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About a year ago, my dog had a nasty ear infection. This cleared up after a course of drops, but it comes back again every few months. Our vet prescribes the drops and it does clear up, but I’m wondering why it keeps coming back.

Do you think the vet should be doing some investigative work? Could there be something more serious at the root cause?

Graham Finch advises…

I’m really sorry to hear your companion has one of those really frustrating ear problems that keep reoccurring. This is not an uncommon occurrence – I had four such cases yesterday! Yes, you are right, there is almost certainly an underlying problem. However, while this may be long term, it is unlikely to be serious unless neglected, which can lead to intractable ear problems or the ear canal closing. Generally, there are three issues to think about when it comes to treating long-term ear disease.

  • The primary problem – genetic perhaps? Is your dog a Shar Pei or other breed with a particular shape of ear canal? What disease process is leading to the problem?  e vast majority of cases are allergic in origin, but hormonal (particularly hypothyroidism) and other less common conditions (such as autoimmune disease) do occur.
  • Secondary problems – this is often what we call ‘an infection’, though more correctly it is an overgrowth of the microbes that naturally sit down the ear and under ‘normal’ conditions do not cause any issues. However, should the ear become in amed/ulcerated then they have a party and contribute to the symptoms of disease.
  • Perpetuating factors – this may be the shape of the ear or the environment the dog lives in (for example, swimming can lead to issues in some cases).

The history you describe makes me immediately think it’s an allergy, but this is clearly an intelligent guess. The ear becomes inflamed, the bugs down the canal go wild and then symptoms occur. Ointments address secondary factors, so these clear that up for a time, but with the threat of reoccurrence.

It is certainly possible to do some work up for a likely allergy and see where that leads you – I’d have a chat with your vet. At this point, it may be entirely reasonable to manage issues as they arise – we do see come cases that develop more frequent issues. Two factors that signal to me we should be more tenacious in our investigations would be increasing frequency and severity of disease.

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