An ear hematoma is a common condition that affects the ear of dogs. This is also called an aural hematoma. Aural hematomas are small, fluid-filled bulges and swelling on the inside of the ear flap (pinna). An ear hematoma occurs when there is an accumulation of blood within the ear flap. The ear flap, or pinna, is made up of two cartilage layers and when dogs develop hematomas in their pinnae, there is a pocket of blood accumulation within those two cartilage layers. There are many causes such as ear infections, trauma or inflammation of the blood vessels within the pinna. The type of treatment will depend on what caused it and may include surgery or non-surgical options.

What is an ear hematoma and what causes it?

An aural hematoma is a small fluid-filled bulge that appears within the ear flap (pinna). In most cases, only one ear is affected at a time but can affect the other ear at a later time. The precise cause of aural hematomas is unknown, although there are several theories. The most frequent cause of aural hematomas, however, is head-shaking/scratching as a consequence of an ear infection. Some dogs however with ear hematomas do not have evidence of an ear infection. In these cases, it is thought that there is an inflammatory process affecting the blood vessels within the ear that results in a hematoma (bloody fluid accumulation) formation. Ear hematomas can affect any breed at any age.

Furthermore, older dogs (>8 years of age) that develop an aural hematoma should have a more thorough medical workup. In some cases, a type of cancer called hemangiosarcoma could be present somewhere in the body, most commonly the spleen. Hemangiosarcoma cancers are known to cause inflammation to blood vessels and subsequent ear hematoma formation.

What are the symptoms of an ear hematoma?

The most common symptom of an ear hematoma is a visible bulge or swelling on the inside surface of the ear flap. In some cases, however, there may not be any external sign that an ear hematoma is present and it can only be detected by your veterinarian during a physical examination. If you notice that your dog has evidence of a hematoma in its ear, check the ear canal closely for signs of discharge, redness and odour as this could signify an ear infection.

What are the treatment options for ear hematomas in dogs

Aural hematomas should be treated as soon as possible. In comparison to those that have been there for several days, acute hematomas respond better to drainage. Surgery is more difficult if a hematoma has formed and thickened. Scarring is more probable, resulting in a permanent cauliflower ear flap appearance.

Non-surgical treatment options:

Nonsurgical drainage of ear hematomas is possible. The success rate of hematoma drainage without any medication is not favourable, however. Better success with treating your dog's ear hematoma is with draining and instilling an anti-inflammatory into the cavity. Your veterinarian may also recommend treating your dog's aural hematoma with oral corticosteroids. Both therapies are designed to reduce inflammation of the blood vessels in the ear, therefore reducing hematoma formation. Some dogs require subsequent drainage of the hematoma in 3-5 days after starting therapy and most aural hematomas have resolved by 7-10 days with proper treatment. Dogs that recover from a non-surgical approach to treating their aural hematomas have a more aesthetically appealing pinna.

Surgical treatment options:

The goals of surgical therapy are to completely drain the ear hematoma, avoid future recurrences, and minimize scarring of the ear. Surgery is usually recommended when there is a large ear hematoma or for dogs that fail to respond to the non-surgical treatment approach. After surgery, the ear flap will be bandaged with a wrap to allow for further drainage of the ear hematoma. The success rate of the surgical treatment approach is high but if the underlying cause (e.g ear infection) is not treated, then there is a possibility that the ear hematoma will recur. In some cases after healing from the surgery, the ear flap can have permanent disfigurement and a cauliflower type appearance due to excessive scarring.

What is the prognosis for ear hematomas in dogs?

The prognosis for ear hematomas in dogs is good if treatment is initiated early. Dogs that have a large ear hematoma or those that do not respond to the non-surgical approach, may require surgery. Surgical therapy has a high success rate but there is always the possibility of recurrence. After surgery, most dogs will have an excellent prognosis with a normal appearance of the ear flap. However, if the underlying cause (e.g ear infection) is not treated, then there is a possibility that the ear hematoma will recur.

How to prevent aural hematomas in dogs?

Ear infections should be treated and monitored for recurrence, which may effectively alleviate head shaking and prevent the formation of a new aural hematoma. If one ear has a hematoma, the other ear should be examined for signs of an ear infection. Successful surgical treatment of the affected ear usually prevents the recurrence of an ear hematoma.

Ear hematomas in dogs can be a very common ear condition. If you notice that your dog has evidence of a hematoma, check the ear canal for signs like discharge and redness or pain during ear cleaning. There are surgical treatment options as well as non-surgical treatments to help reduce inflammation around the ear. If you have any questions or concerns, please contact your veterinarian. Treatment should be initiated as soon as possible for the best prognosis. Prevention is key so make sure to treat ear infections and keep a close eye on your dog for any signs of an ear hematoma.