What is an aural hematoma?

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An aural hematoma is a collection of blood between the skin and the cartilage of the ear of a dog or cat. The result is a large, puffy, swollen ear. It is extremely painful.

In some cases, only a small part of the ear is affected, such as the tip of the ear.

We don't know exactly what causes an ear hematoma, but it is usually there because of the animal shaking their head. In many cases there is an underlying ear infection which is causes the head shaking. Sometimes, allergies can cause it. And sometimes, we just don't know why it happens! There is a theory that this may actually be an autoimmune condition, but to this date no one knows for sure.

Does an aural hematoma need to be treated?

An ear hematoma will go away on its own if it is not treated. However, this is definitely not recommended. It will take several months for the blood to be absorbed. In this time period it is very painful for the cat or dog. The main reason not to allow this to go untreated is that the end result is usually what is called a cauliflower ear. A cauliflower ear is a shriveled up, scarred ear. It is very unpleasant to look at and may be painful for the animal as well.

How is an aural hematoma treated?

There are many different types of treatments available for aural hematomas. What this often means is that we simply don't know the best way to treat these! Treatments can be divided into two categories: surgical and medical.

Surgical treatment

If surgery is done there are usually two steps:

• Cut into the ear and drain out the blood.
• Stitch the ear skin to the cartilage so that there is no more space for blood to collect.

S-Shaped Incision

One common way that this is done is for the surgeon to use a scalpel blade and make either a straight cut or an "S-Shaped" cut. The video on the right show what happens when the ear is incised. Often there is a LARGE amount of blood and blood clots. Then, the skin is stitched to the cartilage of the ear. These sutures are removed in 14 days. The incision in the ear will heal with a scar, but it will not be a painful scar.

Punch Biopsy Incisions

Another way to do this is to use a punch biopsy. This is a tool that is meant to take a round piece of skin out to biopsy it and send it to the lab. It works just as well on the ear. Several holes are made in the ear and the blood and blood clots are removed. Then, stitches are placed over each of the holes to attach the cartilage to the skin. Again, there is some scarring but it is usually barely noticeable and it is not painful.

Medical Treatment

Some vets will treat aural hematomas with oral steroids (usually prednisone). The prednisone will often take down the swelling. It may take several weeks of medication for the ear to clear up. During this time period the medication helps with pain relief. In most cases the ear heals just as well as with surgery. Medical treatment works best if it is started as soon as possible. Some vets have found that if we try medical treatment on an animal that has gone untreated for a while, the ear will scar just as badly as if nothing had been done.

Your veterinarian will advise you on whether surgery or medication is the best treatment for your pet.

Can't I just drain the blood with a needle?

Although it sounds like this would be a good solution, it just doesn't work. In almost every case, the ear fills up with blood again. Sometimes it fills up even bigger than it was before.

Dr. Marie was quick to respond and thorough in suggesting treatment for my cat. I am so thankful- I have been so worried about my cat. Now I have additional options to discuss with my vet.

The service was incredibly fast and the vet's suggestions were right on target. This was incredibly helpful given that none of the vets in my area, mine now included, will take off hours calls now.

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