Why Ear Infections in Dogs Come Back
You know the drill - it's 2 AM, and you're lying in bed listening to that familiar sound -groaannnnnnnn. It's your dog scratching their ear with their paw. You knew this was coming because you got a whiff of that "yeasty" smell earlier in the day. Your heart sinks because you know exactly what this means.
Another ear infection. Again.
You've been here before. The vet visit, they say the words "otitis externa", send you home with some ear drops, the temporary relief... and then, just when you think you're in the clear, that smell and groannnnnnnnnn starts up again. Chronic ear infections in dogs are no joke. You feel like you're trapped in some cruel Groundhog Day scenario, except Bill Murray is sadly not involved, it's you and your poor pup going through the same frustrating routine over and over.
If this sounds painfully familiar, first let me say: You are not alone. And second: I have a resource that's going to change how you think about this entire problem. 🎉
Here is the plot twist 👀
We all have been missing something about ear infections all along.
The problem isn't infection, the problem is inflammation. 🔥
Think of it like this—if your house alarm keeps going off, you don't just turn off the alarm and call it fixed, right? You investigate why it's ringing. Is someone trying to break in? Is there a malfunction? Did the cat trigger a motion sensor again? (I love 🐈.)
Your dog's ears are the alarm system. The infection is just the sound they're making to tell you something deeper is wrong. There's a root cause driving the inflammation, and that inflammation is what creates the perfect environment for bacteria and yeast to thrive.
And here's where it gets really interesting...
In most cases, that inflammation is caused by allergies. Environmental allergies, food sensitivities, or often both. You're here at The Allergic Dog™ after all, so this probably doesn't come as a complete shock. But what might surprise you is how this changes everything about treatment.
Traditional Treatment Often Fails
You are not alone if you are wondering why your dog is stuck in a vicious cycle of ear infection after ear infection. You have done the drops. You have visited the vet. You are cleaning the ear. You might even be keeping him from swimming [spoiler alert - that's not the actual cause of their problem]. But, despite all of that, you just can't get past the up-and-down of recurrence (and frustration).
This happens because we're treating the infection without addressing what's causing it in the first place. 🔥 Inflammation.
I was taught to handle ear infections just like every other veterinarian—look at the ear, collect cytology, prescribe a drop, hope for the best. But during my residency, I realized I needed a systematic approach for ears because this reactive approach wasn't working for me [or my patients].
So I developed my own philosophy for treating every single ear case (yes, every case) I see as a dermatologist—and I'm going to teach it to you here. 💫🐾
The "Aha!" Moment That Started It All
This is where my Inflammation First™ approach was born. It came from years of watching brilliant general practice vets—colleagues I deeply respect—get frustrated with ear cases that seemed "impossible." It came from years of watching awesome dogs (like yours) get wrecked by pain and discomfort associated with preventable ear infections. I knew there was a better way. And, I knew I had to teach everyone about it. 🧠
We are living in a very infection-first time. We are afraid of infection; it's a bad word. "OHno! Does he have another infection?". We need to flip this script. We need to see these infections as preventable and avoidable. We need to see these infections as a sign that we can do better for this particular dog's _____________ [fill in the blank]. We need to care less about infection and more about __________ [fill in the blank].
Answer: inflammation. 🔥
My Inflammation First™ protocol flips this out-dated and ineffective strategy to ears completely. It helps us all (veterinarians, groomers, and dog owners) to treat the root cause—the inflammation—before we treat the infection.
When we do this, we truly get to the heart of the issue.
Dogs are better when an Inflammation First™ protocol is used.
It sounds simple, but it changes everything. When you address what's causing the inflammation (which, as you'll learn, is often allergies), the ear canal environment becomes less of a place where bacteria and yeast tend to overgrow (that's dysbiosis - fancy word alert!) and secondary infection can result. Game. Changer.
Learn My Systematic Approach
I love a system. I come from a long line of problem solvers and worriers (thanks, Mom). But, all joking aside, I have been uniquely trained as a Board Certified Veterinary Dermatologist® to approach skin and ear problems systematically to effect the most change, despite the fact that the grand majority of the skin and ear issues we see and treat cannot be cured.
That's why I developed The Four Pillar Framework™—a systematic way to understand every ear case, no matter how complex, chronic, mild, or severe. This framework is rooted in my hallmark Inflammation First™ philosophy and is the missing piece to this never-ending ear infection game we are all playing. Want to learn about it? Of course you do! 💯
The Four Pillar Framework™:
A Systematic Approach to Understanding Canine Ear Problems
Here's how it works:
Pillar 1: Primary Cause - What's the "why"?
This is where Inflammation First™ shines. We dig deep to find what's actually causing the inflammation—food allergies, environmental allergies (pollen, dust mites), hormonal issues like hypothyroidism, or even structural problems like tumors. This is the foundation everything else builds on. This is the answer to the question "how come my dog has another infection?" or "how come this just won't go away?". #inflammationfirst
Pillar 2: Secondary Infection - Is there infection?
Here is when we look at the bacteria and/or yeast that may have shifted in numbers within the inflamed ear canal environment. Your vet can use cytology (looking at an ear swab sample under a microscope) to see exactly what your dog is dealing with from a infection and inflammation standpoint. But, here is a key point: the ear canal is not sterile. Normal flora (bacteria and yeast) live in the ear in health. Everything in balance. Until....inflammation shifts that balance, leading to overgrowth and overtaking of normal mechanisms for flora maintenance. That is when secondary infection occurs. See how this is already helping? Yes! #inflammationfirst #notinfectionfirst
Pillar 3: Perpetuating Barriers - Any chronic changes?
These are the stubborn changes that develop over time—like biofilm formation or middle ear involvement—that can make ears harder to heal completely. Cocker Spaniels develop ceruminous gland hyperplasia. Labs and Goldens have a tendency for chronic hyperplastic changes that thicken the tissue of the ear canal, making it harder to ever get that ear back to normal despite all the best efforts. Every dog is a special snowflake ❄️ that can develop perpetuating factors over time. Best thing is to avoid these by managing #inflammationfirst.
Pillar 4: Predisposing Factors - What's your lifestyle and breed?
Certain breeds are more prone to ear issues, and lifestyle factors like frequent swimming can play a role. Hair in the ear canal can become problematic. But here's the key: predisposing factors don't cause chronic infections. To develop an infection, you need a primary cause. Not all dogs who swim get ear infections. Not all dogs who have hair in the ear canal get ear infections. The dogs that do have a primary cause that leads to that secondary infection; predispoing factors merely put them at an elevated risk.
If your mind just exploded thinking of how simple, yet complex, this is - welcome. I got you. This is the magic that happens when we address all four pillars systematically, starting with a mindset rooted in Inflammation First™. It's like having a roadmap instead of just throwing treatments at the wall to see what sticks. And...it works. 💫
Your Dog Is Telling You Something
Now that you understand my Four Pillar Framework™, let me help you and your dog's veterinarian decode what your dog might be facing if they keep having ear infections.
⚠️ **Also, really important, I am not here to provide specific medical advice without consent and a valid, legal veterinary-client-patient relationship based on an in-person examination and consultation. This blog and platform is for educational purposes only. ** ⚠️
Here's a little story. I see skin and ear cases every day as a Board Certified Veterinary Dermatologist® and a lot of people ask me if it ever gets boring 🥱. My answer is "ABSOLUTELY NOT because each and every patient is a special little snowflake ❄️ and no two cases are alike".
But...I do love the patterns of these cases, and I like collecting information to support my medical reasoning and differentials.
Call me part detective, part dermatologist. 🔎
So, here are some patterns that I look for:
If your dog has recurring ear infections AND:
- Paw licking that seems obsessive [hint: they are not just bored]
- Face rubbing against furniture
- Seasonal patterns (worse in spring/summer)
- Skin that seems sensitive or reactive
- Red and inflamed skin of their neck, armpits, and belly/groin area
- Anal gland issues
- Soft stool, or at least variable stool quality
- Frequent defecation
- Picky eating [hint: they don't just need more cheese]
- Greasy, yet dry, hair coat
- General odor [things I have heard - Fritos, yeasty, like they live in a barn...]
- ...and (believe it or not) more...
...then congratulations, your dog could have allergies. And, those allergies could be causing the ear and/or skin and/or paw licking at 2AM symptoms that you are all experiencing. This isn't bad news—it's actually great news because now we know what we're really dealing with. 💯
If your dog's infections:
- Respond temporarily to treatment then return
- Seem to happen "out of nowhere"
- Make you feel like you're constantly at the vet
...then I would encourage you to ask how an Inflammation First™ approach could help you determine the real reason for these flares, so that you can manage them instead of react to them.
This is how I can help.
Calling all veterinarians, groomers, and pet owners who are equally frustrated, concerned, and overwhelmed by a dog or twelve with recurrent otitis externa.
For six years, I've been building The Allergic Dog™ platform. It started as a veterinary focused continuing education site, but I always knew I had more to offer. So, in 2025, The Allergic Dog™ got a reboot and opened the educational doors to veterinarians, and pet owners, and groomers. And, eventually we will grow to include other important members of this team - vet techs, breeders, and more!
Why do I do this? Because everyone is here for the same reason - we care about dogs, we want them to be healthy, we know they have problems, we want to learn more about those problems so that we can fix them.
Enter Ear Infection Essentials™, the course I've been wanting to create since the very beginning.
I see about 30 ear infection cases every single week in my clinic (and that's a conservative estimate). Everyone struggles with ear infections. Veterinarians, groomers, pet owners, and....dogs. And, it is through this course and platform that I believe I can make an impact. A real impact, for real dogs and the people who care about them.
Here's what makes this course revolutionary: I didn't just create one course. I created three separate courses—one specifically designed for each member of the care team.
🩺 For Veterinarians: You're seeing ear cases all day, dealing with the pressure to see more appointments while delivering advanced care. I understand this challenge. That's why I developed an engaging and enlightening CE experience. You'll get 3 hours of RACE-approved CE (pending) that will save you time and improve outcomes using my Inflammation First™ system. Take this course, and your confidence with ear cases will soar. For real.
🫧 For Groomers: You're on the front lines, seeing these dogs constantly, and you want to help but aren't sure how. It can be a tough spot to be in, and finding the information you need about ear infections, anal glands, and allergies is hard in your field. Your course will give you the knowledge and confidence to have productive conversations with pet owners.
🐶 For Pet Owners: If your dog has ear infections, it can be puzzling when they keep returning again and again. You're worried, frustrated, and tired of finding information from companies just trying to sell you something. Your course provides expert-level insights without the agenda.
This is the first and only comprehensive offering for the entire care team, created by a specialist who walks the walk and talks the talk (that's me). And...it's free. Zero dollars for expert-curated information. Sign. Me. Up. 🎉
A Real Testimonial:
"I just completed the free ear infection course prepared by a veterinary dermatologist. IT WAS INCREDIBLY WELL DONE. I absolutely loved watching it. It’s explained through dogs, but it also lit up a lot of lightbulbs for me about Rick’s journey. I think anyone — cat or dog owners, pet groomers, vet students, vet techs — can learn something from this. Honestly, even some clinical veterinarians might benefit. There were moments when she was comforting the pet owner and I felt like crying, thinking back on the long and frustrating process we’ve been through 😁 If I had seen this course when Rick first got sick, it could’ve saved us a few months of trial and error. Anyway — I highly recommend it. I watched at 2x speed and it still took a full hour. So packed with information. Thank you Dr. Painter for this immensely informative free course 🙏🏻" - Ricky's owner
⬆️ this is why I do this.
What You'll Actually Learn (Tailored for Your Role)
🏛️ The Four Pillar Framework™: My complete systematic approach that works for everyone—from identifying root causes to understanding perpetuating factors
⚡ Inflammation First™ Method: The revolutionary approach that flips traditional treatment on its head (treating root cause before infection)
But here's what makes this special—each course is expertly curated for your specific needs:
For Veterinarians 🩺
- Interactive CE credit (3 hours, RACE-approved pending)
- Efficient systems for handling any ear case in practice
- My opinions on ear cytology, cultures, and treatment protocols
- Clinical resources you can actually use in your exam room
- Time-saving approaches that improve patient outcomes
For Groomers 🫧
- How to have confident, productive conversations with pet owners
- What to look for when dogs come into your salon with ear concerns
- Professional insights into allergic dog care that advance your expertise
- Practical knowledge that helps you support your clients better
- Join others in your field committed to advancing their education
For Pet Owners 🐶
- Expert-level understanding made accessible and practical
- How to identify if allergies are driving your dog's problems
- Smart questions to ask your vet using my systematic approach
- Money and time-saving insights that prevent endless vet visits
- Confidence to be a true partner in your dog's care team
For Everyone:
- Understanding when cleaning helps versus when it makes things worse
- How to break the maddening cycle of recurring infections
- Red flags that indicate you need specialist intervention
Why I'm Giving This Away for Free
Here's the thing—I've spent over a decade developing these methods. After vet school, I completed additional years of specialized training, passed rigorous board exams, and created the Inflammation First™ method based on The Four Pillar Framework™. I help "impossible" cases that have stumped other vets with my knowledge.
But I actually am just a human being (like you) who has more to give than what I can do inside my exam room. These systematic approaches shouldn't be locked away in my specialist clinics. Every dog parent battling chronic ear infections should understand my Four Pillar Framework™ and have access to the Inflammation First™ method that actually works. Every veterinarian out there who might not have access to referral care or endless resources needs a system to help them overcome the frustration and feel empowered to help these cases. Every groomer is ready to be included in this conversation; to be considered part of the team.
So I'm opening up my playbook.
These are my signature approaches, and I want you to have them. ❤️
Ready to Break the Cycle?
Whether you're a pet owner who's been through this maddening cycle, a groomer who sees these cases daily and wants to help, or a veterinarian looking for a systematic approach that actually saves time and improves outcomes—there's a course designed specifically for your role.
Each course teaches the same core principles—my Inflammation First™ method and Four Pillar Framework™—but delivers the information in a way that's perfectly tailored to what you need to know. Yes, you.
Sign up for Ear Infection Essentials™ here (All three courses are completely free)
When you sign up, you'll be able to choose the course that's right for your role. This represents six years of developing The Allergic Dog™ platform and thousands of ear cases distilled into organized, interesting, fun, and truly useful education. 😃
It's evidence-based, practical, and designed to help us all work together as a unified team for the dogs who need us most.
I'm genuinely excited to share this all with you, and I can't wait to see how what you learn changes the way we all approach ear health. #inflammationfirst #letsgo
See you in the course! 🐾
P.S. - Have questions about your specific situation? Bring them to the course! I've included comprehensive content based on the most common scenarios I see in my clinic every single day.
P.P.S. - Make sure you spread the word about this platform because I can nearly guarantee you are not alone in your struggle or questions.
