Dog's Aural Hermatomas Can Be Tough To Prevent

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Dog's aural hematomas can be tough to prevent
By Bernhard Pukay, Citizen Special January 31, 2011

Q: My 11 year-old Golden Retriever has had three aural hematomas.

The first one, involving her left ear, was successfully drained by the veterinarian and followed by a course of antibiotics. Within a few weeks, another hematoma formed, this time involving the right ear. This was drained with laser and followed by a course of antibiotics. This appeared to heal successfully.

However within a few weeks, another large hematoma formed on the same right earflap. Again, it was surgically drained by laser, followed by a course of antibiotics.

Following all three surgeries, I have kept the ear bandaged according to instructions and the bandage is changed daily. She has been out only on leash so I know she hasn't been rolling on the ear. She does not shake her head or scratch at the ear. However, the ear is slow to heal, and appears to be swelling again.

Blood work was done before the last surgery and it was within normal limits. My dog is on Hill's JD diet, which she has been on for some time.

What is causing these hematomas and why do they recur? Are there other treatments that could resolve the problem?

A: An aural hematoma is a swelling involving the earflap (referred to as the pinna) and is caused by a rupture of a blood vessel under the skin. As the ruptured blood vessel bleeds it creates a pocket of serum and blood in the space between the skin and the cartilage of the pinna.

Aural hematomas are usually the result of excessive shaking of the head, which causes the pinna to flap violently against the side of the head, much like a whip.

Unless the underlying cause of the aural hematomas can be determined, there is the risk that they will recur again and again, as is the case with your dog.

The most common underlying cause is an otitis externa; i.e., inflammation and/or infection of the ears, often caused by allergies, especially food allergies.

Ask your veterinarian to place your dog on an elimination diet (i. e. your dog is fed a diet with ingredients that she has never been fed before). If food is to blame, your dog should stop getting aural hematomas.

Your veterinarian should also determine whether or not otitis externa and/or otitis media (middle ear infection) is present. If present, these conditions may be causing delayed healing and must be treated at the same time as the hematomas for there to be any hope of success.

Often, simply draining an aural hematoma is not sufficient.

There are several surgical procedures that can be done at the same time as the drainage that will prevent recurrences. These procedures involve the placement of sutures in such a way that they will stimulate scar tissue formation. The intention is to create enough scar tissue to reattach the skin to the cartilage so that separation of the skin from the cartilage is no longer possible.

Some success has also been reported injecting steroids into the space created by draining the hematoma. However, the success rate is variable at best.

Discuss these options with your veterinarian. If necessary, ask to be referred to a veterinary dermatologist or surgeon for a second opinion.

Dr. Bernhard Pukay is an Ottawa veterinarian. Address letters to Pet Care, Ottawa Citizen, P.O. Box 5020, Ottawa, K2C 3M4. E-mail: [email protected]
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