Ear (aural) haematomas

These are fluid filled swellings of the ear flap (Pinna). In other words the aural haematoma is a collection of blood or serum, or sometimes a blood clot within the ear flap. The blood oozes out from the damaged blood muscles causing the ear flap to swell up. The swelling may involve the entire ear flap. Smaller haematomas may disappear spontaneously. The larger ones (possibly incorporating the entire ear) need veterinary intervention.

Before I go any further, it would make sense to explain the anatomy of the outer ear flap (Pinna): The ear flap is composed of a layer of skin on each side of a layer of cartilage. The cartilage gives the ear flap its shape. Blood vessels go from side-to-side by passing through the cartilage. Violent shaking causes the vessels to break as the skin slides across the cartilage.

Now that we have an idea of the ear anatomy, we can more easily understand how anything irritating the ear canal or the ear flap itself could result in the dog/cat responding by scratching or shaking its head so excessively that it causes the blood vessels to burst, resulting in bleeding. If no corrective action is taken, the bleeding itself continues, because the animal does not stop shaking its head, thereby removing any clot that is formed in the damaged blood vessels.

 Treatment

pet cornerReally, this is one of those cases where self-help is contraindicated. And the ‘black and red’ capsule (or any other antibiotic, for that matter) won’t work.

Of course, you can leave it alone, and let the dog/cat suffer, and/or go crazy (as we have experienced). But then that is a case for the Guyana Society for the Prevention of Cruelty to Animals and the law courts. Such cruelty is unparalleled. Even if the swelling subsides, the ear(s) will be disfigured for life (see last paragraph below).

The first aim of treatment is to drain the haematoma to relieve the pressure and pain associated with the build-up of fluid within the ear flap. This is achieved under general anaesthesia where either a single incision or multiple small biopsy holes (‘windows’) are made on the inner surface or the ear. The blood is drained and the ear flushed to remove any remaining blood clots. These holes are left open to allow continued drainage of fluid whilst waiting for the ear flap to heal. I myself prefer the one long cut through which a sterilized finger can be inserted and all blood clots and infected material can be removed and the inner area sanitized. This cannot be achieved via small biopsy holes. In addition, the small biopsy holes tend to become blocked easily, therefore precluding drainage.

Reattachment of the ear cartilage is encouraged with the use of multiple sutures placed through the ear flap (with or without the use of a support to maintain the normal architecture of the ear).

These sutures are left in place for 3 weeks. The specific method used will depend on the size, age and position of the haematoma.

The second major aspect of treatment is to work out why the haematoma formed in the first place. As mentioned above, any reason that causes the dog to heftily shake its head can result in the formation an aural haematoma. Some things which can cause this haematoma condition include:

• Grass seed or other foreign body lodged within the ear canal

• Ear infection

• Allergies resulting in an itchy ear, scratching and shaking of head

• Fly bites to the tip of the ears

• Immune mediated disease

• Ear mites (can you imagine the irritation caused by living insects crawling around inside of the animal’s ear?)

It is essential that the cause of the problem be identified and treated if possible. If a foreign body is found, it must be removed. If an ear infection is identified, the ear canal will be thoroughly cleaned during anaesthesia. Appropriate medical ointments or medications will be dispensed by your vet.

Unfortunately, it is not always possible to identify a cause, or it is difficult to manage the underlying cause (eg allergies). In these cases, another aural haematoma may form in the same ear or in the other ear and management may require long term medication.

 Follow-up treatment

The sutures will need to be removed 3 weeks after surgery. At this time, a haematoma is usually healed. If an infection is also being treated, your veterinarian will also check to make sure that the infection is gone. It is vitally important that the infection is successfully treated to prevent further head shaking which may result in further haematomas.

 What happens if your dog does not have surgery?

If a haematoma is left untreated the blood in the ear flap will separate into serum and a clot and will gradually be absorbed over a period of 10 days to 6 weeks. This is an uncomfortable time for your dog and unfortunately some scarring (= shrivelling) will take place during this process. It also causes a deformity of the ear flap resulting in a ‘cauliflower’ ear which may cause further problems.

Please implement disease preventative measures (vaccinations, routine dewormings, monthly anti-Heartworm medication, etc) and adopt-a-pet from the GSPCA’s Animal Clinic and Shelter at Robb Street and Orange Walk, if you have the wherewithal to care well for the animals.  Do not stray your unwanted pets, take them to the GSPCA’s Clinic and Shelter instead. If you do not wish your pet to have puppies or kittens, you may exploit the GSPCA’s free spay and neutering programme. If you see anyone being cruel to an animal, or if you need any technical information, please get in touch with the Clinic and Shelter by calling 226-4237.

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