Today  is the day,  I have decided to jump off the cliff of  veterinary knowledge and plunge into the depths of the world of ear infections – one of the most daunting of subjects.

One may wonder why today is the day.  It is an evening  and  I originally  thought I would write about cancer and how there may be some clear or  clearer ways of preventing it.    Then the inner voice that I  sometimes try to resist  so stubbornly  whispered in my EARRRRRRRRRRRS.  Write about earrrrrrrrrrrrrrs.

“Are you kidding me”,  I  started arguing ,  “I  am not even going to go there. Last time it took me 3 days of preparation to justify my treatments in front of the Provincial Veterinary Association.  Forget it!”  I barked  back…

“But  people need to  know,” my inner voice  replied.

“Ok  ok, I  give up.  I will write about ears if you promise that you will not get me in trouble,” I negotiated.

If you have been reading my blogs for a while,  you are probably  expecting a story, right…?  Why not? ( please note the names and times are fictional for privacy protection).

Ursula and Tamara

The clinic was crazy busy, it was the beginning of  the summer and a time when dogs and cats started  venturing outdoors after the Vancouver torrential rain season.  The most common problems  are sprains, cuts, injuries, swimming, dog and cat  fights and also ear problems.

Ursula loved her dog  Tamara and was a first time client.  She had just  moved to Vancouver to start her new life and had brought  Tamara with her across the range of Coast Mountains; the Western “foreplay” to the mighty Rockies.

Tamara had a history of ear problems in the past and this time, was shaking  and  scratching her cropped ears.  “When will we humans stop mutilating these poor animals,” a thought that flashed through my mind about her  pointy ears. “Imagine the pain she went  through after the surgery.  Ouch!” I shivered.

I examined Tamara’s ears and found only a mild redness at the earflaps, which  likely  came from the scratching; the ear canal  was clean and calm.

“But  there must be an infection!”  Ursula  exclaimed with a tone of irritation in her voice.  She was obviously not  happy with me not  saying what she wanted to hear.  I  examined  Tamara  further and learned that she was on a poor  quality,  processed  food,  had  a history of ear problems  that  were  treated by topical  steroids and  her  liver  points were activated.    This suggested some general signs of toxin  build  up and the need for cleansing.

I explained to Ursula  as tactfully as I could that because of Tamara’s history of traveling in  high altitudes that changed rapidly,  she most likely  experienced  middle ear pain  similar to people  when  flying.

However,  based on the examination, the ear  health was likely affected by the state of her  digestive tract and liver.  I recommended a diet change, liver  cleanse  and some exercise to shed off  the “love handles…”

My client sense told me  that Ursula  was not  convinced about  my recommendations and wondered if I would ever see  her  again.

Two  weeks  later, they showed up at the clinic for a recheck.

“Doctor,  you said that  there was no  infection  and look at  Tamara’s ears,  they are  horrible”…. she exclaimed victoriously.  “Look at the discharge and the smell! I was right last time! In fact I didn’t  tell you,” she continued, “last time, I  wanted to  go to your  neighboring  clinic and mistook the  address so I decided to give the natural treatments a try.”  “Look at  my  poor girl now, she is not happy at  all. I  will give you  one  more  chance and that is  it” !  Talk about  no  pressure, I thought,  Ears  are some  of the most complicated  problems to  treat at the best of times  and  they can be just a nightmare if a client doesn’t understand the whole scope.

“Ursula,  have you used any cleaning solutions” ? I  asked gently.  “ Oh well,  I found  this stuff in the pet store;  it was  supposed to work  well, but  look at it,  my girl is  a mess!” she responded again.

She was right,  the ear canals  were moist and full of discharge and coated with a  grey  layer of dead  skin.   I  have seen  these situations, where the ears  were “over- cleaned” , leaving  the ear canal raw and vulnerable to bacterial infections. Now  we most likely had some bacteria munching on the raw skin.  Bacteria loves  to “party” where tissue damage and inflammation are present.

I sometimes compare the physical  body to trees.  If healthy, not  stressed and well nourished, parasites stay at  bay.   If  stressed and malnourished,  all sorts of bacteriae,  parasites  and fungi come to the feast.

In Tamara’s case, over-cleaning, stress of the move, ear pain when traveling , carb rich processed food and obesity all played a role.

Knowing that Ursula went to  a conventional clinic before and ended up at my practice only by accident, I  decided to  combine the conventional approach;  herbs and homeopathy plus send a bacterial culture to the lab.

I saw that Tamara’s body was too depleted and toxic to fight on its  own and reached for an antifungal and antibiotic treatment; the only one on the market that  didn’t   come with steroids.  We  cleaned her ears with a herbal solution and gave a homeopathic  prescription to ease the discomfort.

A few  days  later, I  received a call from Ursula that Tamara was better, happier and how much she appreciated my help.  However, the improvement didn’t  last long.  As Tamara’s  body gained strength and vigor  on  a better diet, her immune  system woke up and decided to do the “spring cleaning.”

Because this was not the first time  she had suffered with ear infections, she  had been treated with topical  steroids in the past.  Whatever was  suppressed was coming back to the surface. Tamara’s  immune system revved up in a desperate attempt to give  us the signals that more than the ears needed attention.

Similar to the lights on your car’s dashboard, the ears were signaling that something  deeper was wrong.  If steroids are used in such situations  this  can be compared to taking a sleeping pill when your favorite dish on the stove  is about to burn.

While the sleeping  pill   will give you temporary  relief, the consequences  would  be very clear and smoky at best. You would  either need a new pot, or , in the worst case scenario  – a new house.

Similar to the sleeping pill, steroids  put  the immune system to sleep and give us the illusion that all is fine.  They bring the inflammation down, the comfort is temporarily regained until the next flare up that is usually  more difficult  to treat.

I explained to Tamara that because the culture came back with no pathogens growing in the ear canal and only a small amount of yeast which is very common, I suggested that she continue the conventional antifungal medication and address her nutrition;  do a detox and make sure that she gets out more often and loses some weight too. In other words,  I suggested that chronic ear treatment is not  a quick fix and that weeks  and months were  needed.  There was also a high chance that the ear problems may come back as part of  cleansing and must not  be suppressed by steroid medication.

I was thrilled to see an  email a few days later in which Ursula reported an improvement and appreciation for my work.  She also  commented how that her own stress affected Tamara very much plus her anxiety around ears was related to excruciating  ear pain that she experienced as a child.

I didn’t  hear from her until a year  later when I  received my very  first complaint   letter  since my graduation 21 years ago.  It was filed with the veterinary association conduct review  committee.

In the letter, Ursula wrote, that she spent too much time and money in my office and then she went to another vet.  Tamara  miraculously recovered after a prescription of drops which included, guess what – yes, steroids.  The  doctor did  say that  the medication would likely have to be prescribed for a lifetime.  There was also the  possibility that her ear canals  would  have to be surgically removed if they  closed  up due to chronic inflammation.

Ursula  also  requested that the association  stops me from practicing…

I  had two choices. Either I could focus on the negativity or compassionately acknowledge the relative nature of perception and do my  best to defend my work..  I knew I had to stay true to what  I  believed the right treatment was which is contrary  with the conventional view.  Based on my experience, I  rarely saw ear patients that  would require continuous treatment  after the initial regimen was completed.

I spent the  whole weekend going through files and notes to ensure that I would be able to provide the “Conduct Review  Committee” the best report. I felt  it was important to convey my  message that we, veterinarians , needed to look outside of the conventional scope of treatments for the welfare of our pets.  I wanted the  committee to understand that  using homeopathy ,  herbs and natural  nutrition is nothing  more than  using another form of the medical language. It is just another  route of healing and can be compared to the variety of languages that we humans speak on the global level.  English is not the only one, neither is the conventional view of medicine.

I also suggested that I was willing  to give up my BC  vet  license if it was the only way of continuing to use holistic treatments.

After an  hour of questioning by 15 committee members,  I made them laugh by saying:  “Oh boy,  did you make me sweat answering all these question. It felt  like another round of licensing exams.”

In a way, I appreciated the committee’s thorough work and hoped that they would see that I practiced according to the highest medical standards. The next day, I received  a call that they had found nothing wrong with my treatment to Tamara.  I accepted the news with  great relief and was happy that I was still a vet…

That  day I decided that when I had  a minute, I would  post a blog   on ears. I was also very  tempted to call and see how  Tamara  was  doing because from the files of the other reporting vet,  I knew that  she had  an  ear medication dispensed  several times that year.  Perhaps ,  Ursula  who’s  name here is fictional, will run into this blog  by accident or someone will send her a link. In the past,  I tried to open some people’s minds by conviction.  Now  I know that  the mind only opens , if ready.  When the time comes and  how much tough learning we need to go through before it happens is a mystery.

We  all have something to learn….I just hope that  Tamara is well.

Peter Dobias ( still DVM)

11 steps for  dogs  and  cats with ear conditions:

1. Proper  assessment is always necessary.
2. AVOID  corticosteroid based medications  such as  Otomax, Panalog or Surolan.  They appear to blockthe healing process and often make the ear conditions incurable.
3. Remember that ear  inflammation is a result of other underlying issues  – the most  common areas to address are:
   1. Diet
   2. Colon balance
   3. Liver detox
   4. Neck injury, sometimes collar related
   5. Vaccine  side-effects
4. Bacterial  infections or mite infestations are usually secondary problems.   Sometimes they disappear when the underlying issues  are addressed, sometimes herbal solutions or conventional medication may be used at the beginning to ensure comfort.  Once again,  avoid steroids. Antibiotics are not  ideal but  sometimes  necessary  and less damaging.
5. Routine ear  cleaning in a  healthy dog should not be necessary. The  skin in the ear canal  grows up similar  to nails and caries wax  and impurities to  the surface.  It functions as the ears “conveyer belt”
6. Some breeds  have a tendency to certain amount of ear  wax. If the ear is fine otherwise,  leaving them be is safe.
7. If  you  try  to “clean out the ears”  frequently,  you will likely make them worse. The natural self cleaning ability of the ears is lost. It is similar  to frequent  hand  washing.
8. Initial  ear cleaning should be done  professionally,  the use of individually selected  homeopathic remedy, nutritional plan, herbal preparations and a good dose of patience is  important.
9. It takes  1  -  3 months on average  for chronic, medication  suppressed  ears  to get  better; sometimes  even longer. It  is  reasonable for this to take  longer as most ear conditions take up months or  years  to get  to the point of physical manifestation
10. The  good  news  is  that there are very  few  dogs and  cats that  would need ongoing  treatment for life.