Otitis media(middle ear inflammation) usually comes from infection spreading from the external canal or from a foreign object that gets into the ear canal and ruptures (tears or punctures) the eardrum. Rarely, infection spreads through the bloodstream. Otitis media can progress to otitis interna(inner ear inflammation), which can cause balance loss and deafness.
Signs of otitis media overlap with otitis externa, including head shaking, ear scratching, rubbing the ear on the floor, and turning the head toward the affected side. The ear is usually painful and might produce discharge. Recurrent otitis externa suggests that otitis media might be present.
Because nerves to the face pass through the middle ear, dogs with otitis media can develop paralysis, or the inability to move their face, eyes, or eyelids, on the same side as the ear problem. Otitis interna typically results in a head tilt toward the affected side and can cause severe coordination problems, difficulty rising and walking, and uncontrollable eye movements. If infection spreads to the brain, other neurological signs can occur.
Diagnosis is easier when the eardrum is ruptured, but most dogs with otitis media have an intact eardrum. Otitis media is found in over half of dogs with recurrent external ear inflammation. Fluid in the middle ear or changes in bone can be seen with x-rays, CT scan, or MRI testing.
Otitis interna is suspected when balance loss accompanies signs of an ear disorder.
Treatment
Because of the risks to hearing and balance, vets often prescribe long-term antibiotics by mouth or injection for otitis media or interna, commonly for 3–6 weeks. If the eardrum is ruptured, the vet will clean the middle ear carefully. Small perforations (holes) often heal in 2–3 weeks. External ear inflammation is treated at the same time. Anti-inflammatory drugs may be given in the first week to decrease pain and nerve inflammation.
If the external ear is normal but the eardrum is bulging or discolored, the vet might make a small hole in it to relieve pressure, remove discharge, and obtain fluid for culture. Long-term inner ear inflammation with a ruptured eardrum has less of a chance for full recovery. Some nerve-related problems (lack of coordination, head tilt, deafness, drooping lips, inability to blink) can continue even after infection clears. Animals should be allowed time to adapt to any lasting nerve issues.
Early treatment improves the chance of a good outcome. Schedule a vet checkup promptly if you notice signs of ear infection or changes in your dog’s head position or movement.
