Ventral Bulla Osteotomy (VBO): Surgery on the cats right ear to resolve a chronic suppurative discharge

By September 25, 2021 Interesting Cases

Our feline patient is Onslow Hobbes ( OH ), who is on a very effective diabetes mellitus treatment program. He is a domestic  shorthair born May 1st, 2009 who had an ongoing (4 months plus)  suppurative/exudative right ear until a ventral bulla osteotomy (VBO) was performed in combination with a myringotomy in March, 2021. All reasonable steps were taken prior to surgery in cooperation with the owner and our hospital team to establish an accurate diagnosis and alleviate the persistent discharge from the right ear. Extensive treatment included:  multiple antibiotics both systemic and topical directly into the ear, aerobic/anaerobic cultures, anti-inflammatories and skull radiographs. A diagnosis of otitis media was established early in the treatment. The chief problem was the the discharge from the ear was persistent, messy and discomforting for the patient. There was a very limited response to an extensive array of therapies/tests over 4 months. It was decided after all reasonable, extensive therapy was provided with minimal result, that surgery had to be the next step.

The common reasons for middle ear discharge in the feline include the following: polyp, neoplasm, foreign body and exudative sterile or bacterial inflammation. Note that any of these differentials listed would most likely be the reason for conservative treatment failure, the need for imaging and investigative surgery.

A ventral bulla osteotomy with a myringotomy was performed on March 4, 2021 on the right ear. The secretory tissue was debrided inside the bulla and the area opened to allow all exudative matter to escape.

Onslow Hobbs’ recovery was uneventful and the ear remains discharge free since surgery. In addition, there were none of the side effects that are commonly expected as a result of this type of procedure eg. Horner’s syndrome.

The owner continues to manage OH’s diabetes with insulin (Glargine 3 units 2 times per day), a strict diabetic diet (PVD DM Purina) and a home environment rich with encouragement and love.

Staffs’ recent conversation with this thankful owner in September, 2021 says Onslow Hobbes is doing amazing!

OH and home life.

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