Chronic Otitis in Cats: Clinical management of primary, predisposing and perpetuating factors

Abstract

Practical relevance: Chronic otitis can be one of the most frustrating diseases to manage for a small animal practitioner. While it occurs less commonly in the cat than the dog, it is no less challenging. The purpose of this review is to discuss the common and uncommon causes of chronic otitis in the cat within the clinical framework used for diagnosis and treatment. The focus is on diseases that affect the ear canal, rather than those restricted to the pinnae. Clinical challenges: Otitis is multifactorial, which complicates management. A common clinical mistake is to focus solely on treating the infection present. Only by addressing all factors will a clinician successfully control chronic otitis. For the purposes of this review, the authors have adopted the established model of separating primary, predisposing and perpetuating causes of otitis. Primary factors are those that directly cause otitis (inflammation); predisposing factors are those that put the patient at risk for development of otitis; and perpetuating factors are those that result in ongoing clinical signs of otitis or that prevent clinical resolution. Audience: This review is aimed at veterinarians who treat cats and particularly those with an interest in feline dermatology and otology. Equipment: While many practitioners rely on a hand-held otoscope, a video-otoscope can be very helpful for the diagnosis and treatment of chronic otitis. Evidence base: This review presents up-to-date information regarding the diagnosis and treatment of chronic otitis in cats, with emphasis on the most recent peer-reviewed literature.