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 other trauma (fox tail or other irritant causing the pet to shake the head or scratch). In some cases, the cause remains unknown, possibly an autoimmune or bleeding disorder.
The ear flap will be warm, 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.
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.
As mentioned earlier, there are many ways to treat this condition. Your vet may employ surgery to sew the ear onto a firm flap to allow healing, or use less-invasive methods, such as inserting a cannula or laser surgery for drainage and healing. Your vet will also initiate proper antibiotic therapy and treat the underlying causes.
Related Reading:
Aural Hematoma Treatment Photos
Please be advised: this link takes you to the Long Beach Animal Hospital site that shows an actual hematoma surgery with incisions and blood.

