Head shaking and ear scratching Print E-mail
News - Rubrieke
Monday, 24 October 2016 23:19
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Dr Liesel van der Merwe is a small animal medicine specialist. Send her your questions: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Dr Liesel van der Merwe

Many dogs especially suffer from inflammation of their ear canals – this is called otitis. Not only is this rubbing, scratching and shaking irritating for us as owners (my dog suffers from this), but otitis can also be very painful for the dog as anyone who has had a severe ear infection can attest to.

These dogs will also often develop othaematomas, big ‘blood blisters’, on their ears because of all the shaking. These need to be surgically drained otherwise the dog’s ears will crumple and he will look like a rugby player or boxer.

The ear canal is divided into three sections: the outermost external ear canal, the middle ear and the inner ear. The outer ear canal is shaped like an L with the vertical part of the L just under the skin, directed downwards, and the short horizontal part going towards the dog’s skull to meet up with the ear drum.

The ear drum protects the organs of balance and hearing, which are found in the middle and inner ear. The ear canal is lined with normal skin, so any skin allergies or skin disorders will often show up involving the ear.

Some dogs are predisposed to ear problems because of their anatomy: Dogs with floppy ears, such as spaniels and basset hounds, have a problem that there is often not enough air circulation and the canal becomes damp and irritated.

This is compounded in dogs with lots of hair, such as the spaniel, if the ear is not kept well groomed or clipped. Bulldogs and Sharpeis often have very narrow ear canals, which also affects ventilation and natural drainage of wax.

All veterinary students are taught that bacterial or fungal overgrowths in the ear are always secondary to some underlying cause. In some cases it may not even be necessary to treat the infection but just to correct the cause and allow the body to heal itself.

One of the most common underlying causes of ear infections is allergic skin disease. This can be the cause even if only one ear is affected, even though one would think that both should be affected with a generalised cause.

This is common in German Shepherd dogs and Labradors, which have lovely wide ear canals. However, with repeated bouts of inflammation due to allergic skin disease, the skin lining in the canal becomes irritated and permanently thickened. This eventually narrows the canal and results in a physical problem with ventilation and drainage.

Ear mites cause a lot of ear problems in cats but are rare in dogs. Other causes of otitis include foreign bodies such as grass awns, ticks and also growths such as benign polyps or tumours.

Grooming or swimming where water or soap gets into the ear canals are risk factors. Always put cotton swabs into your dog’s ears before bathing him. If your dog is predisposed to inflammation you can also rinse the ear with swimmers solution after swimming in dirty water.

Many ear drop preparations exist to treat the symptoms as they flare up, but that is all that they do – manage symptoms. It is important in cases with otitis to try and determine the underlying cause of all the inflammation. In the vast majority of cases there is an underlying allergic skin disease, either due to environmental allergens (the vast majority) or due to a food allergy.

If the underlying condition is managed properly and early on – before secondary changes have permanently affected the skin lining the ear – the ear condition can be managed. Flare-ups will still occur, but the condition will be controlled most of the time. It is important to note that allergic skin disease cannot be cured. The goal is management with the least symptoms and the least side effects or cost of medication. This depends on what the owner wants or is prepared to do. 

As owners, your expectations have to be managed otherwise you will get frustrated. Just as a person with asthma will always have asthma, so a dog with allergic skin disease will always have allergies.

Control with appropriate or specialised skin diets, Omega three supplementation, control of skin infections with shampoos and, if necessary, antibiotics and control of swelling of the ear and the allergic disease with drugs such as cortisone, immunosuppressants (cyclosporine) and desensitisation treatments is our goal, not cure. Ear drops are purely used to control symptoms. These symptoms will keep coming back unless the underlying cause is addressed as well.

Make sure you ask your vet what all the options are and make sure you are happy and understand the ramifications of the treatment you choose. This will maximise the long-term outcome as will a good vet-owner relationship. Communication both ways is important.


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