Ear Haematomas in Dogs
Last Updated 3 MAY 2024
Aural haematomas, also known as ear haematomas, are a common yet painful condition that can affect dogs of all ages and breeds. These haematomas are characterised by a blood-filled swelling between the skin and cartilage of the ear flap, or pinna. While they may seem like a minor issue, aural hematomas can cause significant discomfort and if left untreated can lead to permanent deformities of the ear flap.
It's important for pet owners to be aware of this condition and to understand the underlying causes, symptoms and treatment options.
This article aims to provide comprehensive information on haematomas of the ear in dogs, and arm you with the knowledge to make an informed treatment plan with your vet if your dog is diagnosed.
What Is An Aural Hematoma?
An aural haematoma occurs when blood accumulates between the cartilage and the skin of the ear flap. Aural haematomas can occur in any animal however they are most common in dogs.
An aural hematoma is most often caused by trauma or injury to the ear - this causes blood vessels to rupture and bleed into the space between the skin and the cartilage which leads to the soft swelling that alerts owners to the problem.
Although any trauma to the ear flap can potentially cause an aural hematoma the most common cause is scratching or head shaking secondary to an ear infection.
When dogs have an ear infection they will often show this by shaking their heads vigorously or scratching the ears with their feet. If the blood vessels within the ear flap rupture due to this trauma an aural haematoma can form.
There are other causes of aural hematomas in dogs which are much less common such as blood clotting disorders or diseases that affect the blood vessel integrity. This can increase the likelihood of spontaneous bleeding, which could lead to the formation of a hematoma in the ear flap.
What Are The Symptoms Of An Aural Haematoma?
Aural hematomas can vary from dramatic swellings that take up the entirety of the ear flap to more subtle swellings only a few centimetres in size.
The swellings may be soft and spongy or more severe hematomas can cause the skin to become taut and feel less fluctuant.
Dogs may show discomfort in the ear (particularly if they have an underlying ear infection) or they may show no symptoms at all.
How Is An Aural Haematoma Diagnosed?
The diagnosis of an aural hematoma is usually quite straightforward. Some aural hematomas are very obvious however smaller swellings that aren't as clear cut may require a small sample to be taken with a needle to confirm it is blood that is filling the space.
Your vet will also want to look into possible causes for the hematoma such as ear infections. In some cases no underlying cause is determined and the cause will be assumed to be an unknown trauma.
Although most haematomas are straightforward there are other conditions that could present similarly - such as swelling secondary to a bee sting, or a lump on the ear. Needle sampling can help to differentiate between these causes. Your vet will also examine your dog for any other signs that could indicate another cause e.g. swelling secondary to a bee sting usually involves the entire face.
How are Aural Haematomas Treated?
It is generally recommended to treat aural hematomas as soon as possible as scarring becomes more likely the longer they are left untreated.
Treatment can be either medical or surgical and your vet will recommend the best option for your dog based on the size of the haematoma, the duration, and any underlying health issues your dog might have which could affect their ability to have a procedure under anaesthetic.
Surgical treatment tends to be the treatment of choice for large or recurrent haematomas as it has a higher success rate.
Medical management involves drainage of the hematoma using a small needle, and in many cases dogs will be prescribed an oral corticosteroid or have an injectable corticosteroid instilled into the hematoma following drainage.
Surgery involves creating an opening for the hematoma to drain and then 'closing the dead space' between the cartilage and the skin. If the hematoma has been drained but an empty space remains between the cartilage and the ear flap it will continue to refill. The 'dead space' is most commonly closed by placing multiple sutures on the ear flap - this encourages the cartilage to reattach to the skin.
Some vets will elect to bandage the ear to the head whereas others will leave it free - hematoma surgery techniques vary widely between vets and it tends to come down to a vets personal preference.
Surgery is not always successful and in some cases the haematoma will recur and a revision surgery is usually recommended.
Small haematomas may be left to scar on their own as they are less likely to cause a major deformity of the ear flap.
What Is The Recovery Like After Surgery?
Dogs tend to recover quite well after a haematoma surgery, particularly if the underlying cause (e.g. an ear infection) is also treated. Your dog should be prescribed pain medication following surgery to ensure any pain is controlled during recovery.
Dogs will usually be required to wear an E-collar to prevent them from scratching at their sutures.
Sutures are usually left in for a longer period of time than other surgical procedures to ensure the ear flap has enough time to adhere to the cartilage. In many cases sutures will remain for a minimum of 3 weeks.
Your vet will advise you of the post-operative instructions based on the type of treatment your dog has had, this may include treatment of an ear infection with daily ear medication massaged in the ear canal.
What Happens If A Haematoma Isn't Treated?
Aural Haematomas are usually painful and left untreated your dog may remain in pain for longer than necessary.
An untreated Haematoma will eventually scar however this can result in a scarred, deformed, 'cauliflower' shaped ear flap. This can lead to obstruction of the ear canal and predispose dogs to developing ear infections again.
How Can I Prevent My Dog From Developing An Aural Haematoma?
The best way to prevent aural haematomas is to have your pet examined by a vet if they are showing any signs of ear discomfort such as head shaking or scratching at the ears. If these behaviours are left untreated an aural haematoma may develop.
Some dogs will require regular cleaning of their ears to keep the ears free from discharge and prevent ear infections occurring. Your vet will be able to advise you whether or not ear cleaning is recommended for your dog.