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Cat Forum / Health and Behavior / April 2006Deep Ear Infection
Has anyone had a cat with a middle ear infection? How did you treat it? We've been fighting Bear's ear infection for months, and today he was put under to have an ear flush and x-rays. Turns out his ear drum is GONE, it's been eaten by the infection. The problem is worse than we thought, it's so deep that it would take major surgery to get to it with no guarantees of getting rid of it. Did anyone's cat have that type of surgery? Did it cure the infection? Did the problem get worse eventually and go into other areas? Thanks, Rhonda > Has anyone had a cat with a middle ear infection? How did you treat it? > [quoted text clipped - 10 lines] > > Rhonda No experience but just wanted to say I am so sorry to hear this about Bear! Have they cultured it to find out what pathogen it is? -L. > > Has anyone had a cat with a middle ear infection? How did you treat it? > > [quoted text clipped - 14 lines] > Bear! Have they cultured it to find out what pathogen it is? > -L. She's probably talking about a lateral wall resection - a/k/a Zepp procedure or the LaCroix which is a variation of the Zepp. The Zepp is only successful in the early stages-- which has come and gone in this case. Since the ear canal is probably destroyed, he'll probably need a total ear canal ablation a/k/a TECA procedure. The TECA is a last resort procedure because it involves the removal of the ear canal and is associated with some serious complications (permanent facial paralysis or neurapraxia which could affect the eye, hemorrhage- that could be life-threatening, to name a few). Since the ear drum is gone, the infection probably invaded the middle ear so a TECA will probably have to be combined with lateral bulla osteotomy. I will never again trust either procedure to anyone but a seasoned surgeon - we were just plain lucky. Very, very few GP vets have experience with TECA in cats with end-stage otitis. Gotta remove *all* infected tissue. Phil Our vet is very good about saying when she thinks someone else needs to be called in. When Bear didn't respond enough to medicine, she started talking about the ear flush and last resort of an operation. From the beginning, she said she'd have someone else do it. I just am not sure how uncomfortable he is, he doesn't act like he's in pain, and if it would be worth a huge operation that may not correct the problem. I would expect to see balance problems or other things happening, but he acts normal, other than scratching at his ear every now and then. Rhonda > I will never again trust either procedure to anyone but a seasoned surgeon - > we were just plain lucky. Very, very few GP vets have experience with TECA > in cats with end-stage otitis. Gotta remove *all* infected tissue. > > Phil > I just am not sure how uncomfortable he is, he doesn't act like he's in > pain, and if it would be worth a huge operation that may not correct the > problem. I would expect to see balance problems or other things happening, > but he acts normal, other than scratching at his ear every now and then. If the problem is that long standing he may just have gotten used to the pain- which is sadder IMO than pain in the first place. I have seen animals with chronic infections that just become inured to it all- the way they carry their head might change but their pain response seems to have withered over the years. They lose the will to care. I have also seen animals whose personalities have become dull experience a 100% turn around after a Zepp or total ablation. What used to be a sad old cat can turn into a happy, fun cat when the pain is stopped. *Any* sort of ear problem is incredibly annoying and something of this degree and duration has to be incredibly painful unless his nerves have plumb burned away. I would either remedy the problem or call it a day and send him on. I don't mean to be harsh but chronic pain can negate any joy at all in life, and personally I think he deserves a little joy..  SignatureToni http://www.irish-wolfhounds.com > *Any* sort of ear problem is incredibly annoying and something of this > degree and duration has to be incredibly painful unless his nerves have > plumb burned away. I would either remedy the problem or call it a day and > send him on. I don't mean to be harsh but chronic pain can negate any joy at > all in life, and personally I think he deserves a little joy.. Toni, I don't think I've met you -- are you a vet? Bear still eats, wants attention and meets us at the door to beg us to follow him to the food bowl. Lately, he's been playing more. Each morning, he wakes us up by walking across both of us and purring loudly. Tonight I heard a strange scupping sound and caught him rolling on the floor with a catnip toy, licking it like crazy. Either he's an extremely tough cat or he's not in that much pain. I do know cats can hide their discomfort which is what concerns me, but I can't believe he'd be playing and eating so well if he needed to be put to sleep. Rhonda > Toni, > > I don't think I've met you -- are you a vet? Not at all. But I have groomed 15 dogs/cats a day five days a week for 34 years so have looked inside well over 100,000 sets of ears, plus have followed each of these animals over the course of their lives. I understand that the lack of a medical degree renders my opinions useless, but I have seen hundreds of animals that seemingly do not feel pain despite raging chronic problems. It is my opinion that they are just amazingly able to compartmentalize pain- in other words learn to ignore it. It's the only option they have if the problem remains unresolved. I did not mean to imply that the animal should be catagorically euthanized- I feel that he should be cured. I did mean that euthanasia is preferable IMO to lifelong chronic pain the magnitude of deep ear infections and that the surgeries work so please go for it. It is worth a try, no? Maybe that's all I should have said. The surgeries work.. SignatureToni http://www.irish-wolfhounds.com Maybe what you were doing to make your point is to play on emotions and were not really making a snap internet decision to break the choices down to surgery or euthanasia. Believe me, you don't need to play on my emotions. What I'm trying to do for Bear is make the best decision for his particular case. He's 14 years old and a surgery like that is a major decision. It has to be worth it for him -- there has to be a good chance to get rid of this. I don't want to put him through hell and have the infection still be there. So my questions remain the same -- do you know any cats that have gone through this particular surgery? Did it cure the infection? Rhonda > Not at all. > [quoted text clipped - 18 lines] > Maybe that's all I should have said. > The surgeries work.. > So my questions remain the same -- do you know any cats that have gone > through this particular surgery? Did it cure the infection? I can (off the top of my head) think of three cats I have seen in the past couple of decades that had the complete ablation procedure, and yes it did clear up the infection- cleared everything the hell out, in fact. It is a complete last resort procedure, but is effective. I can think of perhaps five or so that had the Zepp procedure done and the results there were more mixed, although I believe it depends a great deal on aftercare. Some kept their chronic infections but the ears drained better and were easier to clean. *If it were me* I would have the total removal of everything done and call it over. SignatureToni http://www.irish-wolfhounds.com > > Toni, > > [quoted text clipped - 7 lines] > > I understand that the lack of a medical degree renders my opinions useless, That's not true. Credentials don't necessarily guarantee credibility- one can exist without the other. I'm sure you understand cat psychology better than many vets. Phil >>Has anyone had a cat with a middle ear infection? How did you treat it? > > No experience but just wanted to say I am so sorry to hear this about > Bear! Have they cultured it to find out what pathogen it is? > -L. They did a culture previously and it was not one of those odd, hard-to-treat bacterias. The baytril-type drops and the pills should have worked. When she went in yesterday to see what was going on, she also took a deep culture. We should have that back in a few days. This cat spent his first 10 years as a barn cat. He has deformed ears (looks like a Scottish Fold) from the previous owner's neglect. The ear canal was already scarred and very small, a good breeding ground for bacteria. He's a sweet cat, I just hope this isn't uncomfortable. Thanks, Rhonda > >>Has anyone had a cat with a middle ear infection? How did you treat it? > > [quoted text clipped - 5 lines] > hard-to-treat bacterias. The baytril-type drops and the pills should > have worked. Not necessarily. Culture ain't enough- gotta follow up with sensitivity testing. A lot of middle and inner infections in cats are caused by Baytril-resistant strains of Pseudomonas. > When she went in yesterday to see what was going on, she also took a > deep culture. We should have that back in a few days. Make absolutely sure she orders antibiotic sensitivity testing. Identifying the species ain't enough. > This cat spent his first 10 years as a barn cat. He has deformed ears > (looks like a Scottish Fold) from the previous owner's neglect. The ear > canal was already scarred and very small, a good breeding ground for > bacteria. Ask your vet to take an x-ray of your cat's tympanic bulla- its a sac-like bone that acts like sort of a resonance chamber for the ear. Pus and other infectious crap from untreated external/middle ear infections can accumulate and plug the bulla which in turn can cause resistant, recurrent infections. You might luck out with just a good draining and cleaning. http://maxshouse.com/Illustrations/Tympanic_Bulla.jpg >He's a sweet cat, I just hope this isn't uncomfortable. Of course he's uncomfortable. If he starts shaking his head or pawing his ear he could develop a aural hematoma. > Ask your vet to take an x-ray of your cat's tympanic bulla- its a sac-like > bone that acts like sort of a resonance chamber for the ear. Pus and other > infectious crap from untreated external/middle ear infections can accumulate > and plug the bulla which in turn can cause resistant, recurrent infections. > You might luck out with just a good draining and cleaning. She did x-ray his ear (actually his whole head) and found material on both sides -- in both ear canals. She did a saline flush on the side that is infected and washed it out as best she could without the surgery. I need to talk to her again when the culture comes back and get her take on where to go from here. I wasn't here to get the report after surgery. She knows his situation and is a good vet, I trust her. I mainly posted here because I wanted to see if other people had cats that went through this and what they chose to do -- and the outcome. Rhonda > She knows his situation and is a good vet, If she was a "good vet" she never would have allowed the condition to progress so far- to the point where the infection destroyed the entire eardrum and probably the vertical and horizontal ear canal as well and will now probably require risky major surgery. If she was a "good vet" she would have known that otitis media is a perpetuating factor for chronic or recurrent otitis externa and would not have delayed referring you to a specialist for so long. Your vet is mediocre bordering on incompetent- but you can't see that because you don't know any better. And you- you dole out advice and advise to people to seek a second opinion when their vet isn't making progress yet you allowed your own cat to suffer for months and allowed a reversible disease to destroy his ear. You should have been gone after no more than a month. > I trust her. That's because you don't know any better. > I mainly posted here because I wanted to see if other people had cats > that went through this and what they chose to do -- and the outcome. Yeah, I had the lateral wall resection done on a few of out shelter cats and a TECA preformed on a feral- and they pulled through ok. If I had to do it all over, I would have looked into a vertical ear canal ablation instead of a TECA. But it sounds like your cat's condition is well beyond the Zepp procedure- especially if there's irreversible changes to the vertical and/or horizontal ear canals. If his eardrum is "gone"- the middle is ear probably diseased as well. The eardrum is also a protective barrier for the middle ear. In that case your only option might be a TECA. Btw, did your "good vet" happen to mention that lateral wall resection *does not* cure the underlying cause of the infections? -- it only helps the ear canal to drain and ventilates the ear canal which helps to reduce moisture and humidity- and makes cleaning a little easier. Its *not* a cure. If only the vertical ear canal is damaged, your cat might be a candidate for vertical ear canal ablation- which combines the benefits of both procedures (Zepp/TECA) with fewer potential complications of the TECA. I'm sure your "good vet" explained that to you... I hope your sad devotion to an incompetent vet won't prolong your cat's suffering any longer. Phil, you live in such a strange, fantasy world where you are god of all cat knowledge. You do everything right and everyone else, including all vets, do it wrong. Thanks for playing, but I don't want to. Rhonda > Phil, you live in such a strange, fantasy world where you are god of all > cat knowledge. It just seems that way to you- its a relativity thing. > You do everything right I wouldn't say I "do everything right". But I sure know when to seek a second opinion. What would you have done if he was bleeding? Wait to see if it stopped? and everyone else, including all > vets, do it wrong. Not "everyone" or "all" vets do everything wrong- but you and your bungling vet certainly did. I damned sure wouldn't have waited *months* until an ear infection totally destroyed a cat's eardrum and closed up the ear canal before getting a referral to a specialist or at least seeking a second opinion-- especially when it involves older cats whose diseases need to be resolved quickly due to their overall diminished resistance. > Thanks for playing, but I don't want to. Wise choice. Rhonda What sort of symptoms did Bear have? I've been having trouble with an ongoing problem in my cat's ears that the vet hasn't seemed to fix. Hi Buddy, His symptom was scratching and digging at that ear. The scratching got better with the antibiotic drops but the infection did not go away. Rhonda > Rhonda > > What sort of symptoms did Bear have? I've been having trouble with an > ongoing problem in my cat's ears that the vet hasn't seemed to fix. Hi Rhonda Did he have a lot of dark waxy stuff in his ear, too? His symptom was scratching and digging at that ear. The scratching got better with the antibiotic drops but the infection did not go away. Rhonda Buddy, You can't really see in Bear's ears, they are almost crumpled flat. The vet looked down in with equipment when this first started and said they were "very dirty." She said it was a lot of pus and other debris, and I did see very dark stuff come out on the equipment. He did also have a yeast infection in the beginning but that seems to be gone. Rhonda > Hi Rhonda > > Did he have a lot of dark waxy stuff in his ear, too? |
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