A dog ear yeast infection can cause your dog’s ears to be inflamed, itchy, sore, and stinky. And for some dogs, they become an ongoing problem. Integrative veterinarian Dr. Julie Buzby explains the causes, symptoms, diagnosis, treatment, and prevention of yeast ear infections so that dog parents can feel prepared to navigate them with their dogs.
Does your dog shake his head a lot, scratch her ears incessantly, or have a funky smell coming from the region of the ears when you lean in for a late-night nose boop? Those symptoms could be due to a yeast ear infection.
Ear infections in dogs are surprisingly common and can make your pup feel pretty uncomfortable. The good news? With the proper care, ear infections caused by yeast are usually treatable and preventable.
Let’s take a closer look at dog ear yeast infections so you can learn how to help your sweet dog feel better fast.
What are dog ear yeast infections?
Yeast infections in dogs occur due to an overgrowth of yeast organisms on the skin and inside the ear canals. The most common culprit is the yeast Malassezia pachydermatis. This yeast normally lives on your dog’s skin and in their ears without causing any problems. But changes in the pH and moisture levels within the dog’s ear canal can allow yeast to escape the control of the immune system and start to multiply rapidly.
Yeast thrives in warm, moist environments—like the inside of your dog’s ears—especially if there’s an underlying allergy, moisture buildup, or health issue (such as a weakened immune system or thyroid problems). It doesn’t take long, then, before the dog has a full-blown yeast infection, complete with a buildup of brown, waxy discharge and a painful, itchy, and inflamed ear canal.
Before we can dive too deeply into yeast infections in a dog’s ear, we need to take a quick look at some anatomy and definitions.
Ear anatomy
Dogs have an L-shaped external ear canal, consisting of both vertical and horizontal sections. The vertical canal is visible when we lift a dog’s ear flap and look into it. This is where you would see debris and redness due to a yeast ear infection if you are looking in your dog’s ear yourself.
The horizontal canal is not visible without the use of a special veterinary tool called an otoscope. It has a cone and magnifying glass, which helps your veterinarian check the entire canal during an examination. The horizontal canal dead-ends into the eardrum (tympanic membrane), which separates the external ear canal from the middle ear cavity.
Sitting just above the eardrum and middle ear cavity are the auditory ossicles. These three bones—the malleus, incus, and stapes—transmit vibrations to the inner ear.
The inner ear structure that receives sound waves from the eardrum and turns them into a nerve signal to go to the brain to facilitate hearing is called the cochlea. (The semicircular canals, the other component of the inner ear, are responsible for balance and posture as part of the dog’s vestibular system.)
Ear infections can affect different parts of the ear
Dogs can develop external, middle, and inner ear infections (otitis in dogs). Sometimes, only one of the three areas is affected. But other times the infection may extend from one compartment to another.
Otitis externa (external ear infection) is the most commonly diagnosed of the three. It can be a simple infection when yeast is the only organism causing symptoms. But it becomes more complicated when bacterial microorganisms are also present. Common bacterial co-infections include Corynebacterium, Pseudomonas, Staphylococcus, and Streptococcus spp. Having a mixed infection makes otitis much more challenging to treat.
Additionally, it is important to know that infections that develop in the vertical part of the ear canal may also affect the sensitive skin surrounding the ear canal opening and the ear flap (pinna) itself.
Otitis media involves the middle ear and eardrum (tympanum). It occurs less commonly than otitis externa but may be present in up to 50% of dogs suffering from chronic otitis externa. Otitis media often involves inflammation of the eardrum. Severe cases may lead to rupture of the eardrum, nerve damage, and/or hearing loss.
Otitis interna, which is relatively rare, affects the structures of the inner ear that are necessary for balance, posture, and hearing. Dogs with this type of infection may exhibit a head tilt, repetitive circling to one side, and nystagmus (an abnormal movement of the eyes) secondary to vestibular disease in dogs. They could also have hearing loss.
How do dogs get yeast infections in their ears?
There are many contributors to ear infections in dogs. Veterinarians often break them down into primary, secondary, predisposing, and perpetuating factors. (Note: The exact distribution of the factors into the following categories may vary slightly from one reference to another.)
Primary factors
Primary factors are those that cause inflammation in an otherwise normal ear canal.
Food allergies, seasonal allergies, and contact sensitivity
Food allergy in dogs, seasonal allergies in dogs, or sensitive skin that flares due to contact irritation may predispose a dog to developing an ear infection. In fact, it’s estimated that almost half of dogs diagnosed with allergic skin disease, and close to 80% of dogs with food sensitivities, will experience some level of concurrent ear disease.
Allergic dogs are usually quite itchy, causing them to scratch their skin and ears excessively. Scratching transfers yeast and bacteria from the skin to the feet, and from the feet to the ears. This creates a never-ending cycle of microbial contamination and damage to the ear canals in affected dogs.
External parasites
Ear mites are the most common parasites that cause ear problems in dogs. They’re so tiny you can’t see them with the naked eye, and they live off the earwax inside the ear canal. Their presence makes dogs’ ears extremely itchy, causing them to scratch nonstop. All that scratching can damage the skin inside the ear canals, making it easier for yeast and bacteria to grow and create infections.
Ticks also love to attach in the cartilaginous crevices of a dog’s outer ear canal. Some potential tick bite symptoms in dogs are localized inflammation and pain at the sites where they’ve attached. This can contribute to the dog developing an ear infection.
Immune-mediated diseases
Some dogs develop specific immune system problems where the body accidentally attacks its own tissues instead of protecting them. These conditions can include vasculitis (inflammation of the blood vessels) or pemphigus foliaceus (an autoimmune condition that attacks the proteins that connect skin cells).
When this happens in the ears, it causes blisters on the ear flaps and inside the ear canals, and painful swelling. This irritation makes dogs shake their heads and scratch, which only makes the inflammation worse.
Hormonal imbalances
Hormone imbalances, like hypothyroidism in dogs or Cushing’s disease in dogs, weaken older dogs’ immune systems. This makes it easier for an ear infection to take hold. Plus, hypothyroidism and Cushing’s disease can make senior dogs’ skin and ears more fragile, breaking down the natural protective barrier and leaving them more prone to infections.
Tumors or polyps that obstruct the ear canal
Dogs can develop growths in the ear canal at any age. As the tumor or polyp gets bigger, there’s less space for air to flow in and out of the ear canal. This makes it harder for moisture and wax to be adequately removed from the ear. As a result, the trapped moisture creates a warm, humid environment where bacteria and yeast can quickly multiply. It’s kind of like a mini science experiment right in your dog’s ear!
Foreign debris in the ears
Ear infections can happen when something gets stuck in your dog’s ear, like cotton balls accidentally left behind after a bath, or grass awns (also called foxtails in dogs). Cotton balls can block the ear canal completely, creating that warm, humid environment where bacteria and yeast can grow. Grass awns poke into the sensitive skin inside the ear. This causes itchiness and irritation, which makes your dog scratch.
Dogs with excessive ear hair, such as Poodles, Doodles, and Shih Tzus, are also more likely to develop infections. All that hair in the ear canals makes it harder for their ears to stay clean and dry.
Secondary factors
Secondary factors are the yeast and/or bacterial infections themselves.
When a dog’s immune system is weakened, bacterial infections can complicate an existing ear yeast infection in dogs or vice versa. Some of the more common bacterial pathogens include Staphylococcus pseudointermedius, Escherichia coli, and Pseudomonas aeruginosa.
Predisposing factors
The things on this list make dogs more likely to develop an ear infection, but don’t cause infection on their own.
Medication reactions
Certain topical medications (like nystatin, an ingredient in some ear medications) can cause skin irritation in dogs. In these cases, it’s crucial to alert your veterinarian to the adverse reaction promptly. That way, he or she can make adjustments to your dog’s treatment plan.
Overzealous or frequent ear cleaning
Sometimes, too much of a good thing can, in fact, be bad! Overly aggressive or frequent ear cleaning can disrupt the normal, healthy environment within the canal. Cleansers can alter the normal pH and leave residual moisture in the canals, which may worsen inflammation instead of resolving it. This can contribute to the dog developing a yeast ear infection.
Plus, wiping the ears out with rough or abrasive material like paper towels or napkins can be very irritating to the ear canals.
Breed and lifestyle factors
Dogs with heavy outer pinnae (floppy ears) and those who spend a lot of time in water are at a greater risk of developing otitis. These floppy-eared breeds include:
- Bassett Hounds
- Bloodhounds
- Labrador Retrievers
- Golden Retrievers
- Cocker Spaniels
Additionally, Shar Peis are at risk for developing otitis due to their very narrow ear canals.
Other breeds with a genetic predisposition to allergies, such as Poodles, West Highland White Terriers (Westies), and Schnauzers, are also at risk for otitis.
Perpetuating factors
Finally, perpetuating factors are changes to the ear that keep the infection from resolving. Sometimes chronic ear infections can cause the ear canal to become stenotic (narrowed) and/or proliferative (extra tissue growth). This keeps debris from being able to get out of the ear. And it makes it harder for ear medications to work effectively.
Additionally, middle ear infections (otitis media) can contribute to the persistence of the external ear infection.
What does a dog ear yeast infection look like?
When dogs develop inflammation and a yeast (and sometimes bacterial) infection in the ears, they may show a variety of both physical and behavioral symptoms.
Physical signs of an ear infection
You may notice changes to your dog’s ears such as:
Abnormal odor in and around the ears
The smell of yeast otitis has often been compared to the scent of Fritos corn chips.
Itching (pruritus)
The itchiness from ear infections can be intense. And the dog may cause further damage to his or her skin and ears from excessive scratching or head shaking.
Redness (erythema) of the ear canals and ear flap
One of the cardinal signs of inflammation is redness of the tissue due to increased blood flow. The ear canal, as well as the ear flap itself, may be red and warm.
Ear discharge (otorrhea)
With a yeast ear infection, the ear canals may contain waxy ear discharge (cerumen), yellow to brownish smelly debris, pus, or blood. (Dogs with ear mites often have darker, flakier, and drier debris in their ear canals, which resembles coffee grounds instead.) Pus is usually limited to severe infections or co-infections with more than one organism. And bleeding may develop due to severe infection or self-trauma from scratching.
Thickened ear canals (hyperplasia)
In many active yeast infections, the underside of the ear flap and the skin of the outer ear canal may develop a thickened, cobblestone appearance. This is due to excessive scratching and chronic inflammation of the affected tissues.
Narrowing of the ear canal (stenosis)
Due to chronic inflammation and persistent hyperplasia, the ear canals become narrower, which traps more debris and moisture. In severe cases, it can be impossible to visualize the ear canal at all.
Aural hematoma
Aural hematomas in dogs (blood trapped in the ear flap) are typically secondary to excessive head shaking and ear scratching. These actions cause the tiny blood vessels in the ear flaps to rupture and bleed into the surrounding tissues. Once the hematoma forms, the ear flap looks swollen and feels heavier.
New aural hematomas feel squishy like water balloons. But older hematomas may feel firmer due to the presence of clotted blood and fibrin trapped between the skin and cartilage.
Damage to or rupture of the tympanic membrane
With chronic, recurrent infections that progress further into the canal and affect the middle and inner ear, the eardrum may rupture. This can cause temporary or permanent hearing loss in dogs.
Behavioral signs of a yeast ear infection
Additionally, there may be changes in your dog’s behavior when he or she has an ear infection.
- Head shaking and scratching—It may seem like your dog is constantly scratching his or her ears, rubbing the head on the ground, or flapping his or her ears. These behaviors can lead to an aural hematoma when the tiny blood vessels in the ear flap rupture.
- Signs your dog is in pain—Dogs with ear pain are often head shy, flinching if you touch the ears or even reach toward the head. Some dogs may become aggressive or reactive if the pain is too intense. The veterinarian may need to use sedation or anesthesia to complete a thorough ear examination and cleaning.
- Crying out—Your dog may whimper or cry when you touch the ear or attempt to clean it.
If you are seeing some of the physical and behavioral signs above and suspect your dog has an ear infection, the best thing to do is schedule an appointment with your veterinarian.
How will the vet diagnose a yeast ear infection in dogs?
The vet will start by asking you questions about your dog’s symptoms and past history. Knowing when the problem started, what you are noticing, any home remedies you have tried, and if your dog is prone to ear infections can all be helpful information to share with your vet. Plus, the vet may ask about symptoms that would point to an underlying cause of the ear infection, such as allergies or endocrine disorders.
As part of the physical exam, the veterinarian will perform an otoscopic examination to look for parasites, foreign bodies, growths, and other abnormalities in your dog’s ear canal. He or she will also try to visualize the tympanic membrane to determine if it is intact, swollen, or ruptured. Whether or not the eardrum is intact can affect the ear drops and cleaners the vet can safely use for your dog.
After the otoscopic examination, the veterinary team will collect swabs of the debris in your dog’s ear canals for cytology. Examining the stained sample under a microscope can reveal the presence of bacteria, yeast, red or white blood cells, and parasites. This information helps determine if an infection is present, what the infectious agents are, and which treatment(s) the dog will need.
If your dog has suffered from recurrent infections, your veterinarian may also recommend a culture and sensitivity test. This can help ensure that the prescribed medications will effectively treat the organisms present.
What is the dog ear yeast infection treatment plan?
Once your vet has reached a diagnosis, he or she will work with you to formulate a treatment plan. Typically, treatment for ear infections in dogs uses a combination of topical medications and soothing ear cleansers. The goal is to help resolve the inflammation and yeast infection.
Medicated cleansers
The veterinarian may recommend cleaning your dog’s ears. This helps remove debris so the medications can work better. Plus, some ear cleaners include antibacterial and/or antifungal ingredients.
Tris-EDTA® Aqueous Flush (and other products containing Tris-EDTA) alter the permeability of the cell wall in Gram-negative bacteria like Pseudomonas, making them easier to kill. This makes it a good choice if the dog also has a bacterial ear infection. Other popular cleansers include EpiOtic® Advanced and Zymox® Enzymatic Ear Solution.
Keep in mind, though, that these are just a few of the many ear cleaners available. Your veterinarian may have different ear cleaners that he or she trusts and recommends. His or her recommendation is the one to follow. (The same goes for all other products named in this article.)
Topical or oral steroids
Dogs with ear infections often need topical and/or oral steroids (glucocorticoids) to relieve swelling and inflammation in the ear canal. Sometimes the vet prescribes a short course of oral steroids (prednisone for dogs). Other times, the dog may be on a topical ear medication containing a steroid. For example, Otomax® contains the steroid betamethasone, and Mometamax® includes the steroid mometasone.
Antifungal medications
Many topical ear medications contain antifungal ingredients to treat yeast infections in a dog’s ear. The more commonly prescribed antifungals are from the “-azole” family (ketoconazole, itraconazole, miconazole). Other effective antifungal medications include terbinafine and nystatin.
While topical ear medications are generally the treatment of choice, some dogs may need oral antifungals. Not all pet parents are able to administer topical medications, and the temperament of the dog can make getting anything in the ear nearly impossible (painful dogs often are not cooperative). Plus, in chronic, severe cases, topical treatments simply are not strong enough to resolve the infection.
Antibiotics for secondary infections
Veterinarians may prescribe antibiotics for difficult-to-treat combination infections when bacteria are present. As mentioned earlier, sometimes the vet will use the results of a culture and sensitivity test to select the antibiotic with the highest chances of working well.
Long-lasting ear medications
There are several commercially available or compounded topical ear medications that are designed to be applied in the ear canal at the vet clinic, with no need for continued application at home. Depending on the medication, they may provide up to 30-45 days of control of the ear infection with either a single application or two applications.
These products are usually combinations of steroids, antifungals, and antimicrobials, but some may only have an antifungal and a steroid. Unlike using the daily or twice-daily ear medications, you should not clean the ear during the treatment period when using the long-lasting formulations. This helps ensure maximal contact time with the medication.
These long-lasting products can be an excellent option for dogs who are resistant to having ear medications applied, or in situations where it is physically difficult for the dog parent to apply the medication. Plus, they are handy for busy dog parents!
Are there home treatments for dog ear yeast infections?
There are no safe and effective home remedies for ear infections in dogs. Let’s take a look at some DIY ear remedies I’ve encountered during my years in clinical practice and why I don’t recommend them. I understand the mindset of wanting to use natural ingredients versus chemically formulated compounds. But it is important to remember that “natural” does not always mean safe and effective.
Do NOT use the following home remedies to treat your dog’s ear infection:
- White vinegar or apple cider vinegar—While it is an excellent household cleaning agent, vinegar is not suitable for clearing up ear infections. It can irritate sensitive skin and worsen the existing inflammation and irritation.
- Essential oils (especially tea tree, lavender, or eucalyptus oils)—Essential oils certainly smell wonderful, and they have some proven homeopathic uses for humans. Still, undiluted essential oils can often be toxic to animals and pose risks when ingested, inhaled, or absorbed through the skin. Thus, you should not put them in your dog’s ears.
- Antifungal creams such as Monistat® or Lotrimin®—Human antifungal preparations may seem like a common-sense option for yeast ear infections in dogs. But they may contain other ingredients that are not safe for dogs due to differences in their mechanisms of absorption and metabolism.
- Coconut oil—Coconut oil has skyrocketed in popularity in the past few years as a natural fix for a variety of human and animal ailments. Possible uses include skin disorders, dental disease, hormonal regulation, stress relief, and weight management. However, there is no clinical research to support the use of coconut oil in veterinary medicine as an effective treatment for ear infections.
Consult your vet if your dog has an ear infection
The take-home message is this: While natural remedies sound nice, they tend to be ineffective and possibly even harmful to your dog. Stick with veterinarian-prescribed treatments that have been proven to be safe and effective for ear infections.
How can you prevent yeast infections in dogs ears?
We’ve all heard the old saying, “An ounce of prevention is worth a pound of cure.” It’s true when it comes to most situations, including yeast ear infections. There are several things you can do to cut down on the number of ear infections your dog has.
1. Make it a habit to evaluate your dog’s ears on a regular basis.
Diligent dog parents should regularly examine their dogs at home for any signs of discomfort or disease. This includes performing both visual and “sniff checks” of the ears. If you think your dog might be developing an ear infection, contact your vet promptly.
NOTE: Do NOT use leftover ear medications before heading to the vet (unless your vet has instructed you to do so). What is right for one infection might not be right for the next. Plus, some ear medications can be problematic if the eardrum is ruptured.
2. Clean your dog’s ears periodically.
Cleaning your dog’s ears is a great way to decrease the chances of a full-blown ear infection. But one question I hear commonly is, “How often should I be cleaning my dog’s ears?” And my answer is always the same—it depends on your dog!
If your dog is an active outdoor adventurer, constantly finding his or her way into mud puddles or perfectly clean pools, then there’s definitely a greater risk for having water and debris trapped in the ear canals. Therefore, he or she will need more ear care than a dog whose mission in life is to keep your couch from floating away.
Along the same lines, a dog who has some risk factors for ear infections, such as underlying allergies, hair in the ears, narrow ear canals, or chronic diseases, is going to need more frequent ear cleanings than one who doesn’t.
Talking to your veterinarian and a bit of trial and error can help you find the ear cleaning schedule that works best for your dog.
3. Say “no” to alcohol, peroxide, and homemade ear cleaners for dogs.
Understandably, the follow-up question is usually, “Well, what can I use to clean my dog’s ears at home?” There’s an abundance of information on the internet touting home remedies to clean your dog’s ears. That said, DIY is not always the best or safest option! For example, rubbing alcohol and peroxide, while inexpensive and readily available, are NOT good choices for cleaning a dog’s ears.
Don’t put rubbing alcohol in your dog’s ears
Ear cleaning solutions containing rubbing alcohol (or straight rubbing alcohol) can be very irritating to the tissue in the ears. Plus, they cause significant pain to a dog whose ears are inflamed, much like the discomfort we feel when we get alcohol in a paper cut.
Rubbing alcohol can serve as a drying agent due to its ability to evaporate quickly. But I still do not recommend using it in your sweet dog’s sensitive ears. There are milder drying agents available (like Vetnique’s Oticbliss™ Advanced Cleaning Ear Flush) that don’t sting or alter the pH of the ear canal.
Hydrogen peroxide is not a good ear cleaner for dogs
Along the same lines, hydrogen peroxide can damage sensitive tissues in the ear canal, including the eardrum. This can lead to irritation and worsening discomfort. Plus, the bubbling sound in a dog’s ear can be stressful because they don’t understand where the noise is coming from.
Once the bubbling from the peroxide has subsided, you’re left with water in the ear. This is precisely what we are trying to avoid. Hydrogen peroxide is not a drying agent, and it serves no purpose for effective cleaning and drying of the ears.
4. Ask your vet to recommend the best ear cleaner for dogs with yeast infections.
Instead of using peroxide, rubbing alcohol, or other homemade ear cleaners, it is a much better idea to talk to your veterinarian about what kind of commercially available ear cleaner he or she would recommend for your dog. There are cleaners that also help dry out the ear, cleaners that are antibacterial and antifungal, cleaners that are soothing to irritated ears, you name it. With all these options, there is sure to be one that suits your dog’s needs.
5. Remember to care for your dog’s ears while bathing and after swimming.
It is important to clean and dry your dog’s ears after he or she has been swimming. This can help prevent trapped moisture in the horizontal canals. Several high-quality ear cleaning and drying solutions are commercially available. (I recommend EpiOtic® Advanced or Zymox® Otic ear drops, but your veterinarian may have other excellent product recommendations to consider). These solutions help maintain a good ear canal pH and promote ear health.
When bathing your dog, place a small amount of clean cotton (large cotton balls or rolled cotton) into each ear canal before wetting your dog’s head. The cotton will absorb water and cleaning agents that may reach the outer ear during bathing. Just remember to remove the cotton when bath time is over!
6. Work with your vet to manage conditions that make your dog more prone to ear infections.
As you learned earlier, many factors go into causing an ear infection. It isn’t just the yeast (and sometimes bacteria). Working with your vet to create a plan to manage your dog’s allergy symptoms using allergy medications for dogs can be helpful. So is addressing hormonal imbalances, immune-mediated conditions, or other problems that put your dog at a higher risk for ear infections.
In short, the more you can do to create an environment in your dog’s ears that is not conducive to yeast infections, the better.
7. Ask your vet if plucking your dog’s ears would be helpful or harmful.
Another very common question I get is, “How often do my dog’s ears need to be plucked?” Again, this is also highly dependent on the dog. For dogs with excessive hair growth in the canals, it can be challenging to see what you’re cleaning through thick tufts of waxy ear hair. Plus, all that hair can trap moisture in the ear canals. However, overplucking the ears can sometimes irritate the ear canals as well.
My recommendation is to consult with your veterinarian before attempting to pluck your dog’s ears or taking them to a groomer for the service. Our goal should always be, above all, to do no harm.
8. Consider using probiotics to help prevent ear infections.
Probiotics (good bacteria) are becoming increasingly vital to supporting a healthy immune system, starting with the gut microbiome. Interestingly, the gut houses approximately 70% of a dog’s immune system. If there is an imbalance in gut bacterial populations, this can weaken a dog’s immune system due to the stress and inflammation those bad bacteria cause within the gut.
Plus, there is a connection between gut health and skin health called the gut-skin axis. Sometimes, harmful bacteria can be absorbed into the bloodstream through a leaky intestinal wall. Then, inflammatory reactions can develop on the skin due to a breakdown of the normal, healthy protective skin barrier.
The good news is that probiotics for dogs may be able to combat those problems. These supplements supply healthy populations of beneficial organisms (like Lactobacillus and Bifidobacterium spp.) that compete for survival with potentially harmful microorganisms. You can add probiotics to your dog’s food (like Purina ProPlan® FortiFlora® or Nutramax® Proviable®). And many commercial diets now include probiotics in their formulations.
Additionally, there are probiotic ear cleansers like Skout’s Honor® that can deliver beneficial organisms directly into your dog’s ear canals. The probiotics in those products help relieve inflammation and reduce odors associated with an infection, but they do not treat the infection itself. Rather, they serve as an adjunct therapy.
Partner with your vet to address yeast ear infections in dogs
Dealing with a yeast ear infection can be frustrating for both you and your dog. But with the proper care and a little patience, most dogs recover quickly and comfortably. Just remember, you’re not alone, and it’s not your fault! These infections are common, and most are very treatable.
By following your veterinarian’s guidance, keeping those ears clean and dry, and staying consistent with treatment, you’re doing exactly what your sweet dog needs. With your help, those itchy, irritated ears will be feeling better in no time…and your dog will be back to his or her happy, tail-wagging self!
Does your dog struggle with yeast ear infections?
Please comment below.
