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Ask the Vet: Can a Dog's Ear Hematoma Heal on its Own?

Dog's Ear Hematoma

"Can a dog's ear hematoma heal on its own?" is something many dog owners may wonder at some point. Owners of dogs suffering from an ear hematoma may be concerned about putting their dogs through surgery or perhaps have financial constraints that limit the amount of care their dogs can get. What's the worse that can happen if a dog's ear hematoma goes untreated? Can a dog's ear hematoma heal on its own without surgery? Here is what veterinarian Dr. Ivana Crnec has to say about ear hematomas in dogs and their treatment.

Excessive ear shaking may cause ear flap hematomas in dogs.

Excessive ear shaking may cause ear flap hematomas in dogs.

Understanding Ear Hematomas in Dogs 

When blood accumulates between the skin and the cartilage of the ear flap, a blood-filled blister called hematoma develops. This fluctuating swelling under the skin of the ear flap is hot and soft to the touch.

Hematomas usually occur as a consequence of vigorous head shaking (due to allergies, ear infections, ear mites, foreign bodies or other irritants that initiate overly aggressive scratching), especially in older dogs. They may also be caused by a blood clotting disorder, poisoning with anticoagulants (rodenticides such as warfarin) or head and ear traumas.

Simply put, hematomas develop when the blood vessels in the ear get damaged and start leaking blood into the surrounding tissues. The blood vessels get damaged as a result of the self-trauma – the ear flap slaps against the skull thus damaging its vessels.

The blood accumulates creating a pool or pocket between the ear skin and the ear cartilage. Over time, the accumulated blood starts pressuring the damaged blood vessels and they stop leaking. However, the already accumulated blood has nowhere to go and coagulates. Even if the blood is evacuated, if the underlying cause is not resolved, the accumulation reoccurs.

Generally speaking, dogs with floppy and pendulous ears are at higher risk of developing ear hematomas than dogs with short or erect ears. There is some evidence that both Labrador Retrievers and Golden Retrievers have a genetic predisposition to ear hematomas.

Additionally, since skin allergies are a common underlying cause, dogs prone to skin allergies are also prone to ear hematomas. Last but not least, if the circumstances are right, any dog can develop an ear hematoma.

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Signs of Ear Hematomas in Dogs 

Dogs with ear hematomas have a fluid-filled swelling on either the entire ear flap or just part of the ear flap. If the swelling is located on the very tip of the ear, the ear canal is normal and functioning.

However, if the swelling is generalized and involves the entire ear flap, it may occlude the ear canal. Depending on how progressed the condition is, the swelling can be either soft and fluctuating or firm and non-fluctuating.

Visual examination of the affected ear flap is usually all that is necessary for diagnosis. What is more important and usually trickier to diagnose is the underlying cause that lead to excessive head shaking and ear scratching. This requires inspection of the ear canal (with an otoscope) and swabbing for samples which will be microscopically examined.

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Can a Dog's Ear Hematoma Heal on its Own?

Unfortunately, more often than not, an ear hematoma cannot heal on its own. Depending on the severity of the case it requires either aggressive or at least prolonged treatment. If left untreated, it can progress and lead to complete occlusion of the ear canal.

In a small number of cases, the ear hematoma will resolve on its own, but until it does it will cause a great deal of pain and discomfort for the affected dog. What is more, the ear flap will form thick and wrinkled scar tissue that neither looks nor feels natural.

Dog Ear Hematoma Treatment options

Almost always visual examination of the swelled ear is all that is necessary for diagnosis. What is more important and usually trickier to determine is the underlying cause that lead to excessive head shaking and ear scratching. This requires inspection of the ear canal (with an otoscope) and swabbing for samples which will be microscopically examined.

Once the diagnosis is set, it is time to choose the treatment strategy. Luckily there are several treatment options. Which option will be chosen depends on the severity of the case, the underlying cause and the dog’s response to previous treatments.

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This is the simplest treatment option. It is cheap and easy to perform. The procedure involves using a needle and a syringe to evacuate the accumulated blood. Unfortunately recurrences are common since an empty space is left behind after the fluid removal. Another possible complication is infection that can be introduced through the puncture wound.

Use of a Cannula

Another option is to insert a teat cannula into the dog’s ear (teat cannulas are normally used to treat udder infections in cows). The inserted cannula allows prolonged drainage of the accumulated blood. This technique is suitable for dogs with large ear flops and dogs that will not be bothered by the presence of this gadget in their ears. The cannula remains in the ear for several weeks.

Treatment with Corticosteroids

This method is usually used in combination with aspiration. Once the accumulated blood is evacuated, corticosteroids are injected into the emptied pocket. The application of corticosteroids is repeated once every 10-14 days for several weeks. Unfortunately, recurrences are common.

Surgical Treatment

The surgical treatment includes making an incision on the inside of the ear flap. The blood and blood clots are drained through the incision and to prevent refilling, multiple sutures are made on the hematoma area. The sutures are removed not sooner than three weeks after the surgery or until good scaring is formed.

Cauliflower Ear – Serious Medical Condition or a Purely Cosmetic Issue?

Whether a cauliflower ear will be considered a medical or cosmetic issue depends on the severity of the case. If the canal is occluded and the condition causes pain and discomfort it is considered a medical issue. However, if the canal is clear and the ear retains its normal function regardless of its deformed appearance, it is considered a cosmetic issue.

About the Author 

Dr. Ivana Crnec is a graduate of the University Sv. Kliment Ohridski’s Faculty of Veterinary Medicine in Bitola, Republic of Macedonia.

ivana crnec

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