If you’re a dog parent, chances are good that at some point you may have to deal with an ear hematoma. Disliked by vets due to their tendency to come back again and again, and visually alarming to pet parents (not to mention messy), ear hematomas in dogs can be one of the most frustrating conditions to treat.
Ear hematomas happen when a blood vessel in the ear bursts and starts to bleed into the space between the skin of the ear flap and the cartilage underneath. This is usually the result of the dog violently shaking his head or scratching at his ears, often because of ear infections, skin allergies, or debris (such as dirt or foxtails) getting lodged in the ear canal. Once the bleeding starts, the ear can swell significantly until it looks like a giant, over-stuffed ravioli.
Although ear hematomas are more common in floppy-eared dogs (since their ears flap against their heads when they shake), dogs with straight ears, cats, and even humans can develop ear hematomas. Pets with blood-clotting disorders can also develop them spontaneously, even without any trauma to the ear.
Once an ear hematoma forms, it causes pain and irritation, causing the dog to shake his head even more. If not treated, an ear hematoma can continue to grow so large that it blocks off the opening to the dog’s ear canal, or worse, it may rupture. Any dog parent who’s come home to a dog with a ruptured ear hematoma knows how incredibly scary it is to see blood sprayed all over the walls from the poor dog shaking his head everywhere!
Therefore, it’s best to treat ear hematomas in dogs as soon as they start.
Diagnosis Of The Problem
Diagnosis of an ear hematoma is pretty straightforward – the dog’s ear looks like a swollen pillow and feels squishy to the touch. However, it’s important to diagnose the issue that caused the problem in the first place so it can be treated immediately.
The veterinarian will start with an examination of the ear canal, looking for the presence of ear mites, a bacterial or yeast infection, or any sort of debris which might have gotten stuck inside the ear.
If the ear canal looks healthy, the vet will then examine the dog for signs of allergic skin disease, which is the most common reason why dogs scratch at their ears. If the vet suspects allergies, a change in food or allergy testing may be recommended.
It’s very important to identify and treat the underlying cause of the head-shaking or ear-scratching, otherwise the ear hematoma will just keep coming back.
Treatment For Ear Hematomas
When it comes to treating ear hematomas in dogs, pet parents have 4 options:
Without any treatment, an ear hematoma will eventually resolve on its own; however, there are problems caused by not providing treatment. First, ear hematomas can be, at best, very uncomfortable, and at worst, extremely painful for the dog for a period of several weeks.
Second, if an ear hematoma is not treated promptly, once the fluid in the ear is re-absorbed by the body, the ear will crinkle up and shrivel down into a mass of scar tissue. This results in a permanent, unsightly deformity called “cauliflower ear” that can never be repaired and may make it very difficult to clean the dog’s ear in the future.
Aspiration of blood out of the ear with a needle and syringe.
Although it’s less expensive than surgical repair, simply drawing blood out of the ear has several drawbacks. Sometimes multiple trips to the vet and several aspirations are needed in order to remove all the blood from the ear flap. Also, once the blood is drawn out, it leaves a large open pocket that can quickly fill back up with fluid, making aspiration effective less than 50% of the time. There’s also a risk of introducing infection into the ear with this procedure.
Placement of drainage tubes into the ear.
Another option involves placing a small drain, or rubber tube, into the outer portion of the ear. This drain stays sutured in place for several weeks until all the blood and fluid drains out of the pocket. This method is usually reserved for those patients who are too old or too sick to tolerate the general anesthesia needed for surgical repair.
However, just like with aspiration, there are drawbacks. Some ears, such as those of cats and very small dogs, are too small for this technique to be used. Many dogs will not tolerate a drain being in place for such a long period of time, and the drain can become dislodged when the dog shakes his head. Also, just like with aspiration, the pocket can quickly fill back up again when the drain is removed.
Surgical repair of the hematoma.
Surgery is the most effective treatment for ear hematomas in dogs. While the dog is under general anesthesia, an incision is made in the ear and any fluid and blood clots are removed. Then the veterinarian places sutures in the ear to tack down the outer surface of the ear to the inner surface, holding the two sides flatly together so that when scar tissue forms, the surfaces remain relatively smooth and there is no pocket to fill back up with blood.
Some veterinarians then place a surgical drain to help drain out any fluid that may form after surgery, while others leave a portion of the incision open to drain on its own. The dog’s ear is then flipped up against his head, and an elastic bandage is applied to hold the ear tightly against the head, keeping it in place in case the dog shakes his head after surgery. Lastly, the vet will fit the dog with an Elizabethan collar (e-collar) so the dog can’t scratch at the bandage. Sutures are left in place for anywhere from 2- 3 weeks until the ear is completely healed.
Post-Treatment Care At Home
After treatment, the dog will be able to go home with pain medication, antibiotics, and an e-collar, which must be left on at all times to prevent the dog from re-damaging the ear by scratching it or rubbing it against furniture or carpeting. It only takes a few seconds for all the hard work of treatment to be completely undone if the e-collar is removed.
If the ear hematoma was surgically repaired, several recheck visits with the veterinarian will be needed to change the pads underneath the bandage, make sure the ear is draining and healing properly, and to ensure there is no infection. If all goes well, the ear should heal in 2-3 weeks.
At the final recheck appointment, the veterinarian will remove the sutures (and the drain, if one was placed). Another bandage may be necessary until the ear is completely healed, there’s no more drainage, and the dog is no longer shaking his head.
A Messy, But Treatable, Situation
Ear hematomas in dogs can be painful, unsightly, and downright messy. Although they can’t always be prevented, they can be successfully treated, and the risk of recurrence can be greatly decreased when the underlying issues that caused the head-shaking and scratching in the first place are treated and eliminated.
It’s important to regularly inspect your dog’s ears, keep them dry, and clean them as often as needed, especially if your dog has long or floppy ears. Also, if your dog is scratching his ears, or licking and chewing at his fur and skin, have your veterinarian examine him for skin allergies. These pre-emptive practices will greatly reduce the risk of your dog developing an ear hematoma in the future.
And if your dog does develop an ear hematoma, get to the vet quickly. With fast and appropriate surgical treatment, prognosis for recovery is good to excellent – and you won’t have to worry about spatter damage to your walls or furniture!
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Has your dog ever had an ear hematoma? If so, how did you deal with it? Please share your story with us in the comments below!