Remember Fred? Not long ago I told you how he was stolen and recovered 18 months later. This is the story of what happened next.
His path led to a specialist and a procedure called TECA that increasing numbers of dogs are getting. If you have a dog prone to ear infections, this is for you. Not just so you know it’s there if you need it, but also so you can avoid it.
What Is a TECA?
TECA stands for Total Ear Canal Ablation, the surgical removal of the entire ear canal. It’s usually paired with Bulla Osteotomy, which is the opening and cleaning up of the middle ear.
TECA is a drastic solution to a drastic problem. It’s what we do when all else is lost. But that doesn’t mean it’s a bad. In fact, quite the opposite.
My strong position is that far too few dogs that need TECA ever get the chance.
When A Dog Needs TECA
I always remember a Cocker Spaniel I saw late one evening. His usual vet was closed and he was having another attack of vestibular disease. This is when something affects the balance organs, creating the following signs:
- A head tilt
- Nystagmus (rapid eye flicking)
- Falling to the side or inability to stand
His regular vet had diagnosed it as idiopathic vestibular syndrome, which is a poorly understood but benign condition of old dogs. However, there was a problem.
IVS usually only happens once or twice, and the episode will last a few days before recovery. This dog was having it over and over again, with no clear pattern. It was also associated with an ear infection on the same side.
This dog stays with me because nothing I could do would convince the owner that her dog was in terrible pain. She would much rather believe the better advice that it was a minor problem. Who can blame her?
Which Dogs Need TECA
It’s essential to point out that I actually don’t know if that dog needed TECA. We never had the chance to find out because his ear infection was never treated properly.
He probably had what we sometimes call ‘end stage’ ears. These are ear canals that have closed due to chronic swelling or thickening of the lining, and occasionally polyps. An old name for this was ear canker.
His ear drum would have been ruptured, leading to a middle ear infection. But even that normally doesn’t need TECA. Most of these dogs can still be successfully treated as long as the owner is on board.
But there are plenty of other occasions when an owner does everything right and it still leads to TECA. Here are some recent examples:
- A dog who already had long-standing middle ear disease when he was rescued*
- An aggressive dog that wouldn’t let his ears be treated
- A dog whose ear canals narrowed despite diligent treatment
All of these dogs were unfixable and in pain until surgery. In Fred’s case, like the rescue dog, time was the enemy. By the time he was found, the standard treatments for ear infections no longer worked. The sheer amount of time he’d suffered made it almost inevitable.
If you look at his CT scan at the start, the red arrow shows solid material inside his middle ear and the yellow arrow shows how his horizontal ear canal is completely closed.
A Review Of TECA
Here’s what to know before considering TECA surgery for your dog.
- It’s a last resort. All other options need to be explored first, but especially ear cleaning under general anaesthesia and long term medical therapy with frequent follow up.
- Lateral ear wall resection, Zepp’s procedure or lateral ear canal ablation are all possible alternatives that only remove part of the ear canal. However, these are next to useless if the rest of the canal is just as bad.
- It’s expensive. I would estimate that TECA surgery in Australia would cost at least $4000 at a specialist but there are also some private vets who can do it well for less.
- Success rates are good at around 90%.
- The ear flap is not removed. Fred’s ear at the start and Denver’s ear below show how the result is generally quite pleasing. Most people won’t know it’s been done.
- Dogs probably won’t be deaf afterwards. While hearing will be muffled on the operated side, it’s probably no worse than before. If the other ear is normal, like these two dogs, they hear just fine.
- There are risks of facial nerve paralysis, bleeding and persistent infection but these seem low for experienced surgeons. If a dog had a pre-existing head tilt, like Denver’s, it probably won’t go away but that’s a minor concern.
- Recovery time is like any other canine surgery. That is, much better than us!
If you have a dog who might benefit from TECA surgery, talk to your vet about it. Ear infections are common and frustrating, but there are still other options, like referral to a veterinary dermatologist.
Then there are some dogs I see for second opinions who I immediately refer for surgical evaluation. That’s because everything else has been tried, failed, and the dog is still in pain. In the end, that’s what it’s all about.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. These blogs are from a series regularly posted on email and Twitter. Subscribe via email here to never miss a story!
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