All Pets Veterinary Clinic


Itchy, smelly, lumpy, and bumpy

Ear problems are one of the most common reasons that dogs and cats are presented to
veterinary clinics. Issues such as ear infections, excessive wax build up, hematoma
formation, masses, and hearing loss are all common complaints for our animal companions.
The remainder of this article will discuss these common ear problems in the cat and dog.

Ear infection. Ear infections can be divided into two categories—outer ear infections
and inner ear infections. Animals most commonly have outer ear infections. Infections in
the outer ear typically cause inflammation and irritation of the ear canals to the level of
the ear drum. Signs include excessive ear debris, redness, foul odor, and discomfort that
results in excessive scratching or shaking of the head.

Most outer ear infections are caused by of one or more of the following: yeast, bacteria,
or ear mites. Since yeast, bacteria, and ear mites can result in the same appearance, a
sample of the debris should be examined in order to reveal which pathogen(s) is/are present
and what type of medication is needed. Typically, outer ear infections are treated with a
combination of daily cleaning and twice daily ear drops.

Sometimes chronic yeast and bacterial ear infections are the result of other conditions.
For example, excessive ear hair, ear shape/structure, chronic moisture, foreign objects, and
allergies can all cause chronic or repeat ear infections. In order to effectively treat
these ear infections, identification and treatment of the underlying cause is necessary.
For example, excessive hair needs to be clipped or plucked regularly, wet ears need to be
kept dry, and foreign bodies, such as seed awns, need to be removed. If the pet suffers for
inhalation or food allergy, appropriate medical management of the allergy should aid in
resolution of ear infections.

Inner ear infections affect the structures on the other side of the ear drum. Inner ear
infections may or may not coincide with outer ear infections. Small, pinpoint holes or
full tears of the eardrum can allow infectious agents to pass into the inner ear. Signs
can include nausea, vomiting, head tilt, staggering, seizures, and loss of balance. A
combination of topical and oral medications is often needed to treat inner ear infections.
In addition, medications to control nausea and vomiting may be necessary.

Excessive Wax. Animals can accumulate excessive amounts of wax because of an
excessive amount of wax secreting glands, a lack of removal of accumulated wax, or chronic
irritation of the ear. Some animals can develop a thick, irritating, ball of wax, deep
within the ear canals. If left unattended, secondary ear infection and discomfort can result.
Periodic cleaning can eliminate excessive accumulation of wax and prevent infection.
Professional removal and thorough cleaning under anesthesia may be necessary in extreme
cases of wax build up.

Hematoma. An ear hematoma is simply a blood clot that forms in between the skin and
the cartilage of the ear. Ear hematomas are usually the result of excessive blunt trauma
that results in broken and bleeding blood vessels. This trauma is usually self induced and
a result of chronic itching. It is not uncommon for dogs with severe ear infections to
develop ear hematomas.

Treatment is two fold. First, the blood clot must be surgically drained and removed. The
ear is then sutured to close the space in which the blood clot formed. This helps to
prevent additional blood clot formation. Secondly, the underlying cause must be treated
to prevent reoccurrence. If an outer ear infection is the cause of the ear hematoma, the
ear infection must be treated. If bite wounds caused the hematoma formation, antibiotics
will often be used to prevent/treat abscess formation. Without proper treatment of ear
hematomas, scar tissue will form and contract resulting in a thick, shriveled ear.

Masses. Masses in or on the ear can be polyps, cysts, inflammatory nodules, benign
tumors, or malignant tumors. Diagnosis is often made by histopathology (biopsy) of the
tissue in question. Treatment will vary by the type of mass. Some masses are fully curable
with complete surgical excision. Inflammatory nodules can be the result of chronic ear
infection. They will reoccur if the underlying ear infection is not managed and treated
properly. Malignant masses of the ear can be difficult to treat. Radical surgery and/or
radiation may be necessary to treat aggressive ear tumors.

Hearing Loss. Like people, dogs will often experience hearing loss as they age.
Unfortunately there are no treatments for progressive, age related hearing loss. Hearing
loss can also be the result of ototoxic medications, such as gentocin, and chronic ear
infection. Prompt discontinuation of the offending medication can result in reversal of
the hearing loss in some cases. In other cases, hearing loss may be permanent.

Several over the counter ear cleaning products are available on our website (see link below).

***The information contained here is for educational purposes only and is not intended to
take the place of a veterinarian. As always, if you have questions or concerns regarding
the health of your pet, please do not hesitate to contact a veterinarian.***

Karen Blakeley, DVM, MPH
27 September 2009