Aural hematomas are a common condition affecting the ear flap, or pinna, of animals, particularly dogs and, less frequently, cats. This involves a collection of blood within the ear flap, creating a localized swelling.
Understanding Aural Hematomas
The ear flap consists of two layers of skin with a layer of cartilage sandwiched in between. When these blood vessels rupture, often due to trauma, blood accumulates in the space between the cartilage and skin, forming a hematoma.
The rupture of these vessels often results from vigorous head shaking or scratching at the ears. This self-inflicted trauma is often secondary to underlying irritations, such as ear infections (otitis externa), allergies, ear mites, or foreign objects lodged in the ear canal. Less commonly, direct trauma like a bite wound or underlying bleeding disorders can also lead to aural hematomas.
Recognizing the Signs
Owners might first notice swelling on the ear flap, ranging from a small bulge to a balloon-like appearance. This swelling is often soft and fluid-filled and may be warm to the touch.
Affected animals show pain or tenderness when the ear is touched. They may exhibit increased head shaking, persistent ear scratching, or tilt their head to one side. They may also be reluctant to have the ear handled.
Treatment Approaches
Veterinarians use various methods to treat aural hematomas, depending on the hematoma’s size, duration, and the animal’s overall health. Surgery is often the most effective approach for resolution and cosmetic outcome. Common surgical techniques include making an incision (e.g., S-shaped or linear) on the concave surface of the ear to drain blood and clots. After drainage, sutures reattach the skin to the cartilage, eliminating the space where blood can re-accumulate. Drains may also be inserted for continuous drainage.
Non-surgical options are considered for smaller hematomas or patients unable to undergo anesthesia. These methods include needle aspiration, which draws out blood but often leads to recurrence as the space can easily refill. Steroids, injected or oral, are sometimes used to reduce inflammation and help the hematoma resolve slowly over several weeks. Compression bandages can also reduce swelling and prevent fluid re-accumulation, though maintaining them can be difficult.
Addressing Underlying Issues and Recovery
Treating the underlying cause of the hematoma is important to prevent recurrence. This involves diagnosing and addressing conditions such as ear infections, allergies, or ear mites. Unresolved underlying issues can lead to new hematomas.
Post-treatment care involves keeping the pet calm and restricting head shaking. An Elizabethan collar is often necessary to prevent scratching or further trauma. Depending on the treatment, wound care (e.g., warm compresses, daily cleaning) and medication (e.g., pain relief, antibiotics) will be required. Recovery usually takes a few weeks, with sutures removed after about three weeks for proper healing.
While most cases resolve well, some cosmetic alteration, such as a thickened or “cauliflower” ear, can occur, especially if the hematoma is left untreated. Regular ear cleaning and timely veterinary attention for any signs of ear irritation can help prevent future occurrences.