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Sore ears.

Species: Dog
Breed: Scottis Terrier
Age: 8-11 years
6 months ago my Scottish terrier came down with swelling and fluid on right side of lower head at jaw line, the size of a tennis ball. No clear diagnosis was determined, but given 500 mg clavamox daily, which she responded to immediately; swelling disappeared at 2nd dose.
Never any sign of any ear infection. Vet cannot see anything. Both ears look good.
But head shaking, ear twitching and scratching of both ears has become chronic.
Two more courses of two weeks of Clavamox have since been given but her irritation persists.
Recent CT scan with internist (2 days ago) of head and ear canals showed no abnormalities. Currently on 3rd round of Clavamox (3rd round in six months) plus (Rimadyl and Tramadol added) but head shaking/scratching continues. Need diagnosis and help. Something is wrong, I know it. She wakes up in the middle of the night shaking her head in a real “thwacking” way, it is really bothering her. Need diagnosis and help.

Online vet, Dr. Marie

Dr. Marie replied:

Wow, this sounds like such a frustrating case. It's interesting that the swelling decreased when she was on antibiotics. This definitely makes it sound like some kind of infection.

But, it really is a mystery as to why there is so much discomfort in her ears. And it is even more frustrating that a CT scan hasn't revealed the problem.

I am not likely to have a solution for you, especially if an internest who is examining Aggie doesn't have an answer. But I'll give you my thoughts.

Do you know if she has had a culture test done on her ear? This is where a swab is placed in the ear and then sent away to see exactly what type of bacteria is present. It's possible that there is a resistant ear infection. Perhaps a different antibiotic or a combo of antibiotics is needed?

I am wondering if there is some type of tiny mass or tumor affecting the inner ear. However this would not respond to antibiotics. Plus, it really should be seen on a CT scan.

Perhaps there is a neurological issue? Maybe something affecting the nerves to her ear? If your vet suspects this they may stop the Rimadyl and try Prednisone for a while.

I feel that I haven't helped much. This really is an unusual case. I will continue to think on it and if I think of other possibilities I will let you know.

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:

Hi Dr. Marie:
Thank you for being honest and saying you didn't know about my Scottie. I respect that. I also consulted another online vet who sent me a prewritten article on skin allergies! This after me stating that the problem started with the eedema and that my Scottie didn't have any of the usual Scottie skin problems. I should have known something was wrong when she asked for pictures of my dog's stomach and feet! They probably give everyone the same spiel. This is so wrong, what a ruse. I normally don't like to cause distress to people, but Dr. [edited] charged me twice as much as you so I have asked for my money back. I hope that she will respect this and refund me. This kind of thing ruins it for the honest vets like yourself.

BTW, I heard back from the radiologist today who read the CT scan, and although two general docs and an internist all missed it, it turns out that she has an infected lower right tooth at the bone. She is having surgery on Friday. Just telling you this in case a patient ever presents like this again...started with a huge edema, cleared up, and then head scratching and shaking became chronic for six months. Scratches on both ears even though only one infected tooth.

Thanks again for being honest and big enough to say you didn't know.
Best regards.

Online vet, Dr. Marie

Dr. Marie replied:

Wow, I'm so glad that you have an answer and it is something that is treatable! What an ordeal for you!

I hope that everything goes ok with the surgery. She is going to feel so much better!

Dr. Marie

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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.