Squelchy cats ears

Re: Squelchy cats ears

Anthony Todd — Thu, 12 Jun 2014 07:20:34 GMT

[quote user="Robin Grimmer"]Surely this patient is crying out for an ex-lap!![/quote]

You're so naughty, but I like you.

Re: Squelchy cats ears

Robin Grimmer — Thu, 12 Jun 2014 00:55:34 GMT

[quote user="Anthony Todd"]

[quote user="Tim Charlesworth"]

Most external ear disease/exudate is secondary to middle ear pathology in cats. How old is the cat? Cytology + culture of the fluid may well be a good start. As the others have already said, GA'ing the cat (and take the opportunity to examine the cat's throat) + otoscopy/lavage would be a sensible first step. Main ddx would be polyps (esp if younger cat)/neoplasia/obstruction to Eustachian drainage (which is why worth checking the larynx on induction).

X-rays/CT may be needed if still not sure what's going on after the above

Best of luck,

Tim

[/quote]

But reading the original, it's been cultures lavaged and had all the antibiotics under the sun.....

I still don't see why identifying the fluid isn't the best, easiest, non-invasive no risk and cheapest option as well as giving you so much information!!!

The owner must have spent a fortune already!

[/quote]

I can't believe Anthony, that you want to waste the client's money on a pointless 'test', which actually has given you no useful information as borne out by the OP's latest comment. Surely this patient is crying out for an ex-lap!!

Re: Squelchy cats ears

Miriam Lodewyks — Wed, 11 Jun 2014 20:07:26 GMT

Thanks for your suggestions. Both cats are quite elderly, and as the patients themselves do not appear to be sufferings, the clients decline advanced diagnostics. Repeated cytology and culture results were on the whole a mixed bag, and not helpful. And none of the traditional topical or oral treatments I tried seemed to make much difference. One client is diligent and washes her cat's ear canal out daily, the other has opted to do nothing at all now: both cats remain quite happy, but both still squelchy. No overt middle-ear dz symptoms. If i have the oportunity to sedate one again, I will definitely pay closer attention to the eustachian tube, bulla and middle ear. Thanks!

Re: Squelchy cats ears

Tim Charlesworth — Wed, 11 Jun 2014 17:11:44 GMT

[quote user="Anthony Todd"]

[quote user="Tim Charlesworth"]

X-rays/CT may be needed if still not sure what's going on after the above

Best of luck,

Tim

[/quote]

But reading the original, it's been cultures lavaged and had all the antibiotics under the sun.....

I still don't see why identifying the fluid isn't the best, easiest, non-invasive no risk and cheapest option as well as giving you so much information!!!

The owner must have spent a fortune already!

[/quote]

Sorry - missed the bit about previous cultures but yes cytology to identify the type of fluid definitely the sensible first step!

Re: Squelchy cats ears

Richard Carter — Wed, 11 Jun 2014 14:23:22 GMT

or that it is getting dairy in diet ? (cheese to get the antibiotics down for instance?) - not because of the appearance but thinking of the number of times dairy products brings out interesting hypersecretions in cats.

Re: Squelchy cats ears

Anthony Todd — Wed, 11 Jun 2014 13:37:58 GMT

[quote user="Tim Charlesworth"]

X-rays/CT may be needed if still not sure what's going on after the above

Best of luck,

Tim

[/quote]

But reading the original, it's been cultures lavaged and had all the antibiotics under the sun.....

I still don't see why identifying the fluid isn't the best, easiest, non-invasive no risk and cheapest option as well as giving you so much information!!!

The owner must have spent a fortune already!

Re: Squelchy cats ears

Tim Charlesworth — Wed, 11 Jun 2014 10:42:29 GMT

X-rays/CT may be needed if still not sure what's going on after the above

Best of luck,

Tim

Re: Squelchy cats ears

Michael Woodhouse — Wed, 11 Jun 2014 09:53:46 GMT

[quote user="Anthony Todd"]I seem to remember a chylothorax that looked like pure milk so much so that I thought I had tapped the stomach after the cat had drunk milk....[/quote]

Remember your anatomy - the lymph flows via the gut through the thorax and enters the left subclavian vein via the thoracic duct.

It's the fats from the gut that makes the lymph cloudy.

Re: Squelchy cats ears

Anthony Todd — Wed, 11 Jun 2014 09:21:51 GMT

[quote user="Evelyn Barbour-Hill"]Only from the intestine.[/quote]

I seem to remember a chylothorax that looked like pure milk so much so that I thought I had tapped the stomach after the cat had drunk milk....

Was I more deluded than normal.

I still think that "identifying" the fluid will give more diagnostic and therapeutic information than negative scans and Xrays,

Re: Squelchy cats ears

Evelyn Barbour-Hill — Wed, 11 Jun 2014 01:31:13 GMT

[quote user="Richard Allport"]Try Thornit.[/quote]

In one of my previous practices, one of the partners had a favourite ear lotion he thought was wonderful. The local chemist used to make it up for him by the Winchester. However the chemist eventually regretted that he could no longer make it up: you just can't get the Armenian Bole these days.

Re: Squelchy cats ears

Richard Allport — Wed, 11 Jun 2014 00:02:08 GMT

Try Thornit.

Re: Squelchy cats ears

Evelyn Barbour-Hill — Tue, 10 Jun 2014 23:28:16 GMT

[quote user="Anthony Todd"]Isn't lymph sort of milky?[/quote]

Only from the intestine.

I don't know for certain the answer to the original question, but middle ear exudate can be thin and "milky" (though more usually glairy (lovely word)). I'd be wanting to rule out positively middle ear disease before looking further. An apparently intact tympanum does not rule it out. Plain Xrays of the bulla should help.

What happens if you don't do anything? Does the fluid crust? Overflow? Get splattered up the wallpaper?

Re: Squelchy cats ears

Anthony Todd — Tue, 10 Jun 2014 22:38:20 GMT

I assume you've looked at the fluid: SG, cytology pH exudate/transudate etc. etc.

Where's it coming from and what is it would be the first step a dinosaur would go for, doesn't sound as if it's the result of an infection.

Isn't lymph sort of milky?

Re: Squelchy cats ears

James Laidlaw — Tue, 10 Jun 2014 21:25:37 GMT

I'd guess if you can't visibly see anything then imaging is next step, likely only ct or MRI are going to actually show you anything though... Sounds odd!

Re: Squelchy cats ears

Robin Grimmer — Tue, 10 Jun 2014 21:13:54 GMT

Most ear problems in adult cats I see are due to polyps. +1 for GA clean and examine ears and maybe x-rays.

Re: Squelchy cats ears

Miriam Lodewyks — Tue, 10 Jun 2014 21:13:13 GMT

Thanks James. Both cats have been repeatedly sedated and had their ear canal flushed and examined. Both cases have been going on for months now, so fairly convinced that owners are not chucking anything down the ear that they shouldn't be.

Re: Squelchy cats ears

James Laidlaw — Tue, 10 Jun 2014 20:59:24 GMT

Are you 100% sure the owners aren't putting anything in there? Guess it's difficult to see the TM but maybe sedation/GA to clear the discharge and examine the canal properly might be worth a go?