Common Ear Problems in Pets

October 8, 2019

– Hi, I’m Dr. Jennifer Schissler, assistant professor of dermatology at Colorado State University. Thank you for joining us on Facebook Live. Well today we’ll talk about ears. And you might be wondering
why a dermatologist is talking to you about ears. But actually, in veterinary medicine, the dermatologist is often the ear expert. And really that’s because a lot of animals that have skin problems have allergies. And then they also have ear problems. But we treat a lot more than allergies. So what I wanted to talk to you all about is the anatomy of the ear. And I wanted to show you
how we look in the ear. And some things that we can see in the ear and how we diagnose ear
problems in cats and dogs. And then we’ll move on to
some of your questions. So the ear canal in dogs and cats is in a little L shape here. So you can see it makes a turn. So this is why we can’t
just peek in the ear. We have to have a special scope and position the ear so
we can see everything. And then at the end of the ear canal, we have the eardrum. And it’s a very thin membrane and we need that for good hearing. Then behind the eardrum, we have the middle and inner ears. And they have very
important nerves in there. Like nerves for balance and hearing and appropriate movement
of muscles of the face. So this is why we have to be very mindful of all of the things we do to ears and what we put in ears. So I would certainly
recommend if your dog or cat is having an ear issue, please consult with a veterinarian so that we can treat their ear safely without damaging any of those structures. So you might be wondering, well, then how do we look in that ear with the curve in it? Well, we have otoscopes. And the most commonly used kind
is just a regular otoscope. And you might see this
at your doctor’s office and veterinarians use them too. And they’re quite effective. They do a good job. What we’re very privileged
to have here at CSU is a video otoscope. And the video otoscope
allows us to capture very high resolution images and videos. Not only for educational purposes, but it helps us follow our patients and know what’s going on. So we feel very privileged to have this type of equipment here. And you’re going to see some
images that we can generate from that equipment in just a moment. So the first video I wanted to show you is how we look in a dog’s ear. It really takes a lot of experience to basically restrain that
patient appropriately. But once you do that, you just need to look in
there for a few moments, take some images with our otoscope, and we’re good to go. So Mia is a black lab
that we were looking at and she’s very wiggly. But we were able to very
carefully look in her ear with just a little bit
of minimal restraint. Okay, so, what I like to
show next is a picture of what we saw in Mia’s ear. And so when we looked in her ear, we noticed that she had a
little more wax than she should. And so we can get some
really nice images of that. And what would be good for us to do with that waxy ear is to take some samples under the microscope. But that ear looks pretty good. Well, there’s some more interesting things that we can find in there. The next example is a video of a cat. And this kitty cat was
found by my technician. She found this cat as a stray and he was scratching his
ears and shaking his head. And so we use this scope
to look in that ear and what we found was quite interesting. Especially for those of you who like fascinating creepy crawlies. So in this video, you can kind of see at the
bottom of the ear canal, these little white mites moving around and living their life. And gosh, I can only
imagine how that might feel for that cat and what it would sound like. But the good news is there’s a lot of ways we can safely treat that. And effectively treat that. So that’s the good news. If we can, I’d like to
move on to another video. Speaking of creepy crawlies. Well this is a little dog. He’s pretty young. He’s indoor, outdoor,
and he was scratching at one of his ears. And so we used this
scope while he was awake to look in there. And we found this
whitish-grayish round thing in there when we looked. And so we had him under deep sedation, and we used forceps and
we took this thing out. So he was perfectly still
and it was a big old ear tick that sometimes we’ll have in
the western United States. So that was very satisfying to remove. And for that, he definitely needed to be under deep sedation because we don’t want
to hurt his ear drum. So that was pretty fun. The next image is more
consistent with what we find on a regular basis. It’s an image of an ear with allergy that’s kind of red and has some wax in it. That’s really common in dogs and cats. And sometimes when they have this, they’re itchy on their skin, too. So a lot of these patients
that have the ear allergy also have bacterial or
fungal infections as well. So that’s really common. That’s most of what we do is that image. Now in Colorado, we have a lot
of different grasses outside on the prairie. And so what we frequently
see often in summer and fall around here are
grass sods or grass seeds from a type of grass called cheatgrass. And they have these little pokey seeds and they can sometimes work their way in the dogs ear and go all the way down and rest up right by the ear drum. And so it’s really important that we take those out because
if we don’t take them out, they can actually migrate
through the ear drum. And that’s not good. But that’s a pretty common thing we see. And we’ll take it out
similarly to how we took out that tick. Perhaps not quite as satisfying, but still pretty good. And then our very last
image is of a polyp, which is a round fleshy mass that luckily for this dog, is benign. And so we could actually cure this problem for this patient by removing that with our scope and our instruments. So that was great. So as you can see, there are many things
that can go on in ears of dogs and cats. And they often show the same signs. So they can have itching,
and head shaking, and material coming out of the ears. And redness of the ears. Sometimes if it’s really bad, they might be head tilting
or dizzy or circling. And so those are some
signs of worse infection. Obviously, if you see anything like that in your pet, they should
see a veterinarian. But interestingly, all those things look pretty similar from the outside. So that’s why we need to look in there. And as I mentioned before, the other thing we do to help
figure out what’s going on is to safely place a cotton tip applicator into the ear canal and
then we take that material and we look at it under the microscope so that we can see what’s going on. If there’s an infection, secondary or not. So this first image is
bacteria that we found in the ear under the microscope. And all the little purple dots. That’s a bacteria that shouldn’t be there. And so that helps up make
decisions on what medication that we’re going to put in the ear. The next picture is of yeast. Also very common, sort of peanut shaped or footprint shaped and again, this can happen secondary
to any ear problem and seeing that helps us decide which medication to pick. And the last one, my favorite, are little ear mites. And so if we’re using this scope, then that’s the way we’re
going to find those ear mites. We’re going to take a sample of that wax, look under the microscope, and they’re just moving
around like crazy in there. So that always gets a lot
of attention with that. So I hope you have enjoyed these images so you can start to understand the things that veterinarians can
offer to help your animals. So we can make educated and safe choices of how to treat problems
in your dog or cats ear. So I’d like to move on to some questions that were submitted from the audience. So thanks again for
submitting those questions and trusting me with these answers. Just keeping in mind though,
although I’m a veterinarian, I can’t diagnose or prescribe
anything from this type of venue. But I hope that you can take this information moving
forward and have a discussion with your vet. Okay. So the first question is from Mary. So Mary asks, my dog Sam
seems to be bothered at times with itchy ears. I don’t see anything abnormal in his ears. What, if anything, should
I look for and note if his itchiness is abnormal? He’s a basset hound springer spaniel mix. Which makes me smile
because that’s got to be a really cute dog. Perhaps with giant, giant ears. So Sam’s probably pretty cute. Well I think a little bit of head shaking and ear scratching is
normal if it’s very brief, intermittent, and infrequent. So once or twice a day, probably not an issue. When we start to become
more frequent with that, when you see redness of the ear flaps, stuff coming out, for sure that’s abnormal. But if you have any questions or concerns, of course your veterinarian can look. And that’s something they could
do at a general exam visit. Or I would make a special
visit if he’s doing this a lot. Just so we don’t miss something like a grass seed or
some yeast down in there that we can fix for Sam. He’s certainly probably has
a lot of real estate down in those ear canals
where stuff can happen. So it would be good to find out. Okay, the next question
was submitted by Carly. And she has a very
detailed question I think that represents a lot
of patients that we see in our service. So thank you for that question. So Carly has a black lab
who’s had atopic dermatitis. That’s environmental allergy. Usually of the skin. She got him at three, and he’s been constantly licking his paws and he’s getting ear
infections over and over. And he’s gotten treatments
with prescription ointments that are good ones. She’s also switched his
food many, many times. But it seems like nothing’s helped. They recently did a cytopoint injection which lasted for about two months. And she wants to know, are
these injections worth it? And what else can she do? So this is a great question. We see so many allergies in dogs and they get ear
infections very frequently. So let’s sort of unpack
the different pieces. So your dog definitely has allergies from what you’re describing. The foot licking, the ear issues, very consistent with that. And I know a lot of
people in your position they try different foods
to see if their dog will get better. And it can be pretty confusing because if you go to the pet store, they’ll recommend this or that or this. And to be honest, it’s
really hard, I think, to diagnose a food allergy
with non-prescription foods. And that’s because these foods often have common ingredients. So when we’re trying to
diagnose a food allergy as a cause of ear or skin issues, we want to really try to pick a diet that doesn’t include
anything they’ve had before. And then we know they need to be on it for at least two months and be very particular about everything that goes in their mouth. So that is actually the
best test for food allergy. Not any blood test or anything like that. That’s the best test. So the best way to do
that test is to actually have a veterinarian look at the foods that your dog has been eating and treats. And to pick a prescription diet trial food that doesn’t include any of that. And then we will have
your pet on that food for at least two months. And we like prescription
because those foods are made on equipment
that only makes that food. Because remember, allergy
happens when they only get exposed to a little bit of something. So we want it to be as strict as possible. And then we’ll know for sure
if they’re food allergic or not. And that could be really
important for you guys because if he’s actually food allergic, you might be able to cut
out all this other stuff moving forward. So I would certainly encourage you to kind of re-open that dialogue with the veterinarian or if you haven’t talked about it already and kind of decide if you
like to engage in that. That also, being said,
you mentioned cytopoint. So for the audience, cytopoint
is an injection for dogs. And it’s an injection that
treats itch and dermatitis. And it actually works for many
different kinds of allergies to treat those symptoms. And it’s most appropriately
used, in my opinion, if we’re going to use it long term, it’s a good idea to use it long term in an environmental allergy patient. And if they’re food allergic, then they can come off of it. So number one, as far as
whether or not it’s worth it, from a medical standpoint, if it’s working well, and it’s giving your pet relief, that is great. From a medical standpoint, it is quite safe. So we don’t see a lot
of side effects with it. We published a study here about that. A lot of dogs respond to it and don’t have any issues. So I like that as an option for treating symptoms. The other piece, though, of
that is the food is a piece. We got a piece here about
treating the symptoms. Either short term or long term depending on if he’s food allergic or not. The third piece is just realizing that with the ear part of allergy, sometimes the medications we
use for allergy in general don’t treat that as well. And that doesn’t mean they’re bad. I think it’s just very
hard to treat ear allergy. Especially if it’s severe without the use of topical medications. So for the time being, or acknowledging if your dog
is environmental allergic, we may want to consider
talking to your vet about a maintenance
therapy for your dogs ear. So you might go through a phase
where you use it more often to get the infection under control. And then use it on a maintenance basis to prevent the inflammation
in the first place. So I think that a lot of what
you’re doing is good stuff and perhaps with some tweaks there, we could do even better. But whether or not that
cytopoint has value really is a decision
between you and your vet in terms of the type of
response you’re getting. But for a medical point of view, I think it’s a really good option. So perhaps a few adjustments
and you’ll be fewer bumps in the road, fewer flares there. So that was a really great question. And hopefully that was
helpful for you all out there who have dogs or cats with allergy, those pieces of information. So now we’re going to check and see if there’s any additional
questions at this time. So we’re scrolling through that. But I also just want to say
thank you for turning to CSU for information and answers. Part of what we want to do here is be a resource for everybody to make sure that we can give you good, accurate information about your pets. And I’m thinking at this time, we don’t have any additional questions. Oh, here’s one. Okay, all right, how do
you clean a cat’s ears? Always the hard-hitting questions live. All right, so I could say very carefully. But that’s not, well
that’s partially true. It can be difficult. Because some cats really
don’t appreciate that. Things that can help. Most cats like their ears rubbed. So, if you can get your
medication pre-drawn up in a little syringe, and you’re rubbing their one ear and treating the other
and then rubbing it, sometimes that helps. It usually helps to have a buddy. And, involved in this. And really, I think in general, I think cats are harder
to medicate than dogs. Some easier than others. When it comes right down to it, that really, really puts
in to focus the importance of using the right medications. So we don’t have to use it as long. And figuring out why it
happens so we don’t have to use it as much. But simply put, when we
medicate animal’s ears, dogs or cats, what we do is we place that medication, the applicator, just inside this opening and then if it’s a flush, sometimes we’ll gently
fill up the ear canal. Or drop, we’ll put the
prescribed number of drops and then we’ll message the ear. And then if need be, you’ll do the second ear. And then usually the animal
runs away and shakes. Shakes their head and runs away. So one thing I would
say with allergic ears is they get a lot of
infections and as I said, if you can talk to your vet, once the fire gets put out, if they’re a repeat offender, you might do better by
doing maintenance therapy once or twice a week
so you don’t have to do a lot of treatment intermittently. So that can help, too. I hope that answers your question. I don’t have some magic trick there, but I think definitely
the syringe pre-loading to kind of gently put it in there quickly and being judicious about
what we’re putting in there might minimize how
often you have to do it. So good luck. Perhaps counter-conditioning
for food cats. They know they get their food afterwards. I have a few that go for that. Any other questions? We’re going to see. All right, well looks like
that concludes the questions that we have. Again, I’m Dr. Jennifer Schissler. CSU dermatology. Thank you so much for tuning in, I hope you found this both
interesting and informative. And please open up that
conversation with us or your vet if you’re animal
is having ear problems. Thank you.

No Comments

Leave a Reply