This common cause of ear infections in dogs is among the most frustrating cases that vets treat.

Not all ear infections are created equal.

Ear infections (otitis) are one of the most common reason that pets visit the vet.

Many infections are caused by yeasts or bacteria and will usually respond within a couple of weeks to thorough ear cleaning and sometimes ear drops.

Some infections may be more difficult to manage and require longer and more intense treatment.

Ear infections caused by Pseudomonas bacteria can be more painful, more resistant to treatment, and harder to resolve than infections caused by other organisms.

Pseudomonas infections can be very aggressive and cause permanent damage to you dog’s ears.

Chronic Ear

Pseudomonas infections tend to be more common in dogs who have had recurrent ear infections.

The long term inflammation in the ears causes the ear canal to become thickened and swollen, creating a perfect environment for Pseudomonas.

The same chronic changes that make an ear more likely to develop Pseudomonas infection also make it more difficult treat.

Pseudomonas ear infections often produce a foul-smelling, thick discharge. The ear canal is often red and sore and swollen, and may be ulcerated in places.

Making a Diagnosis

Your vet may be suspicious of a Pseudomonas infection after examining your dog’s ear and looking at a sample of the discharge under a microscope.

The bacteria have a typical skinny rod-shaped appearance, although they may be part of a mixed infection with other rod shaped or round bacteria and yeasts.

If your vet is suspicious of Pseudomonas then they will recommend a swab to be sent for culture to the lab to make a definitive diagnosis.

The lab can also test the bacteria against different antibiotics to help identify what treatment is most likely to work… although with Pseudomonas this isn’t always so straightforward.

Keep reading to understand why!

Treatment

Most cases of otitis respond to either ear cleaning, topical medication, or a combination of these. However, in cases of Pseudomonas otitis a more aggressive plan is often necessary.

One reason for this is that the amount of discharge that is often present can make it harder for the topical treatment to work.

The chronic swelling and thickening that often affects the ear canal skin creates grooves, folds and corners which make it harder to get the topical treatment in.

FLUSHING the ear thoroughly under sedation or general anaesthetic will help to remove the debris and discharge and give the topical treatment a better chance of working.

Flushing the ear canal also gives your vet a chance to assess the ear canal and ear drum more closely than is sometimes possible when your dog is awake and wriggling!

Oral STEROIDS are almost always helpful in cases of Pseudomonas otitis as well.

The steroids will help reduce the swelling and inflammation, making your dog more comfortable, but also making it easier for any topical treatment to work.

We’ve mentioned topical treatment a few times… but WHICH topical treatment to use can be a difficult decision.

Pseudomonas can be resistant to a lot of standard ear medications, making them unlikely to be effective.

Even when laboratory testing shows that the Pseudomonas in your dog’s ear is sensitive to a particular antibiotic, it can develop resistance very quickly (within days) making treatment ineffective.

Regular microscopy and repeat cultures are often necessary to make sure that the infection is responding and not developing resistance.

Vets often have to use use ear preparations mixed in practice combing a cleaner or saline with steroid, antibiotic and silver sulfadiazine in place of commercial licensed ear treatment.

Long term

It can often take many weeks or months to clear Pseudomonas infections, and many dogs will get recurrent infections.

Once the infection has resolved you can reduce the chances of recurrence by investigating and treating any underlying causes such as allergies, an underactive thyroid or Cushings disease.

Regular cleaning and maintenance of your dog’s ears, as well as treating any infections promptly and thoroughly will help reduce the development of the chronic changes that predispose to Pseudomonas infection.

Cytology vs Culture:

What’s the difference and why should we do them?

CYTOLOGY refers to examining cells under a microscope.

Vets use cytology to identify the nature of disease, infections, cancer etc.

Ear cytology can help vets identify whether and what type of infection is present:

Does this ear have a yeast infection, or a bacterial infection?

What sort of bacteria are present?

Vets also use cytology to decide how well treatment is working: Are there less bacteria there now than there were before treatment?

CULTURE refers to growing bacteria, yeasts or fungus the lab.

Once the organism has been cultured it can be tested to see what treatment it is likely to respond to.

Culturing the discharge from an ear infection will help your vet identify what is causing the infection (ie is it Pseudomonas?) and which antibiotic is it most likely to respond to?

How Do I Clean My Dog’s Ears?

So your vet’s told you to clean your dog’s ears… but just how do you do that?

If possible, get your vet or vet nurse to show you how to clean your dog’s ears, and help you practice before you leave.

One of the most important tips is to put the cleaner INTO the ear canal… It’s not going to get rid of the wax and debris in the canal if you just wipe it on the outside.

Also, tip the cleaning solution in until you’ve filled the ear canal. This is far more effective than sousing that to wipe the ear.

Once you’ve filled the ear, massage the ear canal (just below your dog’s ear opening) for as long as possible- ideally a minute or so.

Try and avoid him shaking his head and removing all of the cleaner: it can help to have someone hold your dog while you clean the ear.

You can also put your hand over or fold the ear down slightly to cover the ear opening.

Use soft cotton wool to wipe away anything that has been flushed up out of the ear.

Never insert a cotton bud into the ear, and be extra cautious when cleaning sore ears that may be prone to bleeding or trauma.

Cleaning our pets’ ears can take some practice to get good at, but it is worth persevering as it is one of the most effective ways to treat ear disease and to maintain healthy ears!