Treatment and outcomes for cats with ear ceruminoliths

Abstract

BACKGROUND: Ceruminoliths are accumulations of cerumen and cornified material, in the ear canal that can obstruct the tympanic region (proximal external acoustic meatus). Management typically involves ceruminolytic agents or otic lavage under general anaesthesia. HYPOTHESIS/OBJECTIVES: To describe the clinical presentation, management and outcomes of cats diagnosed with ceruminoliths. ANIMALS: Medical records of cats diagnosed between 2011 and 2024 were reviewed. MATERIALS AND METHODS: Inclusion criteria were visual confirmation of ceruminoliths by otoendoscopy, initiation of treatment and at least one follow-up examination. Treatment efficacy was assessed using otoendoscopy and an owner global assessment of treatment efficacy (OGATE). RESULTS: Thirty-one cats were included; 26 underwent otoendoscopy-guided lavage under general anaesthesia combined with medical treatment, while five received medical treatment alone. Ceruminolytic cleaners and short-term systemic glucocorticoids (2-7 days) were commonly prescribed. Tympanic lesions were frequent, with perforation in 10 cats and thickening/discolouration in five. At final recheck, four cats had tympanic scarring or other irregularities, and one tympanic perforation persisted. At the initial follow-up, 55% of cats were free of ceruminoliths. At final follow-up, 65% remained recurrence-free. OGATE data were available for 15 owners: 60% reported a positive response, with five rating the outcome as excellent and four as good. CONCLUSIONS AND CLINICAL RELEVANCE: Tympanic lesions were frequent and sometimes permanent. The recurrence of ceruminoliths highlights the need to investigate underlying predisposing factors. This study emphasises the importance of recognising tympanic involvement and the necessity of long-term monitoring in affected cats.