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Ask a Vet: My Dog's Ear is Puffy, What Happened?

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Puffy Dog's Ear

If your dog's ear is puffy, most likely your dog has a history of shaking his head repeatedly as a result of itching or pain located in the dog's ear. In most cases, a puffy ear flap in dogs is a medical condition that is known as "ear flap hematoma." Ear flap hematomas in dogs are a challenging condition considering that left untreated, they may lead to an unsightly ear that is not very appealing. The issue though is more of a cosmetic one. Regardless, if your dog's ear is puffy, your best option is to see your vet so that the underlying cause is addressed. Following is some info about ear flap hematomas in dogs by veterinarian Dr. Ivana Crnec.

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If your dog's ear is puffy, see your vet.

Help, My Dog's Ear is Puffy!

Once upon a time dogs’ ears came in one size and shape. This natural ear had an erected and highly mobile flap. The flap was well-insulated with hair on the outside and very smooth on the inside. When planned breeding began, we created an amazing variety of ear shapes and sizes – from the Spaniel’s dropped and fluffy ears to the Basset’s excessively long and smooth ears.

However, in changing the design of the dog’s ear, we have accidentally increased the risks and the incidence of ear problems. In fact, today, ear problems are among the most common reasons why dogs’ parents visit vets.

Ear flap issues are more common in dogs with long, floppy and excessively hairy ears than in dogs with erect and hairless ears. The most frequent ear flap issue in dogs is what is known as "ear flap hematoma."

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An ear flap hematoma in dogs is a blood-filled blister that develops when blood accumulates between the skin and the cartilage of the dog's ear flap. Ear flap hematoma usually occurs on one ear (unilateral). Depending on the severity of the case and the quantity of blood, the swelling may be diffuse if it involves the entire ear flap or localized if it involves only a small area of the ear flap.

Formation of Dog Ear Flap Hematomas 

Excessive ear shaking may cause ear flap hematomas in dogs.

Excessive ear shaking may cause ear flap hematomas in dogs.

To properly understand how ear flap hematomas develop and the events that lead to this condition, you need to know the anatomy of the dog’s ear.

A dog's ear flap is composed of two layers of skin that cover the central cartilage layer. The cartilage is responsible for keeping the ear’s shape. The blood vessels that nurture the ear go from one side of the ear to the other side while passing through the cartilage. Since the skin that covers the cartilage is mobile, when the skin slides across the cartilage, the rubbing may cause certain blood vessels to rupture.

The blood vessels in the ear, once ruptured, will keep bleeding until they fill the empty space between the skin and the cartilage with blood. Over time, the blood coagulates.

Hematomas usually occur as a consequence of vigorous head shaking, excessive ear scratching and ear traumas. In most of the cases there is a hidden, underlying reason for the head shaking and ear scratching. These causes include ear mites, bacterial and yeast infections of the ear canal and skin allergies. Ear flap hematomas may also occur as a result of impaired blood clotting, such as the blood clotting disorder caused by warfarin poisoning.

Lately it has been postulated that certain breeds have genetic predispositions to developing ear flap hematomas. It is believed that those breeds include the Labrador Retriever and the Golden Retriever. Generally speaking, ear flap hematomas are more common in older dogs.

The ear flap hematoma is usually presented as a fluctuating swelling under the skin of the ear flap. Once swelled, the ear flap is hot and soft to the touch. If the condition progresses, as the blood clots, the ear will become either firm or with dough-like consistency. Usually only one ear is affected. However it is not uncommon for both ears to have hematomas.

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At the Vet's Office 

If your dog's ear is puffy, visual examination of the affected ear flap is usually all that is necessary for diagnosis. However, the vet will most likely perform a thorough and complete physical examination of the dog.

The full physical examination is necessary for determining the potential underlying cause and determining the right treatment strategy. The vet may also request a blood analysis (complete blood cells count and coagulation factors) to rule out bleedings in other parts of the body.

In the past, ear flap hematomas were treated by draining the fluid through a wide needle. However, today, this procedure is no longer practiced.

Draining the accumulated fluid only empties the space and temporary lessens the symptoms but it does not treat the cause. Few days after the drainage, the blood will accumulate again.

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Dog Ear Flap Hematoma Treatment 

If your dog's ear is puffy, consider that nowadays there are two treatment options – surgical and conservative.

The surgical treatment is performed while the patient is under general anesthesia. The surgeon makes a hole on the inner surface of the ear flap to allow continuous drainage. Then he mechanically removes the clotted blood. This is followed by applying temporary stitches to prevent the ear flap from refilling with blood.

Depending on the severity of the case, it may be necessary to put a small drain or rubber tube until the blood resolves and the ear heals. If the patient has droopy ears, the treated ear is flipped up and bandaged against the head.

The conservative approach is less invasive, simpler and cheaper. However, the problem with the conservative approach is that it takes more time and unfortunately is not always successful. This treatment includes injecting cortisone directly into the ear cavity, under the ear flap skin. The cortisone injection needs to be repeated after two to three weeks. More serious cases require three cortisone injections.

Regardless of whether the hematoma is treated surgically or conservatively, the underlying cause should be identified and resolved. Ear flap hematomas cannot be directly prevented. However, keeping the ear canals clean and free from mites and infections prevents unnecessary head shaking and ear scratching, thus reducing the risk of developing ear flap hematomas.

Did you know? A dog ear hematoma left untreated,  may lead to what is known as "cauliflower ear" where the ear appears unsightly.

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Photo Credits:

  • Wikimedia Commons, Dog with ear hematoma, Lucyin, Creative Commons Attribution-Share Alike 3.0

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. She is a certified nutritionist and is certified in HAACP food safety system implementation.

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She currently practices as a veterinarian in Bitola and is completing her postgraduate studies in the Pathology of Domestic Carnivores at the Faculty of Veterinary Medicine in Zagreb, Croatia.

Ivana’s research has been published in international journals, and she regularly attends international veterinary conferences.

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