Ear Hematoma
By Dr. Karen Burgess

What is an ear or aural hematoma?
An ear hematoma is a typically non-painful pocket of blood that develops in the ear flap or pinna after rupture of a blood vessel.  Similar to a “blood blister” the cartilage of the ear flap contains the blood creating a swelling on the ear flap that often resembles a pillow or water balloon.

How do dogs and cats get ear hematomas?
Ear hematomas occur after a blood vessel ruptures in the ear flap.  This often occurs after a traumatic episode such as rough play, bite injury, or aggressive flapping of the ears.  It is not uncommon for pets with ear infections or severe ear inflammation to develop an ear hematoma.

How is an ear hematoma diagnosed?
Ear hematomas are diagnosed by visual examination or aspiration by a veterinarian.  Ear cytology may also be recommended to look for an underlying ear infection.

How are ear hematomas treated?
There are a variety of treatments that have been used over the years for ear hematomas.  In the end, this is not typically a life threatening issue and more of an aesthetic concern.  It is important to know that regardless of treatment method there is likely to be some degree of scarring.  The scarring may be more noticeable in pets with upright ears.  For this reason, some may opt to not pursue any treatment, letting the body reabsorb the blood and essentially scar.  This in turn avoids the expense, discomfort, and follow up involved with surgical repair.  Lack of treatment may cause more extensive scarring similar to a “cauliflower ear”.   Surgical treatment can range from incising the hematoma and stitching it flat to placing a cannula into the hematoma for several weeks.  If surgery is performed it is extremely important to protect the surgery site either via and Elizabethean collar or a bandage.  There are some veterinarians that have also had success using steroid injections to treat ear hematomas.  Some might wonder why the ear hematoma cannot just be drained.  Unfortunately this is usually only a short lived solution with the hematoma quickly refilling.