By Dial A Vet Veterinary Team
An aural haematoma looks dramatic. Your pet's ear flap swells up like a soft, warm pillow, sometimes overnight. It is a pocket of blood trapped between the skin and the cartilage of the ear flap, and it almost always has a trigger: vigorous head shaking or scratching, most often because of an itchy or painful ear. A haematoma is rarely an emergency, but it is uncomfortable, and if it is left to heal on its own the ear can scar into a thickened, crumpled shape, sometimes called cauliflower ear.
Key takeaways
- An aural haematoma is a collection of blood in the ear flap (pinna), usually after shaking or scratching.
- The underlying cause, such as an ear infection, ear mites, allergy or a grass seed, must be treated too.
- Options include draining the blood, surgery, or in some cases conservative management. Your vet will discuss what suits your pet.
- Untreated haematomas often heal with scarring and a thick, curled ear.
- Dogs with floppy ears and pets with long-standing ear disease are at higher risk.
Why aural haematomas form
The ear flap is a thin layer of cartilage covered with skin on both sides. Violent shaking or scratching can damage blood vessels within the flap, and blood fills the space. In some pets, especially older dogs, the cartilage itself may be weakened by inflammation. Immune factors may also play a role. Common triggers include:
- Ear infections (otitis externa)
- Ear mites, especially in cats and puppies. See ear mites in pets.
- Allergies causing itchy ears
- Grass seeds lodged in the ear canal
- Fleas or ticks on the head
- Trauma, such as a fight or the ear being caught
Signs to watch for
- A soft or firm swelling on the inner surface of the ear flap, often filling it
- Warmth and tenderness
- Head shaking, scratching, or holding the head tilted
- The ear drooping or sitting differently
- Discharge or smell from the ear canal, if an infection is present
When to see a vet
Same day: the swelling is growing fast, the ear is bleeding, your pet has a head tilt or loss of balance, there is violent one-sided shaking after a walk (possible grass seed), or your pet is unwell.
Within a day or two: a new, soft ear flap swelling in a pet that is otherwise well. Earlier treatment generally gives a better cosmetic result.
How vets diagnose and treat aural haematomas
Diagnosis is usually straightforward from the appearance of the ear. Your vet will also examine the ear canal with an otoscope and may take a swab to look for mites, yeast or bacteria. This is just as important as the swelling itself.
Treatment options
- Needle drainage: draining the blood with a needle, sometimes followed by medication into the space or by mouth. It is quick, but haematomas often refill.
- Surgery: under anaesthetic, the vet opens the swelling, removes the blood and clots, and places stitches through the ear flap to close the space. A bandage may hold the ear against the head. Surgery has a lower recurrence rate but needs recovery and a cone.
- Drains or cannulas: a small tube may be left in place for a few weeks to let fluid escape.
- Conservative management: some small or older haematomas are left to resolve while the ear disease is treated. This avoids anaesthetic but usually leaves scarring.
Your vet will tailor the choice to the size of the swelling, your pet's age and health, and your preferences. Medication to reduce inflammation and treat the ear canal is common. Your vet will prescribe what is appropriate.
Treating the cause
Without controlling the itch or ear disease, shaking will continue and haematomas tend to recur. That may mean treating an infection, clearing mites, managing allergies, or removing a grass seed.
Caring for your pet at home
- Use a cone if your vet recommends it to prevent scratching.
- Keep bandages clean and dry and check them daily.
- Give ear medications as directed.
- Watch for bleeding, swelling returning, or a bad smell, and contact your vet if these happen.
- Do not try to drain the swelling yourself.
Prevention
- Check your pet's ears regularly for redness, smell or debris.
- Treat ear problems early, before they lead to violent shaking.
- Keep all pets on a vet-recommended parasite plan.
- Check ears after walks in long grass during grass seed season.
FAQ
Is an aural haematoma painful?
It can be uncomfortable, especially while it is tense and warm. The underlying ear problem is often painful too.
Will my pet's ear go back to normal?
With prompt treatment, many ears look close to normal. Untreated or recurrent haematomas often leave a thickened, crumpled ear.
Do cats get aural haematomas?
Yes, though less often than dogs. In cats, ear mites are a common trigger. See why cats scratch their ears.
Can a haematoma burst?
Occasionally, especially if scratched. Clean gently and contact your vet.
Talk with a vet
If your pet's ear flap has suddenly swollen and you would like help deciding how quickly it needs to be seen, a Dial A Vet veterinarian can talk it through with you. Talk to Dial A Vet. Bleeding, head tilt or an unwell pet needs in-person care today.
References
- MacPhail CM. Current treatment options for auricular hematomas. Veterinary Clinics of North America: Small Animal Practice, 2016
- Merck Veterinary Manual: Aural hematoma in dogs and cats
- Miller WH, Griffin CE, Campbell KL. Muller and Kirk's Small Animal Dermatology, 7th edition
- Fossum TW. Small Animal Surgery, 5th edition (Elsevier)
Disclaimer: Educational only. This page does not replace an examination or advice from your own veterinarian. If you are worried about your pet right now, contact your local vet or nearest emergency animal hospital.
