Pet Ear Meds That Won’t Affect Diabetes | Ask Dr. Joi

By Dr . Joi Sutton|2018-09-18T09:31:13-04:00Updated: September 12th, 2018|Pet Care, Pet Diabetes, Pet Newsletter|7 Comments
  • Dog smiling with woman in background

I get some great questions from clients. They inspire me with article ideas and keep me in tune with diabetic pet owners. I enjoy interacting with our readers, and sometimes the questions are worthy of a newsletter. I bet if one person has this question and takes the time to write me, there are likely lots of folks with a similar question. Today’s question is about ear infections in dogs and the appropriate pet ear meds that won’t affect pet diabetes.

My 14 year old 1/2 Boston Terrier and Chocolate Lab mix was diagnosed with diabetes about 1 year ago. In fact, we almost lost him early on. Since then we have been trying to stabilize his blood sugar. He formed diabetic cataracts, and he had surgery to remove them in June. He’s recovered nicely, and his blood sugar is stabilized. He is very active. He has recently come down with very dirty ears that I’m sure is from an infection. I had his father, a Choclate Lab, who had many ear infections. They are both water dogs. I don’t want to treat him with steroids as he’s on six different eye drops right now for the cataracts. Is there an ear medication or solution that will not affect his blood sugar?

I’m sharing your email because diabetic cataracts are quite common in dogs, and ear infections are relatively common in all dogs.

Your sweetie is likely on topical ophthalmic steroids (or at the very least a nonsteroidal for a time since the cataract surgery was recent), but any others steroids should be avoided if at all possible. Diabetic cataracts are very common in diabetic dogs. I’m so glad you had the surgery to regain his vision. Great job! This surgery is not inexpensive but can restore vision to dogs with diabetic cataracts.

Many ear preparations contain steroids. Drug companies commonly put steroids in the topical otc ointments or solutions to decrease inflammation. Inflammation is painful. These combination meds typically contain an anti-fungal for yeast infections, an antibiotic for bacteria and a steroid to help decrease inflammation. These combination products are popular because vets hope to improve client compliance and resolve an infection quickly to lessen discomfort for the pet. Client compliance is a big concern for ear infections. Most clients don’t want to be the “bad guy” treating a sore ear. Cleaning a painful ear can affect the human animal bond!

Be sure to allow your vet to do ear cytology (very common in house diagnostic testing that takes just a couple minutes) so that you can treat for the specific issue. Ear cytology tells us if it is a yeast infection versus bacterial infection versus a mixed infection of both. Sometimes it isn’t an infection at all. Sometimes it is simply inflammation without infection. Additionally, cytology tells us if the bacteria are round (cocci) versus elongated (rods). Rods tend to be harder to treat. There are medications WITHOUT steroids such as Baytril Otic and Miconazole that can specifically treat the class of infection without steroid. For a diabetic who would likely have insulin resistance from steroids (yes, even topical steroids) we wish to use a medication without steroids.

We wish to clean the ears when infection is present. Cleaning the ear speeds up resolution of the ear infection significantly when there is an infection. We could use general ear cleaners, or there are numerous brands of “medicated” ear washes that can make a huge impact on how well a pet responds to the topical meds. Medicated ear washes may contain antifungals, chlorhexidine, and drying agents. Be sure to clean the ears daily to get the debris out. Many topical ear meds will fail in the presence of debris. Sometimes we will have clients, whose pets are prone to ear infections, wash the ears with medicated ears washes once weekly to help decrease the frequency of recurrence.

If a pet has recurrent ear infections we must consider the possibility of underlying allergies. Chat with your vet about allergies if ear issues are frequent. And also discuss Cytopoint or Apoquel which are allergy medications that won’t affect the diabetic control. Cytokines are proteins that cause itchiness. Apoquel targets many cytokines, whether from hay fever, food allergy or flea allergy. Apoquel is an oral medication that does not cause insulin resistance, so it is a much better choice than steroids for allergic dogs. Cytopoint is a monoclonal antibody targeting a single cytokine, the cytokine most important for causing itch in hay fever dogs. Cytopoint in an injection, and it provides relief for hay fever dogs for one to two months.

Have a question or comment? Then post below! I always enjoy hearing from my readers!

NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.

About the Author: Dr . Joi Sutton

Dr. Joi Sutton is a 1993 graduate from Oregon State University. She has practiced both in emergency medicine and general practice. Dr. Sutton has done extensive international volunteer work though Veterinary Ventures, a nonprofit organization that takes teams of veterinarians to undeveloped countries for humane medical care. She also runs a small animal practice in South Florida. Connect with Dr. Joi on LinkedIn


  1. Lucie November 17, 2022 at 8:38 am - Reply

    Maybe we should test for hidden allergies in our dog, like you said, because he has recurrent ear infections. Thanks for the suggestions, we might try it soon. And thank you for this helpful information.

  2. Kathrin September 25, 2022 at 5:35 am - Reply

    Thank you for your article and site. My poor 16 year old cat was diagnosed with diabetes in Jan 2022. He has responded well to insulin but now has kidney issues. He has two cysts near his left ear and now he is shaking his head and dropping food. I suspect an inner ear infection. His blood sugar was very high during his stay at the vet- likely do to stress and the infection. Removing the cysts is too risky because of age but they are an ongoing problem because of location and bursting. Thoughts?

    • Dr . Joi Sutton September 25, 2022 at 11:06 pm - Reply

      Pets with diabetes and or kidney disease can be anesthetize, but precautions must be taken. Have a chat with your vet who has examined him. Or perhaps ask for a referral to a boarded surgeon. Best wishes…

  3. Anonymous November 8, 2021 at 4:39 am - Reply

    Our vet has recommended meals & injections every 12 hours.

    • Dr . Joi Sutton November 8, 2021 at 6:59 am - Reply

      Yes, that is the norm to give insulin and meals every 12 hours. If given more frequently the insulin doses could overlap and cause hypoglycemia.

  4. Sherry November 3, 2021 at 12:38 pm - Reply

    I see that dogs insulin shots should be 12 hours apart. My vet’s office said to give him 8 hours apart with breakfast and supper and no lunch. This diabetic thing is already very confusing, why is there such a difference? My dog is a 13 yr old bichon and now he looks too thin. What do you think?

    • Dr . Joi Sutton November 8, 2021 at 7:06 am - Reply

      That is not typical advise from a veterinarian. We recommend giving insulin at the time of meals. Otherwise insulin given without food could result in hypoglycemia. Chat with your vet. And consider reading up on pet diabetes. has a bunch of up to date articles on pet diabetes written for pet owners. (I’ve not written these articles for a few years now.) And you can google for free the very thorough 2018 AAHA Diabetes Guidelines. On our website (ADW) you can search “back to basics” for my 4 part intro articles on pet diabetes that I wrote several years ago that may help you. Do chat with your vet and sit down for a long read if these resources. Also, please do home glucose testing for best control of your pet’s diabetes. Best, Joi

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