Photo of cat ears

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While ear infections in cats are uncommon compared to dogs, detecting them early when they do strike is essential. This is because an ear infection that begins in the outer ear can easily spread to the middle and inner ear, causing additional health issues if left untreated. For this reason, it’s important to recognize the warning signs of a cat ear infection.

A cat’s ear is made up of three sections: the outer ear, middle ear, and inner ear. External ear infections are called otitis externa, middle ear infections are known as otitis media, and inner ear infections are regarded as otitis interna. Read on to learn more about the symptoms, causes, and treatments for the three anatomic locations where ear infections occur.

Cat Ear Infection Symptoms

There are three locations in the ear that can become infected in a cat: the outer ear canal (otitis externa), the middle ear (otitis media), and the inner ear (otitis interna). Symptoms can vary depending on the location of infection your cat has. Let’s take a look at the possible symptoms for external, middle, and inner ear infections below.

Otitis externa (external ear infection) symptoms

Otitis externa (external)

Otitis externa affects the outermost area of a cat’s ear; this includes the ear flap and ear canal. External ear infections are the most common locations of ear infections that cats get and can affect one or both ears. This kind of infection can develop suddenly and last a few weeks or become a chronic issue. Symptoms of otitis externa1 include:

  • Inflammation
  • Head shaking
  • Odor
  • Redness
  • Swelling
  • Ear scratching
  • Increased discharge
  • Scaly skin

It’s essential to stop an external ear infection at this stage since it may spread to the middle or inner ear if left untreated. Once it reaches the inner ear, it can damage the tissue and cause permanent hearing damage.

Otitis media (middle ear)

Otitis media occurs deeper into the ear canal, reaching all the way to the eardrum. Otitis media is often the result of an untreated external ear infection. However, this type of ear infection can be present in the middle ear without otitis externa. Symptoms of otitis media2 include:

  • Head shaking
  • Ear rubbing and scratching
  • Head tilting
  • Rotating head toward the affected side

You may also notice your cat’s face change in appearance since a few nerves pass through the middle ear and can be impacted by the infection. This includes facial nerve paralysis, constricted pupils, sunken eyeballs, protruding or raised third eyelids, or droopy eyelids.

If otitis media is left untreated, it can lead to the inner ear becoming inflamed, resulting in a lack of coordination, difficulty walking and standing, nausea, loss of appetite, abnormal eye movement (called nystagmus) and even deafness.

Signs of otitis media and otitis interna

Otitis interna (inner ear)

Otitis interna is one of the most severe types of ear infections. An inner ear infection can cause irreversible damage to the cochlea and vestibular system, which is responsible for keeping your cat balanced. Symptoms of otitis interna3 include:

  • Loss of balance
  • Difficulty moving
  • Shifting eyes side to side involuntarily
  • Drooling
  • Dry eye
  • Vomiting
  • Nausea

In the case of inner ear infections, many external and middle ear infection symptoms could also be present, including, head shaking, head tilting, redness, and foul-smelling discharge.

Remember, healthy cat ears should be light pink, be free of debris, have a minimal amount of wax, emitting no odors or discharge. Make sure to routinely check your cat’s ears to ensure that they’re clean, healthy, and aren’t demonstrating signs of infection.

Cat scratching ear

What Causes Ear Infections In Cats?

Ear infections can occur for a variety of reasons, including an underlying medical condition, weakened immune system, or ear deformity. We’ll explore a few of the most common culprits of ear infections in cats below so that you can help your feline friend feel better.

Otitis externa (external)

Earmites are small, spider-like insects and are a common cause of infected ears and will often be the first thing veterinarians check for when ear problems arise. These tiny parasites thrive in the ear canal, and their presence can cause extreme itchiness, which can lead to an infection if the cat is constantly scratching.

Mites can also be extremely difficult to spot without the proper equipment since you can’t see them with the naked eye. The only way to rule out mites is by visiting a veterinary professional. If you have multiple cats at home but only one is exhibiting ear infection symptoms, it’s still a good idea to get all cats checked for mites since these insects are transferred from animal to animal.

Other causes for otitis externa include4:

  • Bacteria
  • Yeast
  • Cat dermatitis: When a cat’s skin becomes inflamed due to fleas, food allergies, and environmental allergens. This inflammation can create the perfect breeding ground for bacteria and yeast to thrive, leading to itchy, red, and irritated skin.
  • Foreign objects

Otitis media (middle ear)

Middle ear issues can happen as a result of untreated external ear infections spreading deeper into the ear canal. Otitis media can also be due to a foreign object, such as a grass awn penetrating the eardrum; other causes include inflammatory ear polyps and cancer.

Inflammatory ear polyps, also known as nasopharyngeal polyps, are small abnormal growths that are typically benign and usually affect cats between three months and five years.5 These inflammatory growths can be present at birth or develop from bacterial infections in the ear. Despite not being cancerous, inflammatory ear polyps can still cause discomfort and pain.

Otitis interna (inner ear)

Inner ear infections typically originate from bacterial and fungal infections caused by inflammatory growths, ear mites, and foreign bodies in the ear. Otitis interna is also most common among cats with chronic ear infections that have damaged the eardrum. A damaged eardrum can allow infections to migrate or spread through the eardrum into the inner ear.

Keep in mind that some cats are more susceptible to ear infections than others due to age and breed. Certain medical conditions, such as allergies and diabetes, can also increase the likelihood of ear infections because they weaken the immune system, making it easier for bacterial and fungal infections to occur.

Preventing Feline Ear Infections

While there isn’t a foolproof way to prevent feline ear infections from forming, there are several steps you can take to keep them at bay. These include:

  • Routinely inspecting your cat’s ears to ensure there’s no wax build-up, discoloration, swelling, redness, foul odors, or discharge.
  • Keeping a clean environment that’s free of mites, dust, or other allergens that can irritate your cat’s skin and ears.
  • Learning how to properly clean your cat’s ears with the help of a veterinarian.

Vet administering ear drops to cat

Medicine And Treatments For Cat Ear Infection

An ear infection is a painful experience for your feline, so it’s best to seek treatment as soon as possible to help them recover. That said, the only way to treat an ear infection is with medication.

Once a vet has diagnosed your cat with an ear infection, the type of medicine they prescribe will depend on the cause of infection. Often, vets will prescribe anti-inflammatory medication to manage pain and topical ear medications, which contain a combination of antibiotics, antifungal drugs, and glucocorticoids (steroids that reduce inflammation).6 Oral and injectable medication may also be prescribed if inflammation is present or if the middle ear is infected. If your cat’s ear infection is caused by mites, your pet will be prescribed antiparasitic drugs.

Overall, treatment can last anywhere between one to six weeks. Make sure to administer any medication prescribed by your vet for as long as they recommend, even if your cat’s ears begin to look better or if symptoms resolve before completion. Not following your vet’s instructions can cause infections to return.

Surgery may also be necessary if your cat doesn’t show signs of improvement with prescription drugs and topical medication. Some things that require surgical treatment of the ear are infected or swollen tissue removal, removal of built-up fluid, tumors, and inflammatory ear polyps. Surgery may also be required if foreign bodies are stuck in the ear.

Cat Ear Infections: Frequently Asked Questions

How do you know if a cat has an ear infection?

While there are various tell-tale signs that can indicate your cat has an ear infection, the only way to confirm your suspicions is with a medical diagnosis. Once the cause of your cat’s ear infection is determined by a veterinarian, they can help ease your cat’s anxiety and physical symptoms with medication and prescription treatments.

What happens if a cat ear infection is left untreated?

If an ear infection is left untreated, it can continue to progress and worsen over time. Eventually, untreated ear infections can lead to permanent damage and hearing loss. This is why it’s essential to see a veterinarian right away.

Do cat ear infections go away on their own?

Unfortunately, ear infections will not go away on their own. The only way to get rid of them is with prescription medication, topical treatments, surgery, or all three.

How can I reduce the risk of my cat getting an ear infection?

You can reduce the risk of your cat developing an ear infection by regularly examining their ears for discharge, scabs, swelling, discoloration, hair loss, and temperature changes. Generally, ears should be pale pink, odorless, and free of discharge. You can also minimize the likelihood of ear infections by keeping their environment clean to prevent mites and the formation of dust or other allergens.

Final Notes

If your cat is showing signs of an ear infection, it’s vital to visit your vet right away. Delaying treatment can cause the infection to spread to other parts of their ear and lead to permanent hearing loss. If you’re struggling to make an appointment with your veterinarian, Dutch is available for remote appointments with vets.

With Dutch, you can send your cat’s ear infection pictures to a Dutch-affiliated vet and receive a response within a day. Our network of veterinary professionals are happy to help you determine the root of your cat’s ear infection and the best course of action. Complete our questionnaire to get started with Dutch and schedule your online visit.



  1. Moriello, Karen A. “Otitis Externa in Cats.” Merck Veterinary Manual, Merck Veterinary Manual, 26 Oct. 2021,

  2. Moriello, Karen  A. “Otitis Media and Interna in Cats.” Merck Veterinary Manual, Merck Veterinary Manual, 26 Oct. 2021,

  3. Moriello, Karen A. “Otitis Media and Interna in Cats.”
  4. Moriello, Karen A. “Otitis Externa in Cats.”
  5. Gotthelf, Louis  Norman. “Tumors of the Ear Canal in Cats.” Merck Veterinary Manual, Merck Veterinary Manual, 26 Oct. 2021,

  6. Moriello, Karen A. “Otitis Media and Interna in Cats.”

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