Current Feature: Otitis externa, a.k.a. inflammation of the soft tissue of the outer ear, a.k.a. "Stinky Ears"

It's inevitable. If you own a dog, no matter what breed, sooner or later he is going to have a "bad ear". With luck it may happen once or twice in your pet's lifetime and may not inconvenience either of you too much. But, if otitis is in your pet's future, be prepared for one of the most common and frustrating problems encountered in small animal medicine.

The causes of otitis externa are so varied and complex that a definitive diagnosis and treatment may not always be possible. In many cases, those infected, red and smelly ears are just one of the signs of a more generalized skin condition. Some of the more prevalent primary causes include (i) parasites e.g. ear mites (ii) foreign bodies e.g. grass seeds and (iii) direct trauma to the ear.

There are also certain factors that predispose the ear to inflammation and infection. Some examples include the conformation of the ear canal. Breeds such as the terriers and poodles often have long deep canals with heavy growth of hair in the canal itself. This can lead to an increase in moisture and poor drainage. Another breed with frequent ear problems is the Shar Pei. Here the canals are usually narrow and twisty which results in excessive wax accumulation, irritation and eventually infection. Another unfortunate, but common predisposing factor is the over zealous pet owner. These well-intentioned individuals clean and pluck their dog's ears every few days, regardless of whether they need attention or not. The result is usually a painfully inflamed and infected ear, which requires prompt veterinary attention.

A final group of factors involved in this condition are the microbial organisms. Various bacteria and yeasts are commonly cultured from the ear canal and will certainly aggravate the inflammatory process.

Typically, clinical signs of otitis related directly to the ear include head shaking, rubbing and scratching the ears, as well as pain and a bad smell emanating from the ear canal. Sometimes loss of hearing and even behavioral changes may be noted.

To assist your veterinarian in making an accurate diagnosis, try to provide an accurate history, which may include such things as exposure to parasites or allergies. Mention any medications you have used including ear cleaning agents. A thorough exam should be performed including the use of an otoscope to get a close view of the ear canals. Your veterinarian may find it necessary to culture a badly infected ear so as to determine which antibiotic would be most effective. In certain cases where a growth is detected in the canal, a biopsy and possibly an x-ray may be indicated.

The initial aim of treatment for otitis externa is to reduce the inflammation, since this is the primary cause of discomfort and pain. Once this is controlled, every effort should be made to identify and eliminate the underlying cause of the problem. While there are many aspects involved with treatment some of the following may be required:

a) The use of an external ear canal cleanser. This makes the environment less favorable for bacteria and yeasts to grow and often reduces inflammation.
b) A drying agent to reduce the amount of moisture in the canal.
c) Topical anti-inflammatory and anti bacterial treatment. This might be in the form of a liquid or ointment that is placed directly into the ear canal and gently massaged so as to ensure that the deeper areas are adequately medicated.
d) Topical antiparasitic or antifungal medications. May be used in cases of ear mite infestation or ringworm infection (fungus).
e) Systemic treatment. This includes the use of injectable or oral medications e.g. cortisone and antibiotics. These drugs often help to reduce the pain and inflammation rapidly, thereby improving the comfort of the pet and allowing the owner to properly apply the topical medications.
f) Surgery. In advanced severe cases of otitis externa, surgery may be required to correct defects in conformation of the ear canal and also to improve drainage and ventilation.

As with all medical problems, prevention is better than cure. Take the opportunity during your pet's next physical examination to discuss with your veterinarian how and when to clean your dogs ears. If you notice an inflamed ear or a bad odor, a visit to your veterinarian may save you and your pet a lot of aggravation and discomfort. Don't allow "stinky ear syndrome" to become a permanent part of your dogs life!