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Those Poor Ears

Paper Trained
Scott Sandeman, D.V.M.
Q.)  Hi. I have a 5 yr old pitbull who has been getting ear infections since he was a puppy. In the past, antibiotics and topical medications have worked. Recently, they have been much more serious, causing complete loss of balance, rapid eye movement, etc. I have taken him in to the hospital three times now. One ear was a yeast infection and the other was a bacterial infection. The ear which had the bacterial infection had a ruptured eardrum. They put him on two different kinds of antibiotics, as well as an anti-inflammatory and an allergy medication, Apoquel®. The antibiotics haven't helped. Also, two weeks after I took him in, I noticed left side paralysis of the face. The anti-inflammatory medications helped a little, but the paralysis is still present. They referred me to an internal medicine clinic, where they said they will scope his ears and see if he's on the right medication. Is there any advice you can offer me? It's sad to see him so uncomfortable. I appreciate your time and am looking forward to hearing from you!
A.)  Your friend has gone through a lot.  While a ruptured eardrum is always a concern with ear infections, the majority of them are not serious enough or persist to the point that the drum becomes perforated.   As you know, when that happens, nerves that coexist in that area can be affected.  In your dog’s case, these damaged nerves could be responsible for the eye movement and the facial nerve paralysis.
          The treatments your pet has undergone are the ones most veterinarians would attempt to resolve his issues.  At this point, more diagnostic procedures should be attempted as suggested by your veterinarian.   That may take several forms such as a culture of the bacteria to make sure the antibiotic is effective and a thorough exam with a scope able to not only see the eardrum but magnify the area and take pictures of the damage.  Some specialized clinics will have the ability to do a CT scan to further identify damage to the ear canals and look at the nerves in that area for tumors or other problems that can occur.
     Hopefully the eye movement has already resolved and he can walk normally.  This insult to the nerves of the vestibular apparatus-the part of the brain that controls balance- can resolve on its own.  The facial nerve paralysis also may improve with time and appropriate treatment but it also can have some residual damage.  
    Hopefully the specialist will have a plan to not only help solve your pets current problem but discuss ways to minimize or eliminate future infections.  Good luck! 

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