Ear infections are among the most common reasons dogs are seen by their veterinarian. An ear infection can be caused by bacteria, yeast, or a mix of both. Typically, an owner might notice redness or discharge in the ear canal. Because this condition can be itchy and even painful, the dog may shake his head, in an effort to relieve the sensation. What can result is a swelling created by a broken blood vessel inside of the ear flap. This is known as an ear hematoma.
In addition to ear infections, allergies may also cause head shaking. Sometimes, there is no reason why a dog shakes his head. But if done excessively, an ear hematoma can form. An ear hematoma can cause the ear flap to partially or completely fill up with blood. If the swelling is large enough it can cover the opening of the ear canal. The extra weight of the earflap can cause some discomfort, and may also lead to a permanent change in the carriage of the ears. This article will discuss the normal anatomy of a dog ear, when an ear hematoma can pose a problem, and what treatments are available.
If your dog is shaking its head, have them seen by a veterinarian right away. Early intervention may help reduce the chances of ear hematoma formation.
Ear Anatomy
The ear is made up of the outer, middle, and inner ear. The outer ear consists of the ear flap (pinna), and the ear canal. Dogs have both a vertical and a horizontal ear canal (humans only have a horizontal canal). The middle ear consists of the eardrum (tympanic membrane) and some other important structures, including a tube that connects the outer and inner ear. The inner ear consists of complex structures that include the organ of hearing (cochlea), and the organ of balance (vestibular system). An ear hematoma will involve the ear flap, part of the outer ear.
Did you know that the average dog can hear about 4 times better than the average person, including sounds at higher frequencies than can be detected by the human ear? The ear canal of the dog is much deeper and it creates a better funnel to carry sound to the eardrum.
When is it a Problem?
Sometimes an ear hematoma is so small that it may not need to be repaired. This doesn't mean that the underlying issue should not be addressed, to prevent further damage. Here are some instances where an ear hematoma may need to be repaired:
- If the ear hematoma is large, it may block the ear canal. This makes it difficult to access, assess and treat ear infections or other issues. It should be relieved to address the underlying condition.
- If the ear hematoma is located where natural healing will create scarring, the ear canal will be narrowed permanently. This can predispose them to chronic ear infections.
- If the ear hematoma appears to be uncomfortable for the dog, repair should be considered.
- Repair should be considered, in order to maximize the ability of the ear flap to stand up straight, after hematoma resolution. Also, to prevent excessive scarring in the ear flap for cosmetic reasons.
How is it Repaired?
There are several options for repairing an ear hematoma. Your veterinarian will determine the right method for your dog. Here are some of the more common procedures.
Aspiration
This procedure involves using a needle attached to a syringe to remove fluid from the hematoma. However, the fluid will eventually return, making this a temporary situation. Instilling a steroid into the dead space, can make this method more successful. A low dose of oral steroids may also be helpful. Owners may prefer this method because it can provide instant relief and does not require surgery, making it the inexpensive option. The disadvantages are that it may introduce infection and require multiple attempts to repair it.
Pie-Crusting Sutures
Here, an incision is made in the earflap surgically. The hematoma is drained of fluid and blood clots. Multiple sutures are placed in the hematoma area to prevent it from refilling. Sometimes bandages are applied post-operatively. Sutures are generally left in place for a few weeks to allow good scarring and to reduce the chance of refilling.
Teat Cannula Placement
A teat cannula is a small device used in the treatment of udder inflammation in cattle. They can also be surgically placed in a dog’s ear hematoma if the earflap is large enough to accommodate it. The hematoma is drained of fluids and allowed to heal over several weeks. This method is generally successful, but the dog must tolerate the discomfort of the cannula in the earflap, while it drains fluid.
Leaving the Hematoma Alone
If the ear hematoma is left alone, it will eventually resolve itself. The fluid will re-absorb back into the body and the earflap will no longer bulge. Unfortunately, excessive scarring can occur. If you are concerned about your dog's cosmetic appearance, this may not be the right option. Resolution of a large hematoma can take several months and may be uncomfortable. If the patient is a poor anesthetic risk, consult your veterinarian for other options.
References
- Smith Jr., DVM, DiplACVIM, Francis W. K. and Tilley, DVM, DiplACVIM, Larry P. et al. Blackwell's Five-Minute Veterinary Consult: Canine and Feline 5th Edition. John Wiley and Sons, Inc. 2011. West Sussex, UK. Kindle file
- Brooks, DVM, DABVP, Wendy. Aural Hematoma In Dogs And Cats - Veterinary Partner - VIN. Veterinarypartner.Vin.Com, 2019, https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951446.