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Q: Golden Retreiver chronic ear infection ( Answered 4 out of 5 stars,   0 Comments )
Question  
Subject: Golden Retreiver chronic ear infection
Category: Family and Home > Pets
Asked by: whk-ga
List Price: $25.00
Posted: 26 Aug 2005 08:41 PDT
Expires: 25 Sep 2005 08:41 PDT
Question ID: 560807
Golden Retreiver chronic ear infection.
We have a 3 yr old female Golden retreiver.  She is healthy except for
a chronic ear infection that smells like a dirty sock.  Of course she
loves to play in sprinklers and be wet.  We have taken her to the vet
at a cost of about $400.00 every 2 months.  The treatments include
antiobotic tablets, antiyeast tablets (ketoconazole).  Ear cleaning
every other day with ADL Ear Cleanser, ADL Ear Flushing Drying Lotion,
and Otomax. These products slow things down but don't even come close
to a cure.  I believe we are missing something.  Could she have a
fungus infection?  If constant meds are needed, how can we purchase
them more affordably?  We love our dog but $150 to $350 per month for
the vet is really starting to pinch our children's college fund. 
Thanks.
Answer  
Subject: Re: Golden Retreiver chronic ear infection
Answered By: crabcakes-ga on 26 Aug 2005 13:44 PDT
Rated:4 out of 5 stars
 
Hi Whk,

  I?m sorry to hear about your pooch?s ear problems, not to mention
the cost to you! I?m sure you?re aware that your poor dog?s ear
infection cannot be diagnosed online. However, I have listed a broad
list of possible causes. One of the sites I found, written by a vet,
suggests finding a new vet if your current vet is unwilling to
investigate the cause of infection enough to cure it!



What causes ear infections? 
===========================
?Dogs and cats have an incredible sense of hearing. To protect their
hearing and prevent damage to the ear drum, their ear canals are
L-shaped. The problem with this design is that it allows the ears to
trap parasites, moisture, debris and ear wax. Any of these can lead to
ear infections. Up to 80 percent of ear problems in dogs are linked to
allergies, and ear mites are often the cause of infection in cats.

The traditional treatment for ear infections is to give antibiotics,
antifungal medications or other drugs. The problem with this approach
is that drugs upset the normal chemistry inside the ear and can
possibly turn a simple infection into a long-term problem.? Please
check with your vet before trying the herb pau d'arco, or any
alternative remedy,as recommended on this site. You?ll want to be sure
they are not contraindicated with other treatment your dog may be
receiving.
http://www.naturalfamilyonline.com/1-np/49-pet-ear-infections.htm


Bacterial Infections
=====================

?Q: Dear Mr. Mike: My Golden Retriever occasionally gets ear
infections. I noticed this weekend that his ear was dirty and swollen.
I periodically use EPI-OTIC in his ears to keep them clean. I have run
out, so is there a home remedy I can use to clean his ears until I can
get to the vet? Thanks.
A: Two solutions for cleaning ears that I think are helpful are: 
Mix white vinegar with water in a 1:1 ration (half water, half white
vinegar) The acidity makes it hard for some bacteria to grow and this
has an astringent effect. It stings if there is any ulceration of the
ear canal, though.

OR 

Mix 3% hydrogen peroxide 1:1 with warm water. This is less
antibacterial but is a little better at aiding in the removal of
cerumen from the ears. It is not as likely to cause discomfort if the
ear is inflamed.
There are advantages to the commercial ear washes and they are
probably worthwhile to stick with if helpful. But these solutions are
OK in a pinch.?
Mike Richards, DVM 
http://www.vetinfo4dogs.com/dogear.html#Ear%20infections%20-%20safe%20at%20home%20cleansers

?Some dogs have chronic ear problems (the infection is not controlled
by general medication or returns when general medication is
discontinued).  In these cases, the ear discharge should be cultured
so that the precise organism can be pinpointed and treated
specifically.  Regular treatment at home with disinfecting ear washes
should become part of the pet's grooming routine.
Further testing may be in order to determine why the infection
continues to recur. Allergy is the most common reason for recurrent
ear problems.?
Ask your vet if s/he thinks skipping an ear washing and ear drops the
day of culturing, to allow a greater chance of collecting organisms,
is a good idea.
http://www.marvistavet.com/html/body_ear_infections.html

?Pseudomonas aeruginosa is a very special species of bacteria; it is
resistant to almost every possible antibiotic. It is common for ear
infections to be recurrent and in time, many antibiotics have been
used. The unfortunate tendency is for most bacteria to be killed off,
leaving infection with the very resistant and practically immortal
(not to mention especially smelly) Pseudomonas.
If one if lucky, a culture of the ear discharge will reveal that the
Pseudomonas is still sensitive to oral quinolone antibiotics such as
enrofloxacin or orbifloxacin. It should be noted that especially high
doses of this type of antibiotic are needed to treat Pseudomonas in
the ear and that inadequate dosing will just make Pseudomonas even
more resistant. In other words, Pseudomonas must be treated
definitively from the moment it is diagnosed; once it becomes
resistant to oral therapy, treatment becomes vastly more difficult.
Oral therapy is generally combined with some kind of topical treatment
of the ear. Fortunately there are several concoctions that should be
useful though some your vet must mix him/herself.?
http://www.marvistavet.com/html/body_ear_infections.html

?Chronic ear infections, as mentioned, typically have an underlying
cause (usually allergy). It is important to address this problem in
addition to the infection itself so as to minimize on-going ear
inflammation.?
http://www.marvistavet.com/html/body_ear_infections.html

?Fourth, chronic ear problems should be cultured. You need to know
what, exactly, is growing in there. And you need to follow the culture
with ear swabs to be looked at under the microscope, usually at each
recheck. The bacteria in the ear change with medication, and you need
to try to stay only one step behind, not miles behind. That is, you
need to treat what bacteria is running rampant now, not what the
problem was last month.?
http://www.sonic.net/~cdlcruz/GPCC/library/earclean.htm


Allergies
=========

?Usually, ear inflammation and ear infection that is chronic or seasonal has 
an underlying cause. Since this problem is seasonal, allergies are a very 
likely underlying cause?

Antihistamines can be used to treat allergies in dogs. According to
this web site?s vet,
Tavist (Clemastine) is the most efficient drug for dog allergies.

Dr. Richards says ?I personally like Tavist-D (tm), which also
contains a decongestant, since I think some dogs are bothered by an
inability to equalize the pressure in their ears when they have
blocked eustachian tubes from allergies. Clemastine is beneficial for
about 25% of our patients with ear inflammation. Often, we combine
this therapy with
Synotic (Rx), a cortisone and DMSO ear drop that is pretty potent for
controlling inflammation. Since you don't see signs of infection (the
ear is inflamed but dry -- not inflamed with exudate which usually
indicates infection as well as inflammation).  This combination works
better than either medication alone.?

Dr. Richards goes on to say ?Vinegar mixed 1:1 with water is a good
general ear rinse, as the acidity keeps bacterial infections and yeast
infections suppressed. Once an infection is present, it is often
necessary to use an antibiotic/antifungal/anti-inflammatory medication
(components depend on what exactly is present?although there are a
couple of medications, such as Otomax (Rx) that contain all three.  In
many cases it is necessary to use an oral antibiotic, as well.  Ear
infections can be very frustrating but using the vinegar/water mix on
a regular basis (once a week) helps suppress them and treating
infections that occur right away can help keep them from becoming
serious.?
http://www.vetinfo4dogs.com/dogear.html#Chronic%20ear%20problem%20in%20Lab

?First, chronic ear problems are often linked to allergies. Now,
allergies are life long and incurable, but that doesn't mean they
can't be controlled. If the dog is allergic, then I'd strongly
recommend a vigorous allergy hunt with a board certified dermatologist
-- do the skin testing, etc. This is a YOUNG dog, and ASD's live a
long time, so spending enough money now to get a clear diagnosis, and
enough time to get a real good handle on the allergies will be worth
it over the next 12 years. You'll save a ton of time and money in the
long run by not having to use so much ear goo and see the vet as
often, or on surgery. Treating the allergy as well as the ears is
essential. Both will get better as you treat and understand the
allergy.?
http://www.sonic.net/~cdlcruz/GPCC/library/earclean.htm



Demodex (Mites)
===============

?It is possible that the ear infections could be a symptom of the
demodecosis. Demodex will sometimes cause otitis. Overall, the chances
of clearing up generalized demodecosis with persistent treatment is
probably between 50 and 80% somewhere. It can be difficult to do and
it is relatively expensive but the odds are good enough that I feel
comfortable advising most clients to try for a cure.?
http://www.vetinfo4dogs.com/dogear.html#Chronic%20otitis%20and%20Demodex

?Recurrent ear infections that involve both ears almost always have an
underlying cause that needs to be treated. In my practice area this is
usually allergies but it can be hypothyroidism, immune mediated skin
disease or parasites (Demodex or ear mites. Once in a while a
bacterial or yeast infection does occur as the primary problem but
this is not usually the case.
I do not know how frequently dogs have problems due to the presence of
hair in the ear canals but this might cause problems in some dogs.
Once ear infections are well established it generally takes a two
pronged approach to treatment. The ear must be treated and the
underlying cause identified and controlled if at all possible.?

Your vet can take a sample of any drainage or exudates with a swab,
for a culture and sensitivity, as well as a smear.

?When a pathogenic bacteria is identified, sensitivity testing allows
the veterinarian to choose the proper antibiotic with more certainty.
The ear canal should be cleaned thoroughly. In some instances this
will require anesthesia since the ears are often very sensitive when
infected. Medications appropriate for the infectious organisms found
should be used long enough to eliminate the problem. It often takes
treatment of the ear topically and systemic treatment using oral
antibiotics to eliminate a stubborn infection. It is sometimes
necessary to clean the ear two or three times during the course of
treatment. It may take several months of treatment to control an
infection that has been present for some time.?
?Sometimes you just have to tell your vet that you expect better
treatment for your pet. As long as you are willing to pay for it, he
or she should provide it or refer you to someone who will. It would be
worth a trip to see a veterinary dermatologist, probably.?
http://www.vetinfo4dogs.com/dogear.html#Recurrent%20ear%20infections

?What are the symptoms of an ear infection?
A dog with an ear infection is uncomfortable; its ear canals are
sensitive.  It shakes its head trying to get the debris and fluid out,
and it scratches its ears.  The ears often become red and inflamed and
develop an offensive odor.  A black or yellowish discharge commonly
occurs.

Don't these symptoms usually suggest ear mites?

Ear mites can cause several of these symptoms, including a black
discharge, scratching, and head shaking.  However, ear mite infections
generally occur most commonly in puppies.  Ear mites in adult dogs
occur most frequently after a puppy carrying mites is introduced into
the household.  Sometimes, ear mites will create an environment within
the ear canal which leads to a secondary infection with bacteria and
yeast (fungus).  By the time the dog is presented to the veterinarian,
the mites may be gone, but a significant ear infection remains.  ?
http://www.pethealthcare.net/html/body_canine_ear_infections.html



Fungus
=======

Ringworm:
?Hair loss and scabbing on the outside of the ear can be seen with a
number of different disorders, including allergies, scabies, and
ringworm. Ringworm is a fungal infection of the skin that can be
contagious to other animals and to people. It may occur on various
parts of the body, including the ears. Scabies or sarcoptic mange, is
a mite infestation that can also be spread to people or other animals.
It is diagnosed by a skin scraping and can be treated using a
parasiticide which was discussed in a previous article, ivermectin.?
http://www.espomagazine.com/vet/apr97.htm


Systemic Disorders
==================

?An important part of the evaluation of the patient is the
identification of underlying disease.  Many dogs with chronic or
recurrent ear infections have allergy problems or low thyroid function
(hypothyroidism).  If underlying disease is found, it must be
diagnosed and treated, if at all possible.  If this cannot be done,
the dog is less likely to have a favorable response to treatment. 
Also, the dog might respond temporarily, but the infection will
relapse at a later time (usually when ear medication is
discontinued).?
http://www.pethealthcare.net/html/body_canine_ear_infections.html

Apparently Golden retrievers are more susceptible to thyroid disorders
than most other breeds. The vet can draw blood to test for such
disorders.
?Thyroid hormone regulates metabolism, and therefore, affects almost
every system in the body. Hypothyroidism is a very common endocrine
disorder that affects middle-aged dogs. Genetics can play a role in
the development of hypothyroidism and certain breeds such as Golden
Retrievers, Doberman Pinschers, Irish Setters, Cocker Spaniels,
Boxers, Miniature Schnauzers, Dachshunds and Poodles are more
predisposed to the condition.?
http://vetmedicine.about.com/library/viewers/uchypothy.htm

?Second, hypothyroidism can cause increased problems with allergies
and also can make ear problems extra difficult. Any chronic ear
infection warrants a full thyroid panel.... T4, T3, FT4, FT3, TSH and
auto antibodies to T4 and T3. If your vet won't do a whole screen
(Michigan State University), then GO TO A VET WHO WILL!! A lot of vets
still diagnose just on a T4 or a T3/T4. This is useless, or worse,
misleading.?
http://www.sonic.net/~cdlcruz/GPCC/library/earclean.htm

Hematoma
=========

?If the ear flap itself is swollen and turgid, it is likely that he
has something called an aural hematoma. 'Aural' refers to ear, and
'hematoma' is a blood-filled space. This happens when small blood
vessels in the ear flap rupture and blood fills the area between the
skin and ear cartilage. Click here to see a photo of an aural
hematoma. If the ear/face is diffusely swollen, your dog may have
experienced an insect bite or sting. Either way, a trip to the vet is
in order!
Aural hematomas frequently occur in conjunction with an ear infection
of some sort (fungal, bacterial, mites, etc.) and results from the
trauma of continually shaking the head and scratching. Some pets may
actually hit the ear flap on a table or surrounding object, but most
often, it is the continued shaking/scratching of the ears to cause the
blood vessels in the ear to rupture. Aural hematomas happen in both
cats and dogs, but more commonly in dogs with floppy ears.

Hematomas are uncomfortable, and the extra weight may cause the pet to
shake the head even more. Left untreated, the hematoma will resolve in
a few weeks time, usually resulting in a permanently wrinkled
"cauliflower" ear. Treatment options include: 1) aspirate (using a
needle), 2) surgically open up the ear flap, drain the space and
remove clots, then tack the ear down, or 3) place an indwelling
cannula in the ear to drain away fluid as the ear heals. Aspiration
has risks -- the possibility of introducing infection, and the
possibility of reoccurring. Surgery is the quickest way to resolve the
hematoma, and will hopefully reduce the wrinkling, but once an ear has
had a hematoma, there is often some wrinkled scar tissue present. Not
many dogs tolerate the cannula option, so this is not as common of a
treatment. The severity of post-hematoma wrinkling of the ear depends
on how large the hematoma originally was.?
http://vetmedicine.about.com/cs/cataf/a/earinfections.htm



Applying ear medication
=======================

?Fill the ear canal with cleaner, and I do mean FILL. Let it dribble
out the ear because the canal is so full. Let it sit full a few
seconds if your dog will allow it, then gently massage the ear base,
trying to rub the internal ear canals as much as you can. Then jump
back and let him shake and shake those ears. Later, like five minutes,
come back and clean the outer ear -- everything you can see -- with
gauze pads, cotton, or Q-tips. But start at the inner recesses, no
further in than you can see, and pull to the outside air. The dog is
going to loosen the crud inside the ear, and sling it to the outside.
This is what you want to get. Next cleaning - soon for nasty ears,
like maybe tomorrow or the next day - more goo will get slung out as
the cleaner breaks it down and the dog applies the laws of physics to
the ear crud with the head shake.
  Eighth, don't instill medications or cleaners into achey ears
unless you've had the canal checked by the vet to make sure the ear
drum is intact. Ruptured ear drums happen in really infected ears, and
some medicines will cause the dog to have a head tilt or deafness -
sometimes permanent.?
http://www.sonic.net/~cdlcruz/GPCC/library/earclean.htm


?Is there anything I need to know about getting medication in the ear?

It is important to get the medication into the horizontal part of the
ear canal.  Be aware that the dog's external ear canal is "L" shaped. 
The vertical canal connects with the outside of the ear; the
horizontal canal lies deeper in the canal and terminates at the
eardrum.  The ear canal may be medicated by following these steps:

1)  Gently pull the ear flap straight up and hold it with one hand.

2)  Apply a small amount of medication into the vertical part of the
ear canal while continuing to keep the ear flap elevated.  Hold this
position long enough for the medication to run down to the turn
between the vertical and horizontal canal.

3)  Put one finger in front of and at the base of the ear flap, and
put your thumb behind and at the base.

4)  Massage the ear canal between your finger and thumb.  A squishing
sound tells you that the medication has gone into the horizontal
canal.

5)  Release the ear and let your dog shake its head.  If the
medication contains a wax solvent, debris will be dissolved so it can
be shaken out.

6)  If another medication is to be used, apply it in the same manner.

7)  When all medications have been applied, clean the outer part of
the ear canal and the inside of the ear flap with a cotton ball soaked
with a small amount of rubbing (isopropyl) alcohol.  Do not use cotton
tipped applicators to do this as they tend to push debris back into
the vertical ear canal.?
http://www.pethealthcare.net/html/body_canine_ear_infections.html


You can see an illustration of a dog?s ear canal on the following site:
?  Disease of the ear usually stems from over-production of wax as
occurs in response to irritation.  Allergic skin disease affecting the
ears is one possible cause (especially in recurring cases); other
causes of ear infections include ear mites,  and foreign bodies (such
as grass awns or foxtails), or hair growth deep in the canal (common
in poodles and schnauzers especially). The moisture of the wax
promotes bacterial growth and infection. Soon wax in ears is joined by
pus.
  
  Dogs show discomfort around their ears by scratching, rubbing their
ears on the floor or furniture, or by shaking the head.  If the
infection reaches the middle ear, affected animals may have a head
tilt, a lack of balance, and unusual eye?
http://vetmedicine.about.com/gi/dynamic/offsite.htm?zi=1/XJ&sdn=vetmedicine&zu=http%3A%2F%2Fwww.lbah.com%2Fear_cleaning.htm
http://www.marvistavet.com/html/body_ear_infections.html


Further reading on dog ear infections
======================================

http://www.dermapet.com/articles/es_canine.html

http://www.cah.com/dr_library/eardis.html

http://www.lowchensaustralia.com/health/eareyes.htm

http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00304.htm


Be glad this is not your dog?s problem!
Sagging lips, for goodness' sake!
http://www.topshot.com/dh/MyDog.html

I hope you have found this information helpful. (I'd like to know your
children will not miss out on a college education!) Please request an
Answer Clarification, before rating, if any part of this answer is
unclear.

I wish you both good luck in your search for a cure!

Sincerely, Crabcakes

Search Terms
============
Canine + otitis externa
Canne + otitis media
Demodex
Canine allergies
Canine + fungal + ear
Hypothyroid + canines

Request for Answer Clarification by whk-ga on 28 Aug 2005 08:16 PDT
In your research, did you determine where and how we could purchase
the dog meds on line.  That was the second part of my question.  
Thanks

Clarification of Answer by crabcakes-ga on 28 Aug 2005 14:31 PDT
Hi there,
  I'm sorry I overlooked the part about finding bargain prices!

Since I don't know what you pay, or the dosage, here are some online
stores for vet meds. You will still need a prescription.
Of course, vinegar sells in the grocery for about $1.29-$1.69 a gallon.

Ear cleaners:
http://www.1800petmeds.com/all.asp?LV=82

http://www.petcarerx.com/srchresult.asp?upi=0&ezid=CTPUD16FP9TU8G72GH14G9D41SDN6QLC&

Ketoconazole $1 per 200mg tablet
http://www.discountpetmedicines.com/buy/ketoconazole.htm

http://www.petcarerx.com/srchresult.asp?upi=0&ezid=CTPUD16FP9TU8G72GH14G9D41SDN6QLC&

Discount ear medications
http://search.store.yahoo.com/cgi-bin/nsearch?unique=22b58&catalog=entirelypets&et=43123260&basket=b%3D5C508088d8004f4143122a4294cc191a9a3423b6190456f56c2cfa9c0c75d7792%26l%3D%26s%3DXT_OsWEVdIw6Kj9PqpQo7KtqdGw-

http://store.yahoo.com/entirelypets/earproducts.html

ADL
http://www.amazon.com/gp/browse.html/104-1626582-8500738?_encoding=UTF8&node=12926231&no=12907581&me=A1KV49W6ALVUD5

Allergy
http://www.1800petmeds.com/all.asp?LV=71

http://www.petcarerx.com/srchresult.asp?upi=0&ezid=CTPUD16FP9TU8G72GH14G9D41SDN6QLC&

I just saw generic Tavist for humans in the grocery store last night
for about $3.89. ASk you deoctor which dosage would be right for your
dog.

Hope this helps. Pet meds online are generally much cheaper than at
the vet's office! Should your vet prescribe a more efficient therapy,
you can probably obtain it at one of these online pet med sites.

Again, I wiah you and your dog the best!
Regards, Crabcakes
whk-ga rated this answer:4 out of 5 stars

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