Aural Hematoma (Ear Flap Swelling)

What is it?

The ear flap (pinna) has skin on both sides and cartilage in the middle, with blood vessels just under the skin. Vigorous head shaking or scratching can break these vessels, so blood collects between the skin and cartilage. Most dogs with a hematoma have an ear infection, allergy, bite wound, or foreign material such as a tick or grass awn in the ear. Bleeding or clotting disorders can also cause it.

What signs should I watch for?

The ear flap becomes thick, puffy, and spongy, over the whole flap or just one area. Many dogs also show signs of the underlying ear problem, such as head shaking, scratching, odor, or discharge. Aural hematomas are very painful.

How is it diagnosed and treated?

Your veterinarian will examine the ear and ear canal to find the cause. Surgery is quick and effective: the blood is drained, stitches close the pocket, and a bandage supports the ear. Other options include draining and injecting a steroid, or oral steroids, though these may need repeat visits. The underlying infection, allergy, or foreign body must also be treated, or another hematoma may form.

Can it be prevented, and what's the outlook?

• Treating ear problems early helps prevent the head shaking that causes hematomas.
• Left untreated, a hematoma may slowly reabsorb, but the inflammation can leave a scarred, cauliflower-shaped ear that may block the ear canal.