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A hematoma is swelling created by a broken blood vessel after bleeding has occurred inside a tissue. Hematomas within the earflaps (“aural hematomas”) occur when head shaking breaks a blood vessel within the earflap. The earflap may partially or completely swell with blood. The swelling may be so large that the opening of the ear canal is occluded. The extra weight of the earflap may be uncomfortable and may lead to a permanent change in the carriage of the ears. This condition is more common in dogs but can occur in cats as well. The earflap will feel fluctuant and fluid-filled, like a water balloon.
There are probably as many ways of correcting ear hematomas as there are veterinarians. The following are some commonly performed procedures:
ASPIRATION – This procedure involves simply using a syringe to remove the fluid contents from the hematoma. The problem is that a space is left behind when the fluid is removed and this space readily refills with more fluid leading to only temporary results. The benefits of the aspiration method are that it is inexpensive and relatively easy to perform but the disadvantages are that it may introduce infection and may require multiple attempts. If the clot in the hematoma is already well organized and on its way to scarring, there may not be much fluid left to aspirate and the technique may not work at all. Usually other methods are utilized.
PIE-CRUSTING SUTURES –
Here, an incision is made in the earflap surgically. The hematoma is drained of fluid and blood clots. To prevent the hematoma from refilling with fluid, multiple sutures are placed in the hematoma area either vertically or horizontally, either partly through or completely through the earflap, with or without ear cartilage removal. Sometimes bandages are applied post-operatively, sometimes not. Sutures are generally left in place for 3 weeks to allow good scarring to take place so that refilling will not occur. The earflap is essentially quilted to close any space where fluid might refill.
TEAT CANNULA PLACEMENT – A teat cannula is a small device used in the treatment of udder inflammation in cattle. It can be placed in the opening of the teat to allow drainage of milk or infected discharges. Teat cannulas can also be placed in a dog’s aural hematoma if the earflap is large enough to accommodate the device. The hematoma is drained of fluids and allowed to heal over the next several weeks. This method is generally successful but does involve the dog tolerating a “gadget” inserted in its earflap for several weeks.
Usually there is a reason why a dog has been shaking his/her head: an ear infection. This means that the ear infection must be treated along with the hematoma. The ear will need cleaning, microscopic examination of the discharge, and medication. Sometimes ear shaking just happens and there is no underlying infection but one should be prepared for the expense and trouble of treating an ear infection along with that of the hematoma.
For more information on ear infections click here.
If left alone, an ear hematoma will resolve by itself. The fluid will be re-absorbed back into the body and the earflap will no longer bulge. The problem is that a lot of scarring is associated with this process and the ear is often not cosmetically appealing afterwards (i.e. it becomes a “cauliflower” ear). Resolution of a large hematoma can take several months during which it may be uncomfortable for the pet. If the patient is a poor anesthetic risk it is certainly reasonable to forgo surgery.
Page last updated: 6/21/09
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