Aural (Ear) Hematomas in Dogs and Cats

May 20, 2016

By Julia Williams

If your pet’s earflap becomes puffy and filled with fluid, chances are they have what’s called an aural hematoma. “Aural” refers to the ear, and “hematoma” refers to a swelling filled with blood. An ear hematoma occurs when the small blood vessels inside the earflap rupture, causing bleeding between the skin and ear cartilage. The earflap swells with blood, sometimes so much that the opening of the ear canal is blocked.

Aural hematomas are more common in dogs (particularly breeds with floppy ears), but can also occur in cats. My ginger cat, Tiger, had an aural hematoma. One day I noticed him scratching at his ear and shaking his head. The next day his earflap was swollen and looked like a miniature water balloon, so off to the vet we went.

An ear hematoma can be very painful for your pet. Aside from that, not treating the condition or treating it incorrectly can lead to reoccurrence as well as disfigurement of the ear flap.

What Causes an Aural Hematoma?

The most common cause for aural hematomas in dogs and cats is an ear infection or irritation of some sort (e.g., fungal, bacterial, parasitic, allergies, foreign bodies, etc.). This makes them shake their head and/or scratch at their ear. The hematoma results from the trauma of repeated head shaking or scratching. Some ear hematomas occur when a pet bumps the earflap on a hard surface such as the edge of a table. Hematoma formation has also been associated with hypothyroidism, Cushing’s disease and other medical problems.

Signs and Symptoms 

The most obvious sign of an aural hematoma is the swelling that occurs when blood collects between the layers on the inner ear. This will look like a bulge, inflation or blood blister. Some pets with aural hematomas will hold their head sideways, and many will shake their head or paw at their ear.

Treatment Options

It’s essential to seek prompt treatment for a dog or cat with an ear hematoma. The first thing your vet needs to do is examine your pet’s ears for underlying problems or infections. Not addressing these before treating the hematoma can result in a reoccurrence. Your vet also needs to consider the size of the hematoma and how bothersome it is for your pet.


This procedure involves inserting a needle into the hematoma to remove the fluid. Your vet may also inject cortisone into the ear and apply a drainage device so you can remove additional fluid at home. The benefits of aspiration are that it is less expensive than surgery and doesn’t require anesthesia. However, some hematomas are simply too large for this procedure. Aspiration can also introduce infection, and many times it provides only temporary results, i.e., more fluid simply collects in the ear resulting in another hematoma.


Surgery is often the best way to treat an aural hematoma, since the long-term success rate is typically higher than with aspiration. Most vets are able to treat aural hematomas, so a surgical specialist is usually not necessary. After the hematoma is cut open to drain the fluid and remove any blood clots, stitches are used to close up the incision and any space where fluid might refill. Drawbacks to treating an aural hematoma surgically are that it requires anesthesia and can create wrinkled scar tissue.

My vet used this method for my cat’s ear hematoma. After surgery, Tiger’s earflap healed more slowly than most do; his wrinkled ear was not very pretty to look at, but I think it gave him character and at least the hematoma did not recur.

Teat Cannula

This small device used to treat udder inflammation in cattle can also be placed in a dog’s aural hematoma to help drain away fluid in the ear as it gradually heals. This treatment is generally successful provided the earflap is large enough to accommodate it; however, many dogs won’t tolerate having the cannula in their earflap for several weeks.

What if You Don’t Treat the Hematoma?

Left untreated, an ear hematoma will resolve in time as the fluid is absorbed back into the animal’s body. However, a large hematoma could take months to heal and cause considerable discomfort to your pet. Also, letting the aural hematoma resolve on its own almost always results in a permanently wrinkled ear (aka, cauliflower ear). The severity of wrinkling depends on how big the ear hematoma was.

If your dog or cat has an aural hematoma, they need to see a veterinarian as soon as possible. Your vet will let you know what your treatment options are and what they feel is the best course of action.

Read more articles by Julia Williams

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