The objective of this randomized controlled study was to determine the efficacy of an integrative approach to canine otitis externa (COE) using a combination of Chinese herbal medicine (Long Dan Xie Gan) and conventional medicine (Osurnia) through a randomized controlled trial. The study involved two randomly assigned subject groups diagnosed with acute COE: Group A (n=12) and Group B (n=12). Both groups received Osurnia on Day 1 (D1) and Day 7 (D7). Group A also received oral Long Dan Xie Gan on a twice daily basis for 45 days. Owner and clinical assessments were performed on D1 (pre-treatment), D7, and D45. The improvement of the overall COE assessment score (D1→D7; D1→D45) was used as the outcome measurement for testing the study hypothesis. Both Group A and B had statistically significant improvement at D7 (p=0.0005 and p=0.0025, respectively), however, Group B had no further statistical improvement from D7 to D45 (p=0.3411). Group A continued to show improvement throughout the study with statistically significant results on D45 (D1→D45 p=0.0036; D7→D45 p=0.0008). In addition, study results demonstrated the combined treatment had a 90% success rate as opposed to 30% with topical therapy alone (p=0.00198). Under the experimental conditions of this study, the proposed integrative treatment was found to be more effective than topical therapy alone and suggests this treatment protocol may be an effective therapy for resolving acute otitis externa in dogs.