Ear hematomas develop when the tiny blood vessels in the floppy part of the dog ruptures. The vessels bleed under the skin and form a fluid-filled pocket. Ear hematomas can develop from too much head shaking, obsessive scratching at the ears, trauma to the ears (sometimes caused by smacking the ears against things during head shaking), infection, inflammation, parasites, or most commonly dog fights. If the problem isn't addressed and blood and other fluids continue to accumulate in the skin, the hematoma can become quite large, even to the point of blocking off the opening of the ear canal. It's not uncommon for ear hematomas to rupture while the dog is shaking his head, spraying blood all over the place. Hopefully, pet owners don't let ear hematomas get to this point.
Treatment of an ear hematoma is two-fold: (1) resolving the swelling, and (2) finding the root cause of the problem. Discovering and addressing the root cause of an ear hematoma is necessary to prevent recurrence.
Treating Ear Hematomas
If there is swelling, the ear is warm, and there's a squishy feel to it, the hematoma is probably small. Whereas hot, very firm feel can indicate the presence of a very large hematoma where the whole pinna is affected.
In earlier stages aspiraton may be the first step. This is where a syringe is inserted to draw out all of the fluid from the hematoma. Aspiration is a relatively inexpensive and an easy process to do, but it has a drawback in that unless the bleeding has stopped the space left by the aspirated fluid will simply fill back up. Sometimes multiple aspirations are needed to drain all the fluid out.
However if the hematoma is very large vets may resolve the majority of ear hematomas with surgery. The ear flaps are seperate, the wound is flushed and the flaps sutured together. Sutures are left in place for about three weeks to create a deliberate scarring in the area, which will prevent the earflap from filling back up with blood or fluid.
Arnica pellets and Arnica cream have produced good results in our treatments.
If you've unable to get a vet intervention immediately you will need to ensure that the underlying cause of hematoma, and scratching/ shaking is addressed. The ear is kept clean. Start the dog on an antibiotic such as Enrofloxin 150mg/20kg body weight for 5 days at least to arrest infection on site especially if hematoma is from a trauma/ dog bite/ puncture wound.
All surgical options will result in some degree of pinna scarring. However if the dog's ear hematoma is never addressed – in addition to being very uncomfortable for many weeks or months – intense scarring is unavoidable. A lot of scarring will occur, sometimes causing the entire earflap to crinkle up and shrivel as the fluid is resorbed back into the body.