you need to go to the vet and get an ear swab and determine if it's bacteria, yeast. then they can give the appropriate medicines. if the ear drum is truly punctured, then there is a limited amount of things you can put into the ear without harming the inner ear.
also, if the infection goes into the inner ear you can get neurological signs such as falling over, head tilt, etc.
I'd get it checked as soon as possible.
some dogs do have chronic ear infections and oftentimes this is a food sensitivity so you may want to do a hypoallergenic diet. for a ruptured drum i would not put anything down in the ear unless the vet recommended it. the drum should heal over time. if you put anything down into the ear and the drum is ruptured you risk causing the dog to go deaf.
if you want a holistic approach i'd try and find a holistic vet. you can also ask to be referred to a dermatologist as they handle ear infections. Below is a list of holistic vets:
Is your dog exhibiting any neurological problems such as head tilt or are his eyes oscillating back and forth, loss of balance, etc? these are typical signs of inner ear infection.
I usually treat these dogs with steroids, systemic antibiotics such as antirobe (clindamycin), and anti inflammatory in the ear along with antibacterials/antifungals as appropriate.
eliminating corn is not a hypoallergenic diet unless your dog has been shown to be allergic to it. they can be allergic to chicken, beef, etc. I'd try Hill's ZD ultra or Royal Canin HP. there is also IVD venison and potato or fish and potato and feed the diet exclusively for 4-6 weeks before a challenge is done. Dogs usually are sensitive to the protein in the diet and not necessarily the carbohydrate source.
As before, you can always ask to be referred to a dermatologist in your area by your regular vet.
I am not familiar with that medication but I did look it up and it seems to have all the ingredients most ear medications have. What did the vet say was exactly in the ear canal? If a swab was not done and the causative agent identified then I would have that done. Additionally, a culture sent off would be a good idea, albeit more expense for you.
Usually otitis can be allergy mediated as I've stated before. It is good that she is no longer itching and biting her feet, but she is still exhibiting otitis which may certainly be linked to allergies and/or her diet. I would definitely do a food trial with Z/D ultra from hill's or the royal canin or IVD restricted protein diet (kangaroo, venison, duck, etc.) Be aware that if you do this trial, that you can feed the dog NOTHING ELSE as the diet is designed to restrict proteins to see if the dog is sensitive to them.
I have not examined your dog's ears as your vet has but can tell you that usually you can see the ear drum unless there is extreme swelling which sometimes is present. Head tilt from itchy ears is not what I was referring to with an inner ear infection. Usually you have loss of balance, falling to the affected side, and oscillation of the eyes from the balance problems. What you describe does not sound like inner ear to me.
I cannot speak on sedation and flushing but we routinelly do it where I practice. We have an auriflush which I like; not sure if your vet is set up to do this.
Surgery is an option with chronic non-responsive otitis. The dog is deaf but free of the pain and inflammation that comes with ear infections.
Did the vet give a steroid shot or antibiotic shot?
To recap, I'd do an ear swab if not already done and +/- a culture of ear contents, and definitely do a 4-6 week food trial with the diets listed (organic is NOT hypoallergenic).
**I did not examine your dog and am not second guessing his/her treatment plan, just letting you know how I would treat what you describe**
Let me know if you have any more questions.
The IVD restricted protein diet just provides a new source of protein like duck or venison or kangaroo that the animal has not seen before, and thus, won't make a reaction against. The Z/D ultra just processes the protein molecule down so far that the body doesn't react against it. All dogs but one I have put on Z/D have done great on it. Royal Canin is usually at petsmart and you can get it with a script. Some vets carry IVD. I'd check around and see if anyone in your area or your vet carries it.
I'd ask her when she was doing a mite check if she smeared out and looked for yeast and bacteria; most likely she did. A culture would be something to do if the ear meds you are on did not work.
Ear infections can certainly be more frequent if the thyroid is low. You may see improvement after the thyroid is regulated and not need a diet. I always try and do the diet if I have chronic otitis that does not clear with treatment (after I have fixed or rule out endocrine problems such as hypothyroidism).