# Mometamax and Deafness in Dogs: Real Risk or Myth? Mometamax deafness in dogs is a real but uncommon concern, and it comes from the gentamicin inside the product, not from the steroid or the antifungal. Most dogs finish treatment with their hearing unchanged. The dogs at highest risk are those with a torn eardrum or repeated, long-term ear treatment. This article is educational and is not a substitute for veterinary diagnosis or treatment. ## Quick Answer - Mometamax contains gentamicin, an aminoglycoside antibiotic. Aminoglycosides are the drug class most often linked to permanent hearing loss in animals [1]. - The risk rises sharply if the eardrum is ruptured, because medicine can then reach the inner ear structures that control hearing [1]. - A single in-clinic dose of the gentamicin combination product was safe and effective in a 316-dog field trial, with success in about 89.5% of treated dogs at day 28 [2]. - Never start, stop, or extend ear drops on your own. Your veterinarian decides the dose, the duration, and whether the eardrum is intact before treatment. - Call your veterinarian the same day if your dog stops responding to normal sounds, tilts its head, circles, or vomits during ear treatment. ## What Mometamax Is and What Veterinarians Use It For Mometamax is a prescription ear product for dogs with otitis externa, which is inflammation of the outer ear canal. It combines three medicines in one suspension: gentamicin (an antibiotic), posaconazole or clotrimazole (an antifungal), and mometasone furoate (a steroid that calms swelling and itching). Your veterinarian chooses it when the exam and ear cytology suggest a mixed bacterial and yeast infection. Ear infections are one of the most common reasons dogs see a veterinarian, and they often sit on top of an underlying allergy. That is why some dogs get repeated rounds of treatment. If your dog has had several infections, the article on [how to tell if your dog has an ear infection](/knowledge/veterinary-medicine/clinical-methods/how-to-tell-if-dog-has-ear-infection-reddit) walks through the signs and what testing is used. The single-dose version of this combination was studied in 316 dogs over 42 days. Treatment success was recorded in 128 of 143 dogs (89.5%) given the investigational product, which was non-inferior to the comparison product [2]. That study looked at safety and efficacy together, and the product was considered safe and effective in the dogs enrolled [2]. ## How Mometamax Works Gentamicin kills bacteria by disrupting how they build proteins. Posaconazole or clotrimazole breaks down the yeast cell membrane. Mometasone furoate reduces the redness, swelling, and discharge that make the canal painful and narrow. The hearing concern comes from the antibiotic. Aminoglycosides can damage the cochlea, the hearing organ in the inner ear, and that damage is one recognized cause of permanent acquired deafness in dogs [1]. For damage to happen, enough drug has to reach the inner ear. A healthy eardrum is a barrier. A ruptured eardrum is not. This is why your veterinarian looks at the eardrum with an otoscope before prescribing, and why they may ask you to come back if the first exam was too painful to see clearly. If the drum is torn, they may choose a different product or a different approach. ## Dosing Basics for Mometamax ### Who decides the dose Your veterinarian does. The dose depends on your dog's weight, the severity of the infection, whether one or both ears are involved, and whether the eardrum is intact. Do not borrow a friend's bottle or reuse an old prescription. ### How it is given Most owners are taught to clean the ear if needed, then squeeze the prescribed amount into the canal and massage the base of the ear so the medicine spreads. Some products are given once in the clinic by the veterinary team, and the single-dose combination product was designed exactly that way to improve compliance and canine welfare [2]. ### What to do about a missed dose Give the next dose at the normal time and do not double up. If you miss several days, call your veterinarian. Stopping early is one of the main reasons ear infections come back, and recurrent otitis is a stubborn problem that often needs a longer plan, sometimes with a stabilization phase followed by ongoing maintenance [3]. ## Side Effects: Common and Serious | Side effect | How common or serious | What to do | |---|---|---| | Head shaking, scratching at the ear | Common and usually mild | Keep going unless it worsens, and mention it at the next visit | | Redness or irritation in the canal | Common, often from the infection itself | Call if it is worse than before treatment started | | Temporary hearing muffling | Fairly common while the canal is swollen or full of medicine | Usually clears as the infection resolves | | Head tilt, circling, loss of balance | Uncommon but serious, suggests inner ear involvement | Call your veterinarian the same day | | Not responding to sounds, especially both ears | Uncommon but serious, possible permanent hearing loss | Stop the medicine and call your veterinarian the same day | | Vomiting, wobbliness, or unusual drowsiness | Rare, can suggest the drug is affecting more than the ear | Treat as urgent and call right away | Hearing loss from ear disease is not always permanent. Blockage of the canal from chronic inflammation or wax buildup, a ruptured eardrum, and middle or inner ear inflammation can all reduce hearing, and hearing often returns once those problems are resolved [1]. That is good news for many dogs, and it is a reason to treat the infection properly instead of stopping early. Permanent acquired deafness in dogs most often comes from age-related changes to the cochlea. Other causes include inner ear trauma, very loud noises, diseases, certain drugs such as some antibiotics, anesthesia, and tumors [1]. So if your older dog seems less responsive, the ear drops may not be the whole story. Age-related hearing change and conditions like [canine cognitive dysfunction](/knowledge/veterinary-medicine/clinical-methods/canine-cognitive-dysfunction-syndrome-diagnosis-management) can look similar to owners, and both deserve a veterinary visit. ## Who Should Not Take It and Drug Interactions Mometamax should not be used if your dog's eardrum is ruptured, unless your veterinarian specifically decides the benefit outweighs the risk. It also should not be used in dogs allergic to any ingredient, or in dogs whose ear canal is so damaged that the medicine cannot be delivered safely. Use extra caution in dogs already dealing with balance problems, known inner ear disease, or a history of hearing loss. Dogs that are already deaf in one ear have no hearing to spare in the other, so your veterinarian may pick a different treatment. Tell your veterinarian about every other medication, including other ear drops, oral antibiotics, and anything you give for allergies or pain. Using two aminoglycoside products at once, such as gentamicin ear drops plus an injected aminoglycoside, could raise the risk of ear and kidney effects. Do not combine ear products unless your veterinarian says it is fine. Some dogs cannot safely receive the standard approach at all. If your dog is very old or has other major health problems, your veterinarian may weigh the risks of treatment and anesthesia for ear cleaning the same way they would for surgery, which is the kind of thinking described in [surgical risk stratification in geriatric dogs](/knowledge/veterinary-medicine/veterinary-surgery/surgical-risk-stratification-geriatric-dogs-cats). ## Overdose and When to Call a Veterinarian or Poison Control An overdose of ear drops is uncommon because so little is absorbed from a healthy ear. Problems are more likely if a dog swallows the product, if the eardrum is torn, or if the dose is repeated far more often than prescribed. If your dog swallowed the bottle or a large amount of the suspension, call your veterinarian or an animal poison control service right away. Have the bottle with you so you can read the ingredients and the strength. Do not wait for symptoms. If your dog is wobbling, vomiting, tilting its head, or seems suddenly unable to hear, stop the medicine and call your veterinarian immediately. These signs can point to inner ear or neurologic involvement, and timing matters. ## Limitations and When to Contact a Veterinarian No article can tell you whether your individual dog's eardrum is intact or how much drug is reaching the inner ear. That requires an exam. Individual cases need a veterinarian who can look at your dog, review the history, and adjust the plan. Call the same day if you notice a new head tilt, circling, loss of balance, vomiting, or a clear drop in how your dog responds to sound. Call the same day if the ear looks worse, smells worse, or your dog cries when the ear is touched. Go to an emergency clinic now if your dog cannot stand, has a seizure, collapses, or becomes suddenly and completely unresponsive to sound in both ears. Schedule a routine recheck if the infection is not clearly better by the end of treatment, if the discharge returns within a few weeks, or if your dog has had three or more infections in a year. Recurrent cases often need a broader plan, and long-term management studies show that repeated infections can persist even with treatment, with moderate scores continuing over time [3]. Newer options are also being explored, including antibiotic-free topicals and probiotic ear drops, though these are still being studied and are not a replacement for your veterinarian's judgment [4][5]. If your dog does lose hearing, life goes on well for most dogs. Deaf dogs adapt, and the practical guidance in [deaf dog behavior problems](/knowledge/veterinary-medicine/behavior/deaf-dog-behavior-problems) can help you keep your dog safe and confident at home. ## Frequently Asked Questions ### Can Mometamax cause permanent deafness in dogs? It can, but this is uncommon and is tied to the gentamicin ingredient. Permanent acquired deafness in dogs is most often caused by age-related cochlear changes, with drugs such as certain antibiotics among the less common causes [1]. The risk is highest when the eardrum is torn and medicine reaches the inner ear. ### How would I know if my dog is losing hearing during ear treatment? Your dog may stop turning toward its name, its food bowl, or the doorbell, and may sleep through sounds that used to wake it. A head tilt, circling, or balance problems point to the inner ear and need a same-day call. Unilateral deafness can be easy to miss because dogs compensate well, and definitive testing such as a brainstem auditory evoked response gives the clearest answer [6]. ### Is it safe to stop the ear drops if my dog seems better? No, stopping early is a common reason infections return. Finish the course exactly as your veterinarian prescribed, even if the ear looks normal. If you are worried about side effects, call and ask before you change anything. ### Are some dog breeds more likely to go deaf? Yes, some breeds have a higher rate of inherited deafness, including the Dalmatian, Bull Terrier, Australian Heeler, Catahoula, English Cocker Spaniel, Parson Russell Terrier, and Boston Terrier [1]. Dogs with certain coat patterns, especially grayish-blue and white, are also more likely to be born deaf [1]. That background risk is separate from any drug effect. ### Does a ruptured eardrum always mean my dog will lose hearing? No. A ruptured eardrum and middle or inner ear inflammation can reduce hearing, and hearing often returns once the underlying problem is treated [1]. The key is getting the eardrum checked and following your veterinarian's plan for the right product and follow-up. ## Related Articles - [Deaf Dog Behavior Problems](/knowledge/veterinary-medicine/behavior/deaf-dog-behavior-problems) - [Breeding Soundness Examination of the Canine Male](/knowledge/veterinary-medicine/theriogenology/breeding-soundness-examination-of-the-canine-male) - [How To Tell If Dog Has Ear Infection: Evidence-Based Clinical Guide](/knowledge/veterinary-medicine/clinical-methods/how-to-tell-if-dog-has-ear-infection-reddit) - [Canine Cognitive Dysfunction Syndrome: Diagnosis and Management](/knowledge/veterinary-medicine/clinical-methods/canine-cognitive-dysfunction-syndrome-diagnosis-management) - [Surgical Risk Stratification in Geriatric Dogs and Cats](/knowledge/veterinary-medicine/veterinary-surgery/surgical-risk-stratification-geriatric-dogs-cats) - [Blinding in Veterinary Clinical Research: Methods and Challenges](/knowledge/veterinary-medicine/veterinary-research-methods/blinding-veterinary-clinical-research-methods-challenges) - [Unilateral Deafness in Dogs: Signs and What to Do](/knowledge/veterinary-medicine/symptom-guides/unilateral-deafness-in-dogs) - [Sudden Deafness in Dogs: Causes and What to Do Next](/knowledge/veterinary-medicine/symptom-guides/sudden-deafness-in-dogs-causes) - [Dog Losing Hearing: Causes and What You Can Do](/knowledge/veterinary-medicine/senior-and-chronic-care/dog-losing-hearing-causes) ## References 1. [Deafness in Dogs - Dog Owners](https://www.merckvetmanual.com/dog-owners/ear-disorders-of-dogs/deafness-in-dogs). Merck Veterinary Manual. 2. [Clinical safety and efficacy of a single-dose gentamicin, posaconazole and mometasone furoate otic suspension for treatment of canine otitis externa](https://pubmed.ncbi.nlm.nih.gov/38462781/). The Veterinary record, 2024. 3. [Long-term management of recurrent otitis externa in dogs using a two-phase protocol involving ciprofloxacin-clotrimazole-betamethasone and topical hydrocortisone aceponate](https://pubmed.ncbi.nlm.nih.gov/41501900/). BMC veterinary research, 2026. 4. [Probiotic Engraftment and Suppression of Canine Otitis Externa Pathogens by Probiotic Ear Drops](https://pubmed.ncbi.nlm.nih.gov/42104600/). Veterinary dermatology, 2026. 5. [Comparative Efficacy of a Novel Topical Formulation with Antimicrobial Peptides and Encapsulated Plant Extracts Versus Conventional Therapies for Canine Otitis Externa](https://pubmed.ncbi.nlm.nih.gov/41305350/). Pathogens (Basel, Switzerland), 2025. 6. [Deafness in Animals - Ear Disorders](https://www.merckvetmanual.com/ear-disorders/deafness/deafness-in-animals). Merck Veterinary Manual. ## Further Reading - [American Veterinary Medical Association: First Aid Tips for Pet Owners](https://www.avma.org/resources-tools/pet-owners/emergencycare/first-aid-tips-pet-owners) - [Merck Veterinary Manual: Dog Owners](https://www.merckvetmanual.com/dog-owners) - [Cornell Richard P. Riney Canine Health Center: Canine Health Information](https://www.vet.cornell.edu/departments-centers-and-institutes/riney-canine-health-center/canine-health-information)