41% of Cats Show Silent Ear Disease on Dental CT—Small Size Is a Risk Factor

Prevalence of Ear Disease in Cats Undergoing Cone Beam Computed Tomography for Dental Procedures

Hannah F. Boothe, Mary Krakowski Volker, Jennifer Tjepkema, Adrien-Maxence Hespel

Background:
Feline ear disease is often subclinical and difficult to diagnose through physical examination due to cats’ anatomic conformation and subtle clinical signs. Cone beam computed tomography (CBCT) offers detailed imaging of the feline skull and includes incidental visualization of the ear canal during dental procedures. This study aimed to determine the prevalence of ear disease in cats undergoing CBCT for dental indications and assess associations with oral diseases, seasonal timing, and patient demographics.

Methods:
A prospective, cross-sectional study was conducted using CBCT scans from 303 client-owned cats undergoing dental procedures across two veterinary dentistry clinics. Cats under one year of age were excluded. Scans were reviewed for periodontal disease, tooth resorption, and incidental ear disease using defined radiographic criteria. Additional data on age, sex, weight, and season were recorded and analyzed using generalized linear mixed-effect models to identify risk factors.

Results:
Ear disease was diagnosed in 41.4% of cats (122/303) as an incidental finding, exceeding previous prevalence estimates for feline populations (2–19%). Most cases were bilateral. No statistically significant associations were found between ear disease and periodontal disease, tooth resorption, sex, or age. However, cats weighing ≤10 pounds had a significantly higher prevalence of ear disease compared to those >10 pounds (47.8% vs. 35.9%; p = 0.04). Periodontal disease and tooth resorption were common (78% and 56%, respectively), with older age significantly associated with rostral tooth resorption and caudal periodontal disease, but not with ear disease.

Limitations:
The study was limited to a dental referral population and did not include cytology, culture, or otoscopic confirmation of ear disease. Diagnostic review of CBCT was conducted by a single radiologist, and skull conformation or body condition score were not assessed. Client-reported signs of ear disease were inconsistently captured and unreliable due to variable form completion.

Conclusions:
CBCT imaging during dental procedures reveals a high prevalence of incidental ear disease in cats, especially in smaller individuals. Despite the lack of association with dental disease, these findings emphasize the value of CBCT in detecting subclinical pathology. Routine review of ear anatomy during dental CBCT and follow-up for affected cats is recommended, particularly for smaller or at-risk individuals.

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