If your dog develops a hematoma on his ear -- an accumulation of blood in his ear flap -- you have several options for treatment. A small hematoma might not need treatment, although your veterinarian should examine it. A small swelling will eventually subside, but the ear might look somewhat deformed where the hematoma was. For cosmetic purposes, you might want to let the vet treat a small hematoma; a larger hematoma will require treatment.
Hematomas in the ear are formally known as aural hematomas. Often caused by allergies, ear infections or foreign objects in the ear, aural hematomas can result from head-shaking due to discomfort. Ear trauma can also result in a hematoma. Dogs with blood clotting issues might experience large hematomas from minor bruising. If an aural hematoma isn't treated, it will eventually heal, but that takes a long time. The end result is often a scarred "cauliflower ear," because of the haphazard way the blood reabsorbs. If your dog has stand-up ears, the affected ear won't stay up and straight.
Ear Hematoma Symptoms
If your dog is suffering from an aural hematoma, you may notice swelling of the ear flap or you might discover the hematoma accidentally -- when he cries out in pain when you touch his ear. Your dog might paw at his ear or hold his head to the side. Although only part of the ear flap -- or pinna -- usually is swollen, it's possible that the hematoma affects the entire ear.
Aspirating or Draining the Hematoma
The simplest and cheapest treatment for a hematoma involves your vet's syringing out, or aspirating, the fluid in the hematoma. She might then inject a steroid into the ear and prescribe medication to combat infection. One week later, your vet repeats the process. If the second treatment doesn't work, the vet may advise surgically correcting the hematoma. In larger dogs with hematomas, one alternative is placing a drain in the ear flap. This allows the fluid to drain continuously for a week or more rather than fill again rapidly as often occurs with aspiration. The ear must be big enough to accommodate the drain and the dog willing to put up with it.
Surgical ear hematoma treatment consists of draining fluids via incision, then using a hemostat to get rid of blood clots. When free of clots and fluids, your vet will suture the two cartilage layers together in the ear flap, with a small part of the incision remaining open for drainage purposes. Usually, the dog's ear is carefully bandaged. A week or so later, the sutures are removed, and your dog's ear should look normal once more.