This is a question & mini-rant all in one.

My GSD has allergies to beef and is very prone to getting ear infections.  For the past 3 years, about 2 times per year, she gets an infection in both ears.  Gets bad enough she tries to stick her foot down her ear canal.  
Anyway, the Dr. gives me a tube of Dermagen (Nystatin-Neomycin Sulfate-Thiostrepton-Triamcinolone Acetodine Ointment) to apply inside her ears 2 times a day.  It works very well and clears everything up for her in about 7 days.
The problem is my vet knows this happens twice a year, but won't give me any prescription other than the one tube.  Each time this happens, I have to take her in and he charges me $165 for an office visit and then $25 for the tube of goop.  She does her yearly check ups at normal intervals with this same Dr. as well.
I looked on the Pet Meds website but they require a prescription from a vet before I can order.  I'm just tired of spending more than $300 in office visits for a problem that is well known for my dog.
I'm trying to get to the bottom of the question for me that is Why can't he just sell me the crap the 2 times per year that he knows I need?  Is he milking the money or is there some law that he needs to physically see the dog before he renews her perscription?  Are there any meds that are like this one that can be purchased over the counter or from another online source?

I think its because Dermagen is used  for some other things, so you might have  a hard time getting it.   Might ask your vet if there is another substance that doesn't require a prescription or something you can use as a preventative instead.

GSDs have deep ear canals and usually a good deal of fur, keeping the ear canal a ripe growing ground for fungus and bacterial infection.

Keeping the ear hair trimmed will help. Buy the tool for the job, DO NOT PLUCK as this provides a entry path for infection.  

Warm hydrogen peroxiide, cut to 1-2% concentration, is good for cleaning out the debris.   Rinse with warm alcohol to dry the canal.  Warm each solution in a container of warm water, do not heat on the stove or other heat source.  Barely warm to the touch, NOT HOT.  Test on your forearm, just like a baby bottle.

Another associated problem is mites.  Using Ivermectin-based heartworm prevention, even during the off season, will help as will Frontline or similar flea control products.

I have a GSD that has ear problems too so this is just my experience.  Ear treatments are not tolerated well by most dogs, give them a big treat after to lessen the trauma.  Mine gets two huge Milkbones and most is forgotten.

FYI...ear mites are a relatively uncommon occurence in dogs..and Frontline and Heartguard will not get rid of ear mites...for ear mites you can use Revolution, ivermectin in the ears, orally, or parentally...but like i said, ear mites are usually not a problem in dogs...

however, did the vet ever say what the infection was? yeast? bacteria and if so, what??  

when do these infections occur?? do you notice any pattern to it?? you mentioned she was allergic to beef...anything else you know of??

i will swab an ear, look under the microscope and determine treament...i will do another check in 10 days and have often found new bugs growing while the primary infection has come under control...and then if i still am not getting anywhere, i will sedate the pet and look with a video otoscope and get a sample from the middle ear, and medicate at the same time...ears can be a very frustrating thing for owner, pet and vet.

sounds to me that a good ear work-up has not been done...and i think the dermagen is like pissin in the wind...sorta useless in the ear in my opinion...the only reason i can see as to why it works is the steroid in it...but for yeast or bacteria, it is worthless.

and what is costing you 165$???  

oh, i am actually a veterinarian!

Thanks everyone for responding!

Over the 3 years, every time I'm in for the goop they scrape some stuff out of her ears and run it under the scope.  Every time its the same, Yeast & Bacteria.  Every time, the same hard meds also: Ketoconazole for chronic yeast skin infection & Cephalexin for chronic bacterial skin infection.  This is in addition to the Dermagen.  They have also prescribed her some shampoo as she also has something messed up under her front arms (loosing hair in patches the size of small plates).
Besides the beef (and it seems to be more of the protein) I can't find anything.  We've lived in 3 different houses over the past 3 years so not the carpet, grass, ect.  It seems to coinside with her shedding times twice a year.
But like I say, I'm just getting tired of no different strategy or results.  I voice my opinion, but the Vet says this is what's required & the best they can do for her.  Unfortunately I'm not sure of any specialists for ears or whatever in Anchorage, Alaska where I live.  Just frustriated!

The $165 is to get her in the door to see the Vet.  I have to have a Dr. visit in order to get the ear goop, he won't just give me a tube of it.

No one has suggested knocking her out & taking a closer look.  They've looked with the ear scope thing and taken the samples, but that's it.

My lab used to get ear infections from swimming all the time.
They gave me a liquid called Epi-Otic it is supposed to be for cleaning and drying the ear but my vet said it is good for yeast infections too cause it changes the balance or something in the ear and makes it inhospitable for yeast.

No prescription either I walk in and pick up a bottle.

Quoted: My lab used to get ear infections from swimming all the time. They gave me a liquid called Epi-Otic it is supposed to be for cleaning and drying the ear but my vet said it is good for yeast infections too cause it changes the balance or something in the ear and makes it inhospitable for yeast. No prescription either I walk in and pick up a bottle.

I do have some of that & in the past used it on a cotton ball to clean her ears.  Smells terrible but does a good cleaning job when their not super infected.  When they're like they are today, all inflamed and bleeding, I don't like to use it because I can tell it stings her.
My first doggie was a Lab & she was a major Water Dog!!

$165 office visit? I am apparently practicing in the wrong area.

-Hobbit

So come on up here & give me a discount