Think Your Dog Has an Ear Infection? Here Are the Signs and How Vets Treat It

There are three types of ear infections, says Dr. Nicole Savageau, VMD, a veterinarian with the national, mobile, pet care service The Vets in Austin, Texas:

• Otitis externa (outer ear infection): Inflammation of the external ear canal, which extends from the pinna (the ear flap) to the eardrum. This is the most common type.
• Otitis media (middle ear infection): Inflammation of the middle ear. This includes the structures between the eardrum and the inner ear.
• Otitis interna (inner ear infection): Inflammation of the inner ear, including the structures responsible for hearing and balance.

“Most ear infections are otitis externa … the outer portion of the ear canal,” says Dr. Amy Attas, VMD, award-winning veterinarian, founder of City Pets Vets in New York City. Infections of the outer ear often cause infections of the middle and inner ears, she adds.

When it comes to dog ear infection symptoms, there are a few things to watch for, Dr. Attas says.

“Ear infections make dogs uncomfortable,” she says. The following behaviors could be a sign of an ear infection, particularly middle- and outer-ear infections:

• Scratching at ears with paws
• Rubbing ears on furniture or carpeting
• Wincing when their ear is touched
• Head shaking
• Head tilting
• Not eating normally (Some dogs stop eating due to pain, says Dr. Attas.)

Additionally, the following abnormalities can be telltale dog ear infection symptoms:

• Dark brown or yellow discharge coming from the ear
• Foul odor inside the ear
• Abnormal skin, such as scabs, crusts or redness, inside the ear flap or around the ear canal entrance

Your dog could show more symptoms if they have a middle ear infection. Dr. Attas says that’s because the middle ear contains several facial nerves. When those nerves are inflamed, dogs can develop deficits, including:

• Facial nerve paralysis
• Unequal pupil size
• A drooping eyelid
• Protrusion of the third eyelid

Finally, “Inflammation of the middle ear may progress to inflammation of the inner ear,” Dr. Attas says. The following can occur with an inner ear infection:

• Loss of balance
• Deafness

“Dog ears become infected when bacteria or yeast within the ear canal are

able to multiply uncontrollably,” Dr. Savageau says. There’s usually an underlying cause for an infection, such as:

• Allergies
• Ear mites
• Foreign bodies in the ear canal
• Underactive thyroid
• Tumors or polyps in the ear

Additionally, certain characteristics or activities make some dogs more prone to ear infections, including:

• Long, floppy pinnae (commonly known as floppy ears)
• Narrow or hairy ear canals
• Frequent swimming

Finally, a dog’s breed can play a role in their susceptibility to ear infections due to their anatomy. These dog breeds are especially prone to ear infections:

• Basset Hounds
• Cocker Spaniels
• Poodles

Ear infections can cause a lot of pain—and when left untreated, they can lead to more serious medical problems, like hearing loss.

For these reasons, Dr. Attas recommends making an appointment with your vet right away if you notice symptoms of ear infections.

“Ear infection is a generic term,” says Dr. Attas, meaning there are different sources of infection:

• Bacteria
• Fungus/yeast
• Parasite
• Underlying medical condition, such as an allergy

To determine the source of your dog’s ear infection, your vet will do a physical examination and will likely take a sample of the ear discharge.

Physical Exam

Using an otoscope to view the inside of your dog’s ear, your vet will inspect the eardrum. If the membrane is damaged, Dr. Attas says your dog will need oral antibiotics and your vet won’t use certain medications.

Additionally, the vet will inspect other areas of your dog’s body—like their toes and skin—for clinical signs of infection, as they’re often an indication that allergies may be causing the ear infection, says Dr. Attas. If that’s the case, more comprehensive treatment is needed, she says.

Cytology

Cytology involves using a long cotton applicator to swab your dog’s ear for a sample and viewing it under a microscope. Your vet may even be able to look at the sample during the appointment.

A cytology sample can determine if the infection is being caused by bacteria, yeast or a parasite such as ear mites, Dr. Attas says.

Culture

“A culture will determine which bacteria are present and which antibiotic will be most effective,” Dr. Attas says. A culture usually takes longer, but it’s a valuable diagnostic tool when needed.

A vet will usually take the following steps to treat a dog’s ear infection:

1. Clean the dog’s ears

Ear cleaning is the first step, says Dr. Savageau, because “cleaning is essential for the treatment to work.”

In mild to moderate cases, your vet may clean your dog’s ears with a cleaning solution in the exam room. “In more severe cases, your dog may need to have their ears flushed under a general anesthetic,” Dr. Savageau says.

The vet will also show you how to clean your dog’s ears at home, and they may recommend a specific cleanser, like Virbac ear cleaner.

2. Address the infection

Next, your vet will address the infection. They may prescribe antibiotics or antifungals, says Dr. Savageau, which may be in the form of oral pills or topical medications (like ear drops) that you’ll place in the ears. “Sometimes a combination is needed,” says Dr. Savageau.

3. Prescribe an anti-inflammatory medication

Finally, an anti-inflammatory medication–either in the form of ear drops or oral medication—is usually necessary for both pain relief and to reduce swelling, which opens the ear canal. “This allows any topical treatment to penetrate better,” says Dr. Savageau.

Other considerations

Occasionally, Dr. Savageau says, a dog may need surgery for chronic ear infections when the dog’s ear infection medication isn’t working.

She also notes that it’s important to address the underlying cause of ear infections to prevent them from recurring. For example, if your dog has an ear infection because they got water in their ears after a dip in the pool, dry their ears thoroughly after every swim.

Can you treat a dog’s ear infection at home without a vet?

Resist the urge to try home remedies for dog ear infections. Dogs with ear infections should visit a vet.

“Ear infections are painful—and the longer they go on, the harder they are to treat,” says Dr. Savageau. “If left untreated, ear infections can spread deeper in the ear canal and permanently damage your dog’s hearing.”

Plus, many dog ear infection treatments require prescription medication. Even if you can use an OTC dog ear infection medication, your vet needs to determine what’s causing the infection—for example, is it bacteria, fungus or ear mites?—because the treatment depends on the cause.

The best way to deal with dog ear infections is to not deal with them at all; prevention is the best medicine. Dr. Attas provides the following advice:

• Begin inspecting and touching the insides of your dog’s ears when they’re still young. They’ll get used to it, and you’ll know when something is amiss.
• Continue this habit throughout their life. If you see any discharge, wipe it away and check again later to ensure there isn’t more.
• If your dog swims, prevent moisture buildup by drying their ears after they get out of the water. “Many infections can be prevented if a dog’s inner and outer ear is clean and dry,” says Dr. Attas.