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Star is a 7 year old black lab who came to us with a complaint of chronic ear infections for over 5 years. The owners had been to 5 different veterinarians seeking help for Star's problem. They had tried various ointments, flushes, antibiotics and anti inflammatory drugs over the years but nothing seemed to help for very long.
On presentation, Star was a relatively happy dog, in good flesh with a normal physical exam with the exception of her ears which were quite swollen and painful. We tried to look into the ears with our video otoscope, but the canals were so swollen that we were unable to fit the 4 mm scope down into the ear. The photo to the right shows just how swollen the canals were initially. Interestingly, Star's skin was non remarkable, whereas most dogs with chronic ear infections have bad skin because they tend to be generally itchy.
With a long history of recurrent ear infections, we immediately started to discuss the probability of allergies as the source of Star's problem because in most cases like this, an underlying allergy leads to chronic itchiness, which leads to scratching and rubbing the ears which, in turn leads to recurrent infections.
We agreed to have Star tested for allergies using a simple blood test. At the same time, we sent off a culture of the ear to see what type of infection we were dealing with and what antibiotics would be best to treat it. With the ear canals being swollen shut, we were leery about the ability of the owner to adequately clean the ears and apply the appropriate medication to the them to result in an effective treatment. We discussed a surgical procedure called a "lateral ear resection" which would open the canals and allow for easier and more effective treatment. At this point, the owner was not prepared to have surgery performed on the ears so we decided to try a novel therapy on this chronic problem; cold laser treatment.
We have been using a cold laser for about 6 months now and have seen some remarkable responses with joint pain, back and neck pain and skin wound healing as well as helping in other cases of otitis. So we started Star on a regimen of every other day treatments with the laser. During the treatments, our technicians treat the affected areas with a dual wavelength infrared laser for about 10 minutes. The treatment is painless and Star would sit comfortably by and allow the treatments. Within 3 treatments, the ears were noticeably calmer, less red and swollen and Star was feeling much more lively as described by the owner.
Along with the laser, we employed our usual regimen of anti inflammatory drugs, topical ointment and anti-allergy medicine, cyclosporin. At the same time, we started Star on the best hypo-allergenic food we have called Z/D ultra in order to try and eliminate the source of the itchiness.
The culture came back with two very strong bacteria growing in the ears, both of which were resistant to many different antibiotics. Fortunately, they were both shown to be sensitive to the topical antibiotic we had chosen and so we continued with the topical therapy.
With each successive laser treatment, the ears were looking more and more normal until, after the 8th treatment, they were pretty much back to normal as seen below. The canals had opened up and the owner was able to irrigate the ear canals appropriately.
As you can imagine, the owner was ecstatic that we had finally come up with a treatment plan that fixed Star's ears! The Allergy tests came back a few weeks after we started therapy and did show Star to be allergic to a number of foods as well as various inhalant allergens. Given this information, we offered to try and desensitize Star using a customized "vaccine" for her to address her allergies. The owner is currently considering this, but in the meantime we will keep her on the hypoallergenic diet along with the cyclosporin to keep the symptoms at bay