A hematoma is a localized swelling from blood leaking into a confined area or organ, in this case, the ear flap. The hematoma occurs when a blood vessel in the ear bursts and leads to blood stretching and filling the space between the skin and cartilage. Excessive head shaking (from an ear infection or allergies), scratching, or bite wounds can all cause an ear hematoma. Dogs with long floppy ears are more prone to this problem, but it can occur in any dog, and we’ve even seen it happen in a cat.
How is an aural hematoma treated?
It’s best to have the hematoma treated as soon as possible to minimize discomfort to your pet and to prevent permanent disfiguration of the ear. The best way to treat this is surgery. During the procedure, we will drain the blood through several small holes. The empty space left where the blood clot was (called dead space) is removed by placing multiple stitches through the skin and cartilage. This also promotes controlled scar tissue, which decreases the chances of having another hematoma in the same ear. In addition to treating the hematoma, we will be looking for the cause by flushing and scoping the ear canal.
What happens when I bring my pet back home?
You will need to keep the Elizabethan collar (aka cone of shame) on to prevent any more scratching while the ear heals. We will discuss the underlying cause and talk about how to treat and prevent that problem as well.
Can we just drain it?
The short answer is no. Draining the ear will help temporarily, but in the vast majority of cases, the hematoma will return in a day or two. The stitches we place help close the dead space and prevent the ear from filing up again, but simply draining it does not. If you and your vet choose to go this route, expect to be draining the ear every other day or so for at least a few visits.
Will it just go away on its own?
If an aural hematoma was left alone, it would eventually be broken down and reabsorbed by the body. During this long process though, your pet will be in discomfort. Furthermore, as the untreated ear heals, the space where the blood clot was will scar down, usually causing the ear flap to crinkle and fold (which makes them more likely to have future infections). As the underlying cause has not been diagnosed or treated, your pet is just as likely (if not more so) to have another bout with hematomas again. For these reasons, we recommend surgery as the treatment of choice.
If your baby has been diagnosed with an aural hematoma, or you think they might have one, please contact us right away to book an exam and time for the repair.