We don't see a whole lot of ear issues in cats, nothing compared to dogs, but they can still be quite miserable for the cats when they are present.
Some issues that we see that can affect the ears; ear mites, bacterial infection, yeast infection, polyps, aural hematomas, increased ear wax production, allergies, and tumors.
Ear mites. These are common in kittens and stray cats. These are annoying little bugs that are too small to see with the naked eye, that love to live off the ear wax in your cat's ear. They don't live more than a few seconds outside of the body, and are generally spread by cats sleeping close together or grooming each other. The good news is that they are extremely treatable with a variety of products. The product we use at All Feline will get rid of ear mites with one treatment in 99% of cases. They tend to produce a waste that looks a lot like used coffee grounds. If your cat has anything like that coming out of their ears, and they are very itchy, bring them into the clinic and we will check them for ear mites.
Bacterial infections. These are not very common in cats, but they can be very painful, and in the case of middle or inner ear infections, can even cause a cat to lose their sense of balance and end up with a head tilt or falling over. For outer ear infections, we can often treat this with a topical antibiotic. For middle or inner ear infections, we need a systemic antibiotic. The good news is the infection very rarely comes back. If it keeps coming back, we need to look for a cause such as a polyp or a severe yeast infection.
Yeast infections. There is normally a small amount of yeast present in all ears. In rare cases, this yeast can grow out of control and cause a very itchy uncomfortable ear. The only way to diagnose a yeast infection for sure is to swab the ear, stain it, and look at in under a high powered microscope. Mild to moderate yeast infections can be treated with a topical antifungal. More severe yeast infections may require an oral systemic antifungal.
Polyps. These are very under diagnosed, and we will commonly see a young cat for a 2nd or 3rd opinion who is having chronic ear infections. We will look into the ear with an otoscope, and if we can't see the eardrum because there is something red and shiny in the way, that is probably a polyp. Polyps are benign growths of tissue that are more of a nuisance than anything else, that start developing at birth. Polyps can be removed under anesthesia, and while there are some potential complications from removing polyps, the benefits far outweigh the risks, and the cats will be much happier once the polyp is removed.
Aural hematomas. These happen when your cat keeps itching at their ear so much that they rupture blood vessels inside of the ear, most commonly with ear mites. The ear swells up like a little balloon, and if not treated surgically, will scar down to a little lump of an ear. Draining the ear does not fix the problem, it just fills right back up, unless you can drain it daily for several weeks, and even then you risk the ear scarring down. This can be surgically fixed to the point that the ear retains its shape.
Increased ear wax production. Some cats just make more ear wax than others. Allergies seem to play a part in this, but many times, it may just be genetics. Unless your cat is prone to ear infections, this is not a problem, and you should not need to do any at home care unless directed by your veterinarian.
Allergies. One of the most common places that cats will itch from allergies is their head and neck area, and this includes their ears. We will commonly see hair loss on the ears as a result of an itchy cat from allergies. The way to fix this is to treat the allergies.
Tumors. While these are more common in older cats, we can see tumors in and around the ear in cats of any age. Some of these are benign tumors, some of these are aggressive malignant tumors, which is why we always feel around the ears during a physical exam. Probably the most common benign tumors that we will see are ceruminous gland adenomas which look like little blue blisters in the ear canal. These tend to show up most commonly in cats with chronic ear issues. While these are generally benign, they can proliferate to the point of blocking the ear canal. These can be surgically debrided down with a CO2 laser, but they will return after a few years, or the entire ear canal can be removed in what is called a TECA, or total ear canal ablation. That is a major surgery, and is usually reserved for last resort cases.