mystery ear infections

Question
hi dr. gotthelf,

im so sorry i missed your answer since i was on assignment in the middle east (didn't know i only had 72 hours to go get the answer or i would have waited until i came back) and you have been maxed out since i've come back. i hope you can help my dog, judy.

i have a four year old dog named judy. she is a female scottish terrier/schnauzer mix with stand up ears. from day one, she has had these disgusting ear infections.

for her first visit to the vet (she was born in mid-april of 2000, we bought her from a pet store in mid-july of 2000), she had this dark gooey stuff coming out of her ear and she
smelled like an old shoe. the vet said she wasn't fit for purchase and that we should send her back and that it was most likely a yeast infection. we figured an ear infection is nothing in a dog with stand up ears, but it should have been a sign that it was a problem.

ever since then, she constantly has ear infections just in her LEFT ear. her right ear is fine. for the first three years, they
were accompanied by skin infections and lick granulomas on her belly, bacterial vaginosis to the point where she would do the boot scoot across the carpet and it was also
coming out in her stool as mucus, fever, whining and tilting her head to the left because of her ear and her ear was covered in the gooey brown/maroon ear wax-like discharge with the yeasty/old shoe like smell.

at first, the vet was giving us the blue colored oticleans liquid to clean her ears once a week. it didnt seem to help, but eventually all of the symptoms would go away...so we would live from infection to infection.

then about december of 2002 she became very ill and it began a pattern and a lot of despair over her health. her eyes began to ooze greenish discharge, her underbelly broke out in big red rashes and consequentially lick granulomas, the boot scoot and constant head shaking and
a liquid sloshing sound was coming out of her ears. she also developed a rash in between her front toes which she constantly bit and licked, it was also in her cuticles around her toenails. she also developed a fever and she became
tired but she still ate and was kind of playful when she felt like it. it went away within a few weeks.

in april of 2003 the same symptoms and the same grade of severity came back. the vet put her on malaseb flush for her ears, the spray for her toes and instructed us to bathe her
with the shampoo once a week. she also recieved
prednisone, baytril ear ointment and also 1/2 of the chewable baytril tablet (brown, cut into 4 tablet twice a day) for 14 days. i suggested to the vet that maybe she had a systemic yeast infection considering how chronic it was and
how it was come and go and affect so many systems in her body. after an ear culture and some other tests, there was no yeast present in her body according to the vet, but it smelled like yeast and it seemed to present with all of the
symptoms.

after treating her for about 6 weeks with all of the shampoos and other things, we took her back. the vet said it was probably irritating now more than treating, so we took her off of the stuff and he gave us antihistamines,
which seem to make her ear infections worse, like it thickened the gunk even more and her ear wouldn't even drain. she was ok for awhile and she was on a new diet, with the eukanuba fish and potato specialty food.

then in august, the ear infections came back but none of the other symptoms. she was put on a whole baytril tablet last time and they keep on ratcheting up every time we take her in. the infections are still only in her left ear and she
constantly shakes her head and cries, with the liquid sloshing noise every time she does it. the discharge is still ear wax like except with a little more liquid and brownish maroon and it still smells like yeast.

its an everyday thing now and it worries us. we're afraid to take her back in because it will just mean more antibiotics and no solution and she gets upset every time we get near
her because she thinks we're going to touch the ear. we cant even pet her on the head anymore or she'll yelp and cry.

i hope you can help us because her vet is a good vet, they're a trauma vet and animal hospital in poughkeepsie, ny and these are the only people in the area that could possibly help her out but they aren't even sure what to do and its
frustrating. she is a good dog and we would love to see her better. she is still on the eukanuba diet with fish and potato and still a mess because they insist its an allergy.

my take is since its just her left ear (with no more lick granuolomas or boot scoot, just the left ear oozing stuff), that maybe she has a congential defect in the eustachian tube of her left ear, regular fluids are getting trapped in the bend and getting exposed to bacterium and then infecting her ear. her right ear has always been normal and fine...

please help us, it would mean so much to me and my mother if we could see her better and not suffering so much, she is such a good dog, except for this.

thank you so much.

bridget  

Answer
This sounds like allergies complicated by ear infections. Since the ear infection is confined to one ear, I would tend to think of an untreated middle ear infection. This cannot be treated with eardrops, but requires a flushing procedure in the bone called the tympanic bulla.  This would require anesthesia and a very deep ear examination.  Many vets have a Video Otoscope to see into the horizontal ear cnala and middle ear.  If your vet can do this procedure that is great.  If they can't, find out who has one in your area and go there. Some of these dogs require surgery to open up the ear canal so the goo can drain out.