Franklin Vets Blog

Max’s swollen ear

June 28, 2020

Max woke up one day with a swollen, very sore ear. Inside the ear felt OK but the pinna (cone of the ear) was blown up like a balloon.Max after the aural hematoma is fixed

Max was miserable, so his good mate Ross took him into Paeroa Vets. The vet informed Max that he had an aural hematoma; a build-up of blood between the cartilage and the skin on the inside of the ear.

Usually, these start from a self-inflicted injury, either shaking the head or scratching at the ear. This is more likely to happen if there is an infection in the ear canal (otitis externa) which is painful and itchy. Scratching provides temporary relief but can lead to bigger issues! That’s why it is important to routinely clean dirty ears with a registered solution and treat infections (usually caused by bacteria, yeast or mites) as early as possible. Max was a bit unusual because his ear canals were healthy and he hadn’t been scratching. This is known as an idiopathic aural hematoma (i.e. it has no defined cause).

Example of a canine aural hematoma

Example of an aural hematoma

If left, the fluid would eventually be absorbed from the pocketed ear, however, the ear tissue scars up and forms a cauliflower ear. While this might look impressive it can mean that the canal becomes permanently narrowed or occluded leading to a lifetime of further problems. Not to mention Max was in a lot of pain and it would be unfair to leave him like that.

Ross wondered whether the vet could help Max out by draining it with a needle. The problem with doing this is that when the fluid is removed there is a space left that quickly fills up again. So, after draining the pocket there needs to be a way that the two surfaces are held together. This is achieved by either stitching the layers of the ear together or by inserting a drain and bandaging.Max after surgery for aural hematoma with cone of shame

Max underwent a general anaesthetic and had a small drain placed on the inner surface of the ear. His ear was then bandaged across his head. He wasn’t the most compliant patient and so had to go home with the dreaded cone of shame. Max had the drain in for a week and the bandages stayed on for a week longer. This allowed the layers to heal back together and scar into a normal-looking ear. He’s happy with it anyway!

This is a relatively common condition in dogs. Luckily most of the time it can be avoided by acting on itchy ears early; keep them clean and treat them before they turn into something like this.

Dr Danielle Thomson BVSc (Dist.) – Branch Manager, Paeroa Vets.