The first thing you should know about skin infections and ear infections is that they are generally a secondary response to allergies. You can learn more about allergies here where I do a deep dive on allergy care. It’s incredibly important to read that article first to truly understand the issue of allergies that are causing these infections.
Skin Infections
Skin infections are relatively simple. You’ll identify a rash; there’s potentially scabbing, sometimes it’s moist, but it’s relatively easy to diagnose a bacterial skin infection. Treatment wise: antibiotics usually do the trick pretty easily.
We don’t very commonly have fungal skin infections that are actionable. But occasionally we’ll have a dog who gets a secondary Malassezia infection. Malassezia is a yeast that normally grows on dogs, and occasionally it will overgrow. In this situation, it’s not that the dog has a primary yeast infection. This is a secondary issue to the underlying allergy.
And it’s not surprising that yeast would overgrow because it’s just overgrowth of what’s already there.
There are various things online or at your pet store to decrease carbohydrates or help digestion better with promises to lead to a lower amount of yeast production. But this is not going to do anything to resolve the Malassezia overgrowth.
Malassezia overgrowth is not coming from the inside out and these are normal skin inhabitants. Malassezia is normally going to be on the skin of really every single dog in the United States or across the world. Again, it comes to the allergy issue.
A skin infection will look like a rash, hair loss, scabs, bumpy stuff, itchiness in the zone. If you, the pet parent, are scratching this area that looks a little bit weird, and the dog is going crazy in a way that you know you’re “hitting the spot,” that’s generally going to be a skin infection as well.
Ear Infections
Ear infections can be a little more challenging. Ear infections are almost always going to be secondary to an underlying allergy.
Frequently, the problem here is that you’ll have a dog that goes into the vet, and they get diagnosed with an ear infection. But there is no allergy discussion. This dog may be an itchy dog and they are licking their paws every day. But the pet parent doesn’t really understand it as itchiness, so they don’t report it as itchiness, and nothing gets done about it, and then your infection just keeps on coming back.
And that’s where I think we can really let down our pets and our pet parents. We have to be really good as veterinarians to actually push this conversation along, and to help our pet parents understand what they’re looking at.
A recurrent ear infection on an allergy dog is really kind of expected. But it’s on us to recognize that there’s an underlying issue and explain that to our pet parents so that we stop that from happening.
Included in that conversation is discussion about itch level (you should really be less than 3 out of 10 on the itch scale – more information on what that looks like can be found here) and what the various tools that we have in our toolbox to help mitigate those itchy dogs that keep getting ear infections (again you can learn about all of those tools here).
It’s important to keep an eye on the ears and to smell the ears occasionally. You can even put a Q-tip down in the canal a little bit and just get a sample of the ear debris. Take a little sniff test of that. It shouldn’t smell bad. If you’re getting stuff out of the ears, it’s a 9 out of 10 chance that your dog has an ear infection.
Let’s Talk about Different Types of Ear Infections
We can see three different things under the microscope when we’re talking about ear infections:
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Yeast
Under the microscope we see yeast which is really common. Again, that’s Malassezia and not surprising, that’s very wimpy, easy to kill.
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Cocci
We have Cocci, a little round bacteria. 95% of the time roughly it’s going to be an easy bacteria to kill. Any antibiotic will typically kill this kind of stuff.
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Rods
And then we have rods. Rods are rod-shaped bacteria, but they include families of bacteria that are not good: pseudomonas, E. coli, Klebsiella MRSA for dogs (MRSP). These are much more likely to develop resistance, and to have our antibiotics fail us.
If we see rods under the microscope, the ideal thing is to actually do a culture of that dog’s ear and send it to the lab.
At the lab, the culture will be put on a petri dish, warmed up and cooked basically so the bacteria grows, and it’s tested with different antibiotics.
At the end of the 3 to 5 day test, the lab is going to come back and say something like: “Okay, we identified that there’s E. coli in this dog’s ear. It’s sensitive to antibiotics, A, B, and C, but it’s resistant to all these other ones that we tested.”
And that’s common: that there are multiple antibiotics that these rod ears will be resistant to, which is why it can be extremely frustrating if we don’t do that lab test.
You don’t want to waste your time, money and effort on managing an ear infection that’s not going to respond to antibiotics that you just randomly choose off the shelf, which is what you have to do if you do not send the culture to the lab.
If the culture is not sent, a pet parent may find themselves having two months of ear treatments being done that are not effective at handling the specific rods infection the dog is experiencing.
So we always recommend a culture right off the bat so that we know what kind of medicine to use. And that’s going to increase our success rate in managing secondary ear infections.
Mythbusting
One myth we commonly hear from clients is they think cleaning the ears regularly will prevent ear infections. Unfortunately, that will not do anything to prevent ear infections as it doesn’t treat the underlying issue, which is allergies.
Watch this video to learn more.
Got Ear Infections?
Book an Appointment at Alicia Pet Care Center by calling 949-768-1313. We are a family-owned, full service animal hospital in Mission Viejo, CA and have 9 doctors who can help you with managing your pet’s allergies.
About The Author
Matthew Wheaton, DVM, Chief of Staff Alicia Pet Care Center| Matthew Wheaton, DVM has been practicing Veterinary Medicine for over 25 years. Vet Med runs in his veins; his father was also a well respected Vet in Orange County for 30 years. Matthew Wheaton graduated from vet school at UC Davis in 1996 and quickly started a career in emergency care before purchasing Alicia Pet Clinic in the summer of 2000. He has turned the hospital into the state-of-the-art, 9 doctor veterinary facility that it is today. He also has 3 pets at home, and 3 human children!
You can read his full bio here.
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