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AURAL HAEMATOMA

What is a haematoma?

This is simply a blood blister.  It is a localised collection of blood, usually clotted and can occur anywhere in the body.  For example bruises are really a form of haematoma.  The most common type of haematoma in the dog is that affecting the pinna or flap of the ear.

Why do aural haematomas (? haematomata) occur?

Irritation and infection of the ear canal is very common particularly in dogs with drop ears, e.g. Spaniels, Bassets, etc.  If the ear canal is irritating, the dog scratches and sometimes will shake the head violently.  This can cause damage to the delicate blood vessels in the ear flap which results in bleeding and thus the formation of a haematoma.  Depending on severity and length of time present this can involve just part of the ear flap or the whole pinna can be involved.  The swelling bothers the dog and flapping, shaking and scratching increase, thus making the situation worse.

What can be done?

It is most important to treat the underlying cause.  This in the majority of cases in the dog is infection within the ear canal, causing the irritation which results in head shaking and scratching leading to damage to the blood vessels which lie between the cartilage and the skin on both sides of the ear flap.   The swelling must also be treated.  This can be done in various ways, e.g.

· Drainage via a needle and syringe with or without an injection of a corticosteroid preparation. This is sometimes all that is needed with small swellings

· Surgical drainage and the prevention of recurrence of the swelling is the treatment of choice for the majority.  Various techniques are available to prevent further swelling.  These either involve the insertion of drainage tubes or multiple sutures ensuring that space between the skin and the cartilage of the ear is reduced as much as possible

If it is a blood blister, won't it disappear with time, just like a bruise?

Theoretically this is possible but the discomfort of the swelling encourages the dog to continue shaking and scratching which can lead to further bleeding. If left untreated the ear will be distorted, ending with a typical cauliflower ear.

Can you not just keep draining the swelling?

This is possible but unfortunately the blood clots and although we can remove the fluid, without surgery we cannot remove the clot.  It is this that in turn contracts, forms fibrous tissue and results in distortion of the ear.