Clinical outcome of cats with suppurative otitis media and intact tympanum submitted to myringotomy: retrospective findings from 26 cases

CASE SERIES SUMMARY

The efficacy of medical treatment associated with single myringotomy in cats with suppurative otitis media (OM) and intact tympanum was retrospectively evaluated. Patients' records were retrieved from cats with suppurative OM. Cats were included in this retrospective study based on fluid content within the tympanic cavity on imaging, intact tympanum on otoendoscopic examination and neutrophils on ear bulla exudate cytological examination. A total of 26 cats with middle ear suppurative otitis were included. Just over half of the cats (54%) presented bilateral involvement. Clinical signs included head tilt (13/26), otalgia (9/26), Horner's syndrome (7/26), external ear discharge (5/26), and nystagmus and facial paralysis (1/26). Cocci were identified on cytological examination in 18/40 samples and rods in 2/40. Bacterial culture results were positive in 15/40 samples, with Pseudomonas species (4/15), Pasteurella multocida (3/15), Staphylococcus felis (3/15), Staphylococcus schleiferi (2/15), Staphylococcus canis (2/15), Escherichia coli (2/15), Staphylococcus pseudintermedius (1/15) and Serratia marcesens (1/15) isolation. After myringotomy and gentle flushing of middle ear bullae (0.5-2 ml saline per ear), all cats were treated with oral corticosteroids and a 1-month course of systemic antibiotics according to sensitivity testing. In total, 19 (73%) cats were clinically healed 60-240 days after treatment. One cat was euthanased because of failure to eradicate a Pseudomonas species infection. Another cat died a few hours after the procedure. The five remaining cats were cured after ventral bulla osteotomy.

RELEVANCE AND NOVEL INFORMATION

OM without an aural polyp is a frequent diagnosis in cats, but data on medical treatment are scarce. This simple therapeutic technique, single myringotomy procedure and mild ear flushing, offers a practical, safe and efficient first-line treatment of suppurative OM with an intact tympanum in cats with or without neurological signs.

Intracranial inflammatory polyp with cerebellopontine compression and leptomeningitis secondary to chronic otitis in a red kangaroo

CNS lesions associated with chronic otitis have not been reported in red kangaroos (Macropus rufus), to our knowledge. Here we describe an intracranial inflammatory polyp secondary to chronic otitis in a 6-y-old female red kangaroo with right auricular discharge, loss of balance, and head tilt. Autopsy highlighted a pale-yellow, firm, intracranial polypoid growth that extended from the right tympanic cavity through the internal acoustic meatus and intracranially, with compression of the right cerebellopontine angle. Anaerobic bacterial culture yielded Bacteroides pyogenes from fresh brain and a right external ear swab. Histologically, the tympanic cavity was effaced by neutrophils and macrophages surrounded by lymphocytes and plasma cells, as well as edematous fibrovascular tissue. The epithelial lining of the mucoperiosteum was hyperplastic, with epithelial pseudoglands surrounded by fibrovascular tissue. Areas of temporal bone lysis and remodeling were associated with the inflammatory changes, which occasionally surrounded adjacent nerves. Fibrovascular tissue and inflammatory cells extended from the tympanic cavity through the internal acoustic meatus and into the intracranial cavity, forming the polypoid growth observed grossly; the polyp consisted of a dense core of fibrovascular tissue with scattered clusters of neutrophils and foamy macrophages. Lymphocytes and plasma cells surrounded the leptomeningeal perivascular spaces in the brainstem, cerebellum, and occipital lobe.

Tomodensitometric and histological age-related changes in the normal feline middle and inner ear

Deafness in cats may be due to acquired causes such as aging. Similar age-related morphological changes in the cochlea have been noted in several animal species. However, little is known about the effects of age on the morphology of the middle and inner ear in cats. The aim of the present study was to compare these structures in middle-aged and geriatric cats using computed tomography and histological morphometric analysis. Data were obtained from 28 cats, aged 3-18 years, with no hearing or neurological disorders. Computed tomography showed an increase in tympanic bulla (middle ear) volume with aging. Histological morphometric analysis revealed thickening of the basilar membrane and atrophy of the stria vascularis (inner ear) in older cats, similar to what has been observed in older humans and dogs. Nevertheless, histological procedures could be improved to provide more data for comparison with different forms of presbycusis in humans.

Evaluation of aural masses submitted as inflammatory polyps in 20 dogs (2000-2020)

BACKGROUND

Canine non-neoplastic aural polypoid masses (APMs) are uncommon, with few published studies.

OBJECTIVES

The aim of this retrospective study was to characterise the clinical presentation, diagnostic imaging and histopathological results for APMs submitted as aural inflammatory polyps (AIPs).

ANIMALS

Twenty dogs with APMs evaluated at a veterinary teaching hospital.

MATERIALS AND METHODS

Cases were selected by searching computerised medical records from 2000 to 2020, using keywords 'canine', 'aural/otic polyp' and 'aural/otic inflammatory mass'. Histological samples and medical records were reviewed.

RESULTS

In 14 of 20 dogs, external ear canal masses were characterised by keratinised squamous epithelium with or without adnexa. Tympanic bulla origin was confirmed in four of 20 dogs by the presence of cuboidal to ciliated columnar epithelium, with or without squamous epithelium. The site of origin could not be determined in two dogs. Diagnostic imaging (MRI or CT) confirmed APM presence in 14 of 20 dogs. Otitis media was diagnosed in four of four tympanic bulla APMs and seven of 13 ear canal APMs. In 18 of 20 dogs, debulking, traction avulsion, and total ear canal ablation and bulla osteotomy led to APM resolution in two of eight, four of six and four of four dogs, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Type of epithelium was a key feature in determining the APM origin, and interpretation in conjunction with video otoscopy and diagnostic imaging was crucial. Canine APMs more commonly arose from the ear canal. Tympanic bulla APMs and APMs of undetermined origin were comparable to feline AIPs. Regardless of APM origin site, debulking had the greatest likelihood of recurrence.

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

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.

Evaluation of Video-Otoscopic, Radiographic and Computed Tomographic Examinations of Cats and Dogs with Ear Diseases

The aim of this study was to evaluate the effectiveness of imaging techniques (video-otoscopy-VO, radiography-RTG, computed tomography-CT) in diagnosing ear diseases in cats and dogs. Seven cats and thirteen dogs diagnosed with ear diseases were used for the research. Clinical examination, VO, RTG and CT were performed. Three (42.9%) unilateral otitis externa (OE), three (42.9%) unilateral otitis media (OM), and one (14.2%) bilateral otitis media (OM) with OE were diagnosed in 7 cats. Five (38.4%) unilateral OE, one (7.7%) unilateral OM, four (30.8%) bilateral OE, and three (23.1%) bilateral OM with OE were diagnosed in 13 dogs. All diagnostic methods were determined to be highly efficient for the specified diagnosis. VO and RTG were confirmed as sufficiently effective for the diagnosis of OE. OE plays a major role in the etiopathogenesis of OM, and for this reason, RTG and CT are required diagnostic methods for this condition.

Occurrence of tympanic bone spicules and bone crests in domestic cats

Small and hyperostotic tympanic bone spicules (STBS and HTBS) extending from the tympanic wall or from the septum bullae into the tympanic cavity have been described in large feline species such as Siberian tigers or African lions and in canids such as dogs, red foxes and wolves. Detailed descriptions of prevalence, location and orientation were performed for dogs and African lions by means of necropsy and conventional computed tomography (cCT). Aims of the current study were to describe same characteristics for domestic cats by means of microcomputed tomography (µCT) and cCT. A total of 15 cats or rather 30 ears were examined. Furthermore, new bone formations extending into the tympanic cavity shaped like small lamellae were found and named "tympanic bone crests" (TBCs). The registered phenomenon of a thickened tympanic wall in some cats was named "tympanic wall thickening" (TWT). STBS appeared in 43% of the ears being bilateral in 44% of the cases, whereas HTBS appeared in one ear. TBC was present in 33% of the ears with a bilateral prevalence of 67%, and TWT could be detected in 13% of the ears. The mentioned structures are just barely or not at all detectable with cCT; therefore, µCT is necessary for an identification and detailed description. The origin and the factors inducing the development of examined phenomena are unknown, and it is hypothesized that the occurrence can be assessed as anatomical norm variations.

Morphological and Pathological Findings in the Middle and Inner Ears of Harbour Porpoises (Phocoena phocoena)

Hearing represents the major sense in harbour porpoises (Phocoena phocoena) and impairment of hearing has a great impact on the survival of these animals. In this communication, some anatomical and histological aspects of the tympanoperiotic complex of harbour porpoises are presented. In addition, the ears of 21 incidentally bycaught or stranded freshly dead harbour porpoises of different age groups and sex were investigated histologically. At the entrance to the middle ear cavity, mucosa-associated lymphoid tissue was present that was often hyperplastic in juvenile (9/10) and adult individuals (7/8). Solitary lymphoid follicles were additionally found in the corpus cavernosum and adjacent to the stapedius muscle in single porpoises. The nematode Stenurus minor represented the most common pathogen observed in the middle ear cavity of juvenile and adult harbour porpoises and the parasite was associated with chronic inflammation with metaplastic and hyperplastic epithelial changes. An unusual bone formation at the attachment of the corpus cavernosum to the perioticum was a common finding, even in young individuals. Whether this represents a normal structure or a metaplastic change remains undetermined. Acute haemorrhages in the cochlea and/or the tympanic cavity occurred in all animals and were most likely agonal changes. Single porpoises suffered from purulent otitis media, mycotic otitis media with osteolysis or chronically fractured tympanic bones, likely causing impairment of hearing that may have contributed to by-catch. There was no evidence that stranding in five porpoises was associated with the aural changes. Histological examination of the ears in harbour porpoises is a valuable part of the assessment of their health status. Damage to hearing structures may explain starvation due to impaired ability to catch prey or unusual behaviour such as stranding or entanglement in nets.

Modelos animais para avaliação auditiva: revisão de literatura

RESUMO O objetivo dessa revisão é delinear os modelos animais viáveis para a pesquisa pré-clínica auditiva, considerando suas características anatômicas, fisiológicas, vantagens e desvantagens. Foram consultadas as bases de dados Scielo, Pubmed e Periódicos Capes, utilizando descritores envolvendo audição, testes auditivos e espécies animais, individualmente e cruzados entre si. Foram lidos os resumos dos artigos encontrados nas bases de dados, com posterior seleção baseada nos critérios: artigos disponíveis em sua integridade, uso de modelos animais em procedimentos audiológicos que incluísse a descrição dos métodos de avaliação, as vantagens e/ou desvantagens do uso da espécie, publicados entre 1995 e 2016. Apesar da existência de modelos alternativos, os mamíferos são ainda amplamente utilizados em pesquisa. Constatou-se que os ratos, camundongos e cobaios são frequentemente utilizados e, além destes, ovelhas, coelhos e chinchilas. Os métodos para avaliação auditiva contemplam principalmente emissões otoacústicas por produto de distorção, potencial evocado auditivo de tronco encefálico e avaliação histológica, principalmente em roedores. A escolha do animal de experimentação para avaliação do sistema auditivo depende de fatores anatômicos, fisiológicos, econômicos, espaciais, psicossociais e do objetivo da avaliação.

Primary angiocentric/angioinvasive T-cell lymphoma of the tympanic bulla in a feline leukaemia virus-positive cat

Case summary A 5-year-old neutered female feline leukaemia virus (FeLV)-positive domestic shorthair cat with a 5 month history of otitis media was referred for head tilt, stertor and dyspnoea. Computed tomography scan revealed soft tissue opacities inside the right tympanic bulla, with bone remodelling, and concurrent nasopharyngeal and intracranial invasion. Endoscopically guided bioptic samples were collected from the nasopharynx and middle ear. Histology revealed dense sheets of round, large, neoplastic cells, often surrounding or invading vascular walls. Neoplastic cells expressed CD3, FeLV p27 and gp70 antigens. A middle ear angiocentric/angioinvasive T-cell lymphoma was diagnosed. After improvement of clinical conditions following radiation therapy, the cat died unexpectedly. At necropsy, hepatic and splenic spread was detected.

Relevance and novel information Primary middle ear tumours are rare and their diagnosis is often delayed as clinical signs mimic more common otological conditions. Multiple bioptic specimens are pivotal for a definitive diagnosis. The young age of the cat, serology and immunohistochemistry revealed a possible transforming role of FeLV.