The other day I treated a dog that had a chronic (long term) ear infection.  This dog had been treated for his ear infection 2-3 times by the former veterinarian and it was still a problem.  Well, there are a few reasons this could have happened.  Let me address one of them. 
It is possible that an ear cytology was not done on this dog when he was seen previously.  What this means is that we can take a swab from the ear and look at it under the microscope.  When we do this, we can determine what is actually causing the infection in the first place.  It is usually either yeast or bacteria, but sometimes it is a combination of both.  By establishing what is causing the infection, we can more appropriately dispense medication to correct the problem.  We can also track the progression of our treatment over time by assessing the numbers of organisms subjectively.
Yup, we can do that right in the hospital, during your visit!  It takes us anywhere from 5-10 minutes to prepare the slide and read it, then we can give you an answer while you wait!  If your pet is shaking his or her head or seems sensitive when you pet the ears, this can be a sign of an infection.  Take them to the vet soon – ear infections can be painful and very irritating!