Can bad ears come good? Practical tips for managing chronic otitis.

Chronicity and/or frequent recurrence of ear disease generates frustration for all parties, and – importantly – may cause irreversible changes of the otic structures and thus become self-perpetuating. Surprisingly perhaps, even advanced/severe chronic ear disease may be resolved with medical management if the aetiopathogenic factors involved in each case are identified and resolved/reversed. Of course, not all cases are suitable for medical management due to a variety of patient and owner related factors, and surgical solutions always need to be considered. Due to the insidious progression of long-standing otitis the associated discomfort manifested in changes in behaviour and demeanour is often not noticed by owners or vets, and only obvious in retrospect after successful treatment. Significant discomfort in most cases has to be assumed; no serious attempt at effective treatment is thus not an option. Ideally however, progression to chronic treatment-unresponsive ear disease is prevented by early and successful management of the contributing factors to otitis in at risk patients.