What is it?
•Otitis is inflammation and/or infection of the outer ear
•The middle and inner ear may also be affected
•The outer ear including the pinna and middle ear are more commonly involved than the inner ear
•Otitis occurs more frequently in dogs than cats 

What causes it?
•Otitis externa often results when a change in the normal environment of the ear canal causes the glands lining the canal to enlarge and produce excessive wax
•Gradually, the skin glands produce excessive fibrous tissue (fibrosis) and the canal becomes narrowed
•Some of the most common causes are bacterial, fungal, or rickettsial infections, parasites, plant material, frequent swimming, allergies, hormonal disorders, excess hair in the ear canal, or mechanical trauma
•It may affect any dog at any age, but is common in cocker spaniels, golden retrievers, Labrador retrievers, and miniature poodles
•The most common signs of external otitis are pain or itching of the ear, ear odor and discharge, as well as redness and swelling of the pinna aznd ear canal, head shaking, and pawing or rubbing of the ear
•Symptoms of internal otitis include head tilt, walking in circles, nausea, vomiting, and abnormal eye movements 

What tests are needed?
•Physical examinations are performed to identify the primary causes of otitis externa in which the ear canal is swabbed and examined under a microscope to find any bacteria, yeast, or mites
•A full neurologic exam is usually performed with otitis interna to rule out other neurologic disorders
•Cytologic examination and otoscopy are done to determine the severity of the infection
•Lab tests for fungal diseases and bacteria identification may be recommended
•For noninfectious diseases, radiographic imaging may be necessary to determine the presence of a polyp or tumor or form of trauma 

How is it treated?
•Otitis externa is treated by removing debris from the ear
•The topical therapy may consist of antibacterial, corticosteroid, anti-yeast, and anti-fungal drops or ointment
•In severe cases of otitis externa and otitis media, oral antibiotics and antifungals may be prescribed •Injectable and oral corticosteroids may also be used to reduce the animal’s pain, inflammation, and swelling
•In some severe cases, surgery may be needed for removal of any masses, or of the total ear canal if medication does not manage the condition 

What follow up care is needed?
•Most cases are chronic
•Follow up visits are necessary to monitor the progress of the condition
•Although clinical signs may resolve, it is important to continue medication for as long as prescribed because infection may still be present
•Prognosis is good if early treatment and resolution of the primary causes and predisposing factors are achieved