Ear or aural hematomas are fluid-filled pockets on the inside of the earflap.
There are tiny blood vessels in the pinna or the floppy part of your pet's ears.
When something causes these little vessels to rupture, they bleed under the skin and form a fluid-filled pocket.
Ear hematomas are most commonly seen in floppy-eared dogs, but they can occur in any breed of dog--whether their ears are floppy or not--and even occur in cats.
How Ear Hematomas Develop
Most dogs develop ear hematomas from shaking their heads or chronically scratching at their ears.
The ear could be bothering them from an allergic response that is causing intense itching in the ears, or it could be an ear infection or parasites.
Once bleeding under the skin begins, it creates irritation, which will make your dog shake his head even more. If the problem isn't addressed and blood and other fluids continue to accumulate in the skin, the hematoma can become quite large, even to the point of blocking off the opening of the ear canal.
It's not uncommon for ear hematomas to rupture while the dog is shaking his head.
Diagnosing and Treating Ear Hematomas
Usually a problem with your pet's ear is quite visible and your veterinarian can confirm the presence of a hematoma
If there is swelling, the ear is warm, and there's a squishy feel to it, the hematoma is probably small. A hot, very firm feel can indicate the presence of a very large hematoma where the whole pinna is affected.
Treatment of an ear hematoma involves not only resolving the swelling, but also determining what caused the problem in the first place.
There are a few different procedures that your vet might use to get rid of the hematoma. One is called aspiration. This is where a syringe is inserted to draw out all of the fluid from the hematoma.
Aspiration is a relatively inexpensive and an easy process to do, but it has a lot of drawbacks. The main one is the space left by the aspirated fluid will simply fill back up.
Most vets, including me, resolve the majority of ear hematomas with surgery. Clients almost always want me to try something more minimalistic before surgery. I try to expiain that it probably will fill back up and there is a great chance the ear will be disfigured.
There are a lot of surgical techniques veterinarians use to resolve ear hematomas.
All of them involve draining the hematoma, then placing multiple sutures in the deflated earflap to intentionally create an adhesion between the ear skin and the ear cartilage.
Think of it like a quilt. The earflap is in a sense quilted or closed with sutures so blood or fluid can't get back into that particular area. In some cases, bandages are applied, but not always.
Sutures are left in place for about three weeks to create a deliberate scarring in the area, which will prevent the earflap from filling back up with blood or fluid.
All surgical options unfortunately result in some degree of pinna scarring. Scarring becomes unavoidable if the hematoma has existed for many days or weeks prior to surgery, because the underlying cartilage has been damaged. And surgery will not fix underlying cartilage damage.
The more scarring that occurs, the more crinkled the earflap will be. If the dog's ear hematoma is never addressed -- in addition to being very uncomfortable for many weeks or months -- the intense scarring is unavoidable. A lot of scarring will occur, sometimes causing the entire earflap to crinkle up and shrivel as the fluid is resorbed back into the body.
Root Causes of Ear Hematomas
It's important for your vet to investigate the underlying issue and treat the root cause of the hematoma to prevent recurrence.
If there's an injury to the earflap the wound will be treated. But most of the time, the underlying cause is an ear infection or an intense allergic response.
Your pet's ear will be examined with an otoscope and the discharge will be microscopically examined for the presence of bacteria, yeast, or mites.
If necessary, a culture will be performed to determine what infection is present, and most importantly, what medications will be needed to help resolve the infection.
If the problem is allergies, you'll need to figure out what your pet is allergic to if possible. This means eliminating the source of the problem, whether it's a dietary issue or an environmental allergic response. Allergy testing may be necessary to determine your pet's allergies. If you have a dog with long floppy ears, it's important to regularly inspect them and clean them as often as necessary to make sure they stay dry and clean. Your veterinarian can help you develop a preventative ear plan.
If you have questions regarding ear hematomas contact Dr. Underwood of Best Friends Vet Mobile Service and Trumann Animal Clinic at firstname.lastname@example.org.
Some of the content of this pet talk came from Dr. Karen Becker at Mercola.com