Expert: Dr. Louis N. Gotthelf - 2/3/2006

Question
Hi Dr. Gotthelf
I am really looking for a second opinion regarding my 11 month old yellow labrador retriever.  He developed his first ear infection back in November, we noticed because he kept pawing at his ear and he became disinterested in his food (though his energy level was and remains through the roof!)  We took him to the vet where they diagnosed him with a bacterial ear infection, flushed his ear, gave him a steroid shot, some antibiotics and a topical ointment (montemax) for his ear.  The infection seemed to clear up and he began eating voraciously again and everyone was happy.  About a month later, he began exhibiting the same symptoms- this time even more black residue appeared in his ear.  We brought him back in where he was given another round of antibiotics, this time, Baytril and some more montemax.  THis did not clear up the infection so we brought him back- they told us that he would need to be sedated so they could culture and clean the ear. (the culture was done about 48 hous after his last dose of baytril)  They did that, and found that he had a middle ear infection and that his ear drum had ruptured.  They gave him Cipro and told us they would call us when the results came in.  We brought him back last night for a recheck where the vet confirmed that his ear was not better and to find that the culture results showed no bacterial growth.  The vet was very suprised by that and is still convinced that it s a combination of a pseudonomas (unsure of spelling) and a yeast infection and would be best treated by this high powered antibiotic that is relatively new to the market ( I have to get the name when he calls me today) He would also like the dog to come back and to be sedated for another ear cleaning.  I was just looking for a second opinion on this- I wasnt sure if this could be related to allergies as he is not as interested in his food and is a bit sniffly and has a runnny nose.  The vet said that was a good theory but that he usually doesnt see allerges in pets this young and that his other ear would be infected as well if it was allergies.  Any advice would be really appeciated as we just want our dog to get better and our pocket books need a break as well!  Thanks alot

Melissa

Answer
Most food allergies occur in very young dogs, especially Labs.  Atopy, or allergic dermatitis, does not occur usually until 1 1/2 years or so.  That involves exposure to pollens. molds, etc. over time and the re-exposure at a later date.  A food change to a different protein source  may be needed to help prevent the yeast ear infections.

The other bacterial infection and ruptured eardrum may or may not be associated with allergies.  IF the dog gets water in the ears, that is where Pseudomonas comes from.  That bacteria frequently causes the eardrum to be eaten away by the enzymes that is produces. The otitis media is very painful and results in secretion of mucus and pus that can drain into the throat.

Middle ear flushing and placing antibiotics into the middle ear is the best way I have found to deal with middle ear infetions. The flushes need to be done weekly for 3-4 weeks.  Once the bacterial infection is gone, the eardrum will heal back up.