Chronic Recurring Ear Infections

Liz writes:

We have a 100 pound American bull Dog. He has had a constant yeast infection in his ears for over one year. He flaps his ears so hard that the top of his head is bleeding from flopping his ears.He has been on Ciprofloxacin 500 MGM twice a day and this is not helping.To clean his ears out he has to be put to sleep but that does not last long then back to flapping his ears again. I am at wits end and our vet has not offered any other alterative. Can you advise me?

Hello, Liz,

Since I have not seen your dog, I really cannot give you specific advice.  However, I can give you some general information.

Many dogs with this type of chronic ear infection have some type of allergy as the underlying cause.   This can be an environmental allergen like pollen or house dust. It is possible for an allergic dog to break out nowhere else but inside its ears (which is certainly counter-intuitive).  It can also be a food allergy.  I have had the dermatologists tell me that I should do a dietary elimination trial in these patients, as food allergy is more common than we would like to think.

Food allergy cannot be diagnosed with blood tests or skin tests. It requires a dietary elimination trial.

Dietary elimination trials require feeding an entirely different food source, something the dog has not previously been exposed to.  This means that you can't just switch brands of dog food. You have to use a food with a different protein source (like duck and potato, venison and green pea, kangaroo and oats), or a hydrolyzed protein (Hill's Z/D or Purina HA) where the protein is broken down into short fragments of amino acids.

The dog cannot eat anything besides the new diet, no treats, no cat food, no table scraps, not even flavored heartworm preventive tablets.   This is continued for 10 to 12 weeks to allow every residue of the previous diet to be eliminated from the dog's digestive tract.  Some dogs will respond more quickly, but some will take as long as 16 weeks.

In patients with severe ear infections, even without allergies, a short course of some type of systemic corticosteroid often gives the dog a lot of relief, making cleansing and topical treatment much more tolerable.

Sometimes we use systemic (oral) anti-fungals with yeast ear infections (in addition to topicals).  Topical treatment is usually necessary, and you do need to deal with the underlying cause.  Finding it can certainly be the hard part.

Please talk with your veterinarian about your concerns.  If he/she is uncertain as to how to proceed, then ask for a referral to a specialist with whom they have a good relationship.

15 thoughts on “Chronic Recurring Ear Infections

  1. Sheila says:

    We have had a couple of dogs over the years with recurring ear or skin infections (especially yeast) that responded to the special allergy elimination diet food. They stayed on the allergy diet and did well the rest of their lives. I also have had 2 dogs with recurring ear infections that tested low in thyroid function, and the ears improved dramatically with thyroid supplementation. Might be worth testng the dog’s thyroid?

  2. Doc says:

    Absolutely true. I should have mentioned that. Any patient who gets recurring infections can certainly have an immune system that is below par, and low thyroid sure does that.

  3. Heather says:

    I had a Boston Terrier puppy (now an adult) who has Irritable Bowel Disease. He also had chronic ear infections and every antibiotic the vet gave us simply did not work. Finally, at the suggestion of a friend I tried Zymox Otic (with Hydrocortisone), available over the counter, online. We used it as directed, got him off all his other ear medications, and we treat him once a month with it and we have not had a problem since. He is on a limited ingredient diet due to his IBD, but the Zymox Otic really worked.

  4. Doc says:

    Hello, Heather,
    I have seen some really good success stories with this product. I personally have not had much luck with it. I’m glad you are having good results.
    Thanks for reading and writing.

  5. elizabeth says:

    I have been searching the internet for help for a while, and cant find any information on what I see in my 1 yr old white boxer. I noticed a black cut on edge of his ear that was sensitive to touch about a week or two ago, I cleaned it really good with peroxide. It doesn’t seem to bother him anymore, but I do notice him shaking his head and flapping his ears a lot. Last night I noticed it is no longer a small cut it has grown and looks like a chunk missing out I’d the tip of his ear, almost like something took a big bite out of it. His other ear is forming one too. Do you have any idea of what this can be or what I can do to help him before bringing him to the vet? I do not have the money to bring him at the time, possibly not for about two weeks . I can send a picture if needed.

  6. Doc says:

    Hello, Elizabeth,

    I don’t think that I can help you long-distance. This almost sounds like some sort of auto-immune problem, where the body’s defenses are haywire, and are damaging the circulation to those ear tips.

    I wish that I had some good advice for you, but this may even require a biopsy.

    I hope that you can get to your veterinarian a little sooner.

    Good luck.

  7. Doc says:

    Hello, Craig,

    I asked the clinical pharmacology experts at Veterinary Information Network for more info on this product.

    The ingredients are: IPA Alcohol, Acetic acid, Hydrogen Peroxide, Tea Tree Oil, Mullein Extract, Brilliant Green, Sodium Acetate.

    “…it may have merit
    in mild bacterial otitis and it appears to be a good ear cleaner. ”

    The toxicology consultant is interested in the concentration of the ingredients, especially the tea tree oil. It has a real potential for toxicity, as well as topical irritation.

    So, don’t drink it.

  8. D says:

    I’m using Eco Ears for my dog to prevent infections and clean his ears. He’s a golden retreiver and seems to product a lot more wax than my previous dog (a weimar). The ingredients seem to have been changed since the previous post. The website says it has these ingredients…Nothing I’d want to drink either! but it’s working for me and my dog… Denatured Grain Alcohol, Rosemary Extract, Natural Witch Hazel Extract (made from non-petroleum alcohol), Organic Mullein Extract, Vegetable Glycerine, Tea Tree Oil, Polysorbate 20 (food grade), Ionic Silver Solution, Boric Acid.

  9. Doc says:

    Hello, D,

    I’ve never used the stuff. If the ear is healthy except for excess wax production, then I think it should be okay.

    I would be hesitant to use it if there were an infection. Usually the ear is a little raw in that case, and alcohol will not only be painful, but retard the healing. When something hurts, it is damaging the tissue that needs to heal. It may be killing germs, but it is killing tissue as well.

  10. Doc says:

    Hello, Guy,
    I don’t have any recipes for you. Many commercial ear washes contain a small amount of acetic acid (the acid in vinegar). This does inhibit the growth of yeast. However, if the ear is sore, you will find that the acidity causes the dog significant pain. They work better as preventives. If the dog reacts as though in pain, the ear needs attention from your veterinarian.

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