Perforated eardrum - no licensed treatment?

Esau has been exuding a runny wax from one ear since the weekend. He does tend to get ear infections but this one seemed different to me because the outer part of the ear looked healthy, no swelling or redness, and the wax was runny. When I rubbed at his ear I could hear it squelching, Urch!

I cleaned away excess wax daily, and washed his ear with a veterinary ear wax softener/cleaner twice, but it made no difference, so yesterday I took him to the vet.

To my horror, the vet said he has a perforated eardrum! It was likely caused by a very deep ear infection that went through the eardrum into the middle ear, rather than up as most ear infections do. I may have made matters worse by using the wash! The vet pointed out I could not have known, but I'm suffering terrible guilt pangs

The vet said no single proprietary treatment exists that is licenced to treat ear infections when the ear-drum is perforated, so he said he would make up a medicine himself for us to give as drops into the ear, using a benign base and a range of what would normally be injectable antibiotics. We pick this up later today. He also took a swab for analysis and started Esau on oral antibiotics.

I am a little uncertain about this made-up medicine, and he stressed it would be 'unlicensed' (because he'd made it himself).

This was a new vet I hadn't seen before though he seemed competent - he more or less diagnosed the perforation before he ever looked down the ears, he knew just from looking at the runny wax. He just confirmed it with the auroscope.

Do you think I should trust him or ask for a second opinion with the senior vet? I don't want to insult him but I've never heard of this 'making up' of an unlicencensed medication before. Am I worrying too much?

I can understand your concern.
I have never dealt with this situation so did a quick google for 'infected perforated eardrum treatment dog' and got a few links I quickly scanned. They all make it sound fairly common and not severe in terms of overall well being if given the correct treatment soon enough.
The use of oral antibiotics or antifungals depending on the cause seem like the basic treatment and some links suggest that the dog is anethastised to allow the vet to clean out their middle ear with an appropriate and safe wash.

I would ask more about the drops, but it sounds like your vet wants to treat the infection head on rather than with just oral antibiotics and wants to use a few to widen the scope of what infections will be treated along with making sure it's safe to be in the body rather than just the outer ear or skin.
If you are worried, I don't think there is anything wrong with giving a vet you are more familiar with and trust a call to check things out. After all this is your dog that is going to be treated and you only want what is best for your loved ones.

Thanks, Sarah Jade, your understanding words are very much appreciated.

The vet rang an hour ago - was too late to get the order for the antibiotics back in time for this weekend, so is going to make us up a dilute antibacterial wash, one they would use for surgery, for us to use over the weekend.

Hopefully it will kickstart the healing process.

The worry is that because Esau is on painkillers for arthritis, these masked symptoms of the ear infection/perforation, so he could have had this for longer than we were aware of it. He seems fine in himself.