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Ear Hematomas in Cats
Veterinary & Aquatic Services Department, Drs. Foster & Smith
skin conditions
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Ear hematomas are one of the more common ear problems seen by veterinarians. These hematomas are very painful and if not treated correctly can result with a permanent deformation of the ear. There is usually an underlying medical condition that causes an animal to traumatize his ear resulting in a hematoma. Proper diagnosis and treatment of the underlying problem is necessary to prevent reoccurrence.

What is an ear hematoma?

Ear hematomas, medically known as 'aural hematomas' or 'auricular hematomas,' are a collection of blood and fluid between the skin and cartilage of the ear. A blood vessel in the ear ruptures and the loose space under the skin will fill up with blood. The pressure from the ruptured vessel will often cause the entire surface of the ear to swell creating a very painful condition. These hematomas will occur very quickly, often within minutes of the vessel being ruptured. Affected animals will have a noticeably swollen, fluid-filled ear that is extremely painful to the touch. If left untreated, the pain will subside somewhat after several days, but the swelling will continue and eventually, as the fluid-filled space generates scar tissue, the ear may become permanently disfigured.

Who is at risk for getting hematomas?

Any cat or dog of any age can develop an ear hematoma, although they are more common in dogs. Animals with chronic ear infections, ear mites, or allergies that cause the ears to itch are at the greatest risk of developing an ear hematoma. Animals will scratch their ears or shake their head if their ears are itchy or painful, which can result in a ruptured blood vessel.

What is the treatment?

There are several different treatment options for ear hematomas. The treatment will depend on how quickly the hematoma is identified and treated (the sooner the better), the size of the hematoma, and the personal preferences of the attending veterinarian.

Diagram of an ear hematoma treated with multiple suturesThe most widely used treatment consists of a surgical procedure that involves incising the skin on the underside of the ear, draining the blood, and then suturing (stitching) through the ear with multiple sutures. The ear may or may not be bandaged and then the underlying infections, mites, or allergies are diagnosed and treated. The benefit of this procedure is that there is a good chance that the ear will look normal when healed and a low chance of the hematoma reoccurring.

Another treatment option includes surgically opening and draining the ear and then not placing stitches but taping the ear up over a rolled bandage and allowing the ear to heal. This procedure may be more favorable in show cats where it is very important that the ear not be disfigured. This procedure requires more intensive aftercare.

In cases where the hematoma is very small or old, some veterinarians will remove the fluid with a syringe and if there is no clot present, will allow the ear to heal without surgery. Some veterinarians will also surgically place a cannula or drain to allow blood and fluid to be released and will avoid the surgery and suture placement.

Prevention

Prevention primarily consists of preventing any trauma to your cat's ear. Self-trauma from scratching or head shaking is still the most common cause of ear hematomas. Prompt treatment of all infections and ear mites as well as the proper diagnosis and treatment of allergies, is the best way to prevent hematomas. At the first sign of your cat shaking her head or scratching at her ears be sure to have her examined by a veterinarian so the problem can be diagnosed and treated properly.

 
References and Further Reading

Bojrab, J. Current Techniques in Small Animal Surgery, fourth edition. Williams and Wilkins in Baltimore. Published in 1998. 

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