Aural Hematoma
A common procedure done at the Moab Veterinary Clinic is aural hematoma repair. Fans of boxing or MMA may recognize an untreated and resolved aural hematoma as a “cauliflower ear”. Aural hematomas in pets are most often the result of an infection or foreign body in the ear that has caused a pet to vigorously shake their head, resulting in the rupture of blood vessels within the ear flap. Other causes can include insect bites to the tip of the ear or other ear injuries resulting in excessive head shaking. Aural hematomas can heal without medical intervention, but it often leaves the ear very “crinkly” (the “cauliflower ear” appearance). We can help repair the ear so it appears much more normal after healing.
While we most often see these in dogs, we have seen some cats with this problem as well. Aural hematomas generally present as a swollen ear flap, “puffed up” with fluid. The only prevention for aural hematomas is to bring your pet in if you notice them shaking their head so we can decide what treatment is best- treating for an ear infection won’t help if the culprit is a tick (and vice versa)! If your pet already has an aural hematoma, the best thing is to bring them for evaluation by a veterinarian to confirm the issue and likely schedule for surgery.
While we most often see these in dogs, we have seen some cats with this problem as well. Aural hematomas generally present as a swollen ear flap, “puffed up” with fluid. The only prevention for aural hematomas is to bring your pet in if you notice them shaking their head so we can decide what treatment is best- treating for an ear infection won’t help if the culprit is a tick (and vice versa)! If your pet already has an aural hematoma, the best thing is to bring them for evaluation by a veterinarian to confirm the issue and likely schedule for surgery.
Procedure
Simply draining the ear will not resolve the hematoma as the hole from a needle will soon seal back up and the vessels in the flap will continue to leak fluid, causing the ear to puff up again. Pets will need to be under general anesthesia to repair the hematoma. While your pet is asleep, the doctor will check the ears to confirm infection or foreign bodies (such as grass awns or ticks). Different doctors have different ways of going about repairing them, but this article will focus on how we repair them at the Moab Veterinary Clinic.
Your pet’s ear will be shaved and scrubbed, just like any other surgery we perform. The veterinarian will use a biopsy punch (think of a very, very sharp hole punch) to punch several holes into one side of the ear flap. These holes provide ample opportunity for the fluid in the ear flap to drain out. Once enough holes have been punched into the ear, any remaining fluid is squeezed out along with any present blood clots. The veterinarian will also use some hemostats (very small clamps) to search for fibrin (fibrous material formed from protein) or any remaining blood clots and remove it so the ear flaps can heal back down together. Some veterinarians may suture the ear flap at this point to “tack it down” and others may not use suture at all to allow the ear flap to “tack down” on their own. Neither is a wrong option and both have similar success rates.
Your pet’s ear will be shaved and scrubbed, just like any other surgery we perform. The veterinarian will use a biopsy punch (think of a very, very sharp hole punch) to punch several holes into one side of the ear flap. These holes provide ample opportunity for the fluid in the ear flap to drain out. Once enough holes have been punched into the ear, any remaining fluid is squeezed out along with any present blood clots. The veterinarian will also use some hemostats (very small clamps) to search for fibrin (fibrous material formed from protein) or any remaining blood clots and remove it so the ear flaps can heal back down together. Some veterinarians may suture the ear flap at this point to “tack it down” and others may not use suture at all to allow the ear flap to “tack down” on their own. Neither is a wrong option and both have similar success rates.
Post Op Care
Post op care for an aural hematoma usually involves at least one night at the veterinary hospital. Because these can continue draining for a long time, we prefer to let our patients experience the bulk of this drainage at the hospital instead of in your home. It should go without saying it can get very messy if they’re still draining and shake their heads. Once drainage has slowed down or stopped, we will discharge for home care.
Home care will involve keeping the surgery site clean and applying a special medication into the holes in the ear flap twice a day. This medication helps prevent infection inside the ear flap, as well as keeps the holes open to encourage draining. If these holes close up too soon, the aural hematoma will return.
If your pet had a foreign body removed from the ear canal further treatments may not be necessary, however something like ear mites or ticks may warrant further treatment at home with another medication that will be dispensed to you. If your pet had an ear infection, you will have another medication that will go into your pet’s ear canal (or both canals in the case of both ears being infected). If you have questions about any of your pet’s medications, please ask a staff member.
Home care will involve keeping the surgery site clean and applying a special medication into the holes in the ear flap twice a day. This medication helps prevent infection inside the ear flap, as well as keeps the holes open to encourage draining. If these holes close up too soon, the aural hematoma will return.
If your pet had a foreign body removed from the ear canal further treatments may not be necessary, however something like ear mites or ticks may warrant further treatment at home with another medication that will be dispensed to you. If your pet had an ear infection, you will have another medication that will go into your pet’s ear canal (or both canals in the case of both ears being infected). If you have questions about any of your pet’s medications, please ask a staff member.
