Middle and Inner Ear Inflammation (Otitis Media and Interna) in Dogs
Key takeaways
Inflammation of the middle and inner ear affect the parts of the ear that are behind the eardrum.
- In dogs, this form of inflammation is usually caused by bacterial infection, which most often spreads to these structures from the external ear
- Symptoms include head shaking, pawing at ears, pain when ear is touched, nausea, loss of balance, and head tilt
- Causes include bacteria, fungi, parasites, and foreign objects (e.g., grass awns)
- Diagnosis is by thorough examination of the ear, which often requires sedation or general anesthesia, and cytology
- X-rays, CT, and MRI scans may also be helpful in diagnosis
- Treatment is antibiotics and may also include steroids
- Prognosis with early and aggressive treatment is good to excellent
- In cases where infection has spread to the bone or brain, prognosis is more guarded
Connect with a vet to get more information about your pet’s health.
A closer look: Middle and Inner Ear Inflammation (Otitis Media and Interna) in Dogs
The inner ear communicates where the body is in space to the brain, which is how dogs and other mammals maintain proper balance. Middle and inner ear inflammation (also known as otitis media and interna, respectively) can interrupt the processes involved in balance and coordination. As such, symptoms of middle and inner ear inflammation can be alarming and mimic those of other conditions that are life-threatening. Given this, urgent veterinary intervention is warranted to rule out more serious conditions. Any time dogs show changes in their normal head position, veterinary care is required. The earlier care is sought, the better the outcome.
Connect with a vet to get more information
Risk factors
Middle and inner ear infections are uncommon in dogs. While they are not life-threatening, leaving them untreated can cause serious complications including bone and brain infections. Certain ear conformations (dogs with large, floppy ears) are at a higher risk
Sometimes the facial nerve is damaged by middle/inner ear infections.
In some cases, middle and inner ear infection can cause signs of vestibular syndrome.
In rare cases, inner ear infections can spread into the brain.
Possible causes
Middle and inner ear inflammation is usually associated with infection in the ear canal. Ear infections in dogs may have bacterial, fungal, or parasitic origins.
Main symptoms
Symptoms of middle and inner ear infections depend on the severity and extent of the infection. In general, middle ear infections produce milder symptoms than inner ear infections. Symptoms include
- Redness in external ear
- Foul-smelling discharge from the external ear canal
- Head-shaking
- Head tilt
- Pawing at ear(s)
- Difficulty eating
- Pain with opening mouth
- Head swinging from side to side
- Decreased hearing
Testing and diagnosis
The first step in diagnosing a potential case of middle or inner ear infection is a physical exam.
Additional tests include:
- Blood work
- X-ray
- CT
- MRI
Diagnostic imaging can be helpful to visualize the structures of the ear and skull.
An in-depth ear exam is usually necessary and requires sedation or full general anesthesia. During this procedure, myringotomy (perforation of the eardrum) may be performed to obtain a sterile sample of any fluid within the middle ear for bacterial culture and cytological analysis.
Steps to Recovery
Initial treatment for vomiting or lack of appetite may require hospitalization with IV fluids and antinauseants. Surgery may be indicated depending on the specifics of the case. The middle ear cavity may be drained, or, in severe cases of middle and inner ear infection, the entire external ear canal may be removed.
Further treatment involves oral antibiotics for at least 6-8 weeks. Steroids may also be prescribed. External ear medications are usually not used.
Prognosis is good with early and aggressive treatment. Complicated cases involving nerve damage or spread of infection have a poorer prognosis. If there has been facial nerve damage, some neurologic symptoms in the face may be permanent. Patients need frequent recheck exams to monitor progress.
Middle and inner ear infections are expected to completely resolve with appropriate treatment.
Prevention
As most cases of middle and inner ear infection begin as external ear infection, aggressive and early management of otitis externa will prevent some cases.
Hunting dogs or those who frequent wooded areas may benefit from frequent ear exams to check for foreign bodies such as grass awns.
Is Middle and Inner Ear Inflammation (Otitis Media and Interna) in Dogs common?
Middle ear infections are uncommon in dogs; inner ear infections are rare.
Testing and diagnosis
- Hospitalization
- Thorough ear exam
- Draining/flushing ear
- Systemic antibiotics
- Steroids
- Surgery
