Infections of the nose and ears happen in domestic cats with some frequency. However, sometimes an infection is more than it seems. Cats (especially young cats) who experience frequent, recurrent, or difficult to treat infections of the nose or ears may actually have an underlying disease known as a polyp.
A polyp is a benign growth of tissue on a long, think stalk. The type of polyp that occurs in the ears and nose of a cat is an inflammatory polyp- this means it is composed mainly of fibrous tissue and inflammatory cells. While we do not know the underlying cause of polyps in cats, there are several theories. They may be the remnants of a fetal structure that does not fully regress, or they may be induced by chronic inflammation, such as viral or bacterial infections. Regardless of the cause, inflammatory polyps grow and occupy space. They may traumatize surrounding tissue and promote deep, difficult to treat infections. Most polyps start close to the ear drum, and either extend out the ear canal or through the Eustachian tube and out the nose.
Depending on the location of the polyp, they may be referred to by several names:
- Ears: Otic, Aural, Otopharyngeal polyps
- Nose: Nasal, Nasopharyngeal polyps
- Middle ear polyps
Polyps are sometimes very easy to find and diagnose, and sometimes very difficult. If they become large enough, the ay be visible within the ear (rarely in the nose). Your vet may suspect a polyp is present based on clinical signs such as chronic discharge from a single nostril or ear that does not resolve with antibiotics. Other signs of polyps may include dizziness and a head tilt (for otic polyps) or sneezing (for nasal polyps).
If your vet suspects a polyp, they may recommend an exam under sedation or anesthesia. This will allow a deep ear canal exam, and for the mouth, nasal cavity, and area above the soft palate to be examined. An endoscope, dental mirror, or metal retractor may be used to examine parts of the nose and mouth. X-rays are sometimes used to determine if soft tissue is present in the skull, but they cannot reliably distinguish polyps, infection and cancer. If a polyp cannot be seen but is suspect, a CT scan may be used.
If a polyp is found, it is removed by traction. This means it is grasped with surgical instruments and gently pulled off its base. This is often successful in improving clinical signs very quickly, however recurrence rates are common (15-50%). Aural polyps recur more often than nasal. Treatment with antibiotics or steroid is often used after removal to reduce the risk of regrowth. In situations where traction is not an option, or where regrowth must be avoided, other surgical options are available. Ventral bulla osteotomy is a procedure where the bone of the skull is cut into to remove the polyp. This reduces the recurrence rate to <2%, but is more invasive, more expensive, and often requires a surgical specialist.
The prognosis for inflammatory polyps is good, with most cases resolving with therapy. It is very rare for an inflammatory polyp to result in death. Recurrence rates may be high, however, and traction may need to be repeated or a bulla osteotomy performed for long term control.
If you suspect your cat has a polyp or any other medical issue, or if you have any questions about you cat, please contact the veterinarians and team at The Cat Clinic any time.
Written by Dr Matthew Kornya, DVM
Thank you to Bix and his family for allowing us to use his pictures. Bix is a little cutie that one of our clients fell in love with and adopted. He initially had ear mites but even after treatment his ears still kept bothering him. We were finally able to see and remove his polyp. We are now hoping he will be one of the kitties that it doesn’t regrow.