A puffy or swollen ear flap on a dog warrants immediate attention. While usually non-life-threatening, this swelling can be painful and lead to permanent damage if left unaddressed. The most common cause is an aural hematoma, which requires professional diagnosis and treatment to resolve fully.
Aural Hematoma: The Primary Cause of Puffy Ears
An aural hematoma is a collection of blood that pools within the ear flap, known medically as the pinna. The pinna consists of skin covering cartilage. When a blood vessel ruptures between these layers, the leakage creates a distinct, fluid-filled pocket. This swelling often feels soft, spongy, or fluctuant to the touch, similar to a water balloon, and may feel noticeably warm.
The formation of this blood blister is a result of self-inflicted trauma. Dogs experiencing intense itchiness or pain in the ear canal will violently shake their heads or scratch the area with their paws. This forceful action causes the small blood vessels within the ear flap to break internally, leading to rapid bleeding into the tissue space. The weight of the accumulated blood can cause the ear to droop significantly.
The behavior that causes the hematoma is triggered by an underlying condition that irritates the ear. Common culprits include external ear infections (otitis externa), typically caused by an overgrowth of yeast or bacteria. Other irritants are ear mites or generalized allergic skin disease that affects the ears. Treating the hematoma without resolving this primary source of irritation makes recurrence highly probable.
Other Potential Reasons for Swelling
While a hematoma is the most frequent reason for a puffy ear, other conditions can also cause a dog’s ear to swell. Severe allergic reactions, such as those resulting from an insect bite or sting, can cause localized swelling of the ear flap. In these cases, the swelling is often accompanied by generalized redness, hives, or swelling in other parts of the face.
A deep skin infection (cellulitis) or a localized abscess from a puncture wound may also lead to swelling. Unlike the diffuse, spongy feel of a hematoma, an abscess is a firm, painful, localized lump that may have an open wound or scab at its center. These conditions lack the characteristic fluid-filled nature of a hematoma and are often accompanied by a visible point of entry or a fever.
Foreign bodies, such as grass awns lodged deep in the ear canal, can cause intense irritation that leads to head shaking and subsequent swelling. The ear canal itself may become inflamed, leading to swelling that may be mistaken for a hematoma. However, examination reveals the irritation is confined to the canal rather than the pinna. A veterinarian must rule out these possibilities to ensure the most appropriate treatment is selected.
Veterinary Assessment and Treatment
Once a puffy ear is identified, veterinary assessment is required to confirm the diagnosis and begin treatment. The initial assessment involves a physical examination, checking the ear canal for signs of infection, mites, or foreign bodies. The veterinarian may perform a fine needle aspiration, drawing a small fluid sample to confirm the swelling is caused by blood rather than pus.
The standard treatment for aural hematomas is surgical correction. The procedure involves making an incision to drain the accumulated blood and removing any blood clots. The space where the blood collected must then be eliminated to prevent refilling. This is accomplished by placing multiple sutures through the ear flap in a quilting pattern to tack the skin back down to the cartilage, allowing the tissue layers to heal together permanently.
Non-surgical approaches, such as needle aspiration or the use of indwelling drains, are sometimes employed for small hematomas or in dogs that cannot safely undergo anesthesia. However, drainage often results in the space refilling quickly, requiring repeated procedures. Regardless of the method chosen, concurrent treatment of the underlying cause, whether an ear infection or allergies, is mandatory to prevent the dog from re-injuring the ear.