Liz writes:
We have a 100 pound American bull Dog. He has had a constant yeast infection in his ears for over one year. He flaps his ears so hard that the top of his head is bleeding from flopping his ears.He has been on Ciprofloxacin 500 MGM twice a day and this is not helping.To clean his ears out he has to be put to sleep but that does not last long then back to flapping his ears again. I am at wits end and our vet has not offered any other alterative. Can you advise me?
Hello, Liz,
Since I have not seen your dog, I really cannot give you specific advice. However, I can give you some general information.
Many dogs with this type of chronic ear infection have some type of allergy as the underlying cause. This can be an environmental allergen like pollen or house dust. It is possible for an allergic dog to break out nowhere else but inside its ears (which is certainly counter-intuitive). It can also be a food allergy. I have had the dermatologists tell me that I should do a dietary elimination trial in these patients, as food allergy is more common than we would like to think.
Food allergy cannot be diagnosed with blood tests or skin tests. It requires a dietary elimination trial.
Dietary elimination trials require feeding an entirely different food source, something the dog has not previously been exposed to. This means that you can't just switch brands of dog food. You have to use a food with a different protein source (like duck and potato, venison and green pea, kangaroo and oats), or a hydrolyzed protein (Hill's Z/D or Purina HA) where the protein is broken down into short fragments of amino acids.
The dog cannot eat anything besides the new diet, no treats, no cat food, no table scraps, not even flavored heartworm preventive tablets. This is continued for 10 to 12 weeks to allow every residue of the previous diet to be eliminated from the dog's digestive tract. Some dogs will respond more quickly, but some will take as long as 16 weeks.
In patients with severe ear infections, even without allergies, a short course of some type of systemic corticosteroid often gives the dog a lot of relief, making cleansing and topical treatment much more tolerable.
Sometimes we use systemic (oral) anti-fungals with yeast ear infections (in addition to topicals). Topical treatment is usually necessary, and you do need to deal with the underlying cause. Finding it can certainly be the hard part.
Please talk with your veterinarian about your concerns. If he/she is uncertain as to how to proceed, then ask for a referral to a specialist with whom they have a good relationship.
