# Ear Hematomas in Dogs



## FEWill (Sep 2, 2009)

Ear hematomas in dogs are one of the most common ear problems that affect your pet, and can affect any breed at any age. However, there is one major difference with this condition; it can cause severe and permanent ear deformities. They are also extremely painful to your dog and as result, your dog will do the only thing they understand, scratch intensely at their ear which will only add to the problem. To compound this condition even further, there are no known documented reasons why they occur in your dog. 

What are they?

Ear hematomas in dogs are also known by two other names; aural hematomas and auricular hematomas, and are a collection of blood as well as fluid in your dog's ears. This collection of blood and fluid will occur between the skin and the cartridge of their ear, and is the result of a blood vessel that has ruptured. Once this rupture occurs, it begins to fill up the loose space under the skin of your dog's ear with blood. However, it will also do one other thing to their ear; it causes a tremendous amount of pain.

Once the rupture occurs, it will also cause the entire surface of their ear to swell, and as a result, your dog's entire ear surface will be extremely sensitive as well as painful. Ear hematomas can occur very rapidly, and in some cases, it may be only a matter of minutes after a rupture that the ear starts to swell. 

The hematoma itself will usually appear as a fluid filled swelling and will be located underneath the pinna of your dog's ear. 

The pinna of the ear is the pointed or floppy part, and if this condition is not treated very quickly, it can easily disfigure their ear as scar tissue begins to build. This deformity is most often referred to as a cauliflower ear, and breeds with large ears or floppy ears are more commonly affected than other breeds. However, Golden and Labrador Retrievers are also affected by this very painful condition, even though their ears are not considered to be floppy. 

If your dog has a history of chronic ear infections, or is very sensitive to infections or allergies, they are also at a much higher risk. Although there is no known actual cause, there is some speculation that ear mites may trigger ear hematomas in dogs. However, there is one other potential cause; field or working conditions. If your dog runs through heavy brush or wooden areas daily, they can very easily damage their ears, which in turn can cause ruptures. 

Symptoms:

Ear hematomas in dog's only shows two distinctive symptoms, however, it is very helpful for an owner to understand what is often confused with this condition. The two symptoms include a very sudden and violent shaking of the head, as well a swelling in the pinna area. If you see either of these two warning signs, gently touch your dog's ear. If they are very sensitive to this touch or cry out, you have just confirmed that they have ear hematomas. However, there are some other conditions that are often confused with a hematoma; an abscess or a tumor.

A hematoma is quite unique in that it is fluid filled and swells in the pinna almost exclusively, however, the difference may have to be determined by your veterinarian. An abscess is usually a secondary condition and generally is the result of some type of foreign body invasion or some type of an injury. The injury is usually a bite wound, but both causes will lead to the development of pockets of pus in and around the same area. In the testing process to determine exactly what it is, your professional will insert a small needle. Ear hematomas will produce blood, while an abscess will produce pus that is usually green or yellowish in color. 

Potential tumors will be tested the same way, but they are usually extremely firm and have some type of an ulceration, which is bleeding from the site, hematomas do not. However, it is extremely important that you do not try to determine this on your own; leave it to your veterinarian. 

Treatments:

There are several very effective treatments for ear hematomas in dogs, however, there is one critical factor to consider; never try to treat it on your own. Trying to prick it and drain it is the worst possible thing that you could do, as it will most likely disfigure your dog's ear permanently. However, not having it treated as soon as possible once you have identified it, is just as dangerous.

Trying to manage this condition with medical treatments in most all cases is not successful. For example, if your veterinarian suggests treating it with steroids injections, ask for the success records of this procedure. Most veterinarians will not even attempt this as a treatment, simply because the re-occurrence ratio is way too high. The only successful way to treat this condition is with surgery.

Any type of surgery can be somewhat expensive, and this is a personal decision you will have to make. The goal of the surgery is two-fold; to prevent it from reoccurring as well as protecting the shape of your dog's ear or ears. One of the procedures will involve incising your dog's skin on the underside of their ear, drain the blood, and then stitch it multiple times. However, the ear may not be bandaged, as this is considered a very effective method of returning your dog's ear to a normal appearance. 

There are other alternatives, as the treatments methods are a hotly debated topic. The next method will include opening the ear surgically and then draining the ear, but placing no stitches at all in the ear. Instead, your veterinarian will choose to tape the ear over a rolled bandage that allows it to heal much faster in some cases. If you have a show dog, this is considered to be the only option, as it will in most every case insure that no deformities are caused. However, this form of treatment requires much more attention after the surgery. 

Summary:

Ear hematomas in dogs are extremely painful and can occur very rapidly. If your dog starts to shake their head obsessively, there is a very good chance they have developed this condition. It is not a life threatening situation, but it can very easily disfigure their ear if not treated very quickly. It is extremely important to understand that this is not something you can treat on your own; only your veterinarian can treat it.


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## wooliewoo (May 27, 2008)

our first girl had one of these which presented itself as a swelling on her ear. Looked a bit like a bruise. She ended up haveing surgery to slice the skin layer and drain the fluid with the layers restitched. She recovered well and had no reoccuring problems and the ear looked normal after. Vet said she could of banged her ear on fence or something??


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## FEWill (Sep 2, 2009)

Hi Wollie,

So glad to hear your dog is ok. It is always makes me wonder why we love our dogs so much. They become almost like our children. We notice every little thing about them and love them to death

Thanks,
Frank


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## HannahKate (Jun 6, 2010)

It is common to leave the skin incision open to help drainage and let this heal by secondary intention although it may be sutured too. We would use trans-spinal sutures which go in the direction of the blood vessels in the ear (along its long axis) to avoid damaging more vessels. 
There is also the button method which involves suturing buttons to the ear to increase the area in which pressure is applied, helping to keep the layers of the ear together and prevent reoccurence. 
Vets may have their own methods of treatment for this. My vet inserts a drain, not for the drainage in particular (although it helps) but because it helps create scar tissue to bind the ear together. However it's not the best method if you want your dogs ear looking exactly the same as before as the scar tissue produced is thicker than in other methods, but it does have a good success and low reoccurence rate.. 
The reason that ear mites would cause haematomas would be that they are extremely itchy and like otitis externa would cause itching and shaking of the head. Fighting is also a common cause of these. The haematoma can also be on either side of the ear or both.


> there are no known documented reasons why they occur in your dog


What about increased capillary fragility associated with diseases like Cushings???

(helped along by Fossum's Small Animal Surgery and my professors lecture material)


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