“How do you know I’m mad?” said Alice.“You must be,” said the cat. “Otherwise, you wouldn’t have come here.”

Such is how I feel when faced with the Sysyphian task of taking on another ear infection—especially when it afflicts the same dog or cat I treated the month before. As many of you well know, there is no silver bullet to treating pets with the scourge that is “otitis externa”—save the dreaded TICA (total ear canal ablation), a painful procedure that renders pets deaf in the affected ear.

Even worse than the infection itself is often the frustration and/or denial exhibited by the pet’s caretaker. “But Doc, it got so much better, why did it come back?”

Did I not expressly tell you last time (and the time before that) that this is a chronic condition? (Shall I define “chronic” again?)

Having suffered right along with them (at work and with my own dogs), I can easily empathize with the frustration of the nasty ear syndrome. Consequently, my explanation, (at the very first sign of an ear infection in a pet’s life) includes a discussion the alarming percentage of pets whose very first infection is a harbinger of things to come, and not merely an isolated incident. I also detail the degree of diligence required to manage the condition, the possibility (likelihood) of underlying allergies, and the lifetime commitment their pet should expect from them in an effort to secure their optimal comfort.

So you know, I try to do this succinctly and non-alarmingly, but I’ve found that managing owner expectations is everything when it comes to ears. Nonetheless, some of my clients still come back confused and upset with the prospect of a lifetime of “uck.”

My rejoinder: Your experience of “uck” is nothing compared to theirs of itch and pain. So let’s get going on keeping this under control.

In serious cases that means daily work—something I’ve found most people won’t undertake. But neither will these very same people acquiesce to the admission that their pets are in pain. And that’s where their cognitive dissonance gets the better of me. There’s nothing I can do with an ear infection if a caretaker won’t cave to its realities.

Daily cleanings or observation, careful administration of meds (when required), serial anesthetic flushings (if severe), attack of the underlying allergy by any means necessary (and with the expense that implies) and/or contemplation of the above-mentioned surgical procedure when all else fails.

That’s what it takes. Too bad it’s as hard to find an owner willing to take it all on with the seriousness it requires as it is to find your way out of the proverbial rabbit hole. Don’t believe me? Go ask Alice…

P.S. Yes, that's me with Pluto on my last trip to Disney. For the record, his ears were sealed.