Hematoma of the Ear in Dogs
(Aural Hematoma)
An aural (ear) hematoma is a collection of blood, serum, or clotted blood within the pinna (earflap). When present, the pinna will be very thick. The swelling may involve the entire pinna or it may involve only one area.
The earflap is composed of two layers of skin surrounding a layer of cartilage. The cartilage gives the earflap its shape. Blood vessels go from side-to-side by passing through the cartilage. Violent shaking can cause the vessels to break as the skin slides across the cartilage; however, in some cases, the cause remains undetermined. (See Causes.)
Causes/Transmission
The cause of aural hematomas is unknown. Vigorous shaking of the head and ears has been thought to be responsible, yet a large percentage of affected dogs develop hematomas without shaking their head. Disease of the ear canal is also considered to play a role, but not all dogs with aural hematomas have ear disease (otitis).
Clinical Signs
Most dogs with an aural hematoma have a history of head shaking. Debris or odor may occur in the ear canal if an infection is present. However, the most consistent clinical sign is a thickened earflap.
Diagnosis
A physical examination of the earflap is usually all that is needed to make the diagnosis.
Treatment
There are two approaches to treatment: a medical approach and a surgical approach
Medical Treatment
This is the simplest and least invasive procedure; however, in most cases it is unsuccessful. Some dogs are treated in this manner first. If it is not successful, the surgical treatment is used.
The blood in the earflap is aspirated with a syringe and needle. One of several medications, often a cortisone-type drug, is injected into the space from which the blood was taken. The earflap is then taped over the head. The dog is checked in 3-7 days to assess the outcome of treatment. If an ear infection is present, it is also treated.
Surgical Treatment
The blood is removed from the pinna. This is accomplished by making several small incisions in each end of the hematoma. A rubber drain tube is sometimes passed through the hematoma and sutured to the ear. The incisions are left open. This assures drainage of any more blood or serum that accumulates in the area.
The space where the blood accumulated is obliterated. Since the skin over the hematoma has been pushed away from the cartilage, it must be reattached to it to prevent another hematoma from occurring. This is accomplished by a series of sutures that are passed through the earflap.
Irritation from the surgery may cause the dog to attempt to scratch or paw at the ear. Therefore, an Elizabethan collar (“cone”) is required to be worn for at least 7-10 days after the surgery to let the ear heal.
The cause of the problem is diagnosed and treated. Another important aspect of treatment is dealing with the cause of any potential head shaking. If an infection is present, medication is dispensed to treat it. However, some dogs have no infection but have foreign material (a tick, piece of grass, etc.) lodged in the ear canal. If so, the foreign material is removed. It is also possible that a foreign body initiated the shaking but was later dislodged. If that occurs, and no infection is present, further treatment of the ear canal is not needed.
The sutures are removed after about 7-10 days. At that time, the hematoma is usually healed. The holes left from the incision will close within a matter of a few days. If discharge occurs from the holes before they close, it should be cleaned off with hydrogen peroxide or a non-irritant antiseptic solution.
If an infection was present, it will be necessary to recheck the ear canal to be sure that the infection is gone. Otherwise, another hematoma may occur.
Prognosis
Usually the prognosis is good for recovery, but it is not uncommon for the hematoma to recur at least once.
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(Aural Hematoma)
An aural (ear) hematoma is a collection of blood, serum, or clotted blood within the pinna (earflap). When present, the pinna will be very thick. The swelling may involve the entire pinna or it may involve only one area.
The earflap is composed of two layers of skin surrounding a layer of cartilage. The cartilage gives the earflap its shape. Blood vessels go from side-to-side by passing through the cartilage. Violent shaking can cause the vessels to break as the skin slides across the cartilage; however, in some cases, the cause remains undetermined. (See Causes.)
Causes/Transmission
The cause of aural hematomas is unknown. Vigorous shaking of the head and ears has been thought to be responsible, yet a large percentage of affected dogs develop hematomas without shaking their head. Disease of the ear canal is also considered to play a role, but not all dogs with aural hematomas have ear disease (otitis).
Clinical Signs
Most dogs with an aural hematoma have a history of head shaking. Debris or odor may occur in the ear canal if an infection is present. However, the most consistent clinical sign is a thickened earflap.
Diagnosis
A physical examination of the earflap is usually all that is needed to make the diagnosis.
Treatment
There are two approaches to treatment: a medical approach and a surgical approach
Medical Treatment
This is the simplest and least invasive procedure; however, in most cases it is unsuccessful. Some dogs are treated in this manner first. If it is not successful, the surgical treatment is used.
The blood in the earflap is aspirated with a syringe and needle. One of several medications, often a cortisone-type drug, is injected into the space from which the blood was taken. The earflap is then taped over the head. The dog is checked in 3-7 days to assess the outcome of treatment. If an ear infection is present, it is also treated.
Surgical Treatment
The blood is removed from the pinna. This is accomplished by making several small incisions in each end of the hematoma. A rubber drain tube is sometimes passed through the hematoma and sutured to the ear. The incisions are left open. This assures drainage of any more blood or serum that accumulates in the area.
The space where the blood accumulated is obliterated. Since the skin over the hematoma has been pushed away from the cartilage, it must be reattached to it to prevent another hematoma from occurring. This is accomplished by a series of sutures that are passed through the earflap.
Irritation from the surgery may cause the dog to attempt to scratch or paw at the ear. Therefore, an Elizabethan collar (“cone”) is required to be worn for at least 7-10 days after the surgery to let the ear heal.
The cause of the problem is diagnosed and treated. Another important aspect of treatment is dealing with the cause of any potential head shaking. If an infection is present, medication is dispensed to treat it. However, some dogs have no infection but have foreign material (a tick, piece of grass, etc.) lodged in the ear canal. If so, the foreign material is removed. It is also possible that a foreign body initiated the shaking but was later dislodged. If that occurs, and no infection is present, further treatment of the ear canal is not needed.
The sutures are removed after about 7-10 days. At that time, the hematoma is usually healed. The holes left from the incision will close within a matter of a few days. If discharge occurs from the holes before they close, it should be cleaned off with hydrogen peroxide or a non-irritant antiseptic solution.
If an infection was present, it will be necessary to recheck the ear canal to be sure that the infection is gone. Otherwise, another hematoma may occur.
Prognosis
Usually the prognosis is good for recovery, but it is not uncommon for the hematoma to recur at least once.
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