Last Updated: 19/02/2026
Ear Haematomas in Dogs: Causes, Signs & Treatment
If your dog's ear looks like a soft, fluid-filled pillow, they may have an aural haematoma. Often caused by ear infections or head shaking, this painful condition requires vet care. Discover how to treat haematomas and prevent "cauliflower" ears.
Author: Dr Samantha Wycherley BVSc
Reading Time: 7 minutes - short read
Finding a sudden, squishy swelling on your dog’s ear flap can be quite a surprise. This common condition, known as an aural haematoma, occurs when small blood vessels rupture and leak fluid between the skin and the ear cartilage. While it might look like a simple bump, it is often a sign that your dog is dealing with underlying discomfort, like an itchy ear infection or persistent head shaking. Acting quickly not only keeps your dog comfortable but also prevents permanent changes to the shape of their ear.
What is an aural haematoma in dogs?
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.
Common causes of swollen ear flaps
- 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.
- 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.
- 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.
Signs of ear haematomas to watch for
Signs of an aural haematoma may include:
- Localised swelling: Swellings can range from a small, subtle lump of just a few centimetres to a dramatic bulge that encompasses the entire ear flap.
- Texture changes: the affected area often feels soft and spongy, though in more severe cases, the skin can become taut, firm, and less "squishy" to the touch.
- Head tilt: You might notice them carrying their head low on the side of the affected ear.
- Redness or heat: The area may feel warmer than the rest of the body and appear bruised or angry-red.
- Sensitivity to touch: Most dogs will shy away or yelp if you try to examine the ear, as the pressure from the fluid can be quite painful.
- Obsessive head shaking: This is often both a cause and a symptom. They are trying to "shake off" the heavy, uncomfortable sensation.
- Excessive scratching: They may constantly paw at the ear or rub their head against furniture and carpets for relief.
How vets diagnose ear swellings
Diagnosing an aural haematoma is typically a straightforward process for a veterinarian, though a thorough exam is essential to rule out "look-alike" conditions.
- Physical examination: Most haematomas are easily identified by their characteristic look and feel. However, because other issues like bee stings or localised tumours can cause similar swelling, a vet will perform a full head-to-tail check. For instance, a bee sting often causes more generalised facial swelling rather than a pocket of fluid isolated to the ear flap.
- Fine needle aspirate: If the swelling is small or the diagnosis isn't immediately clear, a vet may use a fine needle to collect a small fluid sample. Confirming the presence of blood within the swelling helps distinguish a haematoma from an abscess or a cyst.
- Investigating the "why": Because haematomas are often a secondary symptom, your vet will look deep into the ear canal for signs of infection, ear mites, or foreign bodies (like grass seeds).
- Idiopathic cases: In some instances, no clear underlying trigger is found. In these "idiopathic" cases, the cause is generally attributed to an unobserved minor trauma.
Treatment options for dog ear haematomas
Treating an aural haematoma promptly is essential, as the risk of permanent scarring and "cauliflower" ear increases the longer the fluid remains. Your vet will recommend a tailored plan based on the size of the swelling, how long it has been present, and your dog’s overall health - especially their suitability for anaesthesia.
Surgical vs medical management: which is best?
Monitoring
In very minor cases where the swelling is tiny, a vet might suggest leaving it to resolve on its own. While this results in some minor scarring, it avoids the need for a procedure if the deformity is expected to be negligible.
Medical management
For some cases, a vet may choose to drain the fluid using a fine needle. This often includes an injection of corticosteroids directly into the space, or oral medication, to reduce inflammation. While less invasive, this method carries a higher risk of the haematoma refilling.
Surgical intervention
This is often the preferred "gold standard" for large or recurrent haematomas. The goal is to remove the fluid and then "close the dead space" between the skin and the cartilage.
- Closing the "dead space": To prevent the ear from simply filling back up with blood, vets place multiple internal sutures across the ear flap. These stitches act like "quilting" to hold the layers together so they can reattach permanently.
- Post-operative bandaging: Depending on the vet's preferred technique, the ear may be bandaged flat against the head to provide support and pressure, or it may be left free.
- Monitoring for recurrence: Surgery offers a higher success rate, but haematomas can occasionally return. If this happens, a revision surgery may be necessary to ensure the ear heals correctly.
Post-operative care and recovery tips
Dogs tend to recover quite well after a haematoma surgery, particularly if the underlying cause (e.g. an ear infection) is also treated.
- Pain relief: Your dog should be prescribed pain medication following surgery to ensure any pain is controlled during recovery.
- Cone/e-collar: Dogs will usually be required to wear an E-collar to prevent them from scratching at their sutures.
- 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.
Preventing ear haematomas and "cauliflower" ears
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.
Learn more about How to Keep Your Dog's Ears Clean.
FAQs
Whether your dog has long, velvety ears or short, pointy ones, aural haematomas are a manageable hurdle in pet parenting. By keeping a close eye on any head shaking and seeking prompt veterinary advice, you can ensure those ears stay healthy and "perky."
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History
Our experts continually monitor the health and wellness space and we update our articles when new information becomes available.
Thu 19 Feb 2026
Edited by Dr Gillian Hill BVSc (Hons)Dr Samantha Wycherley BVSc
Contributing Author, BVSc
Dr Samantha works as a companion animal veterinarian in Melbourne. Graduated from Massey University in New Zealand in 2015. I have worked in NZ, across the UK and in Australia. Special interests include wildlife and senior pet medicine.
