Ear Medications

itchy ears

One of the most common reasons that dog owners bring their pets to a veterinary clinic are ear infections.  Needless to say, ear infections can be a significant source of pain and discomfort for your pet.  Anytime you see your dog or cat scratching their ears, shaking their head and whining or withdrawing when you approach their head … or if you notice a funky odor … it’s a safe bet that they have an infection in one or both ears.  So why are ear problems so common ? Allergies !  The large majority of problems we see with ears are the result of an allergy, either to food, or something in the environment (pollens, dusts, molds, mildews, etc).  Because of changes in the ears resulting from the allergies, many dogs will develop a lot of redness and irritation, as well as a yeast infection, and sometimes a bacterial infection.  Fortunately, we have a number of different ways to help manage these infections, and most crucially, to help your pet get some needed relief.  If there is one lingering source of frustration, it is that most of these infections tend to want to return, mostly because allergies remain the source of these problems, and allergies can persist for life.

So, here are the primary means of defense against ear problems that we see:

  1. Manage allergies whenever and however possible (see my handout on Seasonal Allergies … and my handout on Food Allergies).
  2. Use a good ear cleaner once or twice a week routinely.  My favorite choice is Douxo Micellar Solution Ear Cleanser (details below)
  3. If yeast infections are a recurring problem with your dog, then I strongly recommend frequent (2 to 3 times a week) maintenance by cleaning the ears with Keto-C Flush (details below)
  4. Educate your groomer … and know that sometimes it’s best to leave the ears alone!  We see a number of breeds of dogs that naturally have hairy ears (Poodles, Shih-Tzus, Schnauzers, etc).  Many people and many pet groomers mistakenly believe that hair is the cause of ear problems.  Not true !  Hair can be a contributing factor because it can trap debris, yeast, and moisture in the ears, but it does not cause the infections.  However, we know for a fact that pulling the hair from the ears of a dog’s with healthy ears WILL cause irritation and redness to the ears.  My recommendation:  If your dog does not have any ear problems, tell your groomer NOT to remove the hair from the ears (to be honest, they will probably be thankful, since they don’t enjoy removing hair from the ears).  If your dog has recurring problems with the ears, then it can certainly be helpful to remove the hair.
  5. Know that we rarely see ear mites in adult dogs, so don’t waste your hard-earned dollars on ear mite medications for your dog.  And we virtually never see ear mites in indoor cats, and when we do, it’s usually because the indoor cat has close contact with an outdoor cat that has ear mites.

OtiPack E (Enrofloxacin + Ketoconazole + Triamcinolone) – For Moderate to Severe Ear Infections
*** This is a powerful combination of an antibiotic for infection;  cortisone for inflammation, irritation and pain;  and an anti-fungal agent for yeast infections. We put the medication into your pet’s infected ear(s) with a single application ~ you do not need to put the medication in the ear on a daily basis as with most ear medications.  A single application lasts for ~ 4 weeks, during which time you must leave the ears alone!  No more fighting to treat your pet’s ears daily at home when they are raw, irritated and painful.
0-35 lb pets (1 Ear) – $24
0-35 lb pets (2 Ears) – $30
35+ lb pets (1 Ear) – $30
35+ lb pets (2 Ears) – $38

Claro (Florfenicol + Terbinafine + Mometasone) – For Moderate to Severe Ear Infections
*** This is also a powerful combination of an antibiotic for infection; cortisone for inflammation, irritation and pain;  and an anti-fungal agent for yeast infections. We put the medication into your pet’s infected ear(s) with a single application and it continually treats the ear for 4 weeks.  You do not need to put the medication in the ear on a daily basis as with most ear medications.  Nice!
(1 Ear) – $27
(2 Ears) – $38

Claro vs. OtiPack-E:  Which medication is better?
It’s not a matter of one being better than another.  They are both excellent medications to effectively treat ear infections.  And while the ingredients are not the same, the benefit should be.  The decision of which to use is one Dr. Bob will make.  And the main concern is how ‘gooey’ the ears are.  If they are really gooey and messy, Dr. Bob will choose Claro since it is a liquid solution, as opposed to OtiPack, which is a thick lanolin base.  Best not to add thick goo to an ear that already has a lot of thick goo.  Also, if an ear is very inflamed (very red, very sore, puffy), Claro is a better choice since the cortisone in Claro is more powerful.

Keto-C Flush 12oz – $23
*** Great product for chronic (on-going) yeast infections (most commonly seen in Retrievers and other large dog breeds) since it actually KILLS the yeast.  It also contains an anti-bacterial agent Chlorhexidine which has anti-yeast properties as well.   For those dogs prone to yeast infections, I recommend using this on an on-going basis… just like brushing your teeth. While every pet is different, I generally recommend applying it in the affected ears daily for 1 week, then 2 to 3 times each week on a consistent basis.

Douxo Micellar Solution Ear Cleanser 4oz – $14.50
Why do I like this particular cleanser so much ???
1. It remove excess debris and wax from the ears
2. It controls wax production
3. It controls the normal bacteria in the ears
4. It relieves irritation and redness
5. It controls odor
6. It dries quickly

Zymox w/Cortisone – $21.50 + Tax = $23
*** Great for mild ear infections – Use only once daily for 1 to 2 weeks, then use as needed.  When using Zymox, do not use any other ear cleaners at the same time.

Healthy Ears = Happy Pet!