On a recent evening I paid a house call to check on a friend’s kitty, whom I’ll call Casey. The tip of one of Casey’s ears was swollen and hung down over the ear canal. Her owner said she could hear the tags on Casey’s collar jingling a lot, a sure sign that the cat was shaking her head and scratching her ears a lot. Casey had an ear hematoma, one of the most common ear conditions I see in cats.
Cats and Kittens don’t have ear troubles as often as dogs do. This is because most cats have small, upright ears with hairless canals that provide good air circulation (Scottish Folds, named for their folded ears, are the exception).
Most of the ear problems I routinely encounter are localized to the external ear. The cat ear is divided into three parts. The external ear consists of the upright flap of cartilage, called the pinna or earflap, and the external canal. The middle ear, which transmits sound, consists of the eardrum and the auditory bones. The inner ear contains the hearing apparatus: the cochlea, bony labyrinth, and auditory nerves.
Aside from ear hematomas, I see ear mites, ear infections, and cancers of the pinna. Ear mites are contagious; they can even spread from cats to dogs. I generally don’t see foreign bodies in cats’ ears, though dogs often get things stuck in their ear.
Accumulation of blood
The hematoma in Casey’s ear was an accumulation of blood in a pocket in the ear pinna. Hematomas occur when blood vessels rupture after the cat has persistently scratched its ear or vigorously shaken its head. A hematoma is usually a signal that something in the external ear canal is irritating the pet. Often when there is a hematoma, I find ear mites or an ear infection in the canal. occasionally, a hematoma forms spontaneously.
Your vet can treat a hematoma in one of three ways:
- by aspirating it with a needle to remove the blood
- by placing a small drainage tube or gauze tape in it for continuous drainage
- by surgically removing a small strip of skin over the hematoma and suturing the loose skin back in place
General anesthesia or sedation is necessary in all cases. Regardless of which procedure is performed, there is a chance the pinna will have some deformity after it heals.
Otitis externa (external canal infection) is usually caused by bacteria or yeast and can be a combination of both. Typically, you’ll see dark yellow or golden exudate (guck) in the external canal, and your cat might be in a lot of pain. Yeast infections more often cause itching and produce a dark-brown discharge. When I see exudate in the ear canal of a patient, I take a swabbing of the canal, smear it on a slide, stain it, and examine it microscopically to identify the type of infection present. For recurrent infections, I usually send a swab of the discharge to our laboratory for culture. I treat ear infections by gently cleaning the ear canal.
If the cat is in pain, I sedate her so that I can do a thorough cleaning and so that I can see the eardrum deep inside the canal.
If the eardrum is intact, I’ll prescribe medicated drops or ointments to be applied to the ear canal. If the infection is severe , I’ll also prescribe a course of antibiotics. If the eardrum is ruptured (which is rare in cats), I’ll prescribe only oral antibiotics until the eardrum has healed. I’ll recheck the ears within 14 days to be sure the therapy is working.
Ear mites, Otodectes cynotis, live down inside the ear canals and are contagious; they can even spread from cats to dogs. The mites are usually more numerous in younger animals, and they can make your kitten’s ears intensely itchy.
The small white mites can be seen with the naked eye, but I find that cat owners are much more diligent about treating their pets after they’ve seen the mites under a microscope. I will gently flush the debris and mites from the cat’s ear canals, then apply medicated drops to decrease the inflammation and kill any remaining mites. Most importantly, I treat all the cats and dogs in the household.
Cancer of the ear pinna is more common in white cats or cats with white ears. The tumor I see most frequently is called squamous cell carcinoma. It is thought to be caused by chronic exposure to the sun. If you own a white cat, keep your pet indoors. If the cat must go out, be sure to apply sunblock to the ears.
The tumor starts as dried, flaky areas that resemble sunburn on the edges of the cat’s ears. Left untreated, the tumor eventually becomes ulcerative and practically eats away at the ears, leaving the edges raw and bleeding. When the cancer is caught early, the tips of the ears can be surgically amputated to remove the tumor. Radiation therapy may be necessary when the tumor is more advanced.
Fortunately, I found that Casey’s ear canals were disease-free. I sedated her, clipped the inner side of her swollen ear flap, surgically scrubbed it, lanced the hematoma to remove the blood, and inserted a small drain. Three weeks later, I removed the drain and was pleasantly surprised to find minimal deformity to the healed ear. Casey is looking like her old self.
Ear problems can be difficult to treat. Be sure to follow your vet’s directions and return for follow-up exams. That way, your vet can closely monitor the therapy and modify the treatment.