How to prevent and treat yeast ear infections in cats

Yeast is normal in a healthy cat’s ears in certain amounts. Yeast ear infections (yeast otitis) usually occur secondarily to an underlying health issue that alters the normal ear environment, allowing yeast to overgrow. Treating yeast ear infections usually involves antifungal ear medication in addition to addressing any primary underlying factors that encouraged the yeast overgrowth, including an underlying medical condition, or anatomical or environmental factors. If your feline friend is showing symptoms of a yeast infection, read on to learn:

• How cats get yeast otitis
• Diagnosing and treating yeast ear infections in cats
• Preventing yeast otitis in cats

Signs of a yeast ear infection (otitis) include waxy debris in the ear canal, itchy ears, a strong odor from the ears, and red, inflamed, or crusty ears. Other ear issues, such as ear mite infestations and bacterial infections, have similar clinical signs. Identifying high numbers of yeast organisms in a sample of debris from the ear is necessary to make a definitive diagnosis and to establish appropriate treatment.

Yeast otitis is an ear infection caused by the overgrowth of yeast, usually Malassezia spp., a single-celled fungus. Small amounts of yeast are common in a healthy cat’s ears. Infections typically occur only when an underlying issue (a primary cause) disrupts the environment within the ear, allowing yeast to overgrow. Other names for cat yeast ear infections include:

• Yeast otitis
• Fungal otitis
• Malassezia otitis

Yeast ear infections are usually opportunistic and almost always develop secondarily to other health issues or environmental factors affecting the ear. These are the primary causes or predisposing factors for the ear infection. Factors in the ear environment that can allow yeast to overpopulate include:

• Changes to the shape or structure of the ear (injuries, scars, growths, genetics)
• Moisture buildup in the ear from bathing or due to abnormal ear structure
• Changes to the health of the skin lining the ear canal, such as inflammation from allergies

While it’s uncommon for yeast to be associated with ear inflammation in cats, especially when compared to dogs, examples of primary causes of yeast otitis in cats include:

• Food or environmental allergies
• Ear mites
• Foreign bodies or other debris
• Ear polyps, tumors, or growths
• Anatomical abnormalities

Clinical signs of yeast ear infections in cats

Yeast otitis symptoms in cats include:

• Itchy ears
• Thick, dark ear discharge
• Unpleasant odor from the ears
• Red, inflamed, or crusty ears
• Head shaking
• Signs of discomfort or pain when the ears are touched
• Holding the head on an angle and flattening the affected ear

Feline ear infections can affect one or both ears. Yeast infections are often very itchy, which can lead to open sores and hair loss on the face and ears from scratching.

Affected cats may have additional clinical signs depending on the underlying issue causing the infection. Additional complications, such as an aural hematoma, can occur due to excessive scratching and head shaking. It’s important to get an accurate diagnosis from a veterinarian before attempting treatment. Many ear conditions can have similar symptoms but require different treatment methods.

When a cat presents with itchy, inflamed ears, a vet usually starts by performing a physical examination, including an ear exam with an otoscope. After examining the ears, additional diagnostic tests may be recommended, such as:

• Examining a sample of ear debris under a microscope (cytology)
• Blood tests
• Urinalysis
• Diagnostic imaging, such as X-rays
• Biopsy

Disease-causing bacteria or mites are more commonly found in ear cytology. A yeast infection is diagnosed only when an overgrowth of yeast is observed under a microscope. Other diagnostic tests are used to help identify the underlying disease or environmental factor(s) that led to the yeast overgrowth.

Once yeast otitis is diagnosed, treatment options include:

• Topical antifungal ear drops or ointment
• Oral antifungal medication
• Anti-inflammatories
• Thorough ear cleaning
• Pain medication

Effective treatment of yeast otitis also involves managing the contributing issue that led to the infection. Infections often recur if the underlying problem isn’t treated. Chronic conditions, such as allergies, may require lifelong treatment. Severe ear infections and certain conditions that lead to recurring ear infections may require surgery.

Identifying the best long-term treatment and prevention plan can be challenging. Trial and error is to be expected with so many possible interrelated factors. Since the signs of yeast otitis overlap with some primary causes, such as ear mites, allergic skin disease, foreign bodies in the ear, or ear polyps, it’s essential to determine the exact cause of symptoms in order to decide on the most effective course of treatment.

Can I treat my cat’s ear infection at home?

Ear infections in cats are unlikely to require hospitalization and are usually treated on an outpatient basis with antifungal ear drops or ointment. Treatment for ear infections can take weeks to fully resolve the infection. A thorough ear cleaning may be recommended prior to beginning treatment or at repeated intervals throughout treatment. Some cats don’t tolerate ear cleaning very well, especially if their ears are painful. In these cases, a vet may recommend a deep ear cleaning under sedation.

It’s strongly advised only to give medications that are prescribed or recommended by a veterinarian. Over-the-counter options may not work due to the ingredients being ineffective or because they're intended to treat a different health concern. Ineffective or inappropriate treatment can allow the infection to get worse and may even be harmful. You should never give a cat human pain medication unless directed to do so by a veterinarian because many common drugs that are safe for people are highly toxic to cats.

"Cleaning your cat’s ears may seem harmless, but even substances as mild as tap water or sterile saline can cause permanent hearing loss if the eardrum is damaged. Ear cleaners and topical medications may pose an even greater risk,” explains Dr. Jo Myers, a veterinarian on the Vetster platform. “To avoid complications, never put anything in your cat’s ears unless specifically directed by a veterinarian."

It’s important to follow your veterinarian’s instructions closely on how to clean and treat your cat’s ears as they recover. If you need help cleaning your cat’s ears, giving ear drops, or administering oral medication, a virtual vet appointment can help guide you through the process at home.

Managing contributing health, structural, and environmental factors that increase the risk of yeast infections is the best way to prevent them. In addition, keeping the ears clean and dry may help prevent infection.

Cleaning normal, healthy ears usually isn’t necessary. If your cat’s ears seem to get dirty frequently or have a lot of waxy buildup, this means it’s time to talk to a veterinarian. Healthy cat ears tend to stay clean on their own, and improper ear cleaning can do more harm than good, so cleaning your cat’s ears should be done only when directed by a vet.

External parasites and allergies are two of the most common causes of yeast ear infections, so you can also help prevent infections by keeping your cat on year-round parasite prevention and reducing their exposure to allergens. If your cat is showing signs of an ear infection or you would like advice on how to prevent recurring infections, online vets are available through Vetster’s platform on your schedule.

How do you treat a yeast infection in a cat’s ear?

Yeast ear infection treatment varies depending on the underlying cause and contributing factors, but it usually involves antifungal ear drops or ointments, ear cleaning, and long-term management to prevent yeast overgrowth. Symptomatic care, such as pain medication and anti-inflammatories, may also be recommended.

Why does my cat keep getting yeast ear infections?

The yeast in cats’ ears are opportunists, meaning they normally live there without causing problems. But if conditions are right, they overgrow and cause an infection. Long-term management of health conditions or environmental factors that contribute to yeast overgrowth is critical for preventing recurring yeast otitis. Long-lasting or recurring ear infections can also occur due to not using the right medication or stopping treatment before the infection is completely gone. It’s essential to get an accurate diagnosis for your cat’s ear symptoms and to closely follow your vet’s instructions during treatment, including using proper dosages and finishing the course of treatment, even if your cat seems to get better. Most importantly, working with a veterinarian to address the underlying factors contributing to yeast overgrowth can prevent recurring infections.

How can I tell if my cat has ear mites or a yeast infection?

Cat ear mites and yeast infection symptoms are similar. Both cause itchy ears and visible debris in the ear canal and may lead to scratching, head shaking, and painful ears. Ear discharge can look a little different with ear mites and yeast infections. It’s also possible for a cat to have both ear mites and an infection. Diagnosis depends on seeing large numbers of yeast and/or mites under a microscope, so visiting a vet for diagnosis is the only way to know for sure what’s causing your cat’s symptoms.

Disclaimer: This article, its content, and its related references do not constitute veterinary advice and should not be considered a substitute for veterinary care. If your pet is showing any symptoms that could indicate a medical emergency, please seek immediate emergency care.