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Ear Hematoma - Had An Ear Infection And Now The Ear Is Swollen

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Cat Ear Hematoma by Liz Masoner

Ear Hematoma in a Cat by Liz Masoner

Question: Ear Hematoma - Had An Ear Infection And Now The Ear Is Swollen
Ear infections are common in dogs and cats, for some animals more than others. A VetMed Viewer asks: "My American Bulldog has a chronic ear fungus that he scratches at and it is infected and keeps filling up with blood. He’s been to the vet twice this week and now it’s filled up again, his poor ear is sticking straight out. He’s on antibiotics too, any home remedy until we can get back to our vet?"
Answer: What you are describing sounds like a condition called aural (ear) hematoma, and it is basically a large blood blister of the ear flap. This condition is seen in both dogs and cats, and may be the result of head-shaking due to an ear infection, ear mites, or itchy allergic ears.

Ear Anatomy

The ears of dogs and cats are basically 3 layers: skin, cartilage, skin. The ears have many blood vessels. With damage to these vessels, blood seeps in between the skin and cartilage, forming a 'blister' on the ear flap. The aural hematoma may involve part of the ear flap, or the entire ear flap, sometimes occluding the ear canal.

A history of an ear infection or itchy ears is most common, but not always the case. The cause could be from head-shaking due to ear infection, grass awn and foxtail, allergies, ear mites, or nearby hot spot irritation. In some cases, the cause remains unknown, possibly an autoimmune or bleeding disorder.

The ear flap is usually turgid (fat), and warm to the touch. Uncomfortable at best, and probably painful. The animal usually tilts the head toward the affected ear, and often shakes the head. This can cause more damage or possibly rupture the ear flap skin.

Treatment Options

There are several ways to treat this condition, but they need to be done by a veterinarian. To try and empty this out with a needle at home poses risks such as:
  • Introduction of infection. Bacteria thrive in this warm environment of blood and clots.
  • If the blood does drain (may be difficult due to clot formation), it will likely fill right back up again, creating more trouble.
  • The underlying cause must be addressed, or this will be a recurring problem.

Without treatment, it takes weeks for the body to resorb a large hematoma, which is uncomfortable for the pet and will result in a crumpled ear, also called a cauliflower ear.

Until you can see the vet, try to keep the ear clean, using the previously prescribed ear washes and any ongoing medications. Some dogs will tolerate a loose head wrap to prevent further head-shaking damage, but struggling to get a bandage off will make things worse for many dogs, so owner discretion is advised.

Veterinary treatment options include:

  • Aspirate using a sterile needle
  • Surgically open up the ear flap, drain the space and remove clots, then suture the ear down
  • place an indwelling cannula (drain) in the ear to drain away fluid as the ear heals
  • Administer oral corticosteroids to help reduce swelling and scarring

Your vet will also initiate proper medical therapy and treat the underlying causes.

If you suspect that your dog or cat has a hematoma, while not usually an emergency, please contact your veterinarian as soon as possible to discuss treatment options and prevention.

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