Looking for some advice about Chronic Middle Ear Infection

I have two senior cats around 14 (Smokey) and 15 (Miss Kitty) Back in August we noticed they were shaking their heads and keeping their ears down. We took them to the vet and were confirmed to have ear infections and prescribed meds for a week. The vet didn't even tell us they had to come back for a recheck, she didn't even come back into the room to tell us about their condition. Miss Kitty's infection went away but Smokey, who has renal failure, had this light reddish brown ear gunk a few days after the7 day treatment so we took her back. We requested a different vet to look at her this time but she wouldn't let him check her ears. So he told us to put the same ear meds in for another week then come back 3 days after. She still wouldn't let him look in her ears so she had to be sedated. He cleaned what he could but said he couldn't get all the inflammation out and that both of her eardrums are ruptured, and he can't see the cause. It also seemed by the things he said that we should just euthanize her.  She's had 2  shots of convenia and the Bnt salve in her ears.  Before the cleaning she had a head tilt and couldnt walk, after she seemed to be getting better walking normal no more head tilt or shaking. A week after her cleaning and Bnt  the gunk came back out of  her ears. We called the vet and told him our problem and he was going to see her again, then all of a sudden he calls back cancels the appointment and wants us to go see a surgeon for a bulla osteotomy saying that him taking care of her again is a waste of our money. So Im wondering if anybody had a cat this old with this problem and what I can do since Ive read that its a harsh surgery. Shes got a slight head tilt again, the ear gunk and cant walk straight.

I had a cat with chronic ear infections.  First of all, I'd get to a different vet (not the surgeon) for a second opinion.  Secondly, ask them to culture some of the gunk they remove because it could very well be a yeast infection and those can require more than one application of the BNT ear goop.  Also, it could be triggered by allergies.  If the weather is changing where you are, you might want to look into a daily antihistamine. 

If your kitty has chronic renal failure, then you really have to be careful with surgery since the kidneys flush out the toxins and the meds from the body.  I'd try a culture to see if it's a yeast infection and then treat it.  Also, NO MORE CONVENIA!  That's really hard on their system and isn't even approved for this type of infection.

I really wish I had checked back earlier to my thread. I asked my vet to do the culture and he said no that will only tell if its a bacteria or a yeast and refused to do it. I knew that we needed to do it so i cant figure out why he refused. So we took her to the Surgeon consultation today and they gave her a convenia shot and pain patch cause we don't have the 5,000 to 6,500 they want for the surgery. I also found that my vet was charging me 75 for the convenia shot and the surgeon only charged me 33. Why do they keep recommending this shot? I realized that at the time she got the infection she got bit by fleas from the neighbors backyard dog and She is allergic to them. The surgeon also said because one of her eyes is no longer blinking she most likely has cancer(saw that coming). Ive been searching for a decent vet in my area but I'm having such a hard time because there are so many in the area. I'm definitely going to try another vet and pray to god they will help us. Your advice was very helpful thank you.

You need to do some research on Convenia.  It's really only designed to be given ONCE in a cat's life and it's specifically for skin irritation.  It does have its place in treating our pets, but in this case, I would've objected.  It's got a black box warning here in the US and is often given because it's convenient, hence the name, but not used in the correct situations.  I don't want to scare you, but to warn you.  Keep a very close eye on your kitty and if you notice any of the side effects, get her to the vet or the ER vet immediately. 

Now then, back to your ear issue.  If your vet refuses to do a procedure you've requested, I'd encourage you to seek another vet's opinion.  Most vets that I've seen try to do the least invasive procedures prior to recommending surgery.  How did the vet determine that she needed this surgery? 

He said it was because he cant get out all of the inflammation and he thought its wasting our money because doing another ear cleaning won't help her. He said he hoped it would scar over whatever that means. I have looked at the side effects of convenia so far my cat doesn't have any of them but I'm going to be more vigilant. I was so upset by the time we were done with the consultation I didn't even realize I was letting them giver her that shot again. They made us wait for 2 hours in the office while my cat was starving(she had to fast from 12 am). I couldn't edit my post but its supposed to be 2000 to 6000. They gave us the option to do a ct scan and just have it cleaned and then call us if she needs surgery. That is the option I was going to go with but didn't have half of it for down payment. I'm going to call around to different vets and a dermatologist to a get second opinion or help. Because he didn't even do the culture how the heck is he supposed to know if he can't help her!

Do you give your kitty a daily antihistamine? My girl's ears would get inflammed, the wax wouldn't slough off as it should because her ear canal would get inflammed.  The wax would build into a little ball and then get lodged in there and become infected.  She had her ears cleaned out annually under anesthesia so they could really get down in there and she wouldn't be in pain.  Then, they'd put the BNT ear goop in and it would be cleared up in about 2 weeks.  We gave her a small dose of antihistamine which helped her ears and her eyes, which she would rub.