Monday, April 5, 2010

10. Outer ear infections in people and dogs - comparison

Otitis externa is an outer ear infecion leading to severe pain. This condition is common in people and in dogs. The walls of the ear canal are swollen, red and blocked with fluid. Dogs can't complain about hearing loss but they scratch their infected ear and shake their head a lot.

OTITIS EXTERNA IN PEOPLE
CAUSES
1. Commonest cause is water or fluid entering the ear. For example, during swimming. Dampness inside the ear canal encourages bacterial growth. The canal skin lining breaks and get infected. Pain and swelling occur.
2. Narrowed ear canal in some people due to a different angle narrowing the canal and retaining fluid and dampness. No ventilation. Bacterial growth.
3. Eczema means an allergic skin problem in the ear canal. Scaly and flaky skin.
4. Humid tropical climate in Singapore leads to wet ears. Recurrent ear infections.

TREATMENT BY EAR SPECIALIST
FOR ACUTE OUTER EAR INFECTIONS
1. Strong pain-killer to relieve the pain.
2. Suction instrument to clear the ear canal of secretion one hour later.
3. After cleaning, a tiny cylindrical sponge soaked with antibiotic drops is inserted into the ear canal. This ensures that the deeper swollen end of the ear canal receives the antibiotics. Patient goes home.
4. Return 2 days later to get the sponge taken out and review that the ear drum is intact and normal.

For RECURRENT OUTER EAR INFECTIONS
1. Dry the ear by using swimmer's ear drops bought from the pharmacy. They contain alcohol which dries up the moisture.
2. Ear plugs, custom-made if the problem is due to ear perforation. This is to prevent fluid getting into the middle ear causing infections.

WHAT ABOUT OTITIS EXTERNA IN DOGS IN SINGAPORE?

The dog has a vertical and a horizontal outer ear canal, unlike people. People's ear outer canal is a horizontal one. Therefore the dog's canal traps water from bathing or swimming.

CAUSES
1. POOR VENTILATION. In hairy-eared dogs like the Miniature Schnauzer, the hairs prevents ventilation. Dampness lead to bacterial growth and ulcerations from infections. Head shaking and ear rubbing or scratching are commonly seen.

2. FOREIGN BODIES inside the ear canal. Owner's digging of the ear canal. Groomer's ear powder plugging the canal.

3. EAR MITES infestation. Quite common in puppies and kittens in Singapore. Anti-mite injection.

TREATMENT FOR ACUTE OUTER EAR CANAL INFECTIONS. Similar for people. Painkillers and ear canal cleaning. The dog may be tranquilised and the ear canal is irrigated to clear the pus and debri. No cylindrical sponge for ear canals as dogs don't tolerate objects inside the ear. Ear ointments are prescribed 3x per week. Antibiotics for 14 days. Generally, no more problems. Seldom do owners come back for review.

CHRONIC OTITIS EXTERNA
The owner is asked to come back 7 days later for ear irrigation esp. if the problem still persists. Many of my owners don't come back after the initial treatment. SURGERY - Lateral ear canal resection is the solution if the owner can see the long-term benefits. The surgery costs around $600. Visiting groomer to clean the ears and short grooming may cost $30. So, the owner feels that $30.00 is cheap and he or she has 20 visits in lieu of surgery. If the problem is hairy ears, the costs definitely is much lower. In addition, the time taken to go to the groomer and for the owner to clean the ears, the severe pain and head shaking, the discoloration and swelling of the outer ears and sometimes, ear haematomas requiring surgery are not considered by the owner.

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