I don't usually put these things in the form of a post, but the comments don't seem to be working as they should on the Aural Hematoma post, so I am re-posting this lady's question, along with my answer.
Hello Doc– I'm contacting you regarding my 7 year old golden retriever mix with very floppy ears. He is absolutely my fur baby and having him in pain of any sort breaks my heart. He recently suffered an awful aural hematoma.
After multiple attempts to eliminate other possibilities I believe he is allergic to grass which causes some redness and itching in his ears as well as his lower belly. I treat this with antibiotic cream, hypoallergenic hydro-cortisone spray with aloe vera, and Dynavite in his daily diet, which seems to help a lot. However, he continues to shake his head excessively and scratch quite a bit, resulting in this hematoma.
Unable to afford the very expensive surgery I consulted multiple online sites similar to yours(though I'd easily say yours is the best so far) on which multiple other pet parents encouraged the use of arnica gel as a homeopathic treatment for aural hematomas. I used this for about a week and a half with no result. Very stressed, I was advised by family of a local vet who would perform what was quickly appearing to be the necessary surgery for just $85. With some reservation I opted to seek out this veterinarian.
He did in fact perform the surgery for the price indicated, but his bedside manner was not great. I was never even given the opportunity to speak with him. He simply performed the procedure and sent me home with a large drainage hole in my dogs ear, un-bandaged and bleeding freely, with nyastatin cream as the only additional treatment and instructions to return in two weeks to have the stitches taken out.
I have no way of knowing if he performed the procedure correctly or not. My pet does act as if he feels significantly better. He has returned to his normal exercise and eating levels, but is drinking a lot more water than he used to. His ear is slightly swollen and has been so since the day of the procedure. It is warm but not hot to the touch.
My biggest concern is he continues to shake his head vigorously. It is obvious to me that his ear is itching still and when I catch him he will let me scratch it lightly which helps keep him from shaking. After reading through several posts here I'm worried he may have an infection, and even more so that when we take the stitches out his hematoma will simply fill back up due to the continuous head-shaking. I just don't know what to do. Please advise.
My advice can only be general, as I have not seen your dog.
Personally, I like to send home antibiotics when I have an open draining wound, like an aural hematoma surgery. This doctor may have had different experiences with these surgeries, and has seen your dog, while I have not.
It is good that the dog is feeling better now. That's a plus.
The discomfort may be post-surgical, and additional pain control medicine may be needed. It is also possible that your dog does have an ear canal infection. Did you ask the doctor about this? Are you supposed to put the ointment down into the ear canal?
Ear canal infections need to be thoroughly cleaned of debris before treatment with medicines. Medicine cannot penetrate waxy gunk. This may require sedation or even general anesthesia. The doctor may have done this prior to performing the surgery.
Often the ear canal is swollen and painful, and treatment with oral cortisone is needed to open things up, even before cleaning can be accomplished. Reducing the inflammation also makes the dog feel better, but it is just the first step (though an IMPORTANT first step).
Dogs with chronic recurring ear infections usually have an underlying problem, most frequently allergy. Environmental allergies will usually require some type of systemic cortisone treatment.
Food allergies are more complicated to deal with. Here's an old post on them:
If you do not have confidence in your doctor, then find one that you do have confidence in. These can be complicated cases and can't really be treated "long distance".