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Repeated ear infections.

Species: Dog
Breed: Pomeranian
Age: 5-8 years

My dog Opie is a five-and-a-half-year-old, male (neutered) red sable Pomeranian.

When Opie was a baby, he had ear infections/ear itchiness and allergies twice. After age one, he would have ear problems every now and then, probably a total of three times between ages one and five.

Since this past June, though, Opie is having nonstop ear problems. In June he definitely had an infection. They did a cytology test and the infection was in both ears. He went on Carprofen and Simplicef, and had a topical ointment and wash for two weeks. He seemed to get better. Problems started again in late July, and while the infection was purported to be "possibly slight or just starting if at all," he did another round of Carprofen and Simplicef, along with the wash. Again in September he had problems, and again they couldn't see that he really had an infection. They thought maybe it was allergies. That time, he went on prednisone and Mometemax. While he improved somewhat that time, throughout the time he was on prednisone and Mometemax he continued to have itchy ears.

Now, the problem is back! He is not as bad as sometimes but I am going away in a little over a week and wanted to nip it in the bud. This time, they said the cytology test came back fine for the left ear and "maybe a very slight or starting infection" in the right ear. They said he must be very sensitive because most dogs would not have noticed a problem this slight. They wanted to do Mometemax again and prednisone. I said he stayed itchy last time he was on those and so we are doing Carprofen and Simplicef again, plus Mometemax (but no prednisone). Now I am wondering if I should've let them do the prednisone.

I should mention, he is a sweetie but not when it comes to topical ear medication! He is GREAT about taking oral meds. But when he is on ear drops or washes of any kind I have to take him to the vet each day to get them put in, because he will NOT let me. He is very bad about all grooming-type things with me, so this isn't isolated to his ears but includes brushing and baths. So it is a difficult situation for us when that happens. But, I go every day he's on them and get it done. It's just, it doesn't seem to help!

He goes to the groomer once a month and they clean his ears well each time.

His ears are not itchy constantly this time around. It seems the worst after he has been sleeping and after he comes in from outside. Sometimes he'll be playing and fine and suddenly he'll cock his ear over and start rubbing it. He also does this thing where he runs around like a maniac when his ear is really itchy, like he is running away from it.

His ears are the worst but he is sometimes itchy other places, like his groin area or legs. He is on a high quality dry food, Spot's Stew (Lamb), that does not contain wheat or corn. It does have oats and barley.

Sorry to go on and on but I want you to have the full background! I have spent hundreds of dollars and do not feel any closer to getting answers or relief for Opie. Is it an infection, or is it allergies? Sometimes the answer is clear but lately they do not seem to be sure, and I am getting frustrated.

Thanks so much! Opie and I would really appreciate your advice.

Online vet, Dr. Marie

Dr. Marie replied:

Poor Opie! Chronic ear problems are soooo frustrating!

While I won't be able to say for sure what the issue is, let me give you some of my thoughts.

First of all, when he has had medication put in his ears, does the vet have you go back afterwards to repeat the cytology? I have found that many dogs need longer than two weeks of medication these days in order to clear things up. Often it will look like the ears are better, and the dog is not itching, but when I repeat the cytology there is still some yeast or bacteria there. In those cases, if I had stopped the treatment we would be seeing another infection in a month or two.

Next, if I had a dog who was having chronic ear problems and I had done the repeat cytology mentioned above, then I would be wanting to do a test calle a culture. This is where we send a swab to the lab to find out exactly what kind of bacteria is in there and exactly what medication is the best to treat it with. Some of these chronic problems are happening because of resistant bacteria. In these cases we often need a particular combo of medications to completely get rid of the problem.

It definitely is possible that allergies are contributing to the problem. The majority of allergies are usually not food related. They can be environmental. If I have a dog with ears that I would call "mildly allergic" then often what I will do is once I have the infection 100% cleared up I will give the owner steroid drops that they can put in the ear occasionally if they see they are getting red. So, if allergies flare up then the steroid drops can decrease the inflammation and the ears are much less likely to get infected again.

If allergies seem to be a chronic problem then I do have some dogs that I will keep on a small dose of prednisone. I try to get to the lowest effective dose. For many dogs that means giving a tablet every other day. There is no harm to most dogs in doing this.

Here's another's a long shot though. Is the vet completely sure there are no ear mites there? I have had cases where they were being treated for ear infections but it turned out the dog had mites. Once we treated the mites the problem went away. This is not common in an adult dog though.

You could also ask your vet about the possibility of Opie having a thyroid problem. Usually dogs with hypothyroidism will be overweight and a bit sluggish. But they can be prone to repeated infections.

This type of problem can be very frustrating and in many cases there is no easy solution.

One final thing I could suggest is to ask your vet for a referral to a veterinary dermatologist. These vets specialize in difficult skin and ear infections and possibly could help you a little more.

I really hope things clear up soon!

Dr. Marie.

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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Dr. Marie,

Thanks for your ideas!

The first time he did have a repeat cytology and it came back OK. The others times they seemed uncertain that the original cytology was even positive and that may be why they didn't do a repeat, I don't know. The time in September they said the problems were "too deep" to do a cytology (?), so I know that is why they didn't start with one that time.

We have not had a culture done, so that is helpful information. Are cultures very expensive/more expensive than the cytology?

No one has mentioned steroid drops, either, but that may be because he is such a bear about ear drops! I will ask, though, about that and the continuous small dose of oral prednisone.

The vet said in June that there were no ear mites, but I do not think they have checked since.

From what you describe about hypothyroidism, I don't think that's a possibility...nothing sluggish about Opie! Good to know, though.

I will check to see if there are veterinary dermatologists in my area.

Thanks so much!

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.