Chronic Ear Issues in Dogs: When Ear Infections Become a Long-Term Battle

A guide to chronic ear infections and end-stage ear disease in dogs. Learn what happens when ear infections become a recurring battle, and understand the surgical options, like a TECA, that may be necessary.

Hey there, pet parents. We've talked about the common, simple ear infection. But what happens when those infections keep coming back, over and over again? Or what if an infection never seems to fully go away? This is when you enter the frustrating world of Chronic Otitis. This is a long-term, progressive condition that can cause permanent changes to the ear and a lot of pain for your dog.

What is Chronic Otitis?

Chronic otitis is the result of repeated or unresolved inflammation and infection in the ear canal. Each time the ear gets inflamed, the skin lining the ear canal gets thicker. The glands that produce wax go into overdrive. This creates a vicious cycle:

  1. •An underlying problem (like allergies) causes inflammation.
  2. 1The inflammation leads to an infection.
  3. 2The infection causes more inflammation.
  4. 3The chronic inflammation causes permanent changes to the ear canal.

These permanent changes include:

  • •Thickening and Scarring: The ear canal becomes progressively narrowed, making it even harder for air to get in and for debris to get out.
  • •Calcification: The cartilage of the ear canal can turn hard, like bone.
  • •Middle Ear Infection (Otitis Media): The infection can spread through the eardrum into the middle ear. This can cause more serious signs, like a head tilt or facial nerve paralysis.

At this point, the ear has become so abnormal that it is a perfect environment for a constant, smoldering infection. This is now an "end-stage ear."

The Road to an End-Stage Ear

The path to chronic otitis is almost always paved with uncontrolled allergies. A dog with underlying atopy or food allergies will have constant inflammation in their ears. If this is not managed, they will get repeated secondary infections. Each infection causes more damage, and the cycle continues until the ear is irreversibly damaged.

Another major factor is the development of resistant bacteria. If a dog is treated with many different courses of antibiotics over the years, it's possible to select for a "superbug" (like a resistant Pseudomonas or Staphylococcus) that is very difficult to kill with normal medications.

Signs of Chronic Otitis

The signs are similar to a simple ear infection, but they are more severe and persistent.

  • •Constant Head Shaking and Scratching.
  • •Thick, Foul-Smelling Discharge: Often pus-like.
  • •A Narrowed Ear Canal: Your vet may not even be able to get the otoscope cone into the ear.
  • •Extreme Pain: The dog may not let you anywhere near their head.
  • •Neurological Signs: If the middle ear is involved, you might see a head tilt, facial paralysis (a droop on one side of the face), or abnormal eye movements.
  • •An Aural Hematoma: The violent head shaking can cause a blood vessel in the ear flap to burst, creating a large, fluid-filled swelling.

Diagnosis and Treatment Challenges

  • •Diagnosis: The diagnosis is made based on the history of recurrent infections and the appearance of the ear. A CT scan is often recommended to assess the middle ear and the extent of the changes to the ear canal. A deep ear culture will be needed to identify the bacteria and guide antibiotic choice.
  • •Treatment: Treating an end-stage ear medically is very difficult. Because the ear canal is so narrowed and full of debris, it's almost impossible for topical medications to be effective. The dog often needs to be put under anesthesia just to have the ear thoroughly flushed and cleaned. Long courses of specific, systemic antibiotics (based on culture results) are needed.

While medical management can sometimes control the infection temporarily, it rarely solves the problem because the ear itself is so anatomically abnormal.

The Surgical Solution: TECA

For a true, end-stage ear, the best and most humane treatment option is a Total Ear Canal Ablation and Bulla Osteotomy (TECA-BO).

A TECA is a major surgical procedure where the entire, diseased external ear canal is completely removed. The "bulla osteotomy" part involves opening up the middle ear (the tympanic bulla) to clean out all the infected material.

This surgery removes the source of the chronic pain and infection. The ear flap is left in place, so the dog's appearance does not change dramatically.

What about hearing?

By the time a dog needs a TECA, the ear is so diseased that they are usually already deaf on that side. The surgery will result in permanent deafness in that ear, but it trades a life of chronic pain for a pain-free, comfortable life. The vast majority of owners who go through with a TECA are thrilled with the result and say they got their happy dog back.

The key takeaway is to be proactive. If your dog is suffering from recurrent ear infections, work with your vet to find and manage the underlying cause before the ears get to this end-stage point.

Sources & Further Reading:

  1. •American College of Veterinary Surgeons - Chronic Otitis and TECA
  2. 1VCA Animal Hospitals - Total Ear Canal Ablation and Bulla Osteotomy (TECA-BO)