Ear Hematoma in Dogs

An ear hematoma is a pool of leaked blood that gathers underneath the skin, causing painful swelling and redness. Dogs frequently develop hematomas in the flaps of their ears, the outer portion of the ear connected to the sides or the top of your dog's head. Ear hematomas, also called aural hematomas, are usually caused by excessive head shaking or scratching due to an ear infection, mites, allergies, or other irritation inside the ear canal. The vigorous head shaking can cause a blood vessel inside the ear flap to break, which leads to the swelling.

While any dog can develop an ear hematoma, the condition is most common in dogs with floppy ears, such as Basset hounds, Cocker spaniels, and dachshunds, as head shaking in these dogs causes the ears to slap against the side of the head, leading to trauma.

What Is an Ear Hematoma?

Because ear flaps are very thin, there isn't much room for pooled blood should a blood vessel break underneath the skin. Consequently, the blood tends to create a pocket of swelling that can become large enough to affect the entire outer ear. You'll notice that your dog's ear looks swollen like a balloon, and the affected ear might droop more than the normal ear. Ear hematomas can feel squishy or firm, depending on the amount of swelling. They are very painful, and your dog will likely object to you touching the swollen ear.

An ear hematoma can cause the ear flap to partially or completely fill up with blood, giving the ear an inflated appearance. If the swelling is large enough, it can cover the opening of the ear canal. The extra weight of the ear flap can cause some discomfort, and may also lead to a permanent change in the carriage of the ears. Ear hematomas usually occur in just one ear but occasionally affect both ears.

Symptoms of an Ear Hematoma in Dogs

The main symptom of an ear hematoma is the swelling, which can become quite extensive. Because the hematoma is often due to an underlying ear infection, your dog will likely show a variety of symptoms due to the pain and irritation of both the hematoma and the infection.

Ear hematomas can be small and only affect a portion of the ear flap or can become large enough so the entire ear flap is swollen. The weight of the swelling can cause the affected ear to droop lower than usual, and the pain might cause your dog to scratch at the ear or shake its head in an effort to relieve the discomfort. Often, the dog will sit with its head tilted towards the affected side, as that ear feels heavier than the healthy ear. If the ear is infected, as is usually the case with ear hematomas, you will probably notice signs of infection inside the ear, including excessive ear wax, black or yellowish crusts or spots of debris, and a foul odor.

What Causes Ear Hematomas in Dogs?

Ear hematomas are created by a broken blood vessel inside the ear flap. This leads to bleeding underneath the skin. Because the tissue of the ear flap is thin, the blood doesn't have much room to spread out, so it tends to pool, leading to a swollen, balloon-like appearance of the ear.

The most common cause of ear hematomas is excessive head shaking due to an ear infection, allergies, or a foreign object inside the ear. Occasionally, however, your dog might develop a hematoma after a trauma to the ear, such as a bite from another dog or even an overly vigorous play session. And dogs with blood-clotting disorders are also more prone to developing hematomas, even without prior trauma or infection.

How Do Vets Diagnose Ear Hematomas in Dogs?

Due to the distinctive appearance of an ear hematoma, the diagnosis is generally quite straightforward. Your veterinarian will generally diagnose the hematoma simply by visual inspection but will be more concerned with the underlying cause. Thus, the vet will examine the inside of your dog's ears to see if there are signs of infection, allergies, or a foreign object stuck inside the ear canal. The vet might swab inside the ear and examine the specimen underneath a microscope, which can reveal bacteria or yeast.

Sometimes, your vet will recommend further diagnostic procedures, including needle aspiration of the fluid inside the hematoma to be certain it's just blood. And blood tests to assess your dog's overall health are often also ordered.

How to Treat Ear Hematomas

Sometimes an ear hematoma is so small that it may not need to be repaired. Left alone, the blood inside a small hematoma will eventually reabsorb. There is a risk, however, that an untreated hematoma, even if small, can leave your dog with a permanently scarred or deformed ear. That's why all hematomas should be assessed by a veterinarian, who will also provide pain medications and treatment for any underlying ear infection. Your vet will prescribe antibiotic drops for the dog's ears,
and may also give an injection of antibiotics to start the healing as quickly as possible.

Most often, the hematoma will need to be repaired by your veterinarian. This is especially true if the hematoma is so large that it is blocking the dog's ear canal, it is causing the dog extreme pain, or it is likely to create permanent scarring that will narrow the ear canal.

There are several options for repairing an ear hematoma. Your veterinarian will determine the right method for your dog. Here are some of the more common procedures.

Aspiration

This procedure involves using a needle attached to a syringe to remove fluid from the hematoma. However, the fluid will eventually return, sometimes within days, making this a temporary solution. It can also lead to infection within the ear flap. Still, some owners may prefer this method because it can provide instant relief and does not require surgery, making it the less expensive option. Instilling a steroid into the dead space can make this method more successful. A low dose of oral steroids may also be helpful.

Pie-Crusting Sutures

Here, an incision is made in the ear flap surgically. The hematoma is drained of fluid and blood clots. Multiple sutures are placed in the hematoma area in a quilt-like pattern to prevent it from refilling. Usually, a small tube is left in place to serve as a drain for fluids as the area heals, and often tight bandages are applied over the ear to help reduce swelling. Sutures are typically left in place for up to three weeks to prevent recurrence of the hematoma.

Teat Cannula Placement

A teat cannula is a small device used in the treatment of udder inflammation in cattle. These cannulas can also be surgically placed in a dog’s ear hematoma if the ear flap is large enough to accommodate it. The hematoma is drained of fluids and allowed to heal over several weeks. This method is generally successful, but the dog must tolerate the discomfort of the cannula in the ear flap while it drains fluid.

Prognosis for Dogs with Ear Hematomas

Most dogs recover from an ear hematoma without any problems, as long as the underlying infection is treated and surgical procedures, if required, are carried out promptly. However, leaving an ear hematoma untreated can lead to permanent scarring or disfigurement of the ear.

How to Prevent Ear Hematomas

Because ear hematomas are most often caused by head-shaking due to an an ear infection, the best prevention is to take steps to ward off possible ear infections before they become severe. Regular inspections of your dog's ears are helpful; look for signs of trouble such as excessive wax, crusty debris, redness, or odor. Dry your dog's ears thoroughly after a bath or a swim, especially if your dog has floppy ears, as retained moisture can lead to the growth of yeast within the ear canal. Dogs that are prone to ear infections might need regular grooming and cleaning of their ears to prevent problems from developing.