Expert: Dr. Louis N. Gotthelf - 7/14/2010

Question
Dr. Gotthelf,

We have a healthy, thin 15-year-old male neutered cat.  He is very nice and calm with us, but extremely terrified and  aggressive when he goes to the veterinarian (he has bitten through Kevlar gloves), so for his check-up last month he had to be anesthetized.  He frequently has a dark waxy buildup in his ears, so we asked if they could also clean them while he was under.

When we picked him up, the vet told us that both of his eardrums were ruptured.  She said that she wasn't sure if it had occurred during the cleaning or previously, but she didn't see any fresh blood.  He is normally a calm indoor cat that hasn't endured any trauma, so it seems unlikely that they were ruptured by anything other than the ear cleaning.  The vet gave us an antibiotic to prevent any ear infections, but the prescription was only for 10 days.  When we brought him home, we noticed the third eyelid in his right eye is now often partially closed.  (I googled this, and it seems like it may be "Horner's Syndrome").

Since coming home several weeks ago, our cat has been sleeping more than usual.  When we try calling him or making noises, he usually doesn't react to the sound at all.  Previously he would turn his ears or head when called.  He also is eating very little and appears to be losing weight.  Also, the black, waxy buildup in his ears has returned.

I have several questions that I hope you may be able to answer:

- I read that eardrums usually take 6-8 weeks to heal.  Should he be on antibiotics for that entire duration, or is the initial 10-day prescription sufficient?

- If his eardrums don't heal, will he constantly be at risk for ear infections?  Will he be able to hear?

- What could be causing the frequent dark buildup in his ears?  He has gotten it his whole life, and his veterinarians have ruled out ear mites.

- Perhaps most important, hat should we do about his lack of appetite and sleepiness?  He has always been thin, but in the past few days we have noticed that his spine is more prominent, suggesting weight loss.

- Is there anything else we should be looking out for or should know while our cat recovers from his ruptured eardrums?

I hope you can offer us some information and suggestions.  We are very hesitant about going back to the veterinarian unless it's absolutely necessary, since it would lead to a lot of stress - and possibly anesthetization - for our cat.  Plus, since there's a good chance that our vet may ruptured his eardrums, we'd like to get an outside opinion on our cat's follow-up care.

Thank you so much for your contributions to this site, and I look forward to your reply.

Answer
Cats can spontaneously rupture their eardrums from sneezing.  While it is possible that the vet perforated the eardrums when cleaning, with the constant waxt buildup in the ears, something is going on there.  Cats with allergic skin often have very waxt ears.

As far as an antibiotic, that won't help too much.  Steroid eardrops help more because it relieves any inflammation associated with the trauma.  Cats rarely get middle ear disease from bacteria found in the ear canals.  A shot of dexamethasone is what I normally do for cats with ruptured eardrums and it has the beneficial side effect of increasing the cat's appetite.

Eardrums normally heal in 10 days to 2 weeks, so give it some time.