Ear Hematoma In A Dog And Cat

Health care questions and answers about puppies and dogs

What is a hematoma in a dog and cat?
  
Questions and answers about hematomas in dogs and cats.
A hematoma refers to an accumulation of blood outside the vascular system.  A "blood blister" is a small hematoma.  Dogs more often than cats develop a hematoma under the skin over the cartilage of the ear flap (called the pinna).  Various theories apply regarding why the ear hematoma originates but the leakage of blood and serum under the skin creates an irritating bump of serous fluid that can spread throughout the underside of the pinna.

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Question:
    
My vet says my Lab has an "aural hematoma" and needs expensive surgery and anesthesia to correct it.  Do I have to have the surgery done and what is a hematoma anyway?  
     Will he get one in the other ear, too?  I really don't want to have surgery done if it isn't necessary.  Help!!  What should I do?

Answer: dog... ear...hematoma
    
Some small hematomas will clot, shrink up with scar tissue and be no further bother to the dog but will leave the pinna crinkled and misshapen with scar tissue.  Your veterinarian won't do surgery unless it would benefit the dog's comfort and appearance because some of these will progress throughout the entire pinna and be very painful.  And if they get scratched open it will be a real mess and can get seriously infected.  Simple draining with all sorts of devices have been tried with variable success and failure.  
     One surgical method entails cutting several small holes in the skin over the hematoma and bandaging the ear flap over the head.  The lesion generates scar tissue and reattaches to the cartilage beneath thereby eliminating any reoccurrence of the hematoma.
     Another advantage of anesthesia/surgery is that your vet will be able to inspect deep into each ear canal and check for a ruptured ear drum or foreign material that may have triggered itching or irritation and self trauma to the pinna that initiated the seepage of blood and serum under the skin of the pinna.  Your dog will be back to 100% sooner if hematoma surgery is done. 

        Doctor's Notes
     When the suture is passed through the ear flap (pinna) and tied snugly it eliminates the space where the hematoma formed.  The goal is to have the skin tack back down and heal against the thin cartilage sheet of the pinna.
     Due to swelling after the surgery several materials are used to keep the sutures from cutting into the skin of the pinna.  Buttons, short pieces of iv administration line, or other methods provide a buffer between the suture and skin.
     In the post-op image below the surgeon used pieces of iv line tubing to cushion the skin beneath the suture so the suture wouldn't cut into the skin.

Click on an image to view a larger version in a new window

dog_ear_hematoma retriever with ear hematoma pinna of dog with a hematoma hematoma surgery on a dog
The "bubble" on the underside of the
 pinna is called a hematoma.  The akin has separated from the underlying cartilage.
The hematoma is filled with a fibrinous,
 thin, bloody fluid and some clotted blood.
Simply draining a hematoma seldom corrects the problem and can initiate
 an even more serious infection!
The hematoma has been drained and scraped clean on the inside; sutures
 are placed through the full 
thickness of the ear flap.

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Question:
     Someone told me that cats do  not get hematoma of their ears but I think my cat may have one.  He's been scratching a lot at his ears and now one ear flap looks real thick, like a bubble or something.  Could it be a tumor.

lateral ear canal resection
Lateral ear canal resection

Answer:  cats...ears...hematoma
     Yes, cats sure can develop hematomas of the ear flap (called the pinna).  Your veterinarian will check for reasons for the cat's scratchingcat ear hematoma on pinna at his ears because yeast infections and ear mites can be a common cause of ear itchiness.
     The scratching may have triggered a slight bleeding under the skin of the pinna and now the "bubble" is apparent.  Be sure to have this checked by your veterinarian soon because any unusual bleeding can be a forewarning that the cat could have a clotting disorder, a form of anemia, or a platelet deficit.  
     Any bump or "bubble" could have several causes including tumors, bleeding disorders, rodent poisoning, infection or trauma.  In a few situations where no surgical correction is done the hematoma can resolve into a knot of thick scar tissue which misshapes the pinna and constricts the ear canal opening.  
     Surgery, like the procedure in the photo on the left called a lateral ear canal resection, may be needed to reopen the ear canal!

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