A hematoma is an accumulation of blood under the skin. In the case of the ear this occurs as a result of damage to the ear flap in the pet that shakes its head excessively or scratches at the ear. Those pets with "floppy ears" are more prone to this condition although erect ear dogs and cats are occasionally affected.
The excessive shaking / scratching by the pet is often due to ear canal irritation. This may be due to ear infection (germs or foxtails), ear mites (small bugs that live in the ear canal), allergies (causing "itchy ears"), or fleas (that travel into the ear canal). The self-trauma ruptures the blood vessel inside of the ear flap, causing the blood clot. This hematoma separates the cartilage from the skin of the ear flap and causes the painful swelling.
If the hematoma is not drained the ear will remain painful for a period of time and then start to scar down on its own. This scarring creates a visible deformity of the ear that is permanent and may lead to future ear complications.
There are numerous treatment approaches that can be used:
Aspiration of the hematoma (with a needle & syringe) and bandage of the ear flap for 3-4 weeks. This treatment is the least expensive but also fails 75% of the time. It is considered an "economic alternative" when other methods of repair are not possible.
Drainage of the blood clot with a local anesthetic and placement of a special plastic drain tube into the ear flap is another method of treatment. A bandage is also used for many weeks (even after the tube is removed). This treatment has a higher success rate than simple aspiration (approx. 50%), is somewhat more expensive, but is also considered an "economic alternative" to recommended treatment.
Surgical drainage of the hematoma and applying stitches in the ear (utilizing a special foam ear pad) is the recommended treatment for this problem. The sutures actually serve to reattached the skin of the ear back to the cartilage. This allows for better, faster healing and often eliminates the need for a bandage. The success rate is greater than 98% with this treatment method. Two follow-up visits are required over a 3-week period.
Once the pet has had the hematoma corrected surgically it is rare to see a recurrence in the same ear although without thorough treatment of the underlying problem it could occur with the opposite ear flap.
HOME THERAPY MAY CONSIST OF:
Administration of oral medication or antibiotics
Using medicated ear drops
A special plastic collar to prevent further scratching of the ear flap during healing.