Closed Ear Infections in Canine Patients – Dog Has “Ears Scarred Shut”

   2024-01-25  Posted in Cases & Recs, Client Education, Dermatology, Medications, Recommendations, Techniques & Tips, Treatments, Veterinary Care

Closed Ear Infections in Canine Patients – Dog Has “Ears Scarred Shut”

I had a case in which a dog has an ear infection for so long, and with such a ferocious bacteria (and yeast) that the ear canal had scarred shut. I have some experience with this and this is a tricky case because it had a reaction to the steroids, called “Steroid dermatopathy”.

The owner writes:

I have been dealing with this since august of last year. Nothing seems to work. We’ve done a lot for this ear. The other ear is normal!

It seems completely closed up, and how if I try to clean it I know it’s hurting her – she starts to shake and make noises.
She’s had these two medications:
Also she at one point was prescribed prednisone which she is very allergic to. Her skin peeled off in places. All that was left was sensitive raw patches. Super irritated skin – had to shave areas and put Neosporin on it which helped tremendously.
The last thing the vet did was a culture and then put her on these two meds.
The culture was just re-sent since the start of this back in August.
The only constant is her food – so I thought “well if she’s getting all kinds of meds nothing is working but I giving her the same food and she developed an allergy – maybe change her food also”.

Am I grasping at straws here ?

In this video: Errata:  “Dermatopathy” is misspelled “Dermophy” at one place in the video, also, Betadine is intentionally spelled phonetically for the audio track, chlorhexidine is intentionally spelled phonetically for the audio. One of my favorite medications for “closed ear” at least at first is “EASOTIC” because there’s a potent combination of medications in it, AND the “nozzle” for dosing is long and thin. EASOTIC INFO

ANSWERS:

Actually, on occasion, a dietary “adverse reaction” can contribute to ear infections. Some dogs (not very many) are actually  allergic to food ingredients. Far MORE of these dermatology cases are having an “adverse food reaction” which does not obey the conditions needed to qualify as a “Food allergy”

I’d recommend a diet made with NO CHICKEN NO GRAIN

Or, even better, a grain free diet made with hydrolyzed protein. Chewy has one and I believe it’s actually a Petco brand. WholeHearted” but the bag is critical. You’ll see:

You can finally get a Hydrolyzed Protein diet over the counter. Plus, it’s grain free and it avoids chicken.

It’s called:
WholeHearted Grain Free Skin and Coat Care Pea and Salmon Recipe Dry Dog Food, 25 lbs.

It is VERY hard to get, hard to find. The bag looks IDENTICAL to the other offering they have with salmon, chicken, turkey etc. THERE IS A WHITE ENGLISH BULLDOG ON THE BAG. It actually SAYS “hydrolyzed” (Pea and hydrolyzed salmon) on the front of the bag in small letters.
WholeHearted Grain Free Skin and Coat Care Pea and Salmon Recipe Dry Dog Food, 25 lbs.
WholeHearted Grain Free Skin and Coat Care Pea and Salmon Recipe Dry Dog Food, 25 lbs.

THERE IS A WHITE ENGLISH BULLDOG ON THE BAG. It actually SAYS “hydrolyzed” (Pea and hydrolyzed salmon) on the front of the bag in small letters.

This case developed what is known as “Steroid Dermatopathy” which is very rare. When a dog gets a lot of steroids for a long enough period of time it can cause a dystrophy of the basement membrane. This is a vital layer that units the thin “epidermis” to the dermal layer. Then “thinning” of the basement membrane occurs it may lose it’s grip on the epidermis which can slough off revealing raw patches of dermis. Extremely tender. And as long as you continue the steroids (at least at “full dose”) the situation will not resolve. So you take a leap of faith and rapidly taper off the steroid (or change to 0.15mg/lb PO SID) and let the skin heal. Meanwhile you try to control pain and inflammation other ways.

I like to use a LOT of steroid by injection or by mouth to reduce the swelling of a “closed ear” initially and I like to use an antibiotic, with a preference for Clindamycin or Trimethoprim Sulfa by mouth to try and clear an infection. QUITE often, once the ear opens up we can get a swab in there for culture. We grow the specific germ (and other bystanders) and can refine the drug of choice.

DMSO has been used in the ear, (Synotic) AND systemically for the anti-inflammatory and anti-oxidant benefits. I would NOT hesitate to try that alongside everything else. DMSO can be diluted and used under the skin without discomfort. If used “straight up” under the skin it feels just like a bee sting and lasts five times as long. OUCH. Yeah I tried it.

You can get “prescription” ear “plugs” from Wedgewood Pharmacy. Roadrunner also has these. They’re made from the results of a “culture and sensitivity” in which lab nerds grow the germs from the ear and then “try” a bunch of stuff to kill these germs. They’ll give you a list of germs, and then a list of what kills them. You can order oily (even waxy) “goo” from these specialty pharmacies. The medicine is warmed in hot water until the wax melts. Then you instill this into the ear. When the gelatin hardens up again, the ear canal is “sealed” in “bacterial-death” and there’s no escape. They work rather well.

One condition that COMMONLY underlies these “chronic incurable frail-skin poor immune system” conditions in the skin is HYPOTHYROIDISM.

You can speed healing and increase the immune response in dogs with an additional 180mg/kg of ascorbic acid, ascorbate, liposomal vitamin C. The benefits are not directly proven but there is considerable information available on the internet. I like to give 1 gram (1000mg) per twenty pounds once a day. https://drjohnson.com/vitamin-c-ascorbic-acid-in-canine-companion-pet-dogs/

Ear husbandry is CRUCIAL as well if you want to avoid this problem, or bring it to recovery.

  1. NEVER use rubbing alcohol as an ear cleaner. There is never an indication for that.
  2. If you use hydrogen peroxide as a cleaner, “good on ya” but only use that once, or twice if the ear is rich with blood or plasma. After the first application or two, WATER is the result because hydrogen peroxide is made in water. After the peroxides leave, it’s just water. Second, hydorgen peroxide in the canine ear is irritating.
  3. ALWAYS encourage, or directly REQUEST that the groomer keep hair OUT of the dog’s ears. This is especially true for Labba-Doodles and all that shenanigan. That hair HOLDS moisture, PREVENTS the egress of normal wax from the ear and CAUSES irritation. The groomers don’t like to pull it because MORE THAN HALF THE TIME it reveals a smouldering ear infection AND THE INFANTILE ENTITLED KARENS ALL BLAME THE GROOMER FOR CAUSING (Actually UNCOVERING) THE PROBLEM. SO groomers decline to do it. If you say “Hey look, I’m not a Karen and I’d REALLY appreciate you pulling that hair.” they will probably oblige.Then don’t be a Karen anyway.

Here are some images and commentary from the case:

This is the "normal" ear in the patient. Note that there isn't a ton of hair in the ear. So that isn't a predisposing factor.
This is the “normal” ear in the patient. Note that there isn’t a ton of hair in the ear. So that isn’t a predisposing factor.
This actually *IS* the scarred down ear. No medicine can get DEEP into the ear to topple the invading organisms. It’s hard to even get a sample from inside the ear canal. Opening this up? MEDICATIONS *in* the dog, notsomuch in the ear at first.
Steroid dermatopathy in the canine skin from a LOT of steroids being given.
Steroid dermatopathy in the canine skin from a LOT of steroids being given. You have to stop steroids (taper off) if this happens and figure out how to fix the skin and ears WITHOUT it. Sometimes DMSO becomes even more useful. Sometimes surgery has to be considered.
Author: Dr. Erik Johnson
Dr. Erik Johnson is the author of several texts on companion animal and fish health. Johnson Veterinary Services has been operating in Marietta, GA since 1996. Dr Johnson graduated from the University of Georgia College of Veterinary Medicine in 1991. Dr Johnson has lived in Marietta Georgia since 1976.