Otitis media and interna with extension into the cranial cavity in a cat

Abstract

A 3-year-old castrated male domestic shorthair cat was referred to the Cornell University Hospital for Animals (CUHA) Emergency Service for evaluation after a 2-week history of a worsening head tilt, severe ataxia, lethargy, unilateral facial nerve paralysis, and a 2-day history of anorexia and adipsia. Neurologic deficits and obtundation localized the lesion to his brainstem. Magnetic resonance imaging (MRI) revealed a large contrast enhancing lesion extending from the right middle and inner ear into the caudal fossa causing deviation of the brainstem laterally. There was also evidence of mild cerebellar herniation and otitis media and interna bilaterally. The cat was started on broad spectrum antibiotics and underwent bilateral tympanic bulla osteotomies. He did well post-operatively and was discharged 8 days after admission with dramatic improvement. Multiple rechecks and a repeat MRI revealed continued improvement in the months postoperatively. The diagnostic workup, treatment, and prognosis of this cat’s brainstem lesion will be discussed.