malassezia Ear infection - constant and won't go

[Vodkacranberryplease]

I have a Westie who for the last year almost has had a virtually constant ear infection in one ear. We have been to the vets numerous times and she has had an ear culture done. Nothing works more than partially, and temporarily. I've also used ear cleaners and different drops but she just gets so stressed - it's being going on for so long. I just put one that seemed promising in and she was shaking (eating the treats though).

She has also had, in the past, a malassezia skin infection on her tum, underarms and around her bits. It was severe, and I took her to the vets who gave her antibiotics and steroids 🙄. After much research I found out what I was and managed to get rid of it using nizoral, hibiscrub and a specific dog shampoo for it (same ingredients).

I know that fungal infections can be caused by other factors so have also tried probiotics but not sure which ones to use as my go to is acidophilus but needs to be taken without food.

She was run over as a puppy and had a shattered pelvis so was in a crate for weeks and on various medication. Then a few years ago she was stolen by gypsies and they tried to breed her - I got her back and less than a week later we were at the vets for an emergency op for a severe uterine infection.

I have been cooking her food for years - mince or chicken, rice, and veges. Plus one dental treat (just swapped to an enzyme one, no difference.)

As far as I can see the next move is an operation on her ear. She's 13 now and I don't want to put her through it. Anything at all I can do? I can't clean her ear out every day for weeks - it's had a terrible psychological effect on her and she's starting to see me as someone who just does mean things to her.

Can I put any of these anti fungals in her ear? My dog walker suggested dilute apple cider vinegar but she went nuts - I washed it straight out.

[Veterinari]

Your dog likely has atopic dermatitis - it's immune mediated and can often be controlled with either long term steroids (though side effects are a concern) or immuno suppressants like Atopica (cyclosporine) which is expensive.

However once long term thickening if the ear canal has occurred then a total ear canal ablation (TECA) is usually the only solution. It is a very painful and difficult surgery.

Please don't put random 'alternatives' into your dog's ear. They'll likely cause further distress.

I'd recommend a referral to a veterinary dermatologist if you haven't already had one or otherwise sadly in an older dog with a chronically painful condition, it's important to consider quality of life and how much might be too much

[Vodkacranberryplease]

Is the dermatitis caused by the Malassizia? Or vice versa? Two of the vets I went to over her skin had never heard of it, it was a grass allergy etc. She got steroids and it didn't help along with antibiotics, it took me months of research to find out what it was. Dogs were being put down by owners who were at their wits end. A fungal infection. Thrush fgs. The same thing doctors can't treat properly but can be eradicated with certain probiotics.

It was in her ear swab, and I don't think it's a coincidence. I'm not putting random stuff in her ear - I'm not stupid. I just don't have the bottles to hand virbac was one I think. She's had the anti bacterial and anti fungal ear stuff from the vet.

It's not chronically painful. I can clean her ear/medicate it to bring it down a few levels - I want to eradicate it. I'll look up veterinary dermatologists though.

[Veterinari]

Westies have a genetic predisposition to atopy - it's basically allergic skin disease of unknown or multiple origins (sensitivities to environmental or food triggers). Grass pollen allergies can be a common trigger.

www.ufaw.org.uk/dogs/west-highland-white-terrier-canine-atopic-dermatitis

The malasezia is likely to be secondary colonisation of the inflamed skin rather than a primary disease so just treating the malasezia won't help in the long term.

Treatment relies on eliminating exposure to triggers (hypoallergenic diet, reduce environmental exposures) , and damping down the immune response through the use of the meds I mentioned before. Anything that aims to treat an 'ear infection' is missing the point that this is generally an immune-mediated condition and requires lifelong management to reduce flare-ups

[Girlintheframe]

Our dog gets re occurring ear infections.

Much like pp has said, vet advised us to stop cleaning his ears altogether and felt it was doing more harm than good.
Ours also has allergies so gets a twice daily dose of piriton which has helped a lot.
Not sure if this applies to your Westie but our dogs ear canals are very hairy. Anything we put in his ear including antibiotic drugs just sits in amongst the hair. Once -twice a year he is sedated and the hair removed which helps.
Really though the piriton has had the biggest impact in preventing reoccurring infections.

[Vodkacranberryplease]

@Girlintheframe I'm so glad I logged in thank you so much for explaining that. I don't clean her ears a lot now - it doesn't help that much and stresses her and I'm uncomfortable putting water based liquid into a place already over run by fungus.

It is just SO FUCKED UP that a perfectly healthy dog can be allergic to grass ffs. And that the cure in the past (antibiotics) is an absolutely known cause of fungal infections. And the reason for all this in the first place. I've only ever given her home made food, and she's actually in great nick otherwise.

I moved a few years ago to a place with carpet in the bedrooms. I hate it and am convinced it's harbouring god knows what. I do have a steam cleaner but am planning on ripping the carpet out and getting floorboards like the rest of the place. I did read that the mites in carpet/furniture etc can cause this. I'm trying to think, but I remember this starting after we moved in.

I'd like to try a holistic (not in a hippy way) approach so am currently giving her probiotics and will look into these allergies. I did buy her a hypoallergenic food but it didn't help and was muck compared to what I give her.

I have rosacea so I know how complex these relationships can be between various mites (there's a demodex link there too), the immune system, antibiotics and fungus.

First up is doggy (amounts of) piriton and and another look at hypoallergenic diets. And getting rid of this carpet. Plus I'll keep going on the probiotics because these ones (bioCare) are amazing in humans.

How much portion should I give her and do you have a hypoallergenic diet you can recommend?

[Girlintheframe]

I know it's really frustrating isint it and it's awful seeing them in so much discomfort!
We feed ours Millie Wolfheart's kibble. He gets the Riverside Mix. Ours dog seems to respond well to fish. I've tried him on the other 'flavours' but he's had mixed reactions. You can buy them in small bags so you can try before committing to a big bag.
With regard to piriton we give him a standard 4mg tablet. He is 22kg. If you google you should be able to find out how much by weight. (Sure it's 4mg per 10kg but I could be wrong)
I did double checked with my vet who confirmed he could have two a day. I use Boots own brand. Just make sure it's piriton/own brand equivalent and not priteze.
It might be worth asking about removing the ear hair too. Once our dog has an infection it's the only way to ensure the medication actually gets in the ear properly and doesnt just sit in the ear canal. It's important to get the infection clear once and for all.
I know it's difficult! We have tried lots of things including natural ear drops/anti itch drops/cleaning ears etc. Its incredibly frustrating as nothing seems to work!
You can tell our dog has allergies as he would often face surf, chew paws and the ear infections. We've never been able to pin down exactly what the causes are but it really ramps up March - September but is there in some degree all year.
Good luck.

[Veterinari]

@Vodkacranberryplease

Atopic dermatitis in westies is a genetic condition

It won't be fixed with probiotics and as you've found, a home cooked diet doesn't necessarily help. Reducing exposure to dust mites abd grass pollens may help but is almost impossible to do entirely. Having rosacea is not the same and is nothing whatsoever to do with demodex

Your dog needs consistent lifelong medical treatment not stopping and starting different fads intermittently. Ear cleaning actually does work and is helpful at reducing wax buildup and preventing infection. Antihistamines can certainly be helpful but some brands of human piriton contain decongestants that are toxic to dogs so take care and make sure it's straight piriton

[Vodkacranberryplease]

@Veterinari I know you are helping and thank you. But please don't be so condescending. I don't do 'fads' she has had a LOT of medical treatment which hasn't worked some of which made things much much worse.

I think you should look into the rosacea/demodex thing before dismissing it too. The current Rosacea treatment along with metronidazole is soolantra, which is ivermectin. Which kills demodex mites.
This is just one of many and I haven't spent that much time looking at it.
parasitesandvectors.biomedcentral.com/articles/10.1186/1756-3305-2-13
The Malassezia is also a candida fungus and I have used biocare acidophilus with amazing success on myself when doctors just couldn't clear the recurring thrush I was getting years ago.

@Girlintheframe I think that's the thing, her ear is so full of gunk are the drops even getting in? We need the vet again but I am not letting them give her antibiotics or steroids. I think they will need to do an ear flush (under anaesthetic I think they said).

One vet hadn't even heard of Malassezia either 🙄. There goes the new floorboards.

In the meantime Piriton not piriteze, might as well see how we get on with the biocare, and I'll try the diet. I cook because I want her to have good food it wasn't an allergy thing. Shame canesten oral doesn't work (super bad for them and for some strange reason needs to be taken for weeks I think).

[LadyEvelynBagley]

Get a referral to a dermatologist. The can sedate, flush and do an MRI to check for canal thickening as Veterinari mentioned above.

If you've not seen a dermatologist then you've not yet exhausted the medical treatment options (not even close).

[Veterinari]

But please don't be so condescending. I don't do 'fads' she has had a LOT of medical treatment which hasn't worked some of which made things much much worse.

It's a shame you think that advice to use evidence based medicine is condescending. I'm afraid I can only respond to the information you've provided and so far you've mentioned apple cider vinegar, probiotics and haven't really given any information on which evidence-based treatments you've tried over the years apart from ear cleaning so I 'm just going from the info you're providing

I think you should look into the rosacea/demodex thing before dismissing it too. The current Rosacea treatment along with metronidazole is soolantra, which is ivermectin. Which kills demodex mites.
Interesting - how does that relate to atopic dermatitis in westies?

The link you've provided is simply an 11 year old trial of an antiparasitic and an antifungal on a parasitic and a fungal disease in a single dog. I'm not seeing the connection to rosacea or how rosacea is relevant to your dog.

it's well established that dogs that have dysfunctional immune systems and dermatitis may also develop secondary fungal/demodex outbreaks and thus is seen in westies, but demodex does not cause ear disease. You need a derm exam to establish exactly what is going on.

The Malassezia is also a candida fungus and I have used biocare acidophilus with amazing success on myself when doctors just couldn't clear the recurring thrush I was getting years ago.

And yes the acidophilus may well help temporarily, but Malasezia is not a primary infection in dogs - it's indicative of underlying atopic dermatitis so you need to treat that, not just the superficial yeast infection.

We need the vet again but I am not letting them give her antibiotics or steroids.

Why pay an expert for their advice and disregard it? Steroids are a recognised treatment for atopic dermatitis. Alternatively you can try Atopica or another immunosuppressant as I've already suggested but your dog needs evidence based medicine.

Please stop dabbling with odds and sods of alternative therapies and allow your vets to refer you to a dermatologist for a proper workup or to trial immunosuppressant meds. this would probably be a better use of your money than an ear flush

[Molly357]

My dog had this and so a dermatologist. She put him on a special dog food and had steroids and a weekly bath with special shampoo and ear drops and got it under control. Was a body response to food allergens.

[Molly357]

Although I thought the vet was trying everything , the dermatologist was so much better and knew what to do instantly. And it worked!

[Vodkacranberryplease]

I definitely will find a dermatologist. I saw one for my rosacea and she was great although she couldn't clear it up. I'm just not wealthy enough to do all of the facials etc and £500p/h appointments. But skin is complex. I had spots for years and went to gps and a dermatologist and nothing helped and the antibiotics probably fucked it up further. In the end I, wait for it, followed a protocol I found on acne.org and got rid of it FOR EVER over 10 years ago. 90% in the first 2 weeks and decreasing outbreaks to the point of nothing over the following couple of months. Sometimes 'dabbling' works.

There is also a lot of compelling science around the relationship of the gut to various illnesses and allergies (which didn't exist not that long ago). Antibiotics save lives every day but they have a price. We are a bit behind that one in the UK.

I've got her on the piriton now but the doses are unclear and I'm being cautious. The PP said her Westie was 22kg which is impossible - mines a pretty standard size though. So far I've given her 1 4mg tablet and not sure if she should have 2 a day. But it sounds like that may stop the cause but there's still the various symptoms to deal with. Let's hope they are open.

[Girlintheframe]

My dog is not a westie. I do however have a 22kg dog who has lots of allergies.
Priton worked for me but I did double check with the vet before trying him on it and confirming doses.
Mine gets two, one am and one pm.
My dogs ear infections are definitely linked to allergies. It could be possible he has allergies to his current food but without going on a proper hypoallergenic diet through the vet it's impossible to say. We arent going down that route as things are currently well controlled. Though it's possible we will have to in the future.
Along with food allergies he definitely has environmental allergies as everything ramps up for him during spring/summer months then settles down a bit in autumn/winter.
Food is a massive cause of allergies and my dog certainly does better on some proteins more than others.
It's been very much trial and error for us which I know can be very frustrating. Thankfully, for now, we seem to have things under control.

[Vodkacranberryplease]

That's good to know. Do you do 2 x 4mg tabs which means my little Westie would have less than half that, a third to be precise. Is yours allowed carbs? I did a hypoallergenic diet (not for long admittedly, she didn't like it) and it had sweet potatoes I think in it. But she gets rice. Anyway I'll get her to a dermatologist but I would like an interim measure and there's some really good ones here so thank you very much. She hates kibble though so is going to be well unimpressed when I present it 😁. She will go on strike if I give it to her. But is a bit porky thanks to lockdown anyway. Bless her. She's very sweet, everyone loves her. I even have a photo of her taken by the photographer that discovered twiggy. In her younger days 😉

[Lonecatwithkitten]

These cases are very frustrating for owners and vets, I always prepare my clients when I diagnose atopic dermatitis that we are never, ever going to cure it we are only every going to manage the symptoms. Malasezia is a symptom of atopic dermatitis an opportunist that jumps in when the skins defevensive mechanisms are breached.
Referral to a veterinary dermatologist is a very good idea, but prepare yourself for lots of investigations, skin scrapes and swabs, blood tests and food trials. Controlling atopic dermatitis is largely a trial and error process, each trial needs to last at least 12 weeks to decide whether it is effective.
One thing that does jump out is that you feed chicken - the single biggest food allergen in dogs. Dermatologists will want to use a hydrolysed diet to do a food trial and if that is effective then possibly challenge with protein sources to identify which is the problem.
I am both a vet dealing with Westies with atopic dermatitis and an owner of a cat with atopic dermatitis. My cat is currently only controlled with diet, but it took diet, steroids, atopica and a buster collar for four months to get things under control. As an owner you have to be tough and rigid to get things under control. My cat didn't like the diet at first I just had to tough it out to get her to eat it. She never gets a single treat as just one could cause a flare.

[Vodkacranberryplease]

I very rarely feed chicken. It's usually beef mince rice and veges (peas and lentils). But the food lately has been Lily's chicken. No more though. And bearing in mind she's had these problems for a while no more beef either. Someone suggested a food and it was fish based. I think that's the first port of call because she's never really had fish and it's very different from normal meat.

I've just looked it up though and the hydrolysed food looks vile. Interestingly I also have a hydrolysed collagen powder which is a food supplement for my skin. It has zero taste.

[Vodkacranberryplease]

Are you in London lonecat?

[Lonecatwithkitten]

Not in London no. Cats are fussier than dogs and I just tough it out and she eats the hydrolysed diet and her skin has been perfect for 8months ( I have only owned her a year - yes I adopted the cat with the chronic skin condition).
Really it is better to do diet trials under a dermatologist as by only changing the protein source is not the whole story. Hydrolysed diet is totally allergen free due to it's formulation if the skin improves after 12 weeks on the hydrolysed diet part of your problem is food allergy. My cat has been inside for the whole year so she could be affected by pollens I have yet to find this out. Though I am pinning my hopes on the fact that cats fleas saliva. food allergy, then house dust mites are the most common allergies in cats. Dogs are a lot more complex.
I do a lot of blood testing and have a lot of good success with immunotherapy and we also successfully use apoquel and cytopoint. There is no golden bullet no one thing that works for every dog it takes time and effort to tailor the right combination for the individual dog.

[Girlintheframe]

Ours does have carbs in the form of sweet potato. His food doesnt contain rice, chicken,eggs, gluten or grains.
One of his worse reactions was to beef. Now we just keep him on mainly fish though his current food does contain some duck in it too.
We give him one piriton at each meal. This site has information on dose per weight but I would still double check with your vet.

dogsbarn.com/piriton-for-dogs/

[thaegumathteth]

Is there definitely no pseudomonas infection in there?

My dog is a spaniel but constantly had infections . Whats helped
1.anallergenic dog food and NOTHING else except what he steals off the kids

1. Steroids
2. Cleaning out his ears

[Vodkacranberryplease]

I honestly don't know. She had her ear swabbed and a culture taken last time and there was a bacterial infection and they found the malassizia (god I can never spell it). But probably. She likes to roll around and scratch the side of her face on the ground so goodness knows what gets in there. Fox poo, mud, ugh.

Her dog walker (when I'm working) takes her to a huge park which has a stream and she has a little splash. She comes back literally covered in mud.

The (vet) ear stuff clears it up for a bit but works less now. They include both anti bacterial and anti fungal ingredients. And it's only one ear! The other is fine. And I never clean the other.

Would it make a difference? Such a crazy situation.