The vet and Sandra were both a bit flushed after their third attempt at persuading Micky to allow the vet to look in his ear. Micky, a 5-year-old Cocker Spaniel, was having absolutely none of it; despite the fact he’d had some tablets to calm him down before his appointment after his behaviour over the last few appointments. A veterinary nurse came to assist them. And with her expert help the vet managed a quick look down Micky’s ears with an otoscope, but Micky was clearly stressed, growling loudly throughout.

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As soon as the examination was over, Micky reverted to his normal friendly self, accepting treats from the vet and bouncing around the consult room. Sandra was almost in tears “I don’t know what gets into him,” she said, “he’s such a lovely boy but he just hates his ears being touched after all he’s had done.”

Micky had suffered from multiple ear infections over the last year. He’d been diagnosed with allergies, and started on medication, but this latest ear infection was especially grotty, with a foul smell emanating from his ear canal. It was clearly irritating him as he frequently scratched at them vigorously. 

Ear Disease in Dogs

Ear disease in dogs is usually caused by inflammation and infection of the skin lining the ear canal. This is called otitis externa. The problem can then spread into the middle ear: otitis media. The ear canals are susceptible to infections because the dark, moist, warm environment encourages growth of microorganisms such as bacteria and yeasts. Ear infections are itchy and painful, and middle ear infections can cause imbalance, nausea, hearing loss and a head tilt. Ear disease is common in dogs and has many predisposing factors, including breed and the size and type of ears. Recurrent infections are also strongly linked to allergies in dogs. 

Micky’s repeated ear infections had made him very anxious about having his ears handled

As a result, he was becoming more and more difficult to examine at the vets. The vet explained that his allergies, his droopy ears and his narrow ear canals all made him more susceptible to ear infections; despite treatment for his allergies and regular cleaning. The repeated inflammation was now changing the shape of his ears. The skin was becoming thickened, narrowing his ear canal still further. 

Sandra was finding it difficult to apply ear drops at home, as Micky was very intolerant to the procedure. It was agreed that Micky would come in to have his ears flushed under sedation and treatment applied. 

Common treatments for canine ear disease

Your vet will first examine the ears and any discharge, and they may take samples to look at under a microscope, or to send away to a laboratory for bacterial culture. Treatment is often topical, using medicated drops into the ear canal, but may be oral medication such as tablets. The treatment is usually a mix of antibiotics, antifungals and anti-inflammatories. If your dog’s ears are very sore, additional pain relief may be given. You may be advised to use an ear cleaner. More severe cases may require flushing under sedation or anaesthesia.

Micky’s ears initially seemed better after the flush

However, within a fortnight he was scratching them again, frantically shaking his head and rubbing his ears along the floor. Sandra confessed to the vet that she just couldn’t keep trying to get drops into his ears. “He just won’t let me anywhere near them.”

The vet discussed that perhaps it was time to think about surgical management and discussed the possibility of performing a total ear canal ablation (TECA).

What is a TECA?

A Total Ear Canal Ablation (TECA) is a surgical procedure which involves removal of a diseased ear canal, whilst leaving the inner ear (containing the hearing organ) in place. Surgical management of ear disease is a last resort, if medical management is becoming unavailable or unmanageable. In a TECA, the pinna (the outside ear flap) is left intact, but the external ear canal is removed. The bony wall of the middle ear (the tympanic bulla) is also cut away, so that impacted and infected material from the middle ear can be removed. The procedure may be performed on one ear (unilateral) or both (bilateral).

Sandra was worried about putting Micky in for surgery, and about the costs involved, but she was desperate to get his ears more comfortable

The vet discussed that, as it always seemed to be Micky’s left ear that got infections, they’d just do the TECA on that side. But she couldn’t rule out that the right side wouldn’t need attention at some point. The vet explained the procedure, the potential complications and the costs. 

The TECA would cost about £2000. Sandra had insurance but had already spent quite a lot of her £2000 annual limit on Micky’s treatment so far. She wished now she’d gone for a higher level of coverage, but it had seemed like a lot at the time. However, the insurance would pay for the bulk of the operation and Sandra would top up the rest.

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The day of the operation came, and Sandra was nervous all day.

Potential Complications of TECA surgery

The TECA procedure generally has a good success rate, but, as with all surgical procedures, there are some potential complications. Around 10-20% of dogs experience mild facial paralysis, with drooping of the upper lip and eyelid. This usually resolves in 4-6 weeks. Bleeding is also fairly common due to several fairly large blood vessels in the area. Many dogs also have reduced hearing after the procedure. Although the actual hearing organs in the inner ear should be unaffected. However, this surgery usually takes place due to chronic ear disease, and so these patients often already have reduced hearing acuity anyway. Poor wound healing and abscess formation due to the presence of infected tissue at time of surgery are also possible, but uncommon. Rarely, the patient’s balance may be affected if the delicate organs of the inner ear are accidentally damaged. 

Micky’s surgery was uneventful, and he was joyfully reunited with Sandra

His recovery did involve some minor problems as he didn’t tolerate the post-surgical collar well and managed to scratch at his wound, but all was resolved within a few weeks. Sandra reports that Micky’s quality of life has greatly improved – and she’s no longer such a frequent visitor to her local veterinary surgery! Sandra maxed out her £2000 insurance annual limit and paid the remaining, more manageable, balance herself. She is considering upgrading her policy.   

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