Otitis in Cats

The location of the infection distinguishes its type. Otitis externa is any infection of the outer ear. Generally, this type of infection may be visible if it has progressed far enough to the point that excess ear wax is being produced. These external infections can migrate further inside the ear, at which point they are called otitis media. Once an infection reaches the inner ear it is termed an otitis interna. It is at this stage that severe tissue damage and potential deafness can occur. Younger cats are more prone to otitis development. A veterinary assessment is needed to identify the exact cause of the ear infection so that proper treatment may be applied. 

The ears of a cat are vastly complex. These complexities allow a cat to hear sound frequencies up to 60 kilohertz, which is 40 points higher than the best human ear. Because their ears are so intricate, they are prone to a great number of infections and issues. Ear infections, commonly referred to as otitis, are the most commonly occurring types of infection in cats. Otitis can develop in one or both ears, and can have a sudden onset or be a chronic issue. The severity of these infections ranges drastically, but they can lead to severe health problems or deafness if not treated promptly.

Symptoms of an ear infection are often very subtle at first, and many cases go undetected until they have progressed to a more severe state. Most causes of otitis produce the same symptoms, so further testing is needed to make a diagnosis. Symptoms to watch for are as follows:

• Foul odor from ears
• Pain when ears are touched
• Crusting or scaling around the ears
• Excessive ear wax mixed with exudate, which may be bloody or pus-filled
• Ulcers
• Lesions
• Erythema (redness of the skin) 
• Head shaking
• Lack of balance
• Behavioral changes

By far, the most common cause of otitis in cats is an ear mite infection, with over 50 percent of cases being linked to the parasites. An ear mite infection is easy to identify and usually not difficult to treat. Some cats are more genetically susceptible to ear infections than others. All possible causes are listed below.

• Otodectes Cynotis (ear mite) infection
• Malassezia (a form of yeast) or other fungal infections
• Bacterial infection (such as staph, strep or E. coli)
• Viral infection
• Allergies
• Immune disorders
• Hormonal issues
• Polyp in the ear
• Malignant or benign tumor in the ear
• Foreign body in the ear
• Medication reaction
• Genetic predisposition (as seen with the Himalayan cat breed)

To identify the cause of any ear infections in your cat, you will need to provide the veterinarian with the cat’s full medical history. The veterinarian will perform a complete physical examination of the cat with focus on the ears. Often the cat will need to be sedated to allow an effective examination to be made, as manipulation of the ears may be quite painful. The vet will use an otoscope to magnify the opening of the ear so that obvious signs of damage may be noted. In some cases, swelling inside the ear may be so severe that a prescription of glucocorticoids may be needed to reduce inflammation enough so that the tympanic membrane becomes visible.

The veterinarian will have to differentiate between all possible causes to identify the exact source of the infection. It may be best to use disposable otoscopic ear cones to prevent the spreading of any harmful bacteria. The ears may be flushed with saline to remove debris for an easier assessment. A sample of ear wax from a swab or a skin scraping may be collected for a cytological exam to identify any organisms that may be causing the infection. If any tumors or polyps have been found, a biopsy may need to be taken for further testing. If the infection has moved to the middle or inner ear, X-rays, an MRI or a CT scan may be needed.

Ear infections in cats can be manageable, if not completely curable, if they are identified correctly and treated quickly. If the exact cause has not been identified correctly, the infection may return and become a chronic issue.

Antibiotics A topical or oral antibiotic may be prescribed if a bacterial infection has been identified. If media or

A topical or oral antibiotic may be prescribed if a bacterial infection has been identified. If media or interna otitis is present, a systemic antibiotic may be necessary to eradicate the harmful bacteria. Prescriptions generally last from 1-4 weeks.

Antifungal Medication

If a fungus has been found to be the cause of infection, an antifungal medication, such as itraconazole, may be prescribed to restore the natural flora balance of the ear. In mild cases, the prescription may only last for a month, but in more advanced cases the medication will need to be administered for a longer period of time.

Anti-Parasitic Medication 

A monthly anti-parasitic prescription can help eliminate harmful parasites, such as ear mites, from the ear. These medications are often topically applied and prevent a wide range of insect and parasite infections.

Full Cleaning 

It is best to allow a professional to complete a full cleaning of the ear, preferably while the cat is sedated. The cleaning will remove all of the wax and exudate buildup within the ear canal.

Surgical Removal 

In very severe cases it may be necessary to remove infected and inflamed tissue and materials in the ear to get rid of the infection. Sometimes parts of the ear that are essential for proper function have to be removed in this process. General anesthesia is required for the procedure.

If your cat has undergone surgery, it is very important to follow all at-home guidelines for proper care. Prevent your cat from pawing or scratching at its ear. An Elizabethan collar may be needed to ensure the ear heals. Administer all painkillers and medications as prescribed. Monitor the ear for signs of infection recurrence. The cat may be left permanently deaf post-surgery or if the infection damaged components of the inner ear.

It is best to continue treatment for a month after symptoms disappear to ensure that the infection is truly gone. A follow-up appointment with your veterinarian can confirm if the infection has been eradicated successfully or not. Have your vet show you how to properly clean your cat’s ears to help with healing. Gentleness is essential, as over-cleaning may cause further damage. Maintain good ear hygiene by cleaning once or twice each week.