Text: José Enrique Zaldívar
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Otitis externa is described as an inflammatory process of the external auditory canal. The estimated incidence in the cat is significantly lower than in the dog, ranging from 2 to 6.6 percent. My clinical experience has shown me that the incidence is much higher in young cats (between 2 and 6 months) than in adult cats The reason I will explain later, within this article.
The signs that will show the cats with otitis will depend on the cause that causes it. We can see agitation of the head, scratching, earache, and variable accumulation of earwax and exudates. The different processes that will trigger the inflammation, such as the increase in humidity and PH and the decrease in lipid content in the earwax, will predispose the animal to a secondary infection, which will increase the manifestation of the aforementioned symptoms. It is usually from this moment when you go to the veterinarian.
We can cite several factors as causes of otitis in healthy ears. These factors may not be cured, but they are controlled with proper treatment.
Atopy and food allergy:
It is very common in dogs and not so much in cats although it can also occur, mainly in those in which these allergic processes trigger facial dermatoses. The initial clinical signs consist of intense pruritus in both atrial pavilions, with erythema in the auditory pavilion. In these cases the appearance of secondary infections by a yeast called Malassezia pachydermatis or by bacteria is frequent. Malassezia has been isolated in 18 percent of ears of healthy cats, but when the usual changes appear, when there is an inflammation they will become pathogens, leading to secondary infections, difficult to treat. The same thing happens with bacteria.
Hypersensitivity by contact and irritating reaction:
The cat is an animal very vulnerable to the use of certain medications and in the case of otic cleaners and ear drops it is even more so. This is why it is not advisable to use products for dogs that are not indicated for use in cats, and not even for cleaning wipes for children, which you like so much to use for ear hygiene.
For example, neomycin, propylene glycol, and dimethyl sulfoxide have been associated with irritating otitis. Other products that can cause irritation, but to a lesser extent are alcohol, glycerin, and povidone iodine.
When otitis externa is aggravated with treatment, we should suspect hypersensitivity by contact or by an irritating substance.
We can say that it is by far the most frequent otitis in the cat. 50 percent of otitis in these animals are caused by Otodectes cynotis (auditory mites). The life cycle of these mites is completed in three weeks. They feed on lymph and blood.
In cats, the infestation can be classified in the following ways: 1) otitis externa, 2) ectopic infestation or 3) asymptomatic vector (the intensity of the reaction, that is, the severity of the symptoms, seems to be related to immediate hypersensitivity reactions ). Serological studies show that most cats have been exposed to auditory mites at some point in their life.
I commented earlier that the otitis that we see veterinarians in clinics, at least in mine, is more frequent in young cats than in adults. The explanation is that when a puppy is picked up from the street, from a shelter or from a hatchery, it will almost always be parasitized by this mite. The reason is simple: the control of these in animal nuclei like those mentioned is very difficult. It is absolutely necessary the insecticidal treatment and the thorough cleaning of the residual materials of the premises, in combination with a complete treatment of each animal. The treatment should be repeated every 3-4 weeks.
We will see in these cases, intense pruritus, erythema and scabs in the atrial pavilion and accumulation of exudates in the external auditory canal (appearance of coffee grounds). Mites can be observed during otoscopic examination, in the form of white spots with mobility. These mites are not only located in the ear, but also in the skin of the neck and head of cats. If the infestation is large we can see dermatitis and uneven alopecia in cats. There are many and excellent treatments we have today, but I will name only fipronil and selamectin. A widely used product is oral or injected ivermectin, although its use is not registered in Spain for cats. Your veterinarian will mark the guidelines and ways of how to use these products.
Foreign bodies as causes of otitis in the cat are extremely rare, due to the customs of these animals.
Hereditary keratinization defects in the cat can cause these types of inflammations, especially those that cause seborrhea and that will lead to erythematous and luminous otitis, which can be complicated by secondary purulent otitis. They are more frequent in the Persians.
Immune diseases can be associated with both atrial lesions and external otitis. Some drugs can also cause rashes in the form of lesions in the auricular pavilion or inflammations in the outer ear.
When we meet an older cat who develops chronic or recurrent otitis we must pay close attention to the presence of a benign or malignant tumor or structures attached to the ear. In cats, special attention is required to squamous cell carcinomas of the white ears. Although excessive sun exposure is not a prerequisite for the appearance of these tumors, it is recommended to keep white-eared cats indoors and away from sunlight.
Nasopharyngeal polyps are usually detected in young cats, although they may appear in older animals. These polyps are non-neoplastic proliferations that originate in the middle ear, ear canal or nasopharyngeal mucosa, and should be taken into consideration in the differential diagnosis of medication-resistant unilateral otitis externa or otitis media with respiratory signs.
A relatively frequent complication in cat otitis, which is usually quite itchy, are otohematomas, which appear on the concave surface of the auricular pavilion, between the cartilage and the skin, or inside the cartilage. Some coagulation abnormalities present in some cats could contribute to the appearance of these complications.
You should know that in the ear canal of your cats there is a normal bacterial flora. Bacteria and yeasts are opportunistic pathogenic microorganisms, but they can cause major secondary changes in the ear canal due to a chronic infection. In case of colonization and infection, cleaning the external auditory canal eliminates exudate, waste, toxins, free fatty acids, which perpetuate inflammation and secondary changes of the auditory canal.
Cats can be infected secondarily by Pasteurella multocida, and less frequently, by pseudomonas aeruginosa, proteus or E. coli.
As for the treatment, we will say in a general way that the auditory cleaning has several functions: 1) it eliminates the material that maintains or perpetuates the infection, 2) it eliminates the bacterial toxins, leukocytes and free fatty acids that stimulate inflammation, 3) it allows the Complete analysis of the external auditory canal and the eardrum, 4) allows the topical medication to contact all parts of the auditory canal, and 5) removes the material that can inactivate the topical medications. In case of severe pain, it may be interesting to use an anti-inflammatory treatment before cleaning.
There are a large number of ear cleaning products on the market, whose mission is the removal of earwax, exudate and waste from the ear canal.
You should know that if the veterinarian does not visualize the tympanic membrane, it will only use water or a physiological saline solution in principle, because many topical cleaning products are ototoxic. Once we are sure of the integrity of the tympanic membrane we can make use of these excellent products.
Early detection of otitis prevents unnecessary pain and hearing loss, decreasing the prevalence of chronic refractory disorders.
Treatments of the various ear conditions mentioned must be established by a veterinarian. You may think that simple ear drops purchased at the pharmacy can solve the problem: a big mistake, because there are otitis that if they are not well diagnosed and treated, will be a "torture" for your cat and for you, given the large number of complications that may be submitted An important fact that you should know and that is to blame for the failures of many treatments, is the fact that when you apply a few drops in the ears and the cat shakes and feels upset, it makes you abandon the treatment. Nothing happens, it's normal. We only use systemic treatments (in injections or pills) when, in addition to the discomfort in the ear, there is fever, anorexia, rupture of the tympanic membrane or otitis is part of another condition. Another mistake will be to stop treatment once we observe that the symptoms have disappeared. They should always be extended for another week.
The therapeutic principles of otitis externa include, depending on the cause that produces it:
- Cleaning / drying
- Local or systemic anti-inflammatories
- Local or systemic antibacterials.
- Local or systemic antifungals.
- Local or systemic antiparasitic.
- Surgical treatment: when the aforementioned principles fail to solve the pathology.
Symptoms of ear problems
If your cat has any of the following symptoms you must take it to the vet Since you probably need to be prescribed drops to improve your problem:
- Your ears suppurate or have an unpleasant smell.
- If you have excess wax. In this case you will see that it has many black spots inside its ears. This may be caused by mites.
- If you have balance problems. This may be caused by some ailment of the eardrum.
- If you scratch your ears insistently or tilt your head to the side constantly. This can be a symptom of the onset of otitis.
Have it all at hand
Once the vet has diagnosed the problem and prescribed the drops your cat needs, it is time to get down to work. To avoid surprises, the ideal is to have everything prepared the material what are you going to need:
- An extended towel
- A sterile gauze
- The drops
When you have everything ready it will be time to look for your furry friend. One of the best tricks to put drops in a cat's ear is wait for the cat to be calm. Take advantage when you are sleepy or when he comes to find you, caress him and relax him, it is better not to catch him by surprise or he will be scared.
You can ask someone to help you hold it, although it is recommended roll it up with a blanket or towel, like a burrito, leaving only his head out, and tight enough so that he cannot escape (do not overdo it, it is not necessary to cut his breath) and take it to the place you have prepared beforehand. This step is essential for nervous cats or with a tendency to scratch.
How to put the drops to a cat
With the cat tied in the blanket or in the towel we can drop the drops without danger of escape or try to scratch. The steps to follow are the following:
- We will clean your ears before starting to remove any excess wax or pus that you may have and that hinders the passage of the drops. This can be done with a special cat ear cleaner that you can buy at any pet store or at the veterinarian. However, if you do not have a special cleaner on hand, you can use sterile gauze and, with the help of your fingers, lightly rub the inside of the cavity.
- When you have your ears clean, bow your head to the side and apply the drops recommended by the veterinarian. When you have thrown them out you can give a gentle massage in the ear to make sure they fit well to the bottom.
- When you are sure that the drops have entered the ear well, massage gently, turn the cat over and repeat the operation on the other ear.
If you follow the treatment as instructed by the veterinarian, the disease should subside in a while. Otherwise you must return to find out what the problem is.
This article is purely informative, at ExpertAnimal.com we have no power to prescribe veterinary treatments or make any kind of diagnosis. We invite you to take your pet to the veterinarian in case he presents any type of condition or discomfort.
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