Aural hematomas are a relatively common ear problem seen in pets, particularly dogs and occasionally cats. These hematomas occur when a blood vessel bursts then accumulates between the skin and cartilage of the ear flap (pinna), leading to swelling and discomfort. While they can be concerning for pet owners, understanding the causes, symptoms, and treatment options can help manage this condition effectively.
Causes of an aural hematoma?
Aural hematomas typically develop secondary to trauma or injury to the ear. Common causes include:
- Ear infections or allergies can cause pets to shake their heads vigorously or itch their ears constantly, resulting in trauma to the ear flap.
- Blood conditions such as blood clotting or bleeding disorders can be a cause even without any previous trauma done.
- Trauma such as bite wounds or a foreign object piercing the ear can cause hematoma.
Symptoms to be on the watch for include visible swelling of the ear flap, which can range from mild to severe depending on the amount of blood accumulation. The affected ear flap may also feel warm to the touch and be tender or painful for the pet. Increased head shaking, ear scratching, or rubbing the ear(s) along objects are signs they are trying to alleviate some itchiness or irritation. And in some cases, there may be discharge or signs of underlying ear infection contributing to the hematoma.
Because of the swelling and feel of a hematoma, it is not all too difficult to be diagnosed by a veterinarian. Diagnosis typically involves a thorough physical examination of the ear, including palpation to assess the extent of swelling and possible underlying causes such as ear infections. The veterinarian may also use a fine needle aspirate cytology to confirm that the fluid pocket contains blood. Performing an ear cytology to obtain a sample that can be seen under a microscope to identify any presence of yeast or bacteria that signifies there is an infection may be used. Up to date blood work will also be required.
The goal of treatment is to safely drain the pocket of fluid and assist in skin adhesion to the cartilage again for proper healing. This can be done both non surgically and surgically depending on the pet's circumstance. Non-surgical treatment will involve drainage of the hematoma, one small poke with a needle and syringe, to allow fluid to flow out of the ear. A steroid injection will follow to manage the swelling. A course of anti-inflammatory steroid medication will be prescribed for maintenance, as well as pain medication for comfort. This is the easiest and safest method since there is no use of general anesthesia, it follows with the risk of hematoma recurrence. Some pets treated with this method do see the problem recur within the month, especially within the week following treatment. Recheck appointments to allow for additional draining will be needed. Surgical management is done under general anesthesia, and the surgical veterinarian will brief the risks of anesthesia and adjust the narcotics used for the pet according to their health and history. One large incision or multiple small incisions are done to allow for continuous drainage. Sutures are then applied so the skin and cartilage can slowly heal back together. The ear will most likely be bandaged or a continuous use of an ear wrap will be recommended to use throughout the duration of the healing process. Multiple drainage holes for continuous drainage lowers the chance of recurrence after the initial development. The holes are often well-healed overtime and there is usually minimal scarring after the first few weeks. Warm compresses for the following few days and daily cleaning with a warm cloth helps promote proper healing and prevents infection.
To prevent future hematomas, your veterinarian will recommend a regimen of ear cleaning and products to keep your pet’s ear clean, dry, and healthy. Aural hematomas can be distressing for both pets and owners, but timely veterinary intervention and appropriate treatment can lead to a successful outcome. By working closely with Rock Creek's veterinarians and team, you can ensure your pet receives the necessary care to recover comfortably and minimize the risk of recurrence.
