Ear problems unresolved by exam!

[FaeMomma]

Taysien is a shelter dog he stayed with another family and the dog that they owned had an ear issue they said was a yeast infection of the ear? Their vet gave them pills for the dog to take an it cleared up. Our dog got this ear issue while there and we went to our vet and told them what had happened to their dog. They told us that it required steroids and put him on them this made him aggressive. We were told to discontinue the steroids. While he was on the steroids we did not see improvement in his ears. We went to another vet they told us to try changing his food and had us put him on a rice and lamb diet (expensive), they had us clean his ears with nystatin(sp?) ointment. This did not resolve the problem, only treated it, once the ears were clean if we stopped the nystatin it would come back as bad as before. Then that we should use a little bit of olive oil and clean his ears with that. This did not work either. We moved and are with another vet and they have no idea what to tell us. So I thought since we live in a small state I should ask on here to see if you guys have any suggestions I can mention to our vet for her to check. The ears have what looks like a brown substance all over the insides of his ears. His ears are very painful but also itchy. I am trying to just keep them clean but I'm concerned if this is not resolved it will permanently hurt him. If it hasn't already.

A few more things. He has floppy ears. He is brindle with a black saddle on him and a white 7 on his chest and about 40lbs from looking at pictures of dogs I would guess he could be a blue heeler mix, a pittbull or boxer mix, or even some sort of shiba inu mix. We were told by the shelter his father was an Akita but our dog is only 35-40lbs at the most and that is usually during winter! He is about 2 and a half feet long and about a foot and a half tall. He has a corkscrew tail! Hope this is enough information!

[Kimberly Coyner, D.V.M., DACVD]

I agree with Dr. Hurley, your dog likely has an ear infection (bacterial or yeast or both) which is secondary to an underlying primary disease, most commonly food allergy or pollen/dust allergies in a young otherwise healthy dog. Once an ear infection goes on for over 6-8 weeks, it descends into the middle ear, and infection will recur no matter what topical products are used. If active  infection is present, a hypoallergenic diet will not help, even if food allergy is the underlying cause (the hypoallergenic food won't kill the infection, just prevent it from recurring). I recommend:
1. Cytology (microscopic anaylsis of the ear discharge) to find out if the infection is bacterial or yeast, and if bacteria are found, an ear culture to find out what antibiotics to use.
2. Oral and topical antibiotics and/or antiyeast medications for 6 weeks minimum.
3. An deep ear exam/flush under sedation to remove all the accumulated exudate that is going to act as a nidus for infection, and make sure there are no foreign objects like grass seeds deep in the canal. After deep ear flaush, continue ear cleaning at home twice a week with a good prescription ear cleaner.
4. During the antibiotics, repeat a different hypoallergenic diet that is not lamb/rice based. My favorite is a prescription food with rabbit/potato, there are a couple of OTC diets made by Natural Balance and Solid Gold that have fish or duck/potato which may work also. The key is to feed only the hypoallergenic diet for 8 weeks, with no other treats, table scraps, rawhides, milkbones, flavored supplements etc. Give pills in the canned hypoallergenic food, no bread or pill pockets.
5. If ear infection resolved then recurs despite the strict hypoallergenic diet, then the reason/diagnosis would be pollen/dust allergies, and I would recommend allergy skin testing/desensitization injections for allergies, just like in kids. Your veterinarian can refer you to a veterinary dermatologist (www.acvd.org).
Good luck,
Kimberly Coyner, DVM
Diplomate American College of Veterinary Dermatology

[Brian C Hurley, D.V.M.]

Otitis Externa (Outer Ear Infection)

Good morning.  Sorry to hear your pet is having a chronic issue with the ears.  Ear problems can be very difficult to treat and requires persistence.  Unfortunately, while I understand what has been done, based on the information provided, there is an important test missing.  An ear cytology is important with any ear infection to help the veterinarian determine the cause of the problem.  If a bacterial component is found, we recommend doing a culture and sensitivity is difficult ear infections to identify what medications may help.  

The three most common organisms we see in the ear are as follows:  

1. Staphylococcus spp. (cocci)
2. Pseudomonas spp. (rods)
3. Malassezia pachydermatis (yeast)

These three organisms may occur as a single entity or in combination with each other.

Ear infections, or otitis, can result from the following:

1. Parasites such as Otodetes cynotis (common in the cat), Demodex spp., Sarcoptes and Notoedres.
2. Foreign bodies
3. Atopy (allergies)
4. Hypothyroidism
5. Food allergies
6. Local drug reactions
7. Neoplasia or polyps
8. Autoimmune diseases

A final thought would be to have your pet’s ear flushed to fully examine the canal and ear drum.  Middle (Otitis Media) and Inner (Otitis interna) ear infections often require aggressive treatment.  Routine blood work and a thyroid screen would be recommended as well.
I hope this helps.

[FaeMomma]

Thank you both so much! I'm going to run to my vet with this information! I really hope together we can work to getting my boy healthy!