken as substitute for medical advice or professional veterinary consultation. If your pet displays any unusual symptoms, we strongly advise seeking guidance from a veterinarian

Understanding Outer Ear Inflammation (Otitis Externa) in dogs

The dog’s ear canal is divided into three parts. The first is the outer ear, which begins at the auricle and includes the ear canal up to the eardrum. Dogs tend to suffer from inflammation in this area, which causes significant discomfort and pain. The inflammation is characterized by redness, pain, fever, swelling, and decreased function.

Ear infections are progressive, and the discharge and thickening of the ear canal can worsen them. Left untreated, they might cause chronic ear problems that are challenging to cure, and reoccurrence frustrates both the dog and their owners. Otitis Externa is considered a type of skin problem, since other skin issues often accompany it. This means veterinarians studying this area and treating severe cases are typically dermatologists.

Boomer's story

Boomer is an energetic Cocker Spaniel. Like other dogs of this breed, he has beautiful long ears, which are also prone to severe, recurrent ear infections. In Boomer’s case, these infections are related to his seasonal allergies. With the guidance of a veterinarian specializing in dermatology, Boomer had undergone multiple long treatment cycles that proved inefficient. The veterinarian recommended surgery to remove Boomer’s inflamed ear canals, performed by a specialist veterinary surgeon. The procedure was successful, and following several weeks of recovery and medication, Boomer was in better shape and mood and could even hear better than ever.

Outer Ear Inflammation (Otitis Externa)'s Causes: Uncovering Triggers

Bacteria and yeast: Infections are common in dogs and are caused by bacteria, yeast (Malassezia or other unicellular fungi), or a combination of the two. Still, unlike humans, these infections are almost always secondary and accompany other problems that cause the inflammation, including the following.

Skin allergies: Environmental allergies (Atopic Dermatitis) or food allergies are some of the most common causes of severe, recurrent ear infections in dogs, and such infections often accompany an allergic reaction.
Foreign bodies: Dogs’ ear canals are wide and deep. This is especially true for larger breeds and proves problematic when a curious dog peeps their head and examines new places. Foreign objects can enter their ear and get stuck, causing infections. One common example is the spiky seeds of the notorious foxtails found in open fields.
Parasites: Ear mites thrive by consuming ear secretions and are more common in puppies. Dogs infested with parasites such as ticks, fleas, and mites may suffer from outer ear infections as well. Another parasite-related condition that leads to outer ear inflammation is Leishmaniasis.
Tumors: Benign or cancerous tumors blocking the ear canal can cause infections.
Structural changes: Certain breeds may have narrow canals, hair growth deep in the canal, swimmer’s ear, heavy auricle, and other structural shifts that can cause or complicate an existing inflammation.
Other skin conditions: Seborrhea, lupus, pemphigus, and other skin diseases may lead to recurrent ear infections.
Other systemic diseases: Hypothyroidism, Cushing’s disease, and leishmaniasis, which can cause ear infections.

Recognizing Outer Ear Inflammation (Otitis Externa): Signs and Symptoms

Persistent head shaking or scratching
Ear discharge
Unpleasant odor from the ear
Redness and swelling around the auricle and canal opening
Pain indications like crying, yelping, and an aggressive response to touch
Hearing loss
Aural hematoma, blood-filled swelling often caused by trauma

Outer Ear Inflammation (Otitis Externa) Diagnosis: How it's Identified

Observation, otoscope examination, and a swab sample usually enable vets to characterize the inflammation and determine whether it impacts only the outer ear or involves the middle ear, which infection accompanies it (bacteria or yeast), and what characterizes it (acute/chronic features of structural changes to the canal). Severe cases may also involve sending a swab to the lab for tailored treatment recommendations.

Examining the ear canal while the dog is awake can be challenging due to stress or pain, which may place the dog and veterinarian at risk. An examination under sedation or anesthesia may be necessary. More complex cases may require a special probe to examine the end of the ear canal under anesthesia (videoscopy) or CT to view the entire ear canal.

Diagnosing the cause of the inflammation is more complicated but just as crucial. While finding parasites or foreign bodies makes it clear, some cases may require additional tests to determine the primary cause.

Treating Outer Ear Inflammation (Otitis Externa): Options and Approaches

First, we must match the form of treatment with the specific inflammation and infection. Topical treatment includes irrigation, drops, and/or gel. Treatment may take five days to a month, depending on the severity of the inflammation and infection.
Severe or recurrent cases often require more in-depth cleaning under anesthesia by a veterinarian.
Oral steroids are administered in severe cases of thickening of the ear canal skin lining, which makes it challenging to apply topical treatment. The goal is to significantly reduce the swelling, which may be necessary for several days. This treatment is also relevant when a skin allergy is present.
Oral antibiotic administration isn’t very effective, but it may be relevant when middle ear inflammation is involved or when severe infections prevent effective topical treatment.
Anti-parasite treatment, administered as tablets or ampoules, is highly effective in preventing mites, ticks, parasites, and Demodex. Thus, it is an essential factor in the overall treatment protocol.
Treatment addressing the primary cause of inflammation, such as atopic allergy treatment, hypoallergenic diets for food allergy, skin condition treatment, and more.
Surgery may be necessary in severe, recurrent cases with non-functional ear canals. The outer canal is removed via a process known as TECA, leaving the auricle intact. While this is a relatively extreme solution, it can significantly improve the dog’s well-being. Surprisingly, such procedures actually improve the dog’s hearing. Despite removing the ear canal, the skull bone can also conduct sound, and this option is better than chronic inflammation that blocks the ear canal entirely. Some surgical treatments remove ear tumors and drain hematomas (aural hematoma) caused by constant ear shaking.

Outer Ear Inflammation (Otitis Externa): Surprising Facts

Around 20%-30% of allergic reactions to food only include ear inflammation and excessive licking of the rectal area. This common scenario is known as “ear and rear”.

Studies found that ear infections are among the top three reasons for dog visits to veterinary clinics.

Water sports and bathing can predispose dogs to recurrent ear infections due to moisture build-up. To keep ear infections at bay, always make sure to dry the ears thoroughly with a towel or drying solution.

Vet's Tip: Dealing with Outer Ear Inflammation (Otitis Externa)

A common challenge in effective ear inflammation treatment is owners using the wrong technique. Pay attention to irrigation and drop administration to ensure effectiveness, and consult the medical staff at the clinic if you need clarification.

Price Tag

Examination by a veterinarian

$150

Diagnostic testing

$30-$150

Medications

$50-$100

$2,500-$3,500

TECA surgery

$5,000-$7,000

Latest in Research and Treatments

Typically, irrigation or ear drop treatments are administered once or twice a day for one to two weeks. This form of treatment has many advantages, mainly due to epithelial cell movement and ear canal skin renewal. Still, this approach is irrelevant in many cases, especially if the patient is a dog hesitant to cooperate or in a lot of pain. They might become aggressive, making the treatment difficult to perform and even harming the relationship with their owners. In recent years, different medications have been developed that require less frequent treatment, with one or two clinic visits and further treatment at home. It’s essential to match the treatment with the specific case, but this is positive progress in the field.