What happens if an ear hematoma in dogs remains untreated?
While ear hematomas can be slowly reabsorbed by a dog’s body, they are particularly painful and require treatment to provide relief from this pain. Even if absorbed, inflammation from the hematoma may cause significant scar tissue, resulting in a distorted, cauliflower-shaped ear — damage that is often permanent.
Untreated ear hematomas can also cause additional problems for your dog. The swelling from a hematoma can block access to your dog’s ear canal — preventing you from treating any underlying ear infections that can occur. Hematomas are also known to reoccur and the swelling may fill up at any time if left untreated.
What does an aural hematoma look like?
With an ear hematoma, your dog’s ear flap will be swollen.
If the lesion is confined to just one part of the pinna, the swelling may be small. For larger hematomas, the whole ear flap will be engorged, and the weight of the collection of blood may cause the ear flap to droop and hang lower than usual.
An ear hematoma may feel squishy or taut to the touch. More than likely, your pup will object to you touching it, since the pressure can be painful.
Suspect your pet has an aural hematoma? Book a vet visit.
In almost all cases, some sort of trauma or injury is to blame — that’s what causes the blood vessels between the ear cartilage and skin to break and leak.
The most common type of ear flap trauma is from a dog repeatedly scratching their ear and shaking their head, due to an ear infection, allergic skin condition, ear mites, or a foreign body lodged in the ear canal. For that reason, your vet will take a close look inside your pet’s ears.
Aural hematomas can also develop from an accidental bump or injury to the ear flap. For example, this could happen during vigorous play, if your pup runs through bushes and their ear gets scraped by a sharp branch, or following a bite wound on the ear flap from another dog or a wild animal.
Less commonly, health conditions that cause blood clotting abnormalities can also lead to a blood pocket formation in the ear flap.
Since scratching and head shaking from an ear issue are by far the most common cause, the best way to prevent ear hematomas is by keeping your pet’s ears clean and healthy.
Ask your vet for advice on your pet’s ears because care instructions may vary a lot from dog to dog. Some pups might only need an occasional ear cleaning. However, other dogs — especially droopy-eared breeds like Basset Hounds and Cocker Spaniels that are at a great risk for ear infections and ear problems — may need frequent ear cleanings with special ear maintenance solutions.
What is a hematoma in a dog?
An ear hematoma in dogs, also referred to as an auricular or aural hematoma, is a localized mass of blood that is confined within the ear flap. A hematoma typically occurs in one ear flap but can take place in both ears with swelling throughout the entire or partial ear flap.
What Happens when a Dog’s Aural Hematoma is left Untreated?
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If you’re a dog parent, chances are good that at some point you may have to deal with an ear hematoma. Disliked by vets due to their tendency to come back again and again, and visually alarming to pet parents (not to mention messy), ear hematomas in dogs can be one of the most frustrating conditions to treat.
Ear hematomas happen when a blood vessel in the ear bursts and starts to bleed into the space between the skin of the ear flap and the cartilage underneath. This is usually the result of the dog violently shaking his head or scratching at his ears, often because of ear infections, skin allergies, or debris (such as dirt or foxtails) getting lodged in the ear canal. Once the bleeding starts, the ear can swell significantly until it looks like a giant, over-stuffed ravioli.
Although ear hematomas are more common in floppy-eared dogs (since their ears flap against their heads when they shake), dogs with straight ears, cats, and even humans can develop ear hematomas. Pets with blood-clotting disorders can also develop them spontaneously, even without any trauma to the ear.
Once an ear hematoma forms, it causes pain and irritation, causing the dog to shake his head even more. If not treated, an ear hematoma can continue to grow so large that it blocks off the opening to the dog’s ear canal, or worse, it may rupture. Any dog parent who’s come home to a dog with a ruptured ear hematoma knows how incredibly scary it is to see blood sprayed all over the walls from the poor dog shaking his head everywhere!
Diagnosis of an ear hematoma is pretty straightforward – the dog’s ear looks like a swollen pillow and feels squishy to the touch. However, it’s important to diagnose the issue that caused the problem in the first place so it can be treated immediately.
The veterinarian will start with an examination of the ear canal, looking for the presence of ear mites, a bacterial or yeast infection, or any sort of debris which might have gotten stuck inside the ear.
If the ear canal looks healthy, the vet will then examine the dog for signs of allergic skin disease, which is the most common reason why dogs scratch at their ears. If the vet suspects allergies, a change in food or allergy testing may be recommended.
It’s very important to identify and treat the underlying cause of the head-shaking or ear-scratching, otherwise the ear hematoma will just keep coming back.
Without any treatment, an ear hematoma will eventually resolve on its own; however, there are problems caused by not providing treatment. First, ear hematomas can be, at best, very uncomfortable, and at worst, extremely painful for the dog for a period of several weeks.
Second, if an ear hematoma is not treated promptly, once the fluid in the ear is re-absorbed by the body, the ear will crinkle up and shrivel down into a mass of scar tissue. This results in a permanent, unsightly deformity called “cauliflower ear” that can never be repaired and may make it very difficult to clean the dog’s ear in the future.
Although it’s less expensive than surgical repair, simply drawing blood out of the ear has several drawbacks. Sometimes multiple trips to the vet and several aspirations are needed in order to remove all the blood from the ear flap. Also, once the blood is drawn out, it leaves a large open pocket that can quickly fill back up with fluid, making aspiration effective less than 50% of the time. There’s also a risk of introducing infection into the ear with this procedure.
Another option involves placing a small drain, or rubber tube, into the outer portion of the ear. This drain stays sutured in place for several weeks until all the blood and fluid drains out of the pocket. This method is usually reserved for those patients who are too old or too sick to tolerate the general anesthesia needed for surgical repair.
However, just like with aspiration, there are drawbacks. Some ears, such as those of cats and very small dogs, are too small for this technique to be used. Many dogs will not tolerate a drain being in place for such a long period of time, and the drain can become dislodged when the dog shakes his head. Also, just like with aspiration, the pocket can quickly fill back up again when the drain is removed.
Surgery is the most effective treatment for ear hematomas in dogs. While the dog is under general anesthesia, an incision is made in the ear and any fluid and blood clots are removed. Then the veterinarian places sutures in the ear to tack down the outer surface of the ear to the inner surface, holding the two sides flatly together so that when scar tissue forms, the surfaces remain relatively smooth and there is no pocket to fill back up with blood.
Some veterinarians then place a surgical drain to help drain out any fluid that may form after surgery, while others leave a portion of the incision open to drain on its own. The dog’s ear is then flipped up against his head, and an elastic bandage is applied to hold the ear tightly against the head, keeping it in place in case the dog shakes his head after surgery. Lastly, the vet will fit the dog with an Elizabethan collar (e-collar) so the dog can’t scratch at the bandage. Sutures are left in place for anywhere from 2- 3 weeks until the ear is completely healed.
After treatment, the dog will be able to go home with pain medication, antibiotics, and an e-collar, which must be left on at all times to prevent the dog from re-damaging the ear by scratching it or rubbing it against furniture or carpeting. It only takes a few seconds for all the hard work of treatment to be completely undone if the e-collar is removed.
If the ear hematoma was surgically repaired, several recheck visits with the veterinarian will be needed to change the pads underneath the bandage, make sure the ear is draining and healing properly, and to ensure there is no infection. If all goes well, the ear should heal in 2-3 weeks.
At the final recheck appointment, the veterinarian will remove the sutures (and the drain, if one was placed). Another bandage may be necessary until the ear is completely healed, there’s no more drainage, and the dog is no longer shaking his head.
Ear hematomas in dogs can be painful, unsightly, and downright messy. Although they can’t always be prevented, they can be successfully treated, and the risk of recurrence can be greatly decreased when the underlying issues that caused the head-shaking and scratching in the first place are treated and eliminated.
It’s important to regularly inspect your dog’s ears, keep them dry, and clean them as often as needed, especially if your dog has long or floppy ears. Also, if your dog is scratching his ears, or licking and chewing at his fur and skin, have your veterinarian examine him for skin allergies. These pre-emptive practices will greatly reduce the risk of your dog developing an ear hematoma in the future.
And if your dog does develop an ear hematoma, get to the vet quickly. With fast and appropriate surgical treatment, prognosis for recovery is good to excellent – and you won’t have to worry about spatter damage to your walls or furniture!
Has your dog ever had an ear hematoma? If so, how did you deal with it? Please share your story with us in the comments below!