Questions for Dr. Shawn - Ear Disease

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• Question #1 - Does my cat have ear mites?
• Question #2 - Chronic ear infections

"Dear Dr. Shawn:
"My cat keeps shaking her head and scratching at her ears. She appears to have some black waxy material in the ears. I’m wondering if she might have ear mites. Is there anything natural I can use?"

Answer:
”Ear diseases are very common in our pets. While many owners are quick to blame ear mites, this is actually a parasite that is more common in puppies and kittens. Older pets are more likely to have bacterial or fungal (yeast) ear disease. In my practice I take a swab of the ear, roll it on a slide, and stain it and examine it microscopically to determine the diagnosis. The ears are then gently flushed to clean them; in some pets with sore ears this requires sedation or light anesthesia. Many doctors skip these 2 steps, which is a mistake. While we can guess which infection the pet has, only by looking under the microscope can we make a definitive diagnosis (a microscopic diagnosis requires a microscope!)

Cleaning the ears removes most of the infection immediately, and makes it easier (as well as more pleasant) for the pet owner to continue home care. Following the ear flushing, the owner is then sent home with either a medication or natural therapy (medications are chosen for more serious infections) to continue treatment at home. Never use an ear cleaner with alcohol as it will dry out the ear. Here is one of the products I recommend which is safe enough to use daily and will not dry out the ears.

Usually treating the ears for 2 weeks is adequate. Natural therapies for ear infections include topical and/or oral supplements such as olive leaf extract, antioxidants, fatty acids (fish oil,) peppermint oil, goldenseal oil, or tea tree oil. Never use tea tree oil in cats without veterinary supervision as it can be toxic if not used correctly. Natural insecticides for ear mite treatment includes tea tree oil and natural pyrethrums. The conventional medication Ivermectin is usually safe to use to treat ear mites as well. The main mistake in treating ear mites is not treating long enough: treatment should be for at least 4 weeks to break the mite’s life cycle. Additionally, if only topical ear drops are used the pet should be treated with a natural flea powder weekly as the mites can live around the head outside of the ears.

Finally, some pets have chronic ear infections. These pets usually have some underlying problem, such as atopic (allergic) dermatitis, food allergies, thyroid disease, or an immunosuppressive disease such as feline leukemia virus or immunodeficiency virus (feline AIDS) infection."

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"Dear Dr. Shawn:
"My dog suffers from chronic ear infections. He is a golden retriever. My veterinarian regularly prescribes Otomax for these and advises me to clean his ears weekly with Nolvasan Otic solution. Is this the best regimen for him? Is there anything else I can do?"

Answer:
”I wonder if the Otomax even works anymore since this has been used chronically in your dog’s ears. Do we know what type of infection (bacteria, yeast, mites) are causing your dog’s repeated infections? Only a microscopic examination (cytology) of the ear discharge can tell us this. If chronic bacterial infections occur, ear cultures plus oral medications (in addition to ear drops) are needed. In my practice, most ear infections are the result of yeasts; pets treated incorrectly with antibiotics (drops or oral medicines) will never get better and will in fact worsen.

Keep in mind that your breed of dog is prone to ear infections, but also prone to allergies (which are a common reason for chronic ear problems.) Unless the allergies are correctly treated (and not with just repeated doses of steroids!) your dog’s ear problems will never go aware. Here’s what I suggest. Get the correct diagnosis. Treat underlying problems such as allergies. The ears should be flushed (and anesthesia will probably be needed) before you treat them with the appropriate drops. I’ve had success with various supplements (olive leaf, Echinacea, etc.) in treating chronic ear problems. Once the problem is corrected, regular ear cleaning (several times a week at a minimum) must be done to prevent frequent recurrences.

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