Treating a Dog Ear Hematoma

I noticed a swelling on one of the ear flaps of my German Wirehaired Pointer, Woody, and he didn’t want me to touch his ear. It was obvious that he was in pain and uncomfortable. I called our vet for an appointment, and my vet very quickly diagnosed an ear hematoma.  

What Is A Dog Ear Hematoma? 

Ear or aural hematomas are firm, swollen blisters filled with blood on the inside of your dog’s ear flap. They occur when blood vessels within the ear flap burst, and bleeding occurs in the space between the ear cartilage and the skin. This can cause the ear to swell and become very painful for the dog. 

Hematomas can be very painful, and it is vital to seek veterinary care as soon as possible.  

Causes 

Hematomas can form due to trauma to the ear flap caused by excessive head shaking or scratching, or from injury. Often, the underlying cause is itching and pain from an ear infection, allergies or mites. They can also form when a foreign object is lodged inside your dog’s ear or as a result of a bite wound. Dogs with ear infections or allergies are more prone to developing hematomas due to the increased scratching and head shaking. 

Woody and I have done a lot of water training the past few weeks and on examination his ears were filled with dirt. Lots of shaking from swimming and possibly scratching of the ear are contributors to the hematoma. From now on I will check and clean his ears frequently.  

Ear Hematoma Symptoms 

Dog ear hematomas are fairly easy to spot. Signs to look for include: 

1. Swelling on the ear flaps 

2. Discoloration 

3. Deformity in the ear shape 

4. Pain/discomfort and aversion to touch 

5. Shaking of the head 

6. Scratching at the ear 

7. Redness and warmth of the ear 

Hematoma Diagnosis 

Hematomas can cause your dog discomfort, so he’ll likely shake his head and scratch even more. This can exacerbate the problem and cause even more blisters to form.  

A consultation with your vet is important for a diagnosis, to discuss treatment options, and to agree on a treatment plan. Your vet will perform a physical examination and discuss the findings with you. Seeking veterinarian care is also important to find the underlying problem because your dog could be suffering from ear mites or an infection that’s causing it to shake and scratch its head. 

Treatment 

There are several ways to treat a dog’s ear hematoma, and your vet will recommend the best method on a case-by-case basis. 

Treatment typically involves draining the hematoma and addressing the underlying cause, such as treating an ear infection or allergies. In some cases, surgery may be required to prevent the hematoma from recurring. 

Draining 

Draining is often the preferred course of treatment for small hematomas. This can be done with a needle, which is called a needle aspiration.  

For some smaller hematomas, some vets may opt to make a small incision in your dog’s ear flap and insert a tube to help the blood blister drain. Your dog will be sedated for this procedure, and for the aftercare, a no-flap ear wrap promotes healing as it stops your dog from shaking and keeps the ears protected.

This method involves diligent follow-up care. You’ll have to gently massage your dog’s ear to keep the fluid draining over several days, and then return to your vet to remove the tube and close the incision. The downside of solely using a draining tube is that it doesn’t do a good job of compressing the cartilage and skin back together. So, there’s a greater risk of disfigurement, especially with larger hematomas.  

Surgery 

Surgery requires your dog to undergo anaesthesia and post-operative recovery. Specific surgical techniques vary according to the vet’s preference and your dog’s unique circumstances, but they typically involve the same basic steps. 

1. The skin over the hematoma will be surgically incised to drain the blood and remove any blood clots. 

2. Numerous stitches (sutures) will be placed through the ear to reattach the cartilage to the skin and eliminate scar tissue formation. This helps prevent the recurrence of hematomas. 

3. A surgical drain may be placed to promote drainage. 

4. The pinna, or ear flap, will be bandaged to minimise damage and promote healing. 

Post-Treatment Care 

1. I highly recommend a no-flap ear wrap to keep your dog’s ears secure while healing.  Easy to fit and stays in place. Woody appears to be comfortable wearing the wrap. Good coverage of Woody’s ears and easy to undo velcro for draining the hematoma.  No Flap Ear Wrap The Original (S/M Denim) : Amazon.co.uk: Pet Supplies 

2. Bandaging: The ear may be bandaged to protect the surgical site and reduce swelling. It's important to keep the bandage clean and dry. 

3. Cone-Collar: An Elizabethan collar or similar may be used to prevent the dog from scratching or shaking its head, which can disrupt the healing process. 

4. Medication: Pain relief and anti-inflammatory medications may be prescribed to manage discomfort and reduce swelling. Antibiotics may also be given to prevent infection. 

Follow-Up Care 

Regular follow-up visits with the veterinarian are essential to monitor the healing process and ensure that the hematoma does not recur. The veterinarian may recommend additional treatments or adjustments to the care plan based on the dog's progress. 

Addressing Underlying Causes 

1. Ear Infections: Treating any existing ear infections is crucial. This may involve cleaning the ears and using medicated ear drops. 

2. Allergies: If allergies are contributing to the problem, identifying and managing the allergens is important. This may involve dietary changes, medications, or allergy testing. 

3. Regular Ear Cleaning: Keeping the dog's ears clean and free of debris can help prevent infections and reduce the risk of hematomas. 

Prevention 

Preventing ear hematomas involves managing the underlying causes, such as keeping your dog's ears clean, treating ear infections promptly, and addressing any allergies. 

Here are the usual suspects: 

• Yeast Infections: These thrive in warm, moist environments—especially floppy ears. The smell? Think mouldy bread mixed with foot funk. 

• Bacterial Infections: More aggressive than yeast, these often come with thick, yellow, or brown discharge and a smell that’ll haunt your nostrils. 

• Ear Mites: Tiny, crust-loving parasites that cause intense itching and black, crumbly gunk that looks like coffee grounds. 

• Water Trapped in the Ear Canal: After baths or swimming, leftover moisture becomes a breeding ground for bacteria. 

• Excess Wax Buildup: Some dogs just overproduce earwax, which can trap debris and start to smell if not cleaned out. 

• Foreign Objects or Foxtails: Grass seeds or tiny bits of debris can get lodged deep in the ear, causing irritation, infection, and, you guessed it, nasty smells. 

Can A Dog Ear Hematoma Heal On Its Own? 

Left untreated, a hematoma will slowly reabsorb into the body. This can happen in only a few days for smaller hematomas, but larger hematomas can take weeks or even months to reabsorb. However, it can be quite painful for your dog and cause permanent damage, and the underlying cause will not be treated either.

It may also lead to additional issues, including a blockage of the ear canal. Without treatment, the hematoma may never fully heal. And there’s a risk that scar tissue will cause permanent disfiguration that creates cauliflower ear. This is when the skin takes on the look of a cauliflower floret. Whether this disfiguration is problematic for your dog depends on the location of the hematoma.