Aural or ear hematomas are pockets filled with fluid that are located on the inside part of the earflap. The floppy part of your dog’s ears, or the pinna, contains tiny blood vessels. When something causes those tiny vessels to rupture, that results in them bleeding underneath the skin to form pockets full of fluid. It is more common for floppy-eared dogs to suffer from ear hematomas, however, they can develop in any dog breed – whether or not they have floppy ears – and can occur in cats as well, AKA cat ear hematoma.
1. The Development of Ear Hematomas
Ear hematomas are commonly developed from dogs scratching their ears chronically or shaking their heads. Dogs tend to shake their heads quite often. They shake after taking a bath. They sometimes try shaking themselves dry. Their ear might be bothering them sometimes, which may be an allergic response that causes intense itching inside their ears. It may be an ear infection as well. Just shaking the head may cause the small blood vessels to end up bursting, and so can smacking their ear against something as they are shaking.
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Bleeding can also be caused by trauma to an ear. Other things that can cause ear hematomas include parasites inside the ear, a foreign body in the ear, inflammation or infection of the ear, or the earflap being injured (normally as the result of a dogfight). Once bleeding underneath the skin starts, it creates irritation, and that can result in your dog shaking his head more.
If this problem is not addressed right away and blood, as well as other fluids, keep accumulating inside the skin, a hematoma can grow to be very large, to the point where it blocks off the ear canal opening. Ear hematomas can often rupture as a dog his shaking his head, which can result in blood being sprayed everywhere. Hopefully, pet owners will not allow ear hematomas to become such a serious problem.
2. The Diagnosis and Treatment of Ear Hematomas
When your pet has a problem with his ear it is normally very visible. Your veterinarian will be able to confirm whether or not there is a hematoma present. The hematoma is most likely small if it feels squishy, is warm, and there is any swelling. A very firm and hot feeling many indicate that there is a very large hematoma present that is affecting the entire pinna. To treat an ear hematoma, the swelling must be resolved, and it also needs to be determined what caused the issue to begin with.
There are a couple of different procedures that might be used by your vet to eliminate the hematoma. Aspiration is one of them. This involves inserting a syringe in order to draw all the fluid out of the hematoma. This process is fairly easy and inexpensive to perform, but there are many drawbacks to aspiration as well. Frequently the consequence is that the space left from the aspirated fluid just fills back up. Also, sometimes to drain out all of the fluid, multiple aspirations are necessary.
Also, there is a risk that the aspiration site will become infected. Finally, if the fluid inside of the ar hematoma has clotted and there is already scar tissue forming, there might not be a lot of fluid that can be drawn from the ear. Most ear hematomas are resolved by vets through surgery. However, some veterinarians are open to trying more minimalistic approaches before surgery is performed.
3. Surgical Techniques
Many different surgical methods are used by veterinarians to resolve the problem of ear hematomas. They all involve first draining the hematoma, and then multiple sutures are then placed inside the deflated earflap so that adhesion is created between the ear cartilage and ear skin. It is similar to a quilt where the earflap it closed or quilted with sutures so that fluid or blood cannot return to that specific area. Bandages are applied in certain cases, not always.
Sutures are kept on for around three weeks so that deliberate scarring is created in the area to prevent the earflap from becoming filled up with fluid or blood again. Unfortunately, all surgical options result in some form of pinna scarring. If prior to surgery the hematoma has been present for many weeks or day, scarring becomes unavoidable, due to damage to the underlying cartilage. The underlying cartilage damage cannot be fixed by surgery.
The more scarring that takes place, the more crinkled an earflap will become. If an ear hematoma is not addressed at all – along with it being very uncomfortable for the dog for many months or weeks – it will result in intense scarring. This can sometimes cause the whole earflap to shrivel and crinkles as the body reabsorb the fluid.
4. Root Causes of an Ear Hematoma
Usually, there is an underlying cause for head shaking and ear irritation. It is very important to have the underlying issue investigated by a veterinarian and treat the root cause of an ear hematoma so that it does reoccur. If there is obvious injury or trauma to the earflap, the wound should be treated. However, usually, the underlying cause is an intense allergic response or an ear infection.
An otoscope will be used to examine your pet’s ear and it will be cleaned out. Also, the discharge will be examined microscopically for the presence of mites, yeast, or bacteria. Anything that can potentially create an underlying irritation that causes your dog to shake or scratch will be examined. A culture will be conducted, if necessary, to determine if there is an infection present, and to determine what medications might be necessary to eliminate the infection.
If allergies are the problem, you will need to try to determine what your dog is allergic to. That involves eliminating the source of your pet’s problem, whether it is an environmental allergic response or dietary issue. If your dog has long floppy ears it is especially important to inspect and clean them on a regular basis and ensure they stay dry.
It is particularly important to thoroughly clean and dry them after baths and swimming to help avoid the development of an ear hematoma.