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Old February 13th, 2011, 10:12 AM
TripleL24 TripleL24 is offline
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Hyperplasia of the ear-removing the ear canal?!?!

My sweet schnauzer, Lib, suffers from chronic ear infections. The primary culprit seems to be yeast, but she often has different bacterial infections as well. Her left ear is extremely smaller than the right, as they (the rescue I adopted her from a few years ago) seem to think that she was probably attacked as a puppy and the ear never grew properly. As a result, everything in that ear is stunted and obviously makes for a prime breeding ground for infections.

In late September, while dealing with yet another massive ear infection, it was discovered that Lib had a mass in her left ear that mimicked the appearance of her eardrum. By the time it was discovered, it was blocking the majority of the ear canal, making her hearing quite reduced in that ear (which I had told the vet previously that either my dog was depressed or she couldn't hear me, b/c she just wasn't responding as she normally did). She had surgery in early October to remove the mass (it was removed completely), and it turned out to be a benign hyerplasia polyp. The eardrum was also ruputured but has recovered.

Weekly vet visits showed that the ear, while still having some infection present, was on the mend. We were using topical ear medication daily and then weekly as a preventative. We graduated to every 3-4week vet visits-we know she'll always have ear infections, but the goal was to keep the infections as under control as possible.

We went to the vet on Thursday evening for another monthly check. I knew there was some discharge coming from both ears (when compared to other ear infections, the amount was very minimal), but what came out of her ears when the vet did a deep clean shocked me. The amount of yeast that came out of both ears was astounding. The vet had to use an instrument to pull out impacted, solid chunks of yeast.

I guess that thing that upset me the most, though, was that the vet said that Lib's ear canal is "shrinking"...since the last visit 1 month ago, the vet estimates that the ear canal is 50% smaller in diameter, which she attributes to recurrent hyperplasia. We're using the topical ear med daily now and go back for a recheck in 2 weeks.

I totally trust our vet...we're lucky to have someone who's honest w/ us and also works w/ us. I was reading online about potential treatments...and was scared to read that in some situations, removal of the ear canal is the best option. This option wasn't discussed at the vet visit the other day, but it was mentioned that future surgeries may be necessary to remove the hyperplasia. I know that Lib is suffering...she doesn't show pain much, but I know that she is in some discomfort. I want her to feel at her best. I'm scared though, of putting her through another surgery (or multiple surgeries), and of her potentially be deaf.

Has anyone ever had to make the decision to remove their dog's ear canal? How invasive of a procedure is it? Is the dog still able to hear in the other ear? Have you noticed a change (good or bad)? I know that the ear canal may not be removed in the end, but I want to be prepared...

Thanks!
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Old February 13th, 2011, 12:27 PM
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dbg10 dbg10 is offline
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I have never heard of this treatment and I've had several dogs with chronic ear infections because of their floppy ears. As far as I know they did not develop hyperplasia in the ear canal. However, that doesn't mean that it isn't an accepted treatment in severe cases of hyperplasia. I think that a specialist would have to be consulted about Lib before any surgery of this type was planned. It sounds to me like a surgery done when all other treatments have failed. I would make sure I had taken my dog to a specialist before agreeing to something like this. The big question for me would be whether it would reduce her hearing permanently or not. Good luck with Lib
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Old February 13th, 2011, 12:53 PM
cell cell is offline
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I saw a veterinary show once with a spaniel type dog who had chronic infections in one ear. The scar tissue had begun closing up the ear and it was unable to air and dry properly. They had a ear canal widening surgery where a portion of the bottom of the canal and a wedge was take out of the side of the dogs head to widen the canal and facilitate draining and drying. Is this the type of surgery being recommended?

I think the dog on the show had vertical canal ablation done like the spaniel on this site (surgical photo caution) http://www.kongyuensing.com/animals/..._Singapore.htm
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Old February 13th, 2011, 02:05 PM
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luckypenny luckypenny is offline
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I'd definitely be consulting with a specialist before having my dog undergo this sort of surgery. I'd also be concerned about the cause of the yeast infections...the narrow canals may make it difficult to clear up but I'd want to know what's causing it in the first place. What are you feeding Lib, TripleL24? And what sort of meds have you already tried with her? Has the vet done a culture of her ears? Are you using a cleanser in addition to meds? Does she have any allergy-type symptoms? How is her skin, fur, paw pads? Is she often itchy?
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Old February 13th, 2011, 10:12 PM
TripleL24 TripleL24 is offline
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Quote:
Originally Posted by luckypenny View Post
I'd definitely be consulting with a specialist before having my dog undergo this sort of surgery. I'd also be concerned about the cause of the yeast infections...the narrow canals may make it difficult to clear up but I'd want to know what's causing it in the first place. What are you feeding Lib, TripleL24? And what sort of meds have you already tried with her? Has the vet done a culture of her ears? Are you using a cleanser in addition to meds? Does she have any allergy-type symptoms? How is her skin, fur, paw pads? Is she often itchy?
Lib definitely has allergies. She will bite her legs/paws until they almost bleed. She's currently on nizoral (an anti-fungal oral medication) and benadryl to control what the vet feels is an excessive fungal production that makes her itch. She was on steroids (which caused her liver enzymes to elevate to ridiculous levels) and steroid/antihistamine combos which never controlled the itching/biting long-term. The nizoral and benadryl seem to be working very well for now. She's never been officially tested for specific allergies, but her allergies seem to be very environmentally related (weather changes, etc). We moved from Midwestern US to the Mid-Atlantic region, and her ear infection rates skyrocketed after the move. Should the nizoral lose its effectiveness, I will probably have Lib officially tested for specific allergens.

In terms of ear meds...she's been on different oral antibiotics over the course of all of this. The topical medication that she's currently on is momentomax, which has a steroid plus antibiotic in it. I do try to use ear cleanser on her ears, but she's gotten to a point that she hides whenever she thinks I'm going to clean her ears. I do clean the very outer portion of the ears often to remove the discharge.

I'm not sure if her ears have been specifically cultured recently (I think they were originally when she first presented over a year ago with a major infection), but they are microscopically reviewed...and usually reveal yeast as well as 4+ rod/cocci bacteria (I've gathered that 4+ is a pretty high level of bacterial growth/amount).

Being a typical schnazuer, Lib has elevated triglyceride levels, and was placed on a prescription dog food (Hills W/D) years ago. She does eat some commercial treats (MilkBones, etc).
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Old February 13th, 2011, 10:24 PM
TripleL24 TripleL24 is offline
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Quote:
Originally Posted by cell View Post
I saw a veterinary show once with a spaniel type dog who had chronic infections in one ear. The scar tissue had begun closing up the ear and it was unable to air and dry properly. They had a ear canal widening surgery where a portion of the bottom of the canal and a wedge was take out of the side of the dogs head to widen the canal and facilitate draining and drying. Is this the type of surgery being recommended?

I think the dog on the show had vertical canal ablation done like the spaniel on this site (surgical photo caution) http://www.kongyuensing.com/animals/..._Singapore.htm
From what I've read online, that is the type of surgery that may ultimately need to be done...however, the vet never said anything about it specifically. I'm just being my typical, worried-self that this is the type of surgery she may need eventually, and I want to prepare myself for it if I ever have to make that decision. If the stenosis doesn't get worse for now, I doubt she'd have to have any additional surgeries at this time, but I know that some type of surgery will be needed (again). It's just a matter of when and how invasive. W/ Lib, if it can go wrong, it will...in the past, she's had a major reaction to an intranasal vaccine, her liver enzymes were at least 40 times the normal limit due to steroid use, etc. I just want her to be happy and healthy, but all I can do is worry about her.
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