Sunday, December 11, 2011

770. A cat with stinky right ear

"The right ear is very smelly. Have you considered ear irrigation?" I asked the lady whose cat scratched her whenever she tried to put ear drops into the right ear. "The vets gave me the ear drops and asked me to do it," she said. "But I can't do it."
So she consulted me as the problem had become worse.

As vets, we often prescribe ear drops and ask the cat owner to do it herself and often they manage. Owners who consult us again when they can't do it should be advised about ear irrigation. Otherwise the owner just go to another vet for a solution to her cat's ear problem.

"If ear irrigation fails to resolve the problem, there is the ear canal opening surgery," I said. "We will try ear irrigation first and see if it works."

The 4-kg cat was given xylazine 0.1 and ketamine 0.4 ml IM in one injection. The day before, I gave him 50% of the above formula and it didn't work. Sedation was given as low as possible as this cat was not in good health due to the chronic ear infection and it is always good to be careful.

"In ear irrigation, there must be a correct way of irrigation. Otherwise, nothing would be flushed out of the ear canal," I said to my assistant Min. I demonstrated to him my technique. He could see the big brown mass appeared out of the ear canal. I took a picture in case the cat owner was interested as Min did not keep the "evidence".

When the owner took the cat home, I said: "The cat had a lot of dead cells and wax flushed out of the ear canal. You will need to use this ear ointment to continue."

An ear ointment again? From a vet again? The lady shook her head. Why can't the vet understand that her cat would scratch her. Didn't the vet listen sufficiently?

"The ear ointment is to be applied 2 weeks later," I soothed her anxieties of being scratched. "The drugs and injection would bring down the pain, swelling and infection and you should have no problem applying the ear ointment to clear any leftover infection."

She left and I had not heard from her for over one week. If I don't see her again, I presume all are OK. Unless she went for a 4th opinion. I ought to phone her to follow up.


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