Ear and Skin Conditions in Dogs

Ask A Vet: Adrian Caunter MRCVS

 Treating Ear and Skin Conditions

This month our inbox was flooded with great questions. What stood out to me was that the overwhelming majority of them related to skin and ears.  The two can seem like different conditions but it’s important to remember that the ears are basically an extension of the skin and commonly an animal that has a recurrent problem with one will have a problem with the other.

The same can be said of feet problems, face problems and even sometimes itchy bottom troubles! The workup of these cases is very similar and I thought I would concentrate on one thorough answer which could be applied to most of your questions than trying to tackle them all separately.

The most important thing I can tell you all about skin and ear problems is that they can be really difficult to fix! Some of you will be lucky and have a simple infection, mite/flea problem or hot spot for example. If the correct diagnosis and treatment are given these can clear and never be an issue again.   Most of you, however, will not be so lucky. A definitive diagnosis can be frustrating to pin down, not to mention expensive and the best-case scenario can be a lifetime of management rather than a cure.

I’m not saying there aren’t things that can’t be done to improve things or that you should give up trying. I merely hope you all understand that these things can take a while to fix. I would love to say there is an injection that would fix it but it just isn’t the case.

A number of you will understandably get frustrated at the situation if things aren’t better after a few weeks, especially if your vet hasn’t made this clear upfront. Please bear with us, we will get you there in the end!


So.. How do I approach a skin case...

I will always, always ask about what you use to treat and then I will go ahead and check for fleas...always. Common things are common and not only that but some of the products you use will also rule out mites. It’s amazing how often fleas or flea dirt can be found, even when owners are sure it isn’t that. If your pet has an allergy to fleas then it only takes the odd bite to cause a flare-up and that can be hard to find. The best thing to do is to make sure you are up to date with an effective product and to do the same for all in-contact animals.

If you do have a flea problem then expect it to take several months to clear and remember to treat the house too. Ask your vet or nurse how to do a flea dirt check so you can keep an eye on things at home. Fleas themselves are sometimes hard to find! Whatever skin problem your pet has, always keep up to date with flea treatment as an itchy pet that gets fleas will be much itchier!


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Rule out simple things or concurrent problems...

Some kind of infection is pretty much always present, especially in cases that are chronic. Pets that damage themselves through scratching or overgrooming are prone to causing themselves infections. Likewise, abnormal skin is more prone to getting infected. This is usually a bacteria or yeast problem and can be diagnosed by your vet with a swab they take from the ear or a smear from the skin. This is simple, quick and results can usually be achieved within the time of the consult.

These infections are caused by an overgrowth of bugs that usually live on the skin and make the animal even itchier or inflamed. Once they have been diagnosed specific treatment can be started to clear them up, although sometimes this can still take several weeks if not longer. This will usually be in the form of topical treatment such as creams, drops, shampoo or oral medications such as tablets.
Certain findings – like rod bacteria in the ears may need samples to be sent to the lab to see which antibiotic is effective. This is because in these bacteria resistant to drugs can be common. Other tests that I might run at this time are hair samples, skin scrapes for mites or scanning for ringworm using a UV light. If these tests are positive then it should be considered reliable, though a negative test does not always rule them out.


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Look for a cause.

Generally, these problems are due to an underlying issue. Something is usually predisposing a pet to a recurrent problem and commonly it is some kind of allergy. Allergies can be to literally anything ( I remember well a cat that broke out in skin lesions when it ate a ladybird) and can be hard to prove. These allergies are common to either something animals eat or things in the environment – either in the house (such as dust mites) or outside (such as pollen).

I think that food is often a contributing factor and it is always worth looking at diet whenever you have an animal with any kind of skin problem. There are many diets that are available for allergic animals and it can take a bit of trial and error to find the right one. Grain-free diets can be very effective, hydrolysed diets have proteins that are broken down to reduce the chance of reaction and home-cooked diets allow complete knowledge of ingredients. Personally, I like home-cooked diets to start with as not only do I have more control but it rules out storage mites too (a common allergen that is present in many dry foods). The home-cooked diet is not usually a balanced one and I just use it to see if the diet is involved as it is not generally suitable for long term use. I design all my diets on a case by case basis using individual patient details and they should not be attempted without professional advice.

In addition, I commonly introduce supplements at this stage like omega fatty acids, vitamin E or Zinc as this can be helpful in improving general skin function.


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What if that doesn’t work?

If that was all there was to skin conditions then they wouldn’t be the problem they are! Depending on the case other tests that may be suggested include a blood test, skin biopsy or allergy testing. These will look for and allow specific treatment of other conditions such as hormone problems, disorders of the skin or hair follicles and less common allergies.

It maybe that at this stage you get referred to a veterinary dermatologist and this is always something you can enquire about at any point in your treatment. There are also other medications that can be used for itchy skin such as antihistamines, steroids, more potent immune suppressants or newer anti-itch drugs.
While these are very useful for controlling symptoms in many animals, it should always be remembered that they are not a cure for the underlying problem and can potentially be associated with side effects.



Then what?

It’s important to remember that these problems can flair back up again and as such, we need to keep on top of routine care. Staying up to date with flea control, not changing the diet too much and sticking with our supplements where needed is something that should be continued lifelong.

It is also important to regularly shampoo your pet or clean out their ears if appropriate as well as keeping coats and hairy ears etc all under control.
There is no one rule fits all here though as too often can be a problem too and so these recommendations should be case-specific and as directed by your vet.

Best wishes

Adrian Caunter MRCVS