Q: Our dog seems to go through an endless cycle of ear and skin infections? Why do they seem to go away and then come back again so often?

A: Most ear and skin infections in dogs are actually secondary to inflammation caused by allergies. There are other causes (hypothyroidism and hyperadrenocorticism to name a couple) but allergy is by far the most common cause of inflammation. An allergen (food, pollen, flea saliva, etc.) causes the ear or skin to become inflamed. The inflammation allows bacteria (and sometimes yeast) that normally stay on the skin surface to move deeper into the skin. As the infection moves deeper into the skin, inflammation increases and begins to cause pruritis (itching).

Dogs usually chew or scratch pruritic areas. This worsens the inflammation and infection. Eventually the skin and ears become painful, red, and often have a foul smell.

Antibiotics, antifungal, and anti-inflammatory medications often control the infection and pruritis and return the ears and skin to normal. Unfortunately shortly after the medication is stopped the inflammation starts again because the allergy has not been addressed. The inflammation leads to infection, a veterinary visit, medication, and so on and so on.

The key to stopping the cycle is identifying the underlying allergy. This is often easier said than accomplished. Fleas, food, environment, treats, and even medications can be the source of allergies. Working through these sources takes patience and time. Allergic inflammation in the ears and skin can take months to resolve. Many dogs need to remain on medications for long periods of time while you and your veterinarian are trying to sort out the possible allergies.

Allergies are frustrating for people and dogs alike. Many allergies can be managed but not totally cured. If your dog has recurrent ear or skin infections remember that treating the current infection will not prevent future infections. Working with your veterinarian to identify and address underlying allergies can decrease the frequency of infection or sometimes stop recurrence altogether.