Vail Daily column: Ear hematoma – ‘It’s not a tumor’
Vail, CO Colorado
“It’s not a tumor.” I couldn’t resist using one of my favorite Arnold Schwarzenegger lines to describe ear hematomas. Hematomas of the ears invoke a lot of questions: What are they? How did they get there? How can we fix them and prevent them from re-occurring? Can I call it a hema-tomato?
Whoa there. Hold on! One question at a time, please.
A hematoma is a pocket of blood in an enclosed space. In dogs they most commonly occur in the outer ear lobe, called the pinna. The ear pinna is actually a sandwich of skin with a piece of cartilage as the meat in between. When your pet shakes their head too vigorously they burst little blood vessels and the ear pinna fills up with blood. Hema-tomato, therefore, is a completely acceptable nickname.
Anything that makes your pet shake their head a lot can cause a hematoma. They are almost always the result of an ear infection or an allergy and can occur in one or both ears, although we usually only see them on one side at a time.
After the underlying cause is taken care of there are three basic ways to treat a hematoma. Only surgery, however, is considered effective and curative. The first way we can attempt to treat them is by draining them, injecting the ear with repository cortisone and placing a pressure bandage on the ear. In my opinion and experience this method has a poor success rate, maybe 30 percent. But it is cheaper than surgery and there is no anesthesia or sedation needed. The second method is a messy one; we suture a teat cannula, or tiny drain, in the ear tip. The ear will drain over a period of one to two weeks and if we get lucky, scar tissue will form and heal the ear. Yes it will drain and ooze in your house. This has a success rate of maybe 50 percent and requires sedation and a local anesthetic; it is still an option that some surgery-phobic people request.
Surgery is almost always curative. The reason is two words: scar tissue. When we operate we make an incision the length of the hematoma on the inside of the ear. Then we open it up and clean out the blood and the blood clots. Next we create scar tissue by making small incisions inside the ear pinna itself. These small incisions heal with scar tissue that acts like a glue to prevent it from re-occurring. Finally we place through-and-through mattress sutures in the ear. Viola. A bit of topical medicine and pain killers and we are all finished.
Surgery is definitely the way to go but because of age or economics clients will often request one of the other treatment methods. As long as they are comfortable with the likelihood of failure, we will give it a shot.
Once we have cured this problem you do need to look at preventing it from happening in the other ear. So ask and receive a lesson from your veterinarian about ear infections, ear hygiene and allergic ear diseases.
Dr. Stephen Sheldon practices at Gypsum Animal Hospital. He can be reached at 970-524-DOGS or by visiting the hospital website, http://www.gypsumah.com.