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Cat with middle ear infection

Category: general | Submitted: 20 November 2010 01:51PM | viewed 46622 times
Q Laura asks:

My 4 year old Maine Coon has had recurring outer ear infections. She had her first 2 years ago, was treated and seemed fine. She had another in March this year. This again was treated but erupted again in September. My vet was concerned at the recurring bouts so wanted to investigate. She had a general anaesthetic and xrays and swabs taken. The excess wax was flushed out, and a week later her ears remain clean. She has no polyps, but the vet says the xrays show a chronic middle ear infection which may have been rumbling on since the very first infection. The swabs and cultures (taken from the outer ear and throat) all came back negative - she was tested for fungal infection as well as calicirhinovirus (she has noisy breathing sometimes but the vet thinks itís genetic) and chlamydia. I'm taking her in next Tuesday to be anaesthetised again. They want to incise the eardrum so the cultures can be tested - obviously they have to to know what they're dealing with. But the most recent vet I've seen (never the same one, sadly) wants to actually treat the middle ear infection by flushing the area with antibiotics rather than giving them orally, saying that this may need to be done repeatedly. I'm alarmed as itís going to involve a general anaesthetic every time not to mention resulting scar tissue and damage to her hearing. She has also mentioned to me an operation I may wish to consider, involving drilling through the bone so the fluid can drain away? Is this where they basically build a new ear and close off the old one? Iíd be loathed to put my cat through that. Isnít it using a sledgehammer to crack a nut? Since her ears have been flushed, sheís stopped the headshaking and scratching. There is no head tilt no balance problems. She has a good appetite, plays and buzzes as normal Ė absolutely no external signs sheís in pain or unhappy. Of course, if she has been suffering these problems for some time, it may be that she is used to the pain (horrible thought) but the only time Iíve seen her in any discomfort is when the outer infection has flared up and the wax is irritating her. Iíve had many middle and outer ear infections and know how horrible they are, so obviously I want to get this sorted. I have, however, only received oral medication for this myself Ė is there absolutely no way this can work on a cat? I just donít want to put her through anything so drastic unless it absolutely can not be avoided.

Q Our vet says: I am sorry to hear about your cat's ear infections.

You mention that you always see a different vet, so the first thing I would suggest is that you try to see the same vet at each visit. Simply ask the receptionist if this can be arranged when you book the appointments. In this way you will be able to build trust and a good rapport with your chosen veterinary surgeon.

It is impossible to tell you what is the correct choice of treatment for your cat as I am unable to examine her. However it should be possible to discuss all the issues you have written to me about with your vet and ask them to allay your concerns.

If left untreated the chronic middle ear infection might continue to be present, but perhaps without clear outward signs of a problem.

Chronic but "quiet" infections inevitably put stress on the immune system which cannot be good for your cat long term.
I personally believe that the risks of general anaesthesia (even if necessary frequently) are less than the potential problems and probably pain caused by a chronic infection anywhere in the body.

If there are chronic changes to the tissues associated with the infection it may be a concern that the antibiotics may not penetrate to where they are needed if given orally, so this could be the reason for the treatment plan you have described.

It can be extremely difficult to detect signs of pain in cats- they hide it very well. I explain this to my own clients by asking them to consider if their boss would know they had a headache at work if you did not tell them? Pain can be intermittent or low level and "hidden"so often behaviour can seem quite normal most of the time.

I would ask your chosen vet for a few minutes of their time to go through all your concerns- the care of your cat is a partnership between you and them and a good partnership needs communication on both sides. I am sure your vet will discuss these concerns with you if they are told how worried you are.

I hope it all goes well for you and your cat.

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