Aural Hematoma... A Blood Filled Pocket

A  hematoma is any abnormal blood filled space.  An Aural Hematoma is a collection of blood under the skin of the ear flap of a dog or cat.  (The ear flap itself is called the Pinna.)  Ear hematoma occurs much more commonly in dogs than in cats; a hematoma generally is the result of trauma to the pinna from an injury or from the dog or cat scratching at the ear.  The itchy ear can result from ear mites, allergies, infections or foreign matter in the ear canal.  Frequent scratching at the ear, or even vigorous shaking of the head, can result in a rupture of small blood vessels beneath the skin of the pinna.  Since there is little strength or depth to the tissues of the pinna, clotting may be delayed... especially if the dog or cat continues to upset the clotting by additional self trauma.

The entire ear flap can become swollen, infected and severely uncomfortable to the dog.  Hematomas can heal themselves but will leave behind a scarred, crinkled and shrunken pinna. And since the original cause is usually an infected ear canal, the original cause needs to be treated as well as the hematoma itself.  Veterinarians generally will recommend surgery to open and drain the hematoma and remove dead and degenerating clots and fibrin.  Then sutures are used to tack the skin layers over the thin cartilage center tight to the cartilage to eliminate any space for more blood or serum to accumulate.  Of course this is done only under general anesthesia, and antibiotics and anti-inflammatory medication is used post operatively.  

During the procedure both ear canals are examined and any treatment and cleaning is done.  The sutures are left in place for two weeks, minor cleaning is done at home using peroxide, and the patient is readmitted for a final inspection and suture removal.  As with many kinds of ear troubles in the canine (allergies, infections, wax build-up, mites, etc), diligent aftercare is necessary to keep scar tissue and long term pathology from occurring.  For a look at what chronic ear infections can do.

The Hematoma is seen on the underside of the dog's pinna.  Cats do get Hematomas, too, usually due to ear mites.  Hematomas are painful and surgical intervention is common.	The Hematoma is outlined.  It could spread along the entire underside of the pinna within days.  The ear canals are examined and any pathology is vigorously treated.	The incision is made through the skin down to the thin cartilage to drain and explore the Hematoma.  Once healed, hematomas rarely affect the same ear again.	As many sutures as needed are placed through the entire pinna to tack the skin back to the cartilage. Healing is uneventful and generally occurs within two weeks after surgery.