Dr. Mark is a veterinarian. He works mostly with dogs and exotic animals.
Ear infections in dogs are so common that about 16% of dogs that go into the vet are dealing with this problem. Many are swabbed, diagnosed, get better with treatment, then come right back. Why does this happen again and again, and what can you do to prevent this?
Is your dog a victim of ear infections that keep coming back? Almost all dog owners have dealt with ear infections at some time. They are painful but are usually easily treated in just a few days. The symptoms are easy to notice, especially if you have a dog that has suffered from this problem over and over—recurrent otitis externa.
Symptoms of an Ear Infection
- Foul odor from the ears
- Shaking head excessively
- Rubbing head against the wall, furniture, or carpet
- Scratching at the ears
- Head tilt
- Drainage from the ears
Reasons Ear Infections Keep Coming Back
- If you have a Cocker Spaniel, Springer Spaniel, Labrador, Shar Pei, Basset Hound, or one of the other dogs with abnormal ears, this problem is a pretty common one. Some breeds suffer from long and heavy ears that keep the ear closed all of the time, others have narrow canals (stenotic canals, like those of Shar peis and English bulldogs) that do not leave the ear open, and others, like the Poodle, have ear canals full of hair.
- If your dog is not one of the breeds anatomically predisposed to problems, but still has recurrent ear infections, he may be suffering from food or inhalant allergies. An ear infection may be the only sign present in some dogs with a food allergy.
- If your dog swims often, especially if she has ears those floppy ears that do not get much air, she is more likely to get a new ear infection as soon as the other one is cleared up.
- A dog with a foreign body (like a foxtail) that was never removed will keep having ear infections despite treatment.
- If your dog´s infection (bacteria, yeast, or even mites) is never really taken care of, it will seem to go away but will be back.
Cleaning the Ears and Treating the Infection
The first time your dog has symptoms of an infection the treatment is pretty straightforward. When you notice the symptoms I describe in the section above, have your dog´s ears examined by your veterinarian and make sure that the ear drum is intact.
How to Clean Your Dog's Ears
- Fill the ear with a cleaning solution. I recommend a homemade solution of white vinegar—a mixture of 1/3 vinegar to 2/3 water.
- Fill the ear with the cleaning solution. The amount will vary by the size of the dog, but add enough that it is overflowing.
- Massage the ears, especially the base of the canals all the way down to the head. You should hear the liquid as you move it around in there.
- Stand back—your dog is going to shake her head and the wax and other gunk in the ear canals are going to be loosened by the vinegar and will go everywhere.
- If your dog does not make a mess, even with an ear infection, you might need to repeat this. Make sure to give the ear canals a deep massage.
Vinegar will make the ear acidic and if it is a mild ear infection that change may be enough to take care of the problem. To take care of it as quickly as possible, be sure to purchase the antibiotics or yeast medication that your vet recommends.
(If your dog has been pawing at her ears and they are already scratched up do not use the vinegar until the scratches are healed up. You can apply aloe vera gel to wounds to decrease the swelling and help them heal.
The dose of medication your vet recommends will vary so follow the directions. Some medications will contain antibiotics, others a medication to combat yeast, and others will contain a steroid to decrease itching and swelling.
Keeping the Ear Infection From Coming Back
There is a lot of controversy on what works best to prevent this happening again and again. The reason for all of the controversy is that there are no simple answers.
For a healthy dog, ear cleanings are not necessary, but if your dog is prone to infections, I would recommend that you clean the ears every week. If you take your dog swimming, it is a good idea to put some of the ear cleaners in before you even bring the dog home.
Some vets recommend that you do not mess with the ears since the cleaning might provoke an infection. Frequent plucking of hair (as in Poodles or some other breeds that do not shed) may also provoke recurrent ear infections.
As far as a medication to use in a chronic situation, I cannot recommend one that works every time. If you use a medication prescribed by your conventional vet (an antibiotic/antifungal/steroid combination) your dog may end up with a resistant infection and calcified ear canals.
What If It Comes Back Anyway?
Okay, you follow the instructions, treat your dog, but a few weeks later she starts shaking her head. The ear infection is back.
If this problem comes back as soon as it is cleared up, especially if the dog is not one of those breeds that suffer from recurrent ear infections, there are several possibilities:
- Food allergy
- Inhalant allergy
- Parasite or foreign body that was not taken care of the first time
- Excessive grooming
Take her in for another exam to rule out a foreign body, and have the ears swabbed for mite infestation.
If it is a simple infection, I recommend that you try an elimination diet. An elimination diet is designed to help you decide what your dog is allergic to. Start out with just one new protein source, feed it for a month or so, and if the ear problems clear up introduce another source. If the ear problems come back, stop feeding the new protein source.
If the ear infection only happens in the spring or summer, it is possible that it will clear up with a new diet but then come back next spring. There is nothing you can do but wait and see. When your dog starts licking her paws, scratching, and then develops an ear infection, you can try atopy injections (for inhalant allergies) or alternative holistic therapies.
Surgical Repair: The Last Step
If the ears develop infections no matter what you try, the only alternative is a surgical change. Many holistic veterinarians are against this procedure but for dogs with polyps or chronically swollen ears this might be your only answer.
The ear canals are totally removed and your dog is left with his ear drum exposed.
This is a last-chance procedure.
Is There an Answer for All Dogs?
For all dogs, I recommend keeping the ears clean and dry. This is the best chance of keeping your dog from getting ear infections over and over.
I would also recommend trying a grain free diet. The carbohydrates in grains might make the condition worse, so whether you want to use one of the commercial foods or a homemade raw diet I would do this immediately. This may or may not work, depending on the cause of her problem.
I wish I could tell you that one medication is always going to work in all cases. Traditional vets will prescribe an antibiotic like gentamycin or an antifungal medication, as well as using a steroid against the inflammation and swelling. Holistic vets might try garlic, witch hazel, or probiotic yogurt.
Why are there so many different treatments? It is because nothing works all of the time.
No matter who does the prescribing, treating ear infections that keep coming back is just a hit and miss procedure. If you have an experienced vet available, follow his or her recommendations.
And be sure to keep the ears clean and dry as described above.
This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.
Questions & Answers
Question: We have a Great Pyrenees who has constant ear infections the only time he doesn't is when he is on antibiotics. We have have taken chicken and chick bi-products from his diet which help for a month or two. His ears are so sensitive that even when he scratches or shakes his head he cries. Any suggestions?
Answer: I wish I could tell you that there was a simple answer for your dog. There is not, as I am sure you have already figured out. There are a lot of things to try though.
The first thing I would do if this dog were my own would be a strict elimination diet. I am not referring to one of the diets that are sold that way by your vet or local pet superstore. Those diets are made up in factories that make up other dog foods, and accidents do happen. If you want a pure elimination diet, you have to make it up at home and everyone in the house needs to be sure that your dog is not getting any other food source. No slipping him a bite of ice cream, no food under the table, etc.
Pick one food source. You can use lamb if available. It is going to be expensive with such a big dog, and it is not going to be a balanced diet, but you can keep him on pure lamb for about 6 weeks and monitor his response. You might have to go on for 12 weeks, since you cannot really give up until then. (If you cannot afford this you can also feed brown rice with his lamb. Rice is a much better choice than some of the other grains.)
If his ears are getting better on the diet, you can start cleaning them with the dilute vinegar as described in the article. The acidic environment will make it easier for the ears to clear up.
Question: My ten year old, male Blue Heeler has chronic ear infections and has already had surgery. He is on a daily dose of Prednisone which is taking a toll on him. His ears and hardened and he can no longer hold them up. Could you please suggest something that doesn't have such terrible side effects as Prednisone?
Answer: It is possible that your Blue Heelers ears are hardened because of the chronic infection, not because of the Prednisone. Have you looked into what is causing this recurrent infection? Does the dog have signs of inhalant allergies or food allergies?
There is not a good medical substitute for prednisone, and, as you are noticing, the drug has a lot of side effects. The best chance for your dog is to determine what is causing the infection to come back and fix that. Consider trying to change his diet first.
Dr Mark (author) from The Atlantic Rain Forest, Brazil on July 19, 2020:
Stella, a lot of Poodles have narrow ear canals that are obstructed with hair. I would recommend you put her on a daily cleaning program to prevent pus buildup in the ears. Also ask your groomer about plucking the hair if the ears are blocked.
Stella Richards on July 18, 2020:
We have a toy poodle she is a senior dog (15yo). She has this ear infection for about 2 and half years, sometimes she whines at night of pain, sometimes she is tired and doesn't seem like herself. But then appears very energetic. Her ear stinks and has wax buildup and liquid coming out of it. It may seem we haven't done anything but we have taken her to the vet millions of times. They gives us antibiotics she gets better just a bit and then the infection comes back. Never completely heals. We even cleaned it and give her ear drops. Any suggestions??
Dr Mark (author) from The Atlantic Rain Forest, Brazil on November 12, 2018:
Kristina, it sounds more like house dust mites than a food or seasonal allergy. Here is a link to a list of recommendations for dealing with these allergens in the house: https://pethelpful.com/dogs/tips-to-make-an-allerg...
Not easy. There are about 10 different things you can try though, so I hope she ends up feeling better.
Kirstina Barkman on November 12, 2018:
Hi Dr. Mark. We rescued a blue nose pit bull 3 years ago and have had horrible re-occurrung ear infections since the 3rd month. She is on. LID diet of lamb and rice, has ear infections every spring, and recently I noticed our HVAC furnace triggered immediate head shaking and the cause all her for fall infections. We have a floor return system in an over 100year old home. She whines whenever our heater is on and the head shaking didn't start up again until we turned our heater on. What could the tie in here be? And what can we do to prevent and fix? Thank you for any and all help.
Dr Mark (author) from The Atlantic Rain Forest, Brazil on September 13, 2018:
Hollie, you are correct when you mention that you think long term medications are not the best option for your dog. Unfortunately sometimes not much works. If I had your dog, and was willing to find out anything that might work, I would take her to a holistic vet to try something different. (I am not sure where you are at or who you might go to, but you could try a search engine and look for a holistic vet in your area. The vet you have been seeing may or may not give you a referral.)
Your dogs medical records are yours, even if the vet does not refer. Call ahead and tell them you want copies of the records before visiting the holistic vet.
The new vet might recommend cleaning several times a week with apple cider vinegar (to make the environment in the ear hostile to any bacteria that want to cause an infection) and an alternative treatment like coconut oil. Good luck finding a solution to her painful problem.
Hollie Hollie on September 12, 2018:
I hope this post isnt too old to answer!
2 Years I rescued a Staffy/Patterdale terrier, the rescue home (RSPCA) informed me she had an allergy but it had cleared up.
4 weeks later, shaking of the head, dark discharge from the ears etc started. I have ALWAYS kept her on hypoallergenic food and she gets walked every day - may I say she is a very happy dog.
From the start she has had vets appointements regulary. I have tried ear drops, steroids, an injection (I have forgotten the name) every 6 weeks (at £200 per go) that fights the infection, even all 3 at the same time. I dont use perfumed household cleaners, I dont bathe her in fancy shower gel and she has all bedding washed on 90c. The infections go with medication but return with a week or so of coming off the meds. I hate leaving her as she chews her paws and scratches her ears. I cannot stand to see her in pain but I cant seem to come to a permanent solution with my vet. Can you recommend anything at all?? I have even thought about a TECA but not sure if she will lose her hearing after op??
Happy to give her ear drops for the rest of her life however is that good for her??
Are the vets ripping me off by making me try different solutions and making me come back every week??
The vets seem to only offer steroids however I live in hope that there is a more permanent solution that someone can offer?? I assume steroids long term arent good for dogs?
I cant stand to see her in pain and after having a not very nice first few years of her life, I just want her to be happy and pain free.
ANY advice is welcome.
Dr Mark (author) from The Atlantic Rain Forest, Brazil on March 28, 2018:
Claire, what do you mean by "his ears are bigger". If things are that bad you should definitely not try to clean with vinegar; he will be in a lot of pain. If he were mine I would look into food allergies.
Claire on March 28, 2018:
My spaniel has had 2 really bad ear infections and recently his ear drums both ruptured. His ears are far bigger than an average spaniel and he won't let me near his ears. He is the friendliest dog but when his ears are bad he will not let you go near them and gives you a warning growl is there anything I can give him to help the infection that does not involve touching his ear. Thank you
visanth vs on March 06, 2018:
I had a golden retriever and she use to swing her head so violently that she busted her ear drum because of a ear infection
Dr Mark (author) from The Atlantic Rain Forest, Brazil on November 24, 2017:
Deborah, every 2 hours? Who told you that the dogs ears need to be cleaned that often?
Deborah Sutton on November 24, 2017:
I have to clean his ear at least every 2 hours,hes had this for 2 years straight, cost me a fortune in vet bills
Dr Mark (author) from The Atlantic Rain Forest, Brazil on February 16, 2016:
Thanks for that update. What led you to try Kombucha tea? Do you make it yourself or is it the commercial product? I would really like to hear your further thoughts on this.
Bev G from Wales, UK on February 16, 2016:
Dr Mark, just wanted to update you on our Lab bitch. We have finally conquered the ear infections by giving her home brewed Kombucha tea. I only clean her ears once a week now instead of twice a day. She hasn't done the head shaking thing since starting the tea two months ago. I add about a cup (a generous slosh) to each meal. It is a probiotic, which indicates that the problem was a bacterial imbalance rather than mites.
Dr Mark (author) from The Atlantic Rain Forest, Brazil on February 16, 2016:
Larae, not sure the food is going to help since that breed is prone to recurrent infections if the ears are not totally dry after a swim.
You can try making your own diet at home since it is a lot cheaper that the SD product. Just use one protein source and keep him on it for at least six weeks. This does mean no treats, nothing else, including nothing from the kids. If that is not going to work do not even bother.
The best bet for your Springer is to keep the ears dry, especially after a swim. If his ears still seem moist after the vinegar rinsing you might try a commercial drying product. The expense will be a lot less that if he suffers from recurrent infections.
He is really miserable with these infections, so I wish you the best of luck finding a solution.
Larae Combe on February 15, 2016:
I have a 15 month old Springer Spaniel. I got him because we have a pool at home, and go boating all summer long. Now I feel like these two things are causing him so much pain with constant ear infections. My vet has recommended me Hill Science Diet food for him for food allergies to see if that's what's causing it, but it's so expensive and he's a vaccum to the food that falls from my 3 kids so I feel like it's almost a waste of money. I don't know what to do for my sweet dog that is always in pain it breaks my heart. A local dog food store has suggested Venicine instead of Chicken or Beef type foods.
Sheila Brown from Southern Oklahoma on October 09, 2015:
Our husky seems to get ear infections often, especially now that she is older. We took her to the vet who gave her some antibiotics and ear drops. The ear drops caused her to temporarily go almost completely deaf. Once she got her hear back, I have started cleaning her ears with a q-tip dipped in alcohol. Of course, I can't deep clean with that. I will try your suggestion. Thank you for a very informative hub!
Bev G from Wales, UK on September 30, 2015:
Thanks so much, Dr Mark. I'll sort out a sock bandage and get some white vinegar as well. At the moment, I clean her ears as soon as the head shaking starts so it never goes on for more than a minute or two. I love your hubs, they are my new go-to source of doggy info.
Thank you also from MableAble, Chloe, Mitzi, Daisy & Delilah.
Dr Mark (author) from The Atlantic Rain Forest, Brazil on September 29, 2015:
Hi Bev I am sorry you are having so much trouble with that Lab´s ear. There are only two things I can suggest in that case: the first would be very difficult but is probably the best. The ear needs a lot more ventilation, so if the flap can be held back and kept that way (maybe by putting a sock bandage on the head to hold it in place), that would help. It really depends on the dogs personality though, as a 2 year old Lab is probabably not going to be calm enough to put up with a bandage on all of the time.
The second thing is a little more practical but not as good. Instead of cleaning with mineral oil, use a dilute vinegar solution, which is more acidic and may clear up the infection without resorting to antibiotics or antiinflammatories like prednisone or betamethasone.
If neither method works, however, you really need to resort to something else before your dog starts shaking excessively and develops an aural hematoma (a pool of blood in the tip of the ear).
I hope things clear up for him.
Bev G from Wales, UK on September 29, 2015:
We have a 2-yr old Lab whose ears I clean daily. I wipe them with a cotton swab and mineral oil followed by ear drops. It seems as though it clears up and then a day or so later she's shaking her head again. The problem is only in one ear. We have four other floppy-eared dogs, including another Lab, who have never got ear infections, mites or otherwise.
All dogs are on a raw food diet: minced chicken, beef bones and vegetables are the staples. Plus they have a couple of raw eggs a week, a little garlic and sometimes a tablespoon of plain yogurt.
I am trying to avoid steroids and antibiotics but am at my wits end with her. Help!
Sandy Sawyer on August 15, 2015:
Thank you for all your advise. Living in Uganda it isn't easy to get special food for our to dogs who are both suffering from yeast ears (this I have gleened from your article. Our rottweiler has been on antibiotics and ivomec for 2 months now and his ear infection keeps reoccurring. I will try your advise. Our wire hair terrier had been chewing her paws and scratched her neck raw. Same thing ..The vet but her on antibiotics and ivomec. I clean bit of their ears out with ear cleaner and put candiderm on the effected areas.
Kevin Goodwin on August 14, 2015:
I had a golden retriever and she use to swing her head so violently that she busted her ear drum because of a ear infection.
Dr Mark (author) from The Atlantic Rain Forest, Brazil on July 19, 2015:
Thanks for reading Bob. Believe it or not, I discussed puppy care with a new client the other day, and since he complained about not having time to spend taking care of his new dog, I recommended a good commercial diet. Raw is not for everyone, and a dog owner that is not willing to find the right ingredients and blend them is better off buying a feed at the store. And, as you mentioned, staying away from junk, but that is always a battle here, as everywhere.
Bob Bamberg on July 19, 2015:
Another good, useful hub, Doc. Owners can save time and money if they follow a regimen of regular ear care, and your step-by-step instructions light the way.
I also noticed what Vic did...and maybe that's why I get fewer page views. I automatically write headlines for eye appeal (old habits die hard). But, I notice that no matter how I word a Google search, it pretty much knows what I meant and takes me to the right sites.
I'll bet that, all the way from the Beach of Brazil, you could see my wide-eyed expression when I read your suggestion that a grain free diet might help. See? We're not totally at odds over commercial foods.
I've had a lot of people come up to me at stores I appear at and tell me they took my advice about grain-free (or at least wheat and soy free) and it worked, or helped. Of course, most of these people were feeding brands that contained wheat and soy and making matters worse by giving wheat based treats, plus stuff like pizza crust, toast, bagels, etc.
Changing the food helped, but eliminating all the other stuff was probably a bigger factor.
Voted up, useful and interesting.
Dr Mark (author) from The Atlantic Rain Forest, Brazil on July 17, 2015:
Hi Dressage Husband, it was probably Panalog and you are fortunate that it worked for you. I have seen some Labs that like to swim with chronic otitis and a lot of scar tissue in the ear canals. That is also a very expensive medication here in Brazil, but when it works it is well worth it.
Thanks for reading so closely, Vic Dillinger. I have noticed that if you write out the exact way someone types into the search engine, it produces better results. I really wanted to write "Best method of avoiding recurring otitis externa" but do not think I would have many page views with that title!
Vic Dillinger on July 17, 2015:
Your title should read: "Why Does My Dog's Ear Infection Keep Coming Back?"
Stephen J Parkin from Pine Grove, Nova Scotia, Canada on July 17, 2015:
I found this interesting as we had a Lab that would get ear infections periodically. Fortunately this only happened a couple of times. I suspect that the vinegar solution would have done the trick. However our vet prescribed some fairly expensive ear drops., they did work however and the problem only recurred a couple of times.