Veterinary Guide to Canine Cholesteatoma (Ear Cysts) 2025🐶🩺

By Dr. Duncan Houston BVSc

🔍 Introduction

Cholesteatoma (also called tympanokeratoma) is a rare but serious ear condition in dogs. It starts as a keratin-filled cyst in the middle ear and slowly expands, potentially eroding bone and spreading infection. I'm Dr. Duncan Houston, BVSc, here to guide you through 2025 insights on causes, symptoms, diagnosis, treatment, and prevention—offering clear, empathetic veterinary care for concerned pet owners. 🩺👂

💡 What Is Canine Cholesteatoma?

Non-cancerous but expansile cholesteatomas are made of keratinizing squamous epithelium. They form due to chronic ear infections, repeated surgery, or anatomical abnormalities, leading to accumulation of keratin debris and infection in the tympanic bulla.

Key Causes & Risk Factors

• Chronic/recurrent otitis externa or media (middle-ear infections)
• Eardrum damage or repeated ear surgeries
• Breed tendencies—dogs with narrow ear canals (spaniels, poodles)
• Possible congenital abnormalities in the ear structure

🚨 Signs & Clinical Symptoms

• Persistent or foul-smelling discharge, head shaking, scratching
• Discomfort when opening the mouth or touching the ear/bulla
• Neurologic signs in advanced cases: head tilt, balance issues, facial paralysis
• Dry, pearly keratin material is visible behind the eardrum

🔬 Diagnosis: How Vets Confirm This Condition

• Otic exam using an otoscope/endoscope to assess the canal and eardrum
• Imaging: CT or MRI to evaluate bulla expansion, bone erosion, and involvement of the inner ear or CNS
• Histopathology/cytology: Biopsy confirms keratin content and rules out neoplasia
• Cytology/culture: Identifies secondary bacterial infections

🛠 Treatment Options

Surgical Removal (Preferred & Often Curative)

• Total Ear Canal Ablation + Lateral Bulla Osteotomy (TECA-LBO): Gold standard. Removes infected canal and bulla; about 50% curative
• Bulla osteotomy alone: Considered if the canal is intact but the cyst is confined

Adjunctive Medical Management

• Antibiotics (systemic/topical) to address secondary infection
• Corticosteroids to reduce inflammation, when appropriate
• Repeat ear cleaning and culture monitoring to prevent recurrence

Palliative Care for Advanced Cases

If surgery is not viable due to severe bone erosion or poor health, palliative care—pain control, antibiotics, periodic cleaning—is essential. Unfortunately prognosis is guarded, and euthanasia may be considered for suffering pets.

📈 Prognosis & Long-Term Outlook

• Early surgical removal offers the best chance at cure; recurrence rates vary (~50%)
• Neurologic involvement (facial paralysis, balance) worsens outcome, but can improve post-surgery in some cases
• CNS involvement (meningitis or inner ear infection) is serious and may be life-threatening

📅 Recovery & Follow-Up

• Recheck exams and imaging every 3–6 months to monitor healing or recurrence
• Owners should watch for recurring discharge, head tilt, or behavioral changes
• Maintain diligent ear hygiene and treat infections early

🛡️ Prevention & Owner Advice

• Treat ear infections promptly and fully—don’t stop meds early
• Avoid inserting cotton swabs; use gentle cleaning with vet guidance
• Schedule regular veterinary ear checks, especially for at-risk breeds
• Monitor for subtle signs of neurologic change, like circling or droopy face

🔧 Recommended Tools & Services

• Ask A Vet App: Get 24/7 expert guidance for early detection and emergency direction 📱

✅ Final Thoughts

Canine cholesteatoma demands early recognition and aggressive surgical management to prevent bone erosion, neurologic injury, or CNS infection. With vigilant follow-up and support from services like AskAVet.com, many dogs can recover with a good quality of life. If surgery isn't an option, palliative care prioritizes comfort.

Download the Ask A Vet app today for immediate veterinary advice and stay ahead of ear health issues in 2025 and beyond! 🐾❤️