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Thread: Ear Infection Issues

  1. #11
    Senior Member PennyRetrievers's Avatar
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    We had the SAME problem, for two and a half years. Got her an allergy shot, and she went all winter with no problems. We hunted hard, and she didn't even flinch.
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  2. #12
    Senior Member JusticeDog's Avatar
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    I would have your vet send out a culture on the ear. I had one with an infection that wouldn't clear. Had to use some high powered meds that could have caused her to go deaf. It was in one ear. But, at almost 12, she can still hear the word "cookie"....
    Susan

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  3. #13
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    If an allergy how do you narrow down the agent causing the problem.

  4. #14
    Senior Member Breck's Avatar
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    Quote Originally Posted by EJ View Post
    If an allergy how do you narrow down the agent causing the problem.
    .
    the info was in the link I provided earlier. Here is part of it.
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    Allergy testing: Any method by which sensitization to environmental (or in some cases, dietary) allergens are detected. Such testing usually implies the specific intent to use the information for allergen avoidance or allergen-specific immunotherapy (ASIT). In the practice of human allergy, several testing modalities are employed which may include: skin prick testing (SPT), intradermal testing (IDT), atopy patch testing (APT), and serological methods such as ELISA and RAST. In the practice of veterinary allergy, the SPT and APT are rarely (if ever) used, however the latter may deserve further investigation. Skin tests assay the ability of an allergen to bind to mast cell and basophil-bound IgE or IgG4 (humans)/IgGd (dogs) and provoke degranulation of mast cells which release vasoactive substances that produce an inflammatory response (wheal/flare). Serological tests assay for increased levels of circulating allergen-specific IgE, which may or may not be functional in the allergic reaction.

    1. Intradermal testing in dogs and cats: This is the preferred method used by most veterinary allergists, although it is far from perfect.
      1. Air-borne allergens indigenous to the geographic area are selected (pollens, molds) along with common indoor allergens (dust mite and other insect allergens, natural fibers, human and animal epidermals) and biting insects (flea, ant, mosquito, etc.). The most common allergen for human and canine AD patients in the U.S. and Europe is the house dust mite (Dermatophagoides spp.)
      2. 0.05 to 0.1cc of each allergen is injected intradermally, and the wheal and flare responses are graded on a scale of 1+ to 4+ as compared to a negative control (saline - always assigned a score of 0) and a positive control (histamine phosphate - always assigned a score of 4+). Most allergists limit the number of allergens tested to less than 60 due to technical reasons.
      3. Disadvantages:
        • False positives - even non-atopic animals are capable of reacting to occasional allergens that are present in their environments. Cross-reactivity between biting insects (flea, ant) and arachnids (scabies, house dust mites) may also be a problem. Because of this potential, results must be interpreted in light of the patient's history and the clinical distribution of lesions (ie, flea bite allergy vs. scabies vs. atopy distribution patterns).
        • False negatives - IDT can be affected by exogenous antiinflammatory drugs, stress of the patient ("adrenalin rush"), the presence of secondary infections, and testing patients at the peak of their allergic season or too long after the allergen has disappeared.
        • Cats are especially difficult, as the elasticity of their skin limits the size and turgidity of wheals that are formed. The author uses intravenous fluorescein dye and a Wood's lamp to evaluate feline IDT reactions. Dye dosage: 10mg/kg I.V.
        • Withdrawal periods for antiiflammatory drugs include:
          *oral and topical steroids: 4 weeks
          *injectable steroids: 8 to 12 weeks (may be shorter in some cats)
          *antihistamines: 14 days
          *Omega3/Omega6 fatty acids: 10 days
        • clipping an area for testing is necessary, and sedation of the patient is recommended with rare exception.
        • expense: the veterinarian must be able to test at least a couple of animals/week to maintain stock allergens in a cost effective manner.

      4. Advantages:
        • The organ that is expressing the disease is the one tested
        • Better specificity than serologic tests (see below)
        • If IgGd plays a role, it will be involved in the reaction
        • Higher percentage of "excellent" responses to immunotherapy based upon IDT vs. serologic tests?? This is reported anecdotally but scientific evidence has not been presented.


    2. In-vitro allergy tests (RAST, ELISA, VARL): all serologic tests, regardless of methodology, measure the level of "allergen-specific" IgE in the serum, but cross-reactivity with IgG is known to be a potential problem with most. The newer IgE receptor-based ELISA (Heska Corp., Fort Collins, CO.) is very specific for IgE. RASTS are no longer routinely available in veterinary medicine.

      ELISAs and RAST use a solid phase in which specific allergens are bound to plastic. Antibodies in patient serum may then bind the allergen, and when excess (unbound) patient Ab is washed away, an anti-antibody tagged with either a fluorescent marker (ELISA) or radioactive marker (RAST) is added to "detect" the bound patient antibodies. A liquid phase test currently available in North America is the Veterinary Allergy Reference Laboratory (VARL) Liquid Goldâ test (Pasadena, CA) which guarantees "no false positives" due to the use of Western blot technology to identify the patient antibodies that are captured by the specific allergen in liquid phase, which "eliminates non-specific IgE binding". No scientific evidence to substantiate these claims have been published.
      1. Disadvantages:
        • False positives are a very concerning problem, regardless of the laboratory. This is probably due to non-specific binding by non-allergen specific IgE and IgG. Dogs have extremely high base-line levels of IgE as the result of chronic exposure to endo- and ectoparasites. The IgE receptor-based ELISA by Heska Corp. (Fort Collins, CO) may correlate better with IDAT than other serologic tests, according to the manufacturer.
        • Attempts to improve specificity have led to concerns about false negatives: there is good evidence in humans and horses that local IgE production (in the skin and lungs respectively) may be an important part of allergic skin and airway disease. Therefore, IgE levels in the serum might not correlate with the level of allergen-specific IgE in the target organ. Also, it has been shown that serum levels of allergen-specific IgE decrease in the "off season" when constant exposure is absent, while tissue levels are more durable.

      2. Advantages:
        • No need for sedation or clipping. Drug withdrawal has traditionally not been thought to be as important as with IDAT. This may not be true with Heska's IgE receptor-based ELISA, which recommends steroid withdrawal similar to IDT. In addition, despite its claims of superior specificity, the Heska test doesn't assay for IgGd. While it is unknown how large a role is played by IgGd in canine and feline atopy, I commonly have negative Heska tests when the IDT is positive.

    3. Allergen-specific immunotherapy (tail of newt, eye of frog…): An attempt to modify the immune response toward specific allergens (based upon allergy testing) in patients with clinical signs present for more than 4 months/year that cannot be controlled with non-steroidal regimens.
      1. Mechanism of effect: Despite being in use for nearly 100 years in the treatment of human allergy, the specific mechanisms of effect remain incompletely known. Many theories exist regarding mechanism of effect: ¯ IgE? ¯ reactivity of mast cells/basophils? ¯eosinophil degranulation? Immunization (IgG blocking antibody)? Shift from Th2 to Th1 helper T-cell population? Currently unknown - maybe a combination of factors. In human medicine, ASIT is more efficacious for allergic respiratory diseases, and use in atopic dermatitis patients is limited.
      2. Protocols: There is very little standardization between institutions or practices. No prospective, controlled studies have been conducted in veterinary medicine to suggest the most appropriate doses or protocols for administration, and different clinicians will use different dose/frequency protocols based upon their training backgrounds and personal experiences.

        Most veterinary allergists agree upon the following:
        • aqueous allergens should be used
        • 12 to 15 allergens per vial max (to avoid over-dilution of individual ingredients). Maximum of 2 vials per dog (to avoid overloading the patient)
        • select allergens for injection that are thought to be most clinically significant based upon the history/seasonality
        • subcutaneous injections are given starting with a very dilute concentration (vial 1 = 100-200 protein nitrogen units (PNU)/cc) and progressing through mid-level (vial 2 = 1,000- 2,000PNU/cc) to the highest concentration (vial 3 = 10,000 - 20,000 PNU/cc) for maintenance.
        • Maintenance frequency is determined by the dog's pruritic interval - some need "boosters" as frequently as Q7days.

      3. Advantages: very limited/rare side-effects which may include itching after the shot (decrease dose 50% and gradually increase by 0.1 increments to reach the highest tolerable dose & pre-treat with antihistamines); hives (return to more dilute vial and observe closely after each shot - pretreat with antihistamines); anaphylaxis (virtually unheard of in dogs - discontinue use).
      4. Disadvantages: animals on ASIT need frequent and expert monitoring. They cannot be sent home on ASIT and forgotten. Secondary pyoderma and Malassezia dermatitis are very common, even in dogs with excellent responses. Owners will perceive pruritic infections as "immunotherapy failure"! Most pets require adjunctive anti-pruritic therapies - especially during the first 6 to 12 months of therapy. Even the best responders may have their more difficult seasons. If you are unwilling/unable to diagnose secondary infections and manage these patients carefully, don't waste your client's time and money with ASIT.

    4. Newer therapies......................

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  5. #15
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    I never thought diet played a role in ear infections, but within weeks of putting two dogs on high protein, low carb diets a few years back the ear problems vanished. The added cost of these foods is nothing compared to the vet bills and potential damage to the ear canal. I used EVO Red Meat kibble.

  6. #16
    Senior Member ad18's Avatar
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    Food allergies here too. Always the left ear. Started eliminating various contents and found rice to be main culprit. Zero'd in on chicken, then grains, and finally the rice. Using Nutri Source Lamb and all fine.
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  7. #17
    Senior Member JoeOverby's Avatar
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    Allergy induced ear infections in a single ear here as well. It was his right one. 2 ruptured ear drums later UGA convinced me it was a food allergy...to say I was skeptical is an understatement. Did the food trial for 4 months and started reintroducing things one at a time...chicken was the villain. No problems since eliminating it from his diet. For the rest of the kennel however, when one of the dogs does get otitis now, I use an oti-pack and in 10-14 days its as good as new. For regular maintenance I use a 1/2 vinegar 1/2 alcohol solution...works like a champ.
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  8. #18

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    Our YLM had a chronic ear infection for months and we tried everything with the vet. Finally, on another site, someone recommended the home made remedy Blue Power Ear Treatment. It worked like a charm and have never had another ear infection in the past 4 years with that dog. I still use it once every month or so, just to be safe.

    Basically it is;
    16 Oz. bottle of Isopropyl Alcohol (standard 70%)
    4 Tablespoons of Boric Acid Powder
    16 Drops of Gentian Violet Solution 1%


    Check out the article and instructions here...
    http://www.itsfortheanimals.com/Adob...0Treatment.pdf

    Cheers!
    EB
    "Dogs have all the qualities God said man should have but don't:
    Faithfulness, Steadfastness, Dependability, Loyalty, Forgiveness, Devotion, Hope, and Love!
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  9. #19
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    Thanks for the suggestions. Vet sending out the culture for testing. Mentioned there might be an infection behind the eardrum. Get the culture back and try some antibiotics before getting too crazy.

    Appreciate the help!

  10. #20
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    Quote Originally Posted by EJ View Post
    Thanks for the suggestions. Vet sending out the culture for testing. Mentioned there might be an infection behind the eardrum. Get the culture back and try some antibiotics before getting too crazy.

    Appreciate the help!
    It sounds deep so treat it, but you said this is a chronic problem. Has the dog been eating a typical chicken and grain food? If so, grab a bag of EVO Red Meat because that is the only red meat food that is easy to buy and I am guessing the ear infections will stop. I didn't believe it myself. It is a 42/22 and a good choice for a working or active dog.

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