Do I need to use an ear cleaner?
It is highly recommended to use a good quality ear cleaner. Cleaners with hydrogen peroxide or alcohol can cause irritation within the ear canal, especially if the canal is inflamed or ulcerated. Some ear cleaners have antibacterial or antifungal ingredients to help prevent ear infections. Certain cleaners are also better at removing wax build-up. Your veterinarian can help you decide which ear cleaning solution is best for your pet.
When Do I Need to Use a Dog Ear Cleaner?
Ear cleaning is a preventative measure every dog owner should take. Regular ear cleaning not only ensures your pooch’s ears are kept clean and infection free. It is also a great opportunity to keep an eye on what is happening inside your dog’s ears. A study published in 1988 showed that dogs with pendulous ears are more likely to have trouble with ear infections.
So, if you have a dog with a pair of these long, floppy ears, it is particularly important to keep track of what is going on inside those ears. Wet ears tend to get infected, so if your dog is a keen swimmer, you may need to apply an astringent to help dry it out.
Antifungal Dog Ear Cleaner – Best Dog Ear Cleaner for Yeast
Yeast is a type of fungus. So, while you may hear these conditions referred to as if they are different issues, they are in fact one and the same. If your dog has a fungal ear infection, your vet will prescribe antifungal medication. This treatment will be administered and monitored in a similar manner to a bacterial infection as mentioned above.
Some infections (bacterial and fungal) can take months to go away, and some conditions are chronic in nature. If this is the case, your pooch will need to stay on the treatment prescribed by your vet.
Excess ear wax is the precursor to most dog ear infections, so preventative ear cleaning is the best way to keep on top of this. If a lot of wax has already accumulated in the ear, then your veterinarian may need to perform the first couple of cleans. Your dog’s ears may be sore, and sometimes the dog needs to be anaesthetised to perform the clean to avoid injury to both you and your dog.
Your vet may need to carefully remove other foreign items inside the ear, such as hair. If the build-up is thick and waxy, your vet may need to use a cerumenolytic solution. This will work to break up the wax before any other treatments will penetrate to the skin.
Generally, after a couple of checks and cleans performed by your vet, the associated pain and infection may have cleared enough for you to start gently cleaning your dog’s ears in line with your veterinarian’s instructions.
Cleaning A Dog’s Ears – Veterinary Training
For more information on diagnosis and treatment of chronic otitis, see the May/June 2017 article “The Challenge of Chronic Otitis in Dogs—From Diagnosis to Treatment.”
Deep ear flushing is very helpful not only as a diagnostic tool in assessing chronic otitis but also as part of the treatment plan.1 A short course (2 to 3 weeks) of an anti-inflammatory dose of oral and/or topical glucocorticoids may be needed before deep ear flushing in order to decrease inflammation and stenosis of the ear canals.
The deep ear flush procedure should be performed with the patient under general anesthesia so that the ear can be completely cleaned and the ear canal and tympanic membrane examined. Anesthesia also allows the placement of an endotracheal tube, which precludes the aspiration of fluids that may pass through the middle ear into the auditory tube and then into the posterior pharynx. Ideally, computed tomography of the tympanic bulla should be performed before the flush to stage ear disease and help make the decision to perform myringotomy if otitis media is present. Make sure to collect samples for cytology and bacterial culture and sensitivity testing (C/S) before flushing.
Several techniques to clean and flush the ears exist1; below is the method I use in practice.
1. Evaluate the canal to determine the severity of disease, the type and amount of debris in the canal, and the best initial approach for removing the debris.
2. After examination, if the debris is waxy, soak the external ear canal for 5 to 10 minutes with a ceruminolytic ear cleaner.
3. Flush the ear with warm sterile isotonic saline. A video-otoscope is ideal for this procedure because of its superior magnification and flushing equipment; however, a bulb syringe or an 8-French polypropylene urinary catheter attached to a 12 mL syringe passed through an otoscopic cone can be used. Alligator forceps and ear curettes can be used to remove larger debris.
5. If the tympanic membrane is not intact, obtain samples from the middle ear cavity for cytology and C/S.
6. If the tympanic membrane is intact and appears abnormal, and otitis media is suspected or confirmed with imaging, perform myringotomy to obtain samples for cytology and bacterial C/S and to flush the middle ear cavity. In dogs, an intact tympanic membrane does not rule out the possibility of otitis media.
A normal tympanum usually heals in 21 to 35 days. Therefore, if the ear is kept free of infection after myringotomy, the tympanic membrane should heal within 5 weeks.
Non-ototoxic antibiotic and steroids may be infused inside the middle ear and external ear canal after the ear flushing, if necessary. The patient may also be sent home on empiric topical and systemic therapy according to cytology results, and treatment may be modified once C/S results are available. The ototoxicity of most topical otic medications is not known, so if a myringotomy is performed, owners should be instructed to watch for signs of ototoxicity and discontinue the otic medications if they occur. Signs of ototoxicity include the following:
Owners should be made aware of these potential complications and sign a consent form before deep ear flush and myringotomy are performed.
A short course of oral glucocorticoids and pain medication may be sent home with the patient to reduce discomfort and inflammation associated with the procedure, particularly if trauma to the ear canal occurs or myringotomy is necessary.
Recheck the patient 2 to 4 weeks after the ear flush to monitor the response to otic treatments and evaluate the status of the tympanic membrane, particularly if myringotomy was performed.