Intracranial abscess and otitis interna treated by temporal burr-hole craniotomy and ventral bulla osteotomy in a Maine coon cat.

A 1-year-old Maine coon cat was presented with acute onset of central vestibular syndrome and recurrent generalized tonic-clonic seizures. Computed tomographic imaging of the head revealed a left-sided intracranial lesion consistent with an abscess, associated with bilateral otitis media/interna, with more severe involvement of the left tympanic bulla. Based on clinical and imaging findings, the cat underwent surgical intervention consisting of a left temporal burr-hole craniotomy for abscess drainage combined with a unilateral ventral bulla osteotomy. Purulent material was collected during surgery and submitted for bacterial culture, which yielded Staphylococcus aureus sensitive to amoxicillin-clavulanic acid and metronidazole. Postoperative management included intravenous antimicrobial therapy followed by oral treatment after discharge. Transient vestibular dysfunction and Horner's syndrome were observed after surgery and resolved completely within 3 mo. At a long-term follow-up, the cat was neurologically normal. This case highlights the successful surgical management of an otogenic intracranial abscess in a cat and supports unilateral surgical treatment guided by clinical and imaging findings. Key clinical message: Intracranial abscesses secondary to otogenic infection should be considered in cats that have central vestibular clinical signs and seizures. A combined surgical approach using burr-hole craniotomy and ventral bulla osteotomy, guided by imaging findings, can result in favorable clinical outcomes.