Concerning symptoms with my senior dog, please help

Hello! I have a male 15lb mixed breed (terrier/pug/chihuahua) senior dog (8yrs), we rescued him from the streets when he was about 2 yrs old. He's been a great dog and we've not had any major issues with him until recently. This started 2 weeks ago when he began showing signs of (what I thought was) an ear infection, his ear was mildly red/irritated, had a yeasty smell and he was tilting his head to that side but no ear scratching, discharge or signs of ear pain. I will say he does struggle with both food & environmental allergies that we maintain by diet & meds. We also have to keep up with cleaning his ears & eyes regularly so that's what made me think his ear had gotten infected. He was started on oral antibiotics & medicated ear drops. It's been 2 weeks and he's had no change, actually the head tilt is more pronounced and his balance is off. At this point I'm 99.9% sure it's not an ear infection and now considering it's a vestibular disorder or something neurological, or it's possible that he had a mini stroke that I didn't know about? I'm very worried for him and not sure what route to take at this point, I need some advice please! Symptoms--major head tilt (to his left side), lack of balance/uncoordinated (but still gets around okay), stumbles when he runs/gets too excited (even has difficulty righting himself at times), trouble sleeping (seems anxious or uncomfortable at night). Upsides are he's not in any obvious pain, his appetite is normal, he still goes outside, he's happy and aware. Also, he doesn't have the rapid eye movements like usually seen in neurological issues. I will be grateful for any thoughts/ideas of what's going on and what, if anything, could possibly help him. Thank you!!!

Hello and I'm sorry that you and your dog are having a tough time.  I can't tell you what is going on with your particular dog of course because I don't know them, haven't examined them and don't know enough about them.  However, here are some general observations about ear disease in dogs that you may find interesting:   1) 'ear infection' (i.e. overgrowth of bacteria or yeast down the ear, sometimes even with pus) is rarely a primary problem of a dog, as in 'my previously perfectly healthy dog went out one day and caught an ear (yeast or bacterial) infection.'  To my understanding, this almost never happens.  We UK vets used to think that it did, fifteen or twenty years ago.   2) A more common problem is that ears, which are lined with and covered with thin, sensitive skin, become inflamed e.g. as a result of skin allergies.  It is no coincidence that the dogs that get recurrent allergies are the same ones that tend to have recurring ear trouble.  Inflammation (allergy) in an ear canal can make a big difference to a dog.  It might even predispose it to messing with its ears, damaging the protective layer of cells and thereby catching secondary (often yeast) infection.  3) Various anti-inflammatory drops may calm such ears down, but it is now taught that antibiotics should be matched to the pathogens that are in the ear e.g. one can sample the cells in an ear and look down a microscope at them.  Thereby any bacteria can be identified and even tested and treated with the appropriate antibiotics, avoiding resistance.   4)  Smelly, pussy ears still do not necessarily contain an infection; one cannot judge an ear by its cover.  5) Whatever is going on in an ear, the ear-drum is very close to certain nerves / the brain.  Pressure in this area / damage to the ear drum / innappropriate drug use, even, can lead to neurological signs, usually vestibular signs - the repeated (relatively) slow movement of eyes in one direction, with a more rapid flick back, is typical of abnormalities to this one particular nerve.  6) However, there are lots of other problems that can cause the same signs, including brain abnormailities or nerve abnormalities anywhere along that nerve, lumps or bumps to the ear or brain, changes in pressure and so on.  7)  It sounds as though your dog needs a neurological exam and their ear checked, possibly as an emergency.  Please call your vets and inform them of the development of the new symptoms, and they should be able to advise you regarding how soon your boy needs to be seen.  Once they know what is happening in this particular case, they should be able to discuss with you where to go from here.   8) Hopefully your vet prescribed the ear-drops so knows exactly what was given and the basis for this, which will help.  But if not - or if you see a night-vet out of hours - please do remember to take them along with you.      I hope that something there is useful.

This article from out blog may help to give you some more information:  https://vethelpdirect.com/vetblog/2022/07/11/why-does-my-dog-have-an-ear-infection-2/

I'm sorry, that doesn't appear to have created a link, but if you could copy and paste it into the browser, or search the blog for:  Why does my dog have an ear infection? then hopefully you can access the article.