October 23, 2012
Dogs and cats will sometimes develop a problem we term aural hematoma. The animal frequently has ear infection or ear mites and when they shake their heads hard, they can sometimes burst blood vessels in the ear flap.
Hematoma is a blood bruise. The ear will be painful and a soft swelling of variable size will be seen on the underside/inside. The whole ear flap is sometimes affected.
Prevention consists of controlling ear infections early so that pain and itchiness does not lead to marked head shaking. Dogs with more long, heavy floppy ears are more frequently affected—labs, retrievers and other similar breeds are good examples. In cats, ear mite infestation frequently causes heavy shaking and scratching, leading to hematomas.
Treatment options are varied. The veterinarian may choose to:
Drain and inject anti-inflammatory medicine
Lance, drain and flush, then suture buttons, soft rubber tubes or meshing to hold the skin down tight against the middle cartilage during healing.
Each has advantages and disadvantages, and surgeon preference will determine which method is selected. It is not unusual with the drainage technique to have the hematoma recur. Uncontrolled ear infection also favours recurrence of the problem. Sometimes surgical repair techniques will lead to somewhat irregular healing of the flap, resulting in a wavy appearance. Pain medicine and sometimes even sedation are needed post-operatively.
You will see a small gap left after the surgery is performed so that discharge can escape without swelling inside. Some surgeons bandage the ear, others leave it open and have the caregiver do warm compresses to help with healing.
Without any therapy, the afflicted ear will be painful for quite a while until the hematoma reabsorbs, and will generally be quite distorted after healing, producing a so-called “cauliflower ear”. See your veterinarian for advice if you notice a sudden swelling inside the ear flap of your dog or cat.