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VET SPEAK: What to do if your dog has signs of ear haematomas

By Alison Laurie-Chalmers

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Haematomas are noticed with ear infections, or other reasons for constant head shaking.
Haematomas are noticed with ear infections, or other reasons for constant head shaking.

An ear, or aural haematoma is a blood-filled swelling inside the ear flap between the cartilage of the ear flap and the skin. Ear haematomas occur when blood vessels rupture within the ear flap, or ear “pinna”. As the blood accumulates, your dog’s ear flap will swell up, forming an uncomfortable swelling called an aural haematoma.

An aural hematoma usually arises as a self-inflicted injury from your pet scratching their ears and headshaking. These haematomas tend to occur suddenly, and the ear swelling is usually soft, hot to touch, causing the ear to droop, and your pet may hold their head to one side.

The haematoma swelling may involve the entire earflap, or it may affect only part of it. In most cases, only one ear will be affected, however, both ears can have haematomas.

If your dog has an aural haematoma, often an ear infection or other cause of irritation within the ear is the underlying cause. Signs of an ear infection are excessive headshaking and scratching. You may also notice a smelly odour or discharge coming from your dog’s ear.

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Other causes for headshaking, such as ear mites, foreign bodies within the ear, and other underlying health issues such as allergic skin disease, autoimmune disorders, Cushing’s disease, trauma, or an underlying blood clotting disorder, can also be the cause of aural haematomas in dogs.

Ear haematomas are easily diagnosed by a physical examination. Your vet will recognise the characteristic signs, the earflap is warm, swollen, and often red and inflamed.

Alison Laurie-Chalmers.
Alison Laurie-Chalmers.

Often, haematomas are noticed with concurrent ear infections, or other reasons for constant headshaking. Therefore, addressing the primary cause for your dog’s headshaking is necessary. The vet will carefully examine your dog’s ear with an auroscope, and may recommend taking an ear swab to identify the presence of any bacteria, yeasts or mites.

Aural haematomas are often very uncomfortable, so your dog will need some pain relief and often topical treatments for any underlying ear infections or ear mites, or an anti-itch medication for any underlying allergic skin problem. These treatments would be used in combination with any ear flap drainage or advised surgery.

Some small, painless aural haematomas can be left to heal and resolve by themselves.

However, most haematomas are larger and painful, and these do need to be drained.

Some can be drained with a syringe and needle, but if the swelling recurs, which is very common, surgery will be advised under a safe anaesthetic procedure to open the earflap, remove the blood, and leave a surgical drainage opening, or attach a surgical drain to stop any blood refilling.

Dealing with an aural haematoma also means dealing with the underlying initial disease that caused your dog to shake their head in the first place.

Preventing ear infections by checking your dog’s ears and keeping up with regular, good ear hygiene could help prevent ear infections and the formation of recurrent haematomas.

When ear infections do occur, with symptoms of frequent head shaking, excessive ear scratching, pain, redness, odour, crust, or discharge, these should be treated promptly.

– Alison Laurie-Chalmers is a senior consultant at Crown Vets in Inverness.

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