The 6 Best Vet Recommended Ear Drops for Cat Ear Infections

If your cat is shaking their head or constantly scratching at their ears, an ear infection is a possibility. Not only are these very irritating for cats, the constant scratching and shaking is also bothersome for us to constantly see happen at home.

In this article, you’ll learn a little about ear infections in cats, including how they happen and how they’re treated. We’ll then cover some common ear cleaners and medications that are used.

At a Glance: Our Top Picks for Best Ear Drops for Cat Ear Infection To Buy

Want a quick look at the products reviewed in this article? In the comparison table below, we’ve highlighted some of the most important features of each product. You’ll find more detailed information about each product later in the article.

What Causes Ear Infections in Cats?

When I tell a client that their pet has an ear infection for the first time, I can tell they’re trying to compare this information to what they know about ear infections. Ear infections are very common in human kids and it’s a common assumption that they must have the same causes.

But there’s a “yes” and a “no” to that. This is why the approaches to treating ear infections in pets are very different from how they’re treated in kids.

There are three parts to the ear: the outer, middle, and inner ears. You can have infections in each of these areas.

Are Pet Ear Infections Like Human Ear Infections?

In human kids, they commonly get what’s called otitis media, or a middle ear infection. This occurs when fluid gets trapped just behind the eardrum. Their eustachian tube, which helps to drain this part of the ear, is short and narrow, making it easier for fluid to get trapped. As we grow into adults, this changes, making us less prone.

As any parent knows, it’s common for kids to pick up head colds. Fluid, swelling, as well as viruses and bacteria involved can all lead to otitis media in kids.

In pets, we far more commonly see otitis externa, or infection of the outer ear canal on the other side of the eardrum. Bacteria and fungal yeast live in the ear canal normally and changes to the ear canal through inflammation and swelling can allow these organisms to overgrow and cause nasty, itchy debris buildup.

Ear infections occur much more often in dogs, responsible for 15% (sometimes more depending on the season) of veterinary visits for dogs. In cats, we see them less, at about 5%.

In dogs, we almost exclusively see ear infections secondary to atopic dermatitis, or allergy. This may be related to environmental allergies or food-related allergies. Allergy flare can lead to itchy, red ears and overgrowth of bacteria and yeast make all of that much worse.

Can an ear infection happen after a bath or swim in the lake? Sure, it does happen from water sitting down in the ear. This happens in human kids too (swimmer’s ear), but for all involved, it is a less common cause. While the cat I grew up with oddly loved baths, most cats famously hate water, making swimmer’s ear an unlikely cause in kitties.

Middle or inner ear infections can happen in dogs, but usually only if an outer ear infection gets so bad that the eardrum ruptures and the infection is allowed to get deeper.

How Are Cats Different?

Of course, cats have to do their own thing. In cats, we can see a mix of both an outer ear infection as well as something similar to what happens in human kids with a middle ear infection.

Cats have normal bacterial and fungal organisms that can overgrow secondary to allergy, just like in dogs. In cats that get recurrent fungal yeast growth, which may appear as a dark brown waxy type of debris, this is the most common reason for recurrence.

But cats can also get ear infections due to a viral or bacterial infection working its way up into the middle ear. In one study where just over 300 cats received CT (CAT) scans of their heads, about ⅓ of them had evidence of otitis media.

We can see upper respiratory infections more commonly in cats compared to dogs, especially due to viral infections like feline herpes virus. These can lead to sneezing and eye discharge. There is evidence that these infections can ascend into the middle ear.

What About Ear Mites?

Ear mites can be a common finding in kittens or in cats with compromised immune systems (such as cats with FIV). Ear mites are in a separate category, causing an infestation vs. an infection.

Dark brown debris in the ear is not specific for ear mites. Fungal growth often looks like this and is a more common cause, especially in adult cats. But cats with ear mites can also have fungal growth present too, secondary to the inflammation caused by the ear mites.

Ear mite debris needs to be cleaned out just like we’ll discuss shortly with ear infections, but treatment is different. For mites, an antiparasitic product that works against them (such as Revolution for Cats) is used instead.

Important Parts to Treating Ear Infections in Cats

When we treat ear infections in cats, there are two important parts. The first is an ear cleaning solution. An ear cleanser helps to remove debris buildup. We know that bacterial and fungal growth can “hide” within debris, making ear medications less effective if this debris is not flushed out.

The second part is using an ear medication. These are prescription products used to reduce ear canal swelling and inflammation and kill the overgrowth present.

When Do I Seek Veterinary Care?

If you see some debris in your cat’s ears and they’re a little itchy or scratchy, it’s reasonable to do some basic cleaning.

For further steps and information on how to clean your cat’s ears, see our article on 10 Simple Steps to Cleaning a Cat’s Ears.

But if signs persist beyond 2-3 days of cleaning, a veterinary exam is warranted.

Here are some other situations where you should have your veterinarian get a closer look at your cat and what’s going on with their ears:

• Your cat has a head tilt or balance issues when walking
• Signs of ear irritation worsen
• Eye changes are noticed (changes in pupil size, eyelid closure, eye discharge, etc.)
• An ear problem is coupled with any respiratory issues (snorting, wheezing, sneezing, etc.)
• Ear infections frequently recur or don’t appear to fully resolve

Your vet will take a look down the ear canal with an otoscope to view the eardrum, look for any unusual foreign material, swellings, or masses present. It’s very common to collect a sample of ear canal debris to check and see what kind of growth is present and to what degree.

In cats that do not allow a thorough exam or if the ear is especially painful, sedation may be needed to make sure nothing is missed.

A vet exam is the best way to determine if treatment for otitis media is warranted. In some cases, this may involve oral antibiotics or steroid medication.

5 Common Ear Cleaners for Cats

There are several characteristics of ear cleaners that makes them different from using something like tap water to clean ears:

• Formulated to evaporate in the ear canal and not contribute to moisture build-up
• Break up debris
• Reduce microbial growth attachment to the skin surface
• Has a neutral to low pH to prevent interference with other ear preparations
• May have ingredient(s) to reduce some types of growth

You should never use things at home like alcohol, hydrogen peroxide, or vinegar to clean the ears. These can cause irritation and swelling of the lining of the ear canal. This causes increased secretions, causing more debris buildup and microbial growth.

At a Glance: Our Top Picks for Best Ear Cleaners for Cats to Buy

Want a quick look at the products reviewed in this article? In the comparison table below, we’ve highlighted some of the most important features of each product. You’ll find more detailed information about each product later in the article.

It’s important to remember too, that something that may be okay and non-irritating in a normal ear may not be tolerated in an already inflamed or irritated ear.

Most ear cleaners are over-the-counter and do not require a prescription. Here are some options I frequently use in veterinary practice.

6 Common Ear Medications for Cats

Ear medications are prescription items used to kill overgrowth of bacteria and/or fungal yeast. With the exception of the two leave-in medications in our list, these are commonly used alongside regular use of cleaners to keep debris levels down while treating.

At a Glance: Our Top Picks for the Best Ear Medications for Cats To Buy

Want a quick look at the products reviewed in this article? In the comparison table below, we’ve highlighted some of the most important features of each product. You’ll find more detailed information about each product later in the article.

Most topical ear medications contain three types of ingredients, an antibiotic for bacteria, an antifungal for fungal organisms like yeast, and a steroid to reduce inflammation.

We’ll cover ear drop medications first, which are commonly prescribed. Leave-in medications are less ideal for use in cats, but in some cases, may be the only treatment option. We’ll discuss how they’re used and some precautions.

Note: I’m using the term drop medications to describe those used topically at home one or more times per day, where your cat is prescribed a certain number of drops per dose.

Leave-in Medications

These medications are applied at the veterinary hospital. Their long-acting properties allow them to be effective for several days to weeks. No leave-in medication is approved for use in cats and caution must be taken when using them.

However, given the difficulty many cat parents may have in trying to clean and medicate their cat’s ears even just once a day, a leave-in medication may be the only option in some cases to treat an ear infection.

Side Effects of Ear Medications

It’s extremely important to understand that side effects can occur with any ear medication. Adverse effect signs are very similar in most cases.

Side effects of ear medications may include:

• Hearing loss (temporary)
• Head tilt
• Nystagmus (abnormal eye movement)
• Horner’s syndrome
• Trouble with balance and walking (ataxia)
• Lethargy
• Reduced appetite
• Vomiting (usually from vertigo/balance problems)

Hearing loss I find to be uncommon, but I have had owners describe this on occasion. It is usually temporary and resolves on its own with discontinuation of the medication. The need to treat the infection should be weighed against the side effects to decide whether to continue use or not. This should be discussed with your vet if seen.

The other signs are related to ototoxicity. This means that the inner ear has been affected. The inner ear is part of our vestibular system, which controls our sense of where we are within a space and balance.

A common cause of these side effects can be that the eardrum is not intact. The eardrum is the barrier between the outer ear canal and the middle/inner ear.

Veterinarians do try to assess the eardrum integrity before prescribing ear medications. However, the need to insert the otoscope cone down into a cat’s itchy, irritating, or painful ear is a regular challenge. Sometimes, the eardrum cannot be adequately viewed due to swelling, debris, or a cat’s behavior.

While I find these side effects to be rare in general, I think it’s always important to discuss the potential risks with cat owners, especially if the eardrum cannot be adequately viewed.

Ear Medication Tips

Applying ear medications at home can be a challenge in cats. Here are some tips that may help at home.

• Use a small space. I have always found that when clipping nails, applying eye or ear medications, or anything that requires one of my cats to be held, using a small room, like a bathroom, is useful. Your cat may need a break (such as between cleaning and medicating) and if they can run upstairs under the bed, you may not get a chance to finish.
• Take breaks if needed. Using your small space, you can give your cat a break during your cleaning or medicating process. This might be taking a break between cleaning and medicating. Or it might be a break between each ear. During the break, give your cat some pets and some treats.
• Offer treats during the application. Using a treat paste like Churu or even a jar of baby food can provide some welcome distraction while cleaning or medicating the ears. You can apply it to a table surface or have a second family member offer it.
• Offer treats after application. Even if your cat won’t be distracted during cleaning, try to provide a calming atmosphere after the worst is done. Providing some treats and cuddles as a wind-down will leave that experience in their more recent memory. Salmon-flavored Greenies are my cats’ absolute favorite. Associating cleaning/medicating with food may hopefully reduce the chance that they run when they see the medication bottle come out.
• Towel Wrap. Even if your cat is docile, you might find their patience wears down with ear cleaning and medicating. Cats like to use their paws to push you away or bat away the medication bottle. A simple towel wrap can help safely control their body and expose only their head and ears.

See our article on using a towel wrap in cats for some extra tips.