Aural Hematoma

An aural hematoma is one of the most painful-looking conditions I know of.  Aural means ear and hematoma means bloody swelling.  The pinna is the floppy, outside part of the ear (as opposed to the ear canal, the tube going down and in to the ear-drum).  The pinna is a 3-layer sandwich of skin, cartilage and skin.  When a blood vessel in the pinna breaks, it oozes fluid between the layers, separating the skin on the underside of the pinna from the cartilage.  The ear can look like it has a slight bulge, or it can look as though it has been inflated to the point of bursting.  This swelling means that the area is under a lot of pressure, and that means pain.

Affected individuals are usually holding their head sideways, and they may or may not be shaking their head. They are pretty uncomfortable, if not downright painful.

When I was in veterinary school in the seventies, the conventional wisdom was that the dog (or cat) has an ear infection.  This causes him to shake his head and scratch his ears until he finally breaks a blood vessel in the pinna, which then begins the inflation process.   Treatment would obviously need to include treatment of the ear canal infection that started the process.  Then the pinna would receive a major surgery.  If you don’t drain these bloody swellings, it takes months for the body to stop the leak and absorb all the fluid.  The ear pinna gets badly scarred and deformed and "wadded up" in the healing process, much like the cauliflower ear of the boxer whose head has been pummeled hard enough to break ears, noses, and cheekbones.  Plus,the pet stays really uncomfortable for a long time.

Draining the swelling by simply puncturing it doesn’t work very well.  The pocket refills quite rapidly.  You needed to keep the pocket draining until the vessels inside healed up.  In the old days (jeez, I was a kid in "the old days"), this involved cutting a sliver of skin out of the underside of the ear so that it wouldn’t heal up too fast.  Then the ear pinna was sewn to a piece of some rigid material so that it wouldn’t wrinkle up and "cauliflower" as it healed.  What a horrendous, messy piece of surgery that was, not to mention the mess during the healing process.

A huge advance was the development of a much less drastic technique that works ninety percent of the time and frequently doesn’t even require a tranquilizer.  Using a large-bore hypodermic needle, a small (1/8 inch) incision is made in the pocket and the fluid drained out.  Then a little plastic drainage tube is sutured in place and left for a couple of weeks.  This allows the fluid to escape so that the ear can "stick back together".  You have to keep them on antibiotics during this period, as bacteria can enter the pocket through the tube that the fluid is draining from, and it’s a great place for them to grow.  It’s still pretty messy for a few days, but so much cheaper and easier on the dog, the owner, and the surgeon.

Larsons_tube2 Here’s the basic tube, designed to be put up into a cow’s udder to allow nasties to drain when she has mastitis (breast infections).  It’s got a little screw on cap, a little hole in the end, a little hole in the side, and two little spurs to keep it from falling out.

Modified_tube_2 I cut the end a little shorter to enlarge that hole, cut the existing side-hole larger, and add another hole to the opposite side.  Then the cap is removed, and the round flange trimmed to make a flat surface that will lie against the ear when the tube is inserted.

Tube_in_situ_2 Many dogs do not even need a tranquilizer for this.  You just poke a hole, squeeze out the gooey, pop in the tube and put in one stitch to hold it.

Even better, there has been new work that suggests some of these are NOT due to the trauma of head-shaking and scratching.  I have often seen these hematomas in animals whose ear canals appeared perfectly clean and healthy, i.e. no ear infection.  This was puzzling, but I attributed it to one good hard shake that played "crack the whip" with the ear.   New evidence suggests that many of these hematomas are immune-mediated.  This means that the body’s defense system has gone a little haywire and attacked its own blood vessels, causing the damage that blows up these ears.  What this means in practical terms is that if you suppress the body’s defenses long enough for it stop this self-attack, the hematoma may heal without any surgery or drainage at all. 

Many of these cases will respond to high doses of prednisone (a synthetic form of cortisone) with no other treatment.  It is amazing to see one of these ballooned-up ears return to normal just by taking pills.  The down-side would be the side-effects of the prednisone (excessive appetite, excessive urination, followed by excessive water-drinking, are the most obvious).  Worse would be a patient who gets a bad infection while you are suppressing his body defenses.  That’s not common, but it certainly can happen.  It’s also important to taper the dosage off slowly.  If you stop as soon as the ear swelling goes down, it’s very likely to recur rapidly.

One thing is for sure: small hematomas almost always get bigger.  When you first notice that ear swelling, rapid treatment will result in a much faster and simpler healing process than if you wait until the entire pinna is involved.

530 thoughts on “Aural Hematoma

  1. Kim says:

    I have a 9 year old Weimaraner that just had surgery the 6th time in 1 year for recurrent aural hematomas. Everytime the vet corrects it, the next day, the ear blows up in a different spot. We have spent at least $200-$300 per surgery and are at our wits end. We love this dog, but can’t continue to shell out the tremendous amount of money to correct this problem. She NEVER has ear infections and does not have a clotting disorder. Do you have any other suggestions for us? I will be mentioning the use of prednisone to the vet to see if we can try that. Thanks!

  2. Dr. Everett Mobley says:

    I cannot really speak to cases that I have not examined. I have re-edited the post with additional information on the drainage tube procedure. I have sent Kim a more detailed personal reply.

  3. jason says:

    hi i have a pit bull terrier that we just saved from being destroyed and she has aural hematoma we just noticed last week,it is pretty big now. and i just got laidoff from work im kicking myself not being able to afford a vet right now,is there anything i can try to do at home to help.i feel like a scumbag not being able to go to the vet right doesnt seem to hurt her iv been puttin hot compresses on and i tryed a needle but she wasnt to keen of the idea .will this blister kill her.i could never live with myself if that happined.could you give me some options please!!!!!

    • Pete says:

      I’m dog sitting 6yo very jumpy boy, who won’t sit still and is suspicious of every pat.
      He has had his aural haematoma drained and catheter inserted, but he is not very compliant with having the plug removed, saline solution flushed into it, and plugged replaced. Can anyone suggest a way to manage this, especially links to any video you might know of? Thanks in advance

      • Doc says:

        Hello, Pete,
        If you can stand the mess, I usually leave these open to drain, but then I have to keep them on antibiotics orally, as we have an open wound.

        BUT, you don’t have to keep monkeying with the ear.

      • Daniel Whitton says:

        Should have used an Auralsplint and avoided any surgical remedy. Only the auralsplint addresses the broken blood vessels actually causing the specific expansion of tissues. As per the study’s findings, by providing an environment of equilibrium in the ear flap, the animal’s own rehabilitative processes coagulate the thin layer of blood into an all encompassing clot allowing the reproductive sealing of the broken blood vessels and building the attachment tissues to bind the cartilage and skin tissues together just as natural as before, for a permanent healing solution.

  4. Doc says:

    Dear Jason,

    No this will not kill her. It’s like a big blood blister. It is uncomfortable from the pressure. Sticking a needle in it is not a good idea. It will just fill up again, and you could easily introduce germs. A blood-filled cavity is not a good place to add germs, as it would be a wonderful place for them to grow. Then you would have a nasty infection instead of just the pressure.

    Heat opens blood vessels and would make them leak more. Cold causes them to close up and leak less. When something first happens, cold is best to prevent further leakage. Use a therapeutic cold pack, or just a rag soaked in ice water. Apply for 10 to 15 minutes at a time, resoaking the rag as necessary. Do not use ice directly, as it is too cold.

    When the problem is a week old or more, heat may help to break up the clots and enhance resorption, but may also re-start the bleeding.

    The pressure is what causes the discomfort, but additional head-shaking makes it worse. If she would let you put a soft bandage to put the ear over the top of her head, that might let things start to resolve.

    If there is no ear infection that needs to be treated, the hematoma will eventually resolve. It may take several weeks, however, and the ear will look sort of “wadded up” when it finally heals with scar tissue between the ear layers. It won’t be pretty, but when the pressure is gone, it won’t be painful either.

    Best of luck, and thanks for reading and writing.

  5. Julius says:

    Hi- My dog recently developed an aural hematoma and I immediately brought him into my vet for an exam. The first thing our vet recommended recommended was to aspirate the hematoma with a syringe. She informed me that this was only going to be a 30% success rate. We waited a few days and sure enough the pinna filled right back up again. I spoke with my vet about other options and she mentioned to either aspirate again or insert a drain with minor surgery- stating surgery would yield a 90% success rate. I opted for surgery since it seemed like my best option at the point. Like an earlier post I wish my vet would have sat me down to explain what to expect post surgery. We went ahead with the surgery and the outcome was nothing like what I expected. I brought him back to the vet 4 days post surgery because I noticed a slight odor from the bandage. The bandage was removed by a technician and she cut the tip of my dog’s ear by accident. The surgery site showed signs of slight infection plus the new wound created by the technician caused my dog to go onto an antibiotic. The wound was rebandaged and a couple of days later my dog was somehow able to remove his bandage and cause a mess. A few days have gone by and I notice he is doing excessive head shaking and pawing at his ‘bad’ ear. I also noticed that his ear seems to be filled up again. What are my options now? My vet seems to treat me like an overconcerned parent but I really don’t feel like I’m getting much direction here. Should we aspirate again? I definitely don’t want to put him through surgery again. What if I leave it alone and put cold compresses on it daily?

  6. Doc says:

    I can really only give you general advice, here, as I
    mentioned in another post.

    That being said, if the hematoma is full, it needs to
    get un-full. I am not visualizing how the ear is
    bandaged. Usually when surgery has been performed,
    there is either a pretty good-sized opening or a
    drainage tube so that fluid does not re-accumulate.
    If there is such an opening, it is common to prescribe
    antibiotics until things are closed up again. Bloody
    fluid is a great place for germs to grow. You are
    already on antibiotics because of the unfortunate
    un-bandaging accident, so stay on them. If your dog
    is not receiving any type of pain medicine, I think it
    would be good to ask your veterinarian about getting
    some. If the ear is swollen, it’s under pressure,
    which means it’s uncomfortable at best.

    I would be very hesitant to recommend the prednisone
    treatment at this point, since you have wounds to deal
    with and the prednisone suppresses the body’s
    defenses. It is possible that the small teat-tube
    surgery (simple insertion of the small drain tube, as
    illustrated in the post) may be helpful at this point.
    Also, aspirating (sucking out) the fluid and using a
    compression bandage may be an option.

    The bottom line is that the doctor who is on the scene
    is in a better position to know what is going on. I
    can understand that you are not happy with the results
    to date. If you feel that you and your veterinarian
    are not communicating well, you need to let him/her
    know that. Simply say that you don’t understand what
    to expect and what the options are, and you need some
    help to see the big picture.

    You could also consider asking him/her to refer you to
    another doctor for a second opinion. Personally, I’d
    much rather give a copy of the medical record to the
    client and give him a list of other doctors I respect,
    than to just have him pick someone at random out of
    the phonebook.

    I hope this is helpful. Thanks for reading and

  7. Stacy G says:

    It looks as though my dog has an aural hematoma. She has always had itchy ears and sometimes gets infections. I know the hematomas can go away on their own but there is also surgery for treatment. Is there any benefit to the surgery other than the prevention of malformation? Can i treat the infection if present and hope the hematoma will go away? How do i know if there is a chance of rupture?

  8. Doc says:

    I will answer your questions as best I can.

    “She has always had itchy ears and sometimes gets infections.” This is something that needs to be addressed. It would be a good idea to investigate possible underlying causes for this, like allergic problems.

    “I know the hematomas can go away on their own” This is a very slow process – weeks to months.

    “Is there any benefit to the surgery other than the prevention of malformation?” As long as the ear is swollen, it is under pressure, which means that it is painful. Whether the pressure is relieved by surgical drainage, a drain tube, or treatment with prednisone, it IS important to relieve the pressure so that the dog won’t be painful. Just treating the infection in the ear canal won’t do that.

    “Can i treat the infection if present and hope the hematoma will go away?” Your dog will be painful for a longer period of time.

    “How do i know if there is a chance of rupture?” Rupture is not likely to occur.

    Your dog will get better sooner if she receives care from your veterinarian.

    Thanks for reading and writing.

  9. Tim says:

    Hi Doc –

    Great information. While there are many sites that offer information on the subject, in my opinion there are none that explain the cause and subsequent treatment options as well.

    Of course on to my question . . . I have a lab who has undergone two previous “quilting” surgeries for aural hematomas and now we may be going in for number 3. There is a spot on her left ear that was not quilted as it was not affected by her previous hematomas. The area is not too large and the chance for it to spread is minimal (or so we’ve) been told due to the prior surgeries.

    At this time the hematoma is not filled – there is some puffiness, but the area is not completely filled with any fluid. To avoid putting her through another extensive surgery I was wondering on your thoughts of treating her with prednisone.

    I understand that it is very difficult to give an opinion without actually seeing the dog, however any insight you may be able to provide would be greatly appreciated.

  10. Teri Owens says:

    Our Basset Hound is 9 or 10 yrs. old. He was a rescue and the sweetest dog in the world. On Thanksgiving, he was playing with a couple of other smaller dogs and all of the sudden, this hematoma shows up on his ear. We took him to the vet on Saturday morning,and they drained it (22cc’c)and put him on prednisone (10mg. twice per day). The hematoma filled back up after 10 days and we chose to drain again (34cc’s) and the vet doubled the dose of prednisone and perscribed it for a longer period of time. The vet is recommending the surgery, if this does not work. My
    questions are: Can we continue draining and allow the prednisone treatment to work? Could there be complications from continuing to do it this way? The vet did mention something about inserting a tube, but really recommends the surgery where they would puncture the ear with holes and stitch in a quilted pattern. I am really unsure of which way to go, the surgery seems so invasive and with extensive recovery time.
    The vet also mentioned that if the hematoma was caused by trauma, which we are not sure how it happened, that really the only thing to fix it is the surgery. What is your opinion on that statement?

    Thank You, I got a lot out of your answers.

    Teri Owens

  11. Doc says:

    Since the hematoma is small, I don’t think it would hurt your veterinarian’s feelings to just ASK about the prednisone. Of course, we all cringe when a client says “I was looking on the internet, and…”. There may be reasons why they are not comfortable with this approach for your dog. It is also possible that they have not tried it for any of their patients. I can tell you that it was a bit of a leap of faith the first time I tried it. It’s by no means guaranteed to be successful, but it is worth investigating.

    Thanks for reading and writing

  12. Doc says:


    I hope I can help with your questions.

    “Can we continue draining and allow the prednisone treatment to work?” Yes, providing that it actually does work. If you’re not seeing improvement with the higher doses in a week or so, it’s probably not going to work.

    “Could there be complications from continuing to do it this way?” Yes. Everytime you poke a hole into a cavity filled with bloody fluid, you risk starting an infection there. Also, prednisone is not without side-effects.

    “The vet did mention something about inserting a tube, but really recommends the surgery where they would puncture the ear with holes and stitch in a quilted pattern.” The tube surgery is really rapid and fairly inexpensive. If it doesn’t work, you can still go to the more extensive surgery, should it be needed.

    “I am really unsure of which way to go” No kidding. Any time you find fifteen different ways to do something, it lets you know that there is not one best way for every patient.

    “The vet also mentioned that if the hematoma was caused by trauma, which we are not sure how it happened, that really the only thing to fix it is the surgery. What is your opinion on that statement?” I agree that surgery may be necessary.

    It sounds to me like your veterinarian is being thorough, giving you options, and doing his best to advise you as to what he feels will give your dog its best outcome.

    Good luck, and thanks for reading and writing.

  13. Jackie says:

    I have a Calico cat that had a ear hematoma surgically removed today. The tube is in her ear but her ear is quite swolen again and she’s bleeding through the incision the tube is in. is this normal? How do I relieve the pressure from the blood building up in her ear?

  14. Doc says:

    It sounds like the drain tube may be clogged. You should contact your veterinarian. The solution may be something as simple as taking a small needle and un-clogging the tube. DO call your veterinarian.

    Thanks for reading and writing.

  15. Laurie says:

    What is a good way to bandage dogs ears after arual hemotoma surgery, my dog has been shaking head and very stressed since she has come home 2 days ago I am afraid that the stress can’t be good for her she is 12 and in general good health but the vet tech has practicaly her whole head taped up very tight

  16. Doc says:

    Head bandaging is difficult. I have used ether to make the tape really sticky, then used the tape to make a “handle” from the end of the ear. The handle gets taped down to the dog’s head. You need padding both under the ear and over it.

    You really do want to immobilize the ear for a while so that shaking of the head doesn’t spray blood everywhere, and you don’t want them to scratch it.

    It is certainly true that some dogs are distressed by the mere presence of a bandage. However, I would also be concerned that your dog’s pain is not fully controlled. You should contact your veterinarian and ask if he/she can add some additional pain medications, and possibly a mild sedative for a few days.

    I hope this is helpful.

    Thanks for reading and writing.

  17. Tom Nelson says:

    My older dog (11) has what seems to be an aural hematoma on his ear. I suspect this as he had one on the other ear, although not throughout the entire ear flap like this one. I have elected to just let the swelling go down on it’s own. I was also curious as whether there is something I could give for pain whether over the counter or prescription, until the swelling goes down? The dog seems to be in some discomfort by this.

    Also, would repeated ice packs help with swelling?

    Thanks, Tom

  18. Swade's Mom says:

    Hi Doc,

    After doing extensive research, I finally came across your article. My dog, Swade, a 6-year old pitbull mix has gone through 3 hematomas back to back. Two occurred in the same ear and the most recent was in the other ear. All were treated with a drainage tube.

    I’ve gone to 2 different vets and have been trying to find out the CAUSE of his hematomas. He does not have any ear infections, all vets have confirmed this. One technician at the vet office suggested it may be a food allergy. I did happen to change his diet about 4 months ago right around the time of his first hematoma. I have since then switched him back and been giving him vitamins daily.

    No one has been able to explain the cause and I’ve been dishing out hundreds of dollars getting his ear drained. I’m really interested in learning more about prednisone and mostly on the cause of his reoccuring hematomas. There must be a reason. Is it a clotting problem? Both vets said there’s no way to isolate the cause and that it could reoccur… sounds like I’d have to keep paying them.

    To give you more history on my dog, he’s never had any issues like this before. He was neutered in September… the hematomas started in october. He stays outside in the backyard until I come home. He used to sleep outside at night as well until back in August. Could it be something in my house that he is allergic to? I’m so frustrated at the incompetence of these vets. After questioning one extensively, he suggested I give my dog claritin. While I could do so, I still don’t know why he is having these issues? Now, his original ear (the one that had healed back in January) looks like it might become a hematoma yet again. There are 2 small blisters right next to each other and one was bleeding.

    I’m really hoping you can shed some light on this for me and at least point me in the right direction so I can learn more. As I said, you’re the first I’ve come across that’s noticed the lack of an ear infection. I live in Atlanta so if you know of a good vet, please let me know. I really appreciate your time.

    Swade’s mom

  19. Doc says:

    Hello, Tom,

    It is possible that the ice-packs will help slow the swelling. Cold causes blood vessels to constrict, tightening them down, slowing leakage (conversely, heat causes them to open up). Be sure and use a therapeutic cold pack, or a rag soaked in ice water. Ice applied directly is just too cold and should not be used.

    OTC pain relievers can be used, but they do have their pitfalls. Aspirin causes mild stomach bleeding, but can be used short term, one regular strength aspirin tablet per forty pounds of body weight, given two or three times daily. Tylenol can also be used short term at a similar dose rate.

    Ibuprofen and naproxen are unpredictable, possibly causing severe bleeding ulcers, and I would not recommend them at all for your dog.

    Your veterinarian can help you with more effective, safer alternatives for long-term pain control.

    Thanks for reading and writing

  20. Doc says:

    Hello, Swade’s Mom,

    I am sorry that you have had such difficulty with your dog. From your description, he does sound like a possible candidate for prednisone therapy. Until I ran across this idea on Veterinary Information Network, it would never have occurred to me to try immunosuppressive doses of prednisone to treat this blood vessel leakage. These large doses of prednisone can have their own side-effects, so the treatment is far from perfect, even when it works.

    While most of us cringe when a client says “I read on the internet…”, you might at least mention it to your regular veterinarian.

    I am sure that there are many good veterinarians in Atlanta, but I do not know any personally. You might consider a trip over to the veterinary school at Athens. I’ll bet they have a veterinary dermatologist there.

    Good luck with your dog. Thanks for reading and writing.

  21. Tracy says:

    My 17 yr.old cat has developed a hematoma on its ear. He has been completely deaf for over a year, thus the scratching of the ears. My problem is this, financially I just do not have the money to get him treated (which kills me, but living in Maine with the high oil prices etc…we are having all we can do to get by)is there anything I can to at home to make him more comfortable? I have been trying to keep the outside clean with peroxide, which he does not seem to mind. He has been eating, going to the bathroom, sleeps a lot (nothing new at his age). I hope you can help put my mind at rest and help me help my cat. Thanks!

  22. Doc says:

    Dear Tracy,

    I wish that I had a good suggestion for you. Sometimes we recommend pain control if nothing else is feasible. Unfortunately, cats do not tolerate any over-the-counter pain medicines. Tylenol (acetaminophen) is unpredictable, and can cause massive hemolysis (rupturing of the red blood cells) and death. A healthy, ten-pound cat can tolerate one baby aspirin once every 48 hours. I would not recommend this for your cat, due partly to the age, and partly because aspirin inhibits platelet function. The hematoma could conceivably get worse, even if the aspirin didn’t cause other problems (which it very well may, especially in such an ancient cat).

    Your cat may or may not be a candidate for the prednisone treatment. If she has an ear infection, I guarantee you that it is constantly painful. Even without an ear infection, the hematoma is under pressure, which is uncomfortable at best.

    If your cat does not have an ear infection, the prednisone treatment is very inexpensive. I urge you to get her looked at by a veterinarian.

    Good luck, and thanks for reading and writing.

  23. Julie says:

    First of all I want to thank you for your site as it has been very helpful.

    Our 12 year old lab just had a drain placed today to drain his hematoma…(and he is so much more content now). He is also being treated for a mild yeast infection in both ears, which we are giving him ear drops for. My concern is that he wasn’t given any other oral antibiotics. I am worried about the drain becoming infected. Is just daily cleaning with peroxide going to be enough? Thanks

    • Jessica says:

      How long does it take for an ear hematoma to grow? It’s the size of a penny right now. So approximately when do you think she got the ear hematoma? Thank you. (11 year old chihuahua with mild seizure like spasms while eating certain foods & no ear canal infection)

      • Doc says:

        Hello, Jessica,
        The rate of growth is really variable. I have seen them enlarge gradually over a week or more, and I have seen them fill the entire ear flap within 24 hours (at least, if the owner’s account can be trusted).

  24. Doc says:

    In regard to just cleaning the drain versus systemic antibiotics:
    If your pet’s doctor has had good luck with that, then more power to him. I have always been afraid of leaving that bloody hole open, so have given the antibiotics. I do not have any research to support my position. Your dog may do just fine, and antibiotics DO have the potential for side effects. I would recommend that you keep it clean, and monitor for swelling, or for a change in the character of the drainage. Stay in touch with your veterinarian. The doctor who is seeing your pet is the best person to advise you.

    Thanks for reading and writing.

  25. Golden Retriever Mom says:

    Dear Doc,

    This was exactly the procedure they used on my Golden Retriever. He was healing very well. After they took the drainage tube out I just keep on cleaning the incision and making sure to drain out any fluid. He finished his 10 days of antibiotic (clavamox) and antiinflammatories (Previcox) and 3 days later he stated producing a lot more fluid than before, the wound closed, filled up again and he was in pain. I had to rush to the vet. They reopened the incision and took out a little abscess. they put him back again on antibiotics for another 10 days(now Antirobe) and 10 more days of Previcox. It has been now 4 days. every day a lot of transparent yellowish fluid comes out. Last night the wound closed up again and I can not get the fluid out. I can see it starting to fill back up again. He still has over one week of this new antibiotic to go. What should I do? Can you please give me some advise? should I wait couple of days and see if it stops filling up? or should I rush again to the vet?

    Also his ear infection has not heal either. First they gave him synotic and conofite drops for 14 days. when he finished they did another culture and now he needed Baytril drops for another 14 days.

    I have spent over $1,000 and after 3 weeks he is still not well. I would appreciate any advise you can give me. Does all of this sound normal? I have followed the vets instructions very carefully but I am getting frustrated and very broke. I am scared I take him back and maybe he needs another drainage tube and its going to cost a lot more money again.

    Thank you so much in advance,

    Golden Mom.

  26. Doc says:

    I can appreciate your frustration in this case. It does not sound straightforward. I am not really in a position to evaluate or prescribe for you. It is possible that you will need to see a veterinary dermatologist.

    Having said that, I do have a couple of thoughts. Has your dog had any previous allergic problems? It sounds like there is a lot of inflammation present. Golden Retrievers are certainly prone to allergic problems. Many ear infections are secondary to allergic problems. If I were looking at a dog with a lot of ear inflammation, I would certainly consider treatment with corticosteroids at a dose that would suppress allergic reactions. If the hematoma by chance involves vasculitis, then high doses of cortisone can stop the fluid leakage. You would definitely have to let the Previcox wash out for a couple of days before starting the cortisone.

    Again, it is not possible for me to give you an accurate long-distance assessment. The doctors who are seeing the dog have a better basis to recommend treatment.

    Good luck with your dog.

  27. Golden Retriever Mom says:

    Dear Doc,

    Thank you very much for your prompt response. I had placed a call to his practice and I have an appointment tomorrow Monday at 10am. His vet is on vacation so another Vet will be seeing him which also makes me a bit nervous.

    To answer your question, my 9 year Golden has always had perfect health. No history of allergies and this is the very first ear infection / serious health concern. Never needed more than his yearly check up.

    The vet mentioned over the phone that the culture for the ear bacteria came back (which they never called to notify me) and to stop immediately the antibiotic Antirobe (which I probably could have stop earlier if they had called) as this bacteria would be immune to it as well as the very first antibitic he initially took Clamavox. He offered reimbursement for the Antirobe. What I do not understand is why they prescribed antibiotic and drops without having made this culture on the first place (initially they just did a cytoloty for the ear smear). They only did a bacteria culture 2 weeks after they found out the first treatment for the ear infection did not work. Is that normal procedure? or I just had to pay for countless drugs for them to run the experiment? they said that the first drops cured yeast but that somehow bacteria took over…

    He explained just as you did that pretty much every vet has different ways to treat Aural Hematomas. He advised me to stop food and water after midnight in case he considers he will need surgery tomorrow morning when he sees him. I am very scared, I guess surgery will be another huge bill.

    I will ask the vet tomorrow about vasculitis. I do not think they mentioned this before.

    Thank you very much. I greatly appreciate you help and time and I congratulate you for your great devotion in helping us all.

    Golden Mom

  28. Doc says:

    I would say that it is not standard practice to culture ears on the first visit. Really resistant bacteria are fortunately not very common, so we frequently treat with a broad-spectrum topical the first time out. If we don’t get the expected results, then a culture may be indicated.

    Even though your dog does not have previous histories of allergy, he may have an allergic component now. Also, with these bad ears, cortisone often has a better anti-inflammatory effect than the NSAIDs like Previcox (which IS a good drug, generally speaking).

    Good luck!

  29. Peg says:


    I am so grateful to have found your site and hope you can help.

    My cat has developed an aural hematoma and it appears very large. He seems ok and is eating, going to the bathroom, purring, etc., though he seems understandably uncomfortable. He recently had surgery on his leg and I am hesitant about putting him through more, not to mention the cost factor. I hate to even say it, but I simply cannot afford it.

    My questions are: Is it safe to let the hematoma go away on its own and will it most definitely go away over time? I feel like a horrible person to say I cannot afford to have this treated, but its the truth. Is there any topical steroid I can use to make the swelling go down, it common for there to be alot of swelling and how long before I can see swelling go away? I’m afraid of this bursting. Thanks for any advice.

  30. Doc says:

    Hello, Peg,

    I’m sorry you’re in such a frustrating situation.

    “Is it safe to let the hematoma go away on its own and will it most definitely go away over time?” Eventually, the body will close off the leak. The pressure that makes that ballooned-up ear so uncomfortable is also gong to stop the leak… eventually. When that happens, the blood in the swelling will organize into a clot. The body will finally dissolve and get rid of the clot. The ear flap will heal, but it will be pretty wadded-up-looking. The scar-tissue will really wrinkle it (think about the old time pugilist’s “cauliflower ear”).

    “Is there any topical steroid I can use to make the swelling go down?” Nope.

    “How long before I can see swelling go away?” Weeks to months.

    “I’m afraid of this bursting.” It won’t. It will just be darn uncomfortable for quite a while. It is important to be sure that the underlying cause is not an infection in the ear canal. That is REALLY painful.

    Thanks for reading and writing.

  31. Gwyn says:

    I just discover your website while doing research one the aural hematoma. My 9 year old german shephard/huskie mix just had surgery on Saturday. When we brought her home she looked like a nightmare. It made my 2 1/2 year old daughter cry. They did not put a bandage on her ear, just fitted her with an extremely large e-collar. We ended up on Sunday morning replacing the large e-collar with an inflatable collar. The poor dog couldn’t even walk without tripping on the collar! I had to take it off so she could walk up and down stairs, eat, drink, anything! If I wouldn’t have put the inflatable on her I probably would have stayed home from work to make sure that she didn’t hurt herself in the monster collar she was fitted with. The problem is that the inflatable isn’t really big enough to protect the ear if she decides to start scratching.

    I guess my ultimate question is whether it is common not to bandage the ear after the surgery. It just seems like with an open wound like that it would be easily infected. plus, we have two other dogs in the house who are sniffing at it, as the wound is seeping a little.

    Thanks for listening.

  32. Doc says:

    Hello, Gwen,

    Without seeing the surgical procedure, I do not know whether a bandage is needed or not. The bandage can function to keep light pressure on the ear (to minimize swelling from fluid accumulation), to protect the ear from additional trauma, or to immobilize the ear to keep the dog from shaking it and spraying drainage everywhere. Leaving an opening in a major hematoma surgery IS routine to allow fluids to escape. Many doctors would have the dog on antibiotics while the wound is open, and pain medication is essential for several days.

    It is best to address your concerns with your dog’s regular doctor. Sometimes they believe that they have answered all your questions. If you don’t call, they assume everything is okay. Call them.

    Good luck, and thanks for reading and writing.

  33. Peg, again says:

    Hello again,

    I wrote you a few days ago in regards to my cat’s large hematoma and you were so kind as to respond. As an update, I brought him to the vet and just picked him up today. After discussing options, I decided to have the drain placed in his ear and we subsequently learned that the hematoma was caused by ear mites. Who knew? He is all black, so its difficult to see down there though I check periodically. With that said, if you could tolerate another question or two concerning two things, my mind would be put at ease: The elisabethian collar – he hates it. He is trying to get it off and the vet insisted on him keeping it on. I am trying my best to keep it tight (but comfortable) but I know he’s going to get it off his neck. What options do I have here and would it be horrendous if it was off? Second question is in regards to my instruction to ‘drain’ the drain myself daily. Is this the norm? If so, how much pressure do I place on it, and where do I start the pressure point? These are both things I forgot to ask the vet before I left this evening. Doc, if you could help me once more (or maybe thrice more!!) , I would be so grateful!

  34. Doc says:

    Hello, Peg,

    No offense, but why not call your doctor back? I’m sure he/she would be glad to help you. People are often afraid of looking dumb, but, jeez, it’s easy for us doctors to get in a hurry and leave something out of an explanation. That means that WE are the ones who messed up, not you.

    As to the E-collar, its purpose is to keep the cat from removing the drain prematurely. If you don’t want to have the cat sedated again to replace the drain, try your best to cope with it. I really don’t know a good alternative, short of you holding his hands for a week or so.

    As to “draining the drain”, the drainage tube can become clogged. We use a rigid tube and often send home a needle to insert in the middle of the tube to unclog it. Since cat ears stand up instead of hanging down like a dog’s ear, gravity doesn’t help so much in draining the fluid. That is why you would “milk” the ear to removed the fluid that is accumulating. It shouldn’t take much pressure to milk all the fluid through the drain. If it takes much pressure the drain is blocked and you need to call your doctor. Start at the base of the ear and milk/squeeze gently toward the tube opening. I would probably do this two or three times daily.

    Seriously, I think that your doctor would be happier if you got your questions clarified, rather than showing up a week later with a poor result (but you didn’t bother him/her with questions).

  35. Layla's Mom says:


    My dog, 3 year old Maltese, has an aural hematoma. Well, I freaked out last wednesday and I took her to a 24hr clinic, and they drained it. It came back, not surprisingly. She has no sign of infection at all, per 2 vets.

    I went to my regular vet today, and he said that he doesn’t want to operate on it because it’s not big enough(or football shaped, as he said). He said it will hopefully go away on it’s own if she stops shaking her head and scratching her ears.

    Is this s good idea? I just don’t want it to get to the point where it is uncomfortable for her. She is a small dog, and i worry!! I also wonder why she’s scratching…i gave her flea and tick meds..but maybe an allergy? She does lick her paws on occasion to the extent where i have to tell her to stop.

    Do you think it will go away on it’s own? I just don’t want to have to spend more money if it gets huge and does need surgery.


  36. Layla's Mom says:

    I just wanted to make a note…i read my post and the last sentence doesn’t sound right..i meant…i heard that it costs a lot more $$$$ if you wait til the hematoma gets bigger(makes it harder to operate?)..i have no problem spending $ on my dog at all..i want whats best for her because i love her so much!..but if i can cut the costs now a little and get surgery asap, it might be better for my financial situation! thanks again!

  37. Doc says:

    Hello, L.M.,

    I see your dilemma. It’s too little to do surgery, so if it doesn’t recover spontaneously and gets much bigger, then she can have surgery. In the meantime, she’s still uncomfortable and you don’t WANT it to get bigger.

    With no evidence of an ear infection, you do indeed need to look for another reason for her head-shaking (besides the discomfort of a swollen ear, that is). The major foot-licking does suggest the possibility of an allergy. There is also the possibility that her hematoma is due to an immune-mediated vasculitis, as I discussed in the original post. Using prednisone (a synthetic from of cortisone) may address both those causes.

    I guess I’m not optimistic that your dog will “just quit” shaking head and scratching her ears. Even if the original inciting cause has gone, the pressure of the ear swelling continues to cause discomfort.

    If you haven’t told your veterinarian about the foot-chewing, he/she may be missing that piece of the puzzle.

    As always, the doctor who is actually seeing your pet is in a better position to judge the situation than I am. Do be sure to share all your information with him/her, and update him/her on your dog’s progress (or lack of it).

    Good luck, and thanks for reading and writing.

  38. Scout says:

    Hi Doc –

    My 7yr old choc lab has gotten two ear infections in the last 4 months – I’m pretty sure due to water not drying up in there after swimming in the lake. My fault, I know. This last time I let the ear infection go longer than I should have, and he developed an aural hematoma. Started out small, now is about half the size of the inner ear. He’s on an oral and topical treatment for the infection – vet said it was my call whether or not to do surgery. I’m leaning towards not, esp after hearing about all of the horror stories about them coming back. The cold compress seems to be helping his discomfort, so thanks for that suggestion.

    Any other things I can do to try to prevent this from happening again? I’m going to keep him out of the water for a while, and will be sure to check his ears daily. Do you think the ear infections could be caused by allergies though? He has been licking his paws a lot lately, and the vet said he could do a blood test to find out for sure. I’ve heard otc Benadryl can be given to dogs (he weighs 75lbs) to help with allergies.

    Any suggestions?

  39. Doc says:

    Hello, Scout,

    Allergies can definitely predispose dogs toward getting recurring ear infections. Even food allergies can do so. Weirdly enough, sometimes only one ear is affected, even though the underlying cause is an allergic reaction. That makes no sense to me, but it is assuredly so.

    In your case, treating as an allergy could really be helpful. We often use corticosteroids (like prednisone) to calm the patient’s allergy. Prednisone at higher doses sometimes causes the hematoma to resolve without surgery.

    Benadryl may help calm his itching (it works in no more than 20% of dogs), or it may make him too sleepy to scratch (the same drug is sold as a sleep aid). It won’t do anything for the hematoma, and the prednisone might. I’ve had good luck with a lot of them, and don’t put in near the number of drains that I used to. You might discuss a short-term trial therapy with the prednisone ( it does have side-effects).

    Thanks for reading and writing.

  40. Penny says:

    Hi apparently from what I am reading my cat has an aural hematoma. I do not know if this is from digging at her ear or we kinda tripped over eachother this morning (I have a walker from a recent hip replacement)anyway her ear looks like a balloon and I feel awful. Probably not as bad as she. I cant drive to a vet at this point and do not have money right now because of my surgery. Any ideas what I can do for my dear dear furry girl? I have had her for 14 years and she has never had this problem before. I feel terrible! Can you help us?
    Thank You
    Penny & Scarlett

  41. Doc says:

    Hello, Penny,

    I wish that I could give you a good home remedy for the hematoma, but I fear that there isn’t one. Cats don’t tolerate many over-the-counter pain medications. An average size adult cat can tolerate one baby aspirin about once every 3 days, but this would inhibit platelet function, making the hematoma more likely to bleed and enlarge, so I can’t recommend that. Other NSAIDs are not safe in cats, and tylenol is not safe in cats.

    It is possible that a cold compress will help with the discomfort. Cold makes blood vessels shrink, slowing bleeding and oozing. Heat opens blood vessels, making the hematoma potentially worse in the early stages.

    Heat can help circulation, but should not be applied while the hematoma still contains a lot of fluid.

    Cold compress for 10 to 20 minutes three times daily for about 3 days. Wait 3 days, and then consider warm compresses three times daily.

    Your cat really needs to go to the doctor.

  42. Susan says:

    Hello, I have a GSD with the hemotoma. It came out of nowhere. She does not have any mites or ear infection. She is 8 years old. My question is, will these eventually go away on their own and how long can that take? I cannot afford the $400 surgery and my vet will not drain it because he says that doesn’t work.

  43. Doc says:

    Hello, Susan,

    Eventually, the hematomas do resolve. However, this can take many weeks and the pressure is uncomfortable for the dog in the meantime. Also, the ear will be considerably deformed in most cases.

    If your dog’s ears are clean and there is no history of ear trauma, you might consider asking your veterinarian if he has ever treated these for vasculitis.

    There are some dogs that will respond dramatically to just medical therapy.

    As I cannot see your dog, I can only give you general answers. The doctor on site is best qualified to make recommendations on the case.

    Thanks for reading and writing.

  44. Kayla Crabtree says:

    I took my lab to the vet today to get surgery on his ear. He had a large hematoma that took up his whole ear. We had put this surgery off for quite a while b/c we were hoping that it would heal on its own and b/c of money issues. We finally got to the point where we had to do something b/c it wasn’t getting better, only worse. So he had his surgery and the Dr. called me right after. He said that there was barley any blood at all in the ear. He said it was mostly tissue. In all of his years in practice he said he has never seen this. He said that he cut some of the tissue out but it is still quite large. He was also telling me that the stitches might loosen up as well w/ the healing process. Have you ever had this happen to you? I just feel so bad for putting it off for so long. Will his ear always be a lot thicker than normal? The Dr. said he got the ear down to half the size it was when I brought him in. It was probably 3 inches thick when I took him to the vet. I am just worried that the tisue will continue to thicken. Is that true?

  45. Doc says:

    Hello, Kayla,

    I have never encountered such a problem, myself, either. It would have been ideal to biopsy the tissue at the time of removal, but you mentioned that money is a concern, and that would be an extra expense, to be sure.

    If I were looking at something like you describe, I would probably be taking pictures and consulting with a veterinary dermatologist.

    I really could not predict what this is going to do. I would suspect that the ear will always be abnormal. Scar tissue shrinks as it matures. This may thin things a little, but it also has a tendency to make them pucker, producing the “cauliflower ear” of the pugilist.

    Your veterinarian is really the best person to advise you here.

    Thanks for reading and writing.

  46. Eli says:

    I was very happy to find information here about a problem that tortures my family all this year. (Sorry for the English, I am not native, I live in Bulgaria). Yesterday, it was the 6th time when aural hematoma occurred in my 1-year siamese cat (once the right year and 5 times on the left one!). The single surgery of the right year was 100% successful and the pinna healed completely with a small deformation. But the other… every time the bloody blister occurred more closely to the base of the ear and suturing became more and more difficult because of ear “geometry”. I must note that I am working a a veterinary medicine faculty and I am sure to receive the best possible service, but my colleagues surgeons are already very concerned about stopping the hematomas to appear. The cat has no other ear problems, is very calm and even allows suturing without being anesthesized…

    Any suggestions from you are very, very welcome!
    P.S. Could inbreeding be possibly involved in the etiology of the condition?

  47. Doc says:

    Hello, Eli,

    I am not aware of any research looking at genetics in regard to aural hematoma formation.

    If your cat does not have evidence of infections or inflammation in the ear canals, this may be a case where corticosteroid therapy would be helpful.

    As I noted in the original post, while the underlying reasons have yet to be found, there are many animals with this problem where the leaking blood vessel appears to be caused by the body’s own defenses attacking the vessel.

    I have been surprised at how many animals have responded to treatment with immunosuppressive doses of some type of cortisone.

    I am no expert in this, but I am told that when using oral corticosteroids, that cats do better with prednisolone than with prednisone. An immunosuppressive dose of 2mg/kg once daily has shrunk several of these hematomas for me. I only use this high dose until the hematoma shrinks. Then the dose is tapered down gradually over a period of several weeks.

    I was initially skeptical of this form of treatment for aural hematomas, but with the multiple recurrences that you are seeing, you might ask your veterinarians to investigate this avenue. Your veterinarian is actually seeing the patient and is best equipped to evaluate the case and prescribe treatment.

    Good luck with your cat.

  48. Fawn says:

    I have a 7 year old pitbull/mastif mix who I rescued a year ago. When I got him he had just had a surgery done for a hematoma on one ear which was never well taken care of afterwards but hasn’t caused him much problem. He shakes his head and scratches at his ears constantly, mainly when he gets excited or is stressed out. A couple days ago I noticed his other ear was swollen up like a balloon. I had to go to work right away and while I was gone my roommate decided to make a 1/2 inch cut in his ear (without my permision and without me knowing!!) and now I am not sure what to do. I don’t get paid for a few more days and have no money until then. I have been cleaning the wound often and as best as I can but he is obviously in a lot of pain and the whole situation worries me. What more can I be doing to help him and make sure he is alright until I can get him in to see a vet?
    Any advice would be greatly appreciated!

  49. Doc says:

    Hello, Fawn,

    I can’t really prescribe “over the phone” for you, but I can give you some general suggestions.

    The dog certainly needs some type of pain control. Ibuprofen and naproxen (Advil and Aleve) are not very safe in dogs, and I would not use them. Aspirin can be given to dogs (one regular tablet per forty pounds of body weight), but it inhibits platelet function, so you would have more bleeding, and I would not give aspirin in this case.

    It is usually safe to use one regular-strength Tylenol per forty pounds of body weight given three times daily for short-term pain relief.

    Keeping the wound clean with mild soap and water is good.

    You really do need to get your dog to your veterinarian.

  50. Brian says:

    I need some insight and advice, perhaps you can help. We have a Golden Retriever, female, 9 years old, 90 lbs. 6 weeks ago I discovered a balloon ear on our dog. She was shaking and scratching frequently a day or two before. To make a long story short…I took to her to see the Vet. I was told that Sam had an Aural Hematoma and an ear infection. The Doc suggested meds for the infection. She gave me three options for the Hematoma.
    1. Aspiration
    2. Teat Cannula
    3. Surgery

    I was told that options 1&2 had a possibility of recurrence. I was told that option 3 (surgery) would permanently fix the problem and the hematoma would not return.
    We opted for option 3.
    ChaChing!! I was told that Surgery, post op and healing were a success. However, yesterday the Hematoma returned. My dog is miserable and I am a little miffed. Can you give me some guidance on the next step to take?

  51. Everett Mobley says:

    Hello, Brian,

    “I was told that Sam had an Aural Hematoma and an ear infection. The Doc suggested meds for the infection.” When there is an ear infection, you surely need to handle that. It is painful for the dog, whether or not you have a hematoma. Pain also causes more head-shaking, which worsens the hematoma.

    “She gave me three options for the Hematoma. 1. Aspiration 2. Teat Cannula 3. Surgery” These would be the standard options. I only use the prednisone therapy when there is no evidence of ear infection, suggesting that the hematoma was not a result of trauma. Aspiration almost never works, even when accompanied by wrapping the ear to keep it from refilling.

    The teat cannula method worked for me in 90% of cases (before I started using prednisone therapy as first line). I like it. The major surgery option is so…MAJOR.

    “I was told that options 1&2 had a possibility of recurrence. I was told that option 3 (surgery) would permanently fix the problem and the hematoma would not return.” When 1&2 don’t work (and neither does pred) the old major surgery is the only option left. The problem is this: there is no way to guarantee the hematoma will not return. That was a slip-up in communication. Even when surgery is the best option, there can be no guarantee that the problem will not recur. It doesn’t matter who does the surgery, or how great they are. We are dealing with a biological system and you can’t predict the outcome 100%. All you can do is your best.

    I really cannot speak to what would have looked like the best option. Your veterinarian was seeing the dog and was best situated to evaluate the problem. That Monday-morning-quarterback thing is just not meaningful.

    Having said that, I can understand your disappointment. You were not prepared for a possible treatment failure (regardless of the dollars). Unfortunately, I cannot just ask people to slip me an extra hundred for the guarantee (like buying the extended warranty). There just are no guarantees possible.

    Golden retrievers often have allergy problems. The insides of their ears can itch, even when there is no infection. Also, the allergy can cause conditions inside the ear canal to favor the development of yeast infections. Finally, it is possible that your dog does have the immune-mediated vasculitis that would respond to prednisone therapy.

    I would advise you to avoid getting confrontational with your doctor. First, I believe that they did their best to help your dog. Second, when you put people on the defensive, they GET DEFENSIVE. Now they are just defending their position instead of working with you.

    A lot of doctors hate being jammed up with a bunch of crap clients have pulled off the internet. However, after the dog has been re-evaluated for presence (or absence) of a new ear infection, you might bring up the question of underlying allergic problems or immune-mediated vasculitis.

    Thanks for reading and writing.

  52. Amber says:

    I have a yellow lab who has developed an aural hematoma that hasn’t gotten too out of hand yet. I would like to try the prednisone option with him but cannot find a vet to help me go that route. I am a Doctor of Pharmacy, so I am not a typical vet owner who is going to oversose or misuse the medication so I don’t know why I can’t find a vet to help me at least try this option instead of jumping to surgery right away. Please e-mail me so that maybe we can talk about this option and if you know any vets that would be willing to help out the unconventional way. Thanks, Amber

  53. Doc says:

    Hello, Amber,

    While I respect and can appreciate your expertise as a pharmacist, you must know that it is both illegal and inappropriate for me to prescribe for a patient I have not examined. Aside from the fact that I could easily make an inaccurate diagnosis over the phone, the law is very clear in requiring a “doctor-client-patient relationship”. If some unforeseen complication developed, how would I deal with it?

    I wish that I had better advice for you than to to “keep calling”, but I really don’t know how to put you in touch with someone in this way. I can only advise you to ask more friends about their veterinarians. When you speak to someone, you might even start with “I know that you probably cringe when someone tells you that they read it on the internet, but would you be willing to explore this option for me?”

    Good luck.

  54. Lori Smith says:

    We adopted a 7 year old weimaraner from a weim rescue organization yesterday. She had been starved and neglected before the rescue organization got her, and she came to them with a large aural hematoma. We have no way of knowing how old the hematoma is, only that they found her this way in August. She spent a month in veterinary care for the starvation issue and is now back up to 80 pounds and regrowing her coat, but she still has a hard lump in the bottom of her ear, and the ear is quite crinkled up. We’ve gotten conflicting answers as to whether it did have surgery or it didn’t, but since there’s still a lump, our question is whether there’s anything that can be done to repair the damage to her ear at this point, or whether the scar tissue will soften up over time. It doesn’t seem to hurt her at all. She does scratch at her ears, but she that may be due to a food allergy. She’s been on Z/D prescription diet with brewer’s yeast and benadryl twice a day for that. I guess the real question is whether anything can be done for the look of her ear after it’s already crinkled up?

  55. Doc says:

    Hello, Lori,

    With a long-term problem like this old hematoma, it is unlikely that you can do a lot to improve the cosmetics. This is equivalent to the “cauliflower ear” of the old time boxers who got their heads punched a lot.

    This appearance can result whether you have had surgery of not, but it sounds more like “not”. The body’s attempt to resolve the hematoma has produced scar tissue, which shrinks as it matures, crinkling the ear into a hard knot. It is possible that a board-certified surgeon might improve it some, but I wouldn’t count on anything pretty.

    The most important thing now is to be sure that the ear canals are open, and not inflamed. Until you have things on an even keel, I’d ask your veterinarian to check the ears monthly, at least.

    The wadded-up ear isn’t pretty, but probably not uncomfortable. An inflamed ear canal is definitely uncomfortable.

    Thanks for reading and writing.

  56. Jeremy says:

    Hi doc,
    I just happened to come across this site as I am researching my dogs hematoma. Not two or three days ago I noticed it. It was very small and after a few days I could tell it was getting smaller. But this morning I woke up to a slight whimpering and discovered my dogs ear to be completely limp and swollen. I am worried cause money is a struggle right now but here huge went from almost nothing to a monster swell. I guess I have no choice but to take her in I am so worried she is such a beautiful dog and I just pray that her ear wont be permanentely disfigured. Thanks for reading.

  57. Doc says:

    Hello, Jeremy,

    Since the ear has just recently blown up hugely, the odds are good that treatment will allow it to heal without a lot of disfiguring.

    The longer it goes untreated, the more likelihood there is that the scarring will wad it up.

    Many hematoma cases have a small degree of scarring, no matter how fast and aggressively they are treated.

    Good luck

  58. Jeremy says:

    I just had one last question for you thanks for responding. Today is wed and the vet said he cant get me in until tuesday for the actual surgery. Should I wait tell then? Will it make a huge diffrence in her ears. And last I have been doing research and learned there is a laser treatement available but it costs more. Is it worth it to go this road or should I stay on the original path? Thanks so much again!

  59. Doc says:

    Hello, Jeremy,

    I really haven’t had any experience with laser treatment of the hematoma, so I cannot speak to that. Laser treatment can seal leaking blood vessels and in some surgeries (like cat declaws) creates less post-operative pain.

    Due to charring of the wound edges, there are some surgeries where healing might actually be slower.

    Your doctor probably has a lot more experience with the techniques that are successful in his hands. I don’t think that the wait of several days will make a huge difference in your outcome.

    It is important that you are comfortable with your doctor, and ask him any questions that you have.

    Good luck

  60. sandi says:

    Dear Doc,
    Thank you so much for having this blog! It is so helpful to read what others have experienced with their pets and your thoughtful responses. AS for me, I have an 11 yr old wonderful Weim who first had a left aural hematoma last July. Reilly had surgery and it was almost 4 months before his ear healed. He was on antibiotics and several courses of steroids. Even after the wound healed, I to had to aspirate fluid daily from small pockets that would develop in his ear where there were not stitches. We had about a month of peace and then he developed a hematoma in his other ear.This one initially started out in the mid area.He has been on a 2 week course of steroids (Medrox)and the fluid is now in the bottom of his ear flap. Since recovery from his previous surgery was so lengthy, I opted (for now) to aspirate the fluid which was initally serosanguinous, then frank blood and now serosanguinous again. I withdraw about 9 to 15 cc twice a day and the fluid fills up quickly.
    I want to avoid a second surgery because of Reilly’s age, heart murmur, traumatic recovery for both him (and me), keeping his ear wrapped & head collared and cost.. I am wondering if it is now time to change course and have the surgery…My vet has been supportive of my choices-he said he has never had a situation where the owner was willing to aspirate daily so this is a bit of an experiment from his point of view.I am willing to continue with with this present course for another month or so and see how things go. Either way, the surgery or BID needle sticks, are uncomfortable for Reilly.
    I am wondering if you have any thoughts or suggestions that may help me and Reilly now and/or in the future?

    Many Thanks,

  61. Doc says:

    Hello, Sandi,

    My concern with the daily or twice daily needle sticks would be that there is always the possiblity of introducing contamination. Then you have bacteria in a pocket of bloody fluid. It sounds like you are being very careful to maintain sterile technique, or this would have happened long ago.

    In re the oral steroid use, you have to use pretty high doses, like immunosuppressive doses, not just anti-inflammatory doses if you are going to be successful with that approach. You might discuss that with your veterinarian.

    If you are aspirating that often to remove fluid, I’m wondering if you are also doing anything to try to eliminate the pocket. I’ve had poor luck with wrapping the ear around some kind of padded core, but I wasn’t able to change it and drain it daily, either. Keeping the ear wrapped around some sort of padded core to eliminate the dead space should slow the refilling. If it refills just a little, as you change your bandage daily, then you could aspirate that.

    Again, you might discuss that with your veterinarian, also.

    If the dog is traumatizing the ear at all, I would consider an e-collar, and some type of pain medication, like Tramadol. Again, discuss this with your veterinarian.

    Good luck.

  62. Paula says:

    Thanks for your postings. I just noticed my 5 year old Golden Retriever had a lump on her ear yesterday. We researched on the web and “Google diagnosed” her problem as being an aural hematoma. She doesn’t seem too bothered by it. Here is my problem – we spoke with the vet prior to going in about him billing us and her pet insurance which he agreed to over the phone. Once in the office he said that he would need the money upfront and that we would need to file with the insurance – he wants $800 for the operation – which we don’t have right now. How quickly do we need to act? As she is a Golden with furry ears would any scarring be noticeable – right now if you just looked at her you wouldn’t really notice anything. Also, the vet warned of the hematoma rupturing – is this common? What can we do to avoid this. Thank-you in advance for your help!

  63. Doc says:

    Hello, Paula,

    It is highly unlikely that the hematoma will rupture. It may become much larger, and be very uncomfortable. Also, if the underlying cause is an ear infection, that is also painful. Your dog should at least have the ears checked.

    The scarring actually tends to “wad up” the ear into a crinkled shape.

    You may not need extensive surgery, but the dog should be examined.

    Sorry to be so late with my reply, but my community has been without power since 1/27/09.

    Good luck

  64. Vela's mom says:

    Dear Dr Mobley,

    A doctor myself (although my practice is limited to humans) I freely admit that I am committing the cardinal sin of using the internet as a medical reference. I am, however, very limited in my ability to see a vet at this moment as I am at sea on a Navy cruiser. My cherished pup is home with my dog sitter who adores her and will do anything to help her. As such I will, with my head down, admit that I taught him how to drain the heamtoma and provided him with the necessary equipment. (He demonstrated excellent sterile technique)

    Vela, my dog is a 10 year old mix that looks like a white shepard but only weighs 50 pounds. In the days preceding my deployment, she developed a painless, nonfluctuant swelling in her ear. I took her to a nearby Army base (we are stationed in Japan) to the vet’s office. I explained that I was preparing for deployment and stressed that I was looking for definitive treatment. He drained it on the spot and provided me with addtional butterfly needles and syringes and told me that my sitter could bring her in any morning at 0830 for repeat procedure “if it recurs”. In that my sitter is also active duty and not on the Army base, I elected to have one of my med techs come by and I taught them both how to drain it themselves.

    (I really can’t believe that I am admitting to all of this.)

    I did contact a Japanese vet that the base vet recommended (his surgical days are booked through 25MAR09) only to find that the DVM was on emergency leave until 22MAR09 and the vet techs wanted me to bring her in anyways. I declined as they are not English speaking and the dificulty of finding a translator to go in with me just to confirm that the doctor is gone and all they can do is precisely what I am already doing… the view wasn’t going to be worth the climb.

    Vela is an otherwise healthy dog and the vet confirmed that she did not have any other ear pathology on the primary visit. He told me that this would go away with repeated drainings and that if it was still there when he had surgical availability he would be happy to perform the “quilting procedure.”

    I have been getting daily reports that she is doing well, although she continues to produce about 3cc/day. She tolerates the draining very well (she trusts her pack implicitly and is very calm and compliant). The fluid is serosanguinous. Her energy level is reportedly at it’s normal high level and her appetite is likewise normal. My fiancee returned to Japan last night from the Philippines and my current dilemma is: is the depot steroid worth a trial or should we seek surgery? If we should seek surgery, is this a “the sooner the better” scenario (requiring a great deal of research and the need for translators) or is it something that will not have a worse outcome if we continue to drain it until the Army vet is available? My third question is: What is the likelihood htat the ear will regain it’s normal erect posture?

    I sincerely appreciate this service that you provide and the knowledge I have gained from reading the article and subsequent posts.

    By the way, nice bike… you should bring it to Japan… we do a lot of riding here as well. Lots os HOG members here.

  65. Doc says:

    Hello, Vela’s Mom,

    The veterinarian on post has seen the dog and I haven’t, but I have never seen one of these resolve just with repeated drainage. The pocket refills rapidly, as there is still a leaking blood vessel and a dead space to fill.

    I have (rarely) had success by draining and wrapping the ear pinna around a soft core (like a rolled-up paper towel) to provide a little pressure that eliminates the dead space while the leaky vessel heals.

    I rarely use depot steroids in dogs. I do use immunosuppressive doses of oral prednisone until the swelling resolves, then tapering the dose at two week intervals until we are down to 1/2mg per pound every 48 hours to finish. This works in a surprising number cases, but the dog needs to be monitored and the veterinarian needs to be on board with this approach. Steroids are not innocuous drugs.

    Vis a vis the quilting surgery, and “the sooner the better”, long-term drainage may introduce contamination. Long-term filling with serum is eventually going to build up fibrinous material. I suspect that this will make cicatrizing deformity (“Cauliflower ear”) more likely and more noticeable. Some “crinkling” of the ear is quite common with this more radical surgery.

    Therefore, with more extensive surgery, the ear may very well stand erect, but possibly not in its previous smooth curvature.

    When the steroids are successful in resolving the vasculitis that is causing the leak, those ears have returned to normal configuration.

    I’m sorry that you are having to handle this “long distance”. Please remember that my advice is by necessity of a general nature only. The veterinarian who is attending your dog is the best one to inform you as to the individual case.

    Good luck.

  66. Terri says:

    I have a 4.5 yr old Red Heeler.. in Novemeber I had her to the vet for a hematoma in her left ear. It didn’t seem to bother her unless i was trying to touch it. She has never had a problem with shaking her head or anything of the such and the vet had said that both of her ears looked free of infections. She happens to play rather rough while throwing frisbees or tennis balls. and also like to put her nose under our back fence. The vet suggested that it was just from hitting her ear too hard. At the time, the vet had given me an option to just have it drained (less costly) or to have surgery (sky high). I opted for the less expensive procedure. My heeler had been fine ever since until last week. The Hematoma has come back, which was expected. However, this week, her other ear now has the same thing!!!

    I had recently priced the cost to have surgery and deeming that it would take approx 1 hr… the surgery will be $750. That was before her other ear became swollen. Not really something I can afford.

    I’ve been doing some googling and have read that the hematomas may resolve on their own in 4-6 weeks. I know that they are uncomfortable and probably painful when i try to feel them, but as long as they aren’t bothered, will they really go away without having to have surgery?! Also, i know that her ear will already remain floppy regardless of surgery or no surgery, but can or will “cauliflower ear” become any type of medical issue she’d have to see the vet for? The ears are slightly warm to touch, but not necessarily hot as described that would lead me to believe she suddenly has any infections. Her ears are not something i’ve ever had any trouble with before this.

    Any suggestions?

  67. Doc says:

    Hello, Terri,

    When a hematoma resolves without intervention, it does not usually just disappear. You start with bloody fluid accumulating between the ear cartilage and the inner ear skin. These two layers are usually tightly adhered to one another, so this creates an abnormal pocket of space (filled with fluid).

    Some of this fluid will form fibrin clots, which eventually will stop the leak. It also will form lumps in the abnormal pocket. When the leak is finally stopped, the fluid will be reabsorbed rapidly by the body. The lumps will take much longer to be reabsorbed.

    As the inner ear skin finally re-adheres to the cartilage, it will not be stuck smoothly to its original location. The final healing process will crinkle up the (now thickened) ear. This is the “cauliflower ear”. It is unsightly, but not painful.

    While the ear is ballooned with fluid, however, it is under pressure, and pressure is uncomfortable. Ever had a “blood blister”? I have to feel like the dog is having discomfort while that thing is swollen. How painful? For how long? I can’t say.

    Your dog is one that I would investigate the possibility of having immune-mediated vasculitis as the cause. A significant number of these dogs have dramatic responses to high doses of prednisone. You might ask your veterinarian about this.

    I hope is is helpful to you. Talk to your veterinarian about your concerns.

    Good luck.

  68. Harriet says:

    Dear Doc,

    Thank you so much for your wonderful source of information! Our 9 year old Rhodesian Ridgeback Kip had surgery on March 11 for a large aural hematoma (the entire pinna was swollen up like a balloon). On March 27 the stitches were were taken out. An incision on the underside of the ear has closed up since then and stopped draining serum, and the hematoma is starting to fill up again. I took him to the vet 2 days ago and the vet’s advice was to leave it alone at this stage as Kip was not troubled by it. Since then it has grown bigger, and I personally doubt that it will resolve by itself. I am concerned that it will soon be really big again. Kip is still not particularly troubled by it. Do you recommend intervention as soon as possible, or, given that he does not appear to be in pain, do you recommend waiting to see how big it will become, and whether it might slowly be reabsorbed?

    Kind regards,


  69. Doc says:

    Hello, Harriet,

    This is a case where it is really impossible for me to give you good advice. Since the ear has changed since your veterinarian saw it, it would be best for you to give him/her that information.

    Generally speaking, when these are left to resolve on their own, there is more scarring and wrinkling of the ear. If the dog is not uncomfortable and you are okay with that, then it’s okay to let it go.

    This is a case where the doctor “on the ground” is in a much better position to advise you. If you are not happy with his advice, tell him/her that you need more information and clarification. If it is still not forthcoming, tell him that you’d really like to do more. If he/she is not interested, you could ask for a referral to a specialist.

    FIRST give your regular doctor some feedback and the opportunity to communicate.

    Everett Mobley, D.V.M.

  70. Lisa says:

    I have a 14 year old Golden Retriever, who’s ion very good condition for his age, slight arthritis etc but nothing major.
    However he now has an aural haemotoma, (he has an appointment with the vet tomorrow). He shakes his head occasionally, not excessively, maybe three times a day. I wonder, considering his age, would the vet decide against surgery?

  71. Doc says:

    Hello, Lisa,

    As always, your veterinarian is in the best position to make this judgment, as he/she can see the dog and I cannot.

    Generally speaking, I prefer to be as conservative as possible. If non-surgical remedies work, then great. If they don’t, then we proceed to surgery.

    Any time that you find fifteen different ways of doing something, it should be obvious that there is no one best way that works for every case. If there were, that’s what everybody would do.

    I am glad that you are taking your dog in to see the doctor. The head shaking could be from an ear canal problem or just from the discomfort of the swollen ear.

    Certainly with a fourteen years old dog we have more concerns about anesthesia than with a younger dog. However, when it’s a “have-to” case, we go ahead. We certainly don’t want the dog to be in constant pain.

    With an older patient like this, we would want to do some pre-op risk factor assessment. Do some bloodwork, get a chest X-ray, maybe an ECG, as well. We’d put in an I.V. catheter and have him on a slow I.V. drip to support him during surgery and be ready to perform more intensive support if needed.

    Good luck.

  72. laser hair removal montclair says:

    Very informative blog i had a same problem before, my ear also have a blood swelling and i don’t know how to controlled it,so im going on the specialist for the operation for now i alright. How i wish i saw this post earlier because it important to taper the dosage off slowly. If you stop as soon as the ear swelling goes down, it’s very likely to recur rapidly.

    by: sphin

  73. Dawn Lepine says:

    Hello, I have a 7 year old lab who has an aural hematoma. It is not severe (yet). I took him to a local vet who charged me $118 to asperate it. He also gave me Methylprednisolone and dosage information which I forgot to write down and is not on the container. I tried calling the vet but they closed at 11am for the holiday weekend and will not open until Tuesday. Could you please give me an idea of what his dosage might be? He weighs 73 lbs, he is 7 years old?

  74. Doc says:

    Hello, Dawn,

    I don’t know that I can help you much, as I don’t use the drug much myself, and not at all for this condition. I certainly cannot prescribe for your dog at “long distance”.

    From Plumb’s Veterinary Drug Handbook, sixth edition, page 603:
    For labeled uses:
    Dogs weighing 40 – 80 pounds: 4 to 8 mg.
    These total daily doses should be divided and given 6 to 10 hours apart.

    The drug is supplied in a variety of strengths with tablets available in 2mg, 4mg, 8mg, 16mg, 24mg and 32mg.

    I’m sorry that the labeling doesn’t give you all the information that you need. Can you leave a message on your veterinarian’s answering machine? Many times, we have to visit the clinic even when it is closed, and you might get a call back.

    Good luck.

  75. Doc says:

    Hello, Lesha,

    The cost of treatment really varies. A course of prednisone therapy might be less than $20, plus the cost of an examination and consulation. Placing a tube drain is pretty inexpensive, unless the dog requires sedation, $25 to $50, (plus exam, etc.)

    If extensive surgery is required, then you may have pre-anesthetic testing needed, plus the surgery itself. That could run $200 to $300 easily.

    This really varies with what the dog requires, what level of medicine a clinic is practicing, the geographic area and so forth. More support personnel means better care, but more overhead, necessitating higher fees.

    You get what you pay for.

    Thanks for reading and writing.

    Everett Mobley, D.V.M.

  76. Shiloh says:

    My dog is a 12 year old female pit bull. My Vet has prescribed Prednisone 2(20mg) pills every 12 hours along with carafate (1gram). On one web site the dogs recommended dose was 0.5mg of Prednisone once daily. Is 40 mg of pred. every 12 hours too much. Please help I’m supposed to start the medicine tomorrow.

  77. Doc says:

    Hello, Shiloh,

    Since we are using the prednisone to treat the problem as though it is an auto-immune disorder (the body’s own defenses attaching itself), we use immuno-suppressive doses. This would be one to two milligrams per pound daily. I usually start with 1mg/pound once daily, which would be 40mg for a forty-pound dog, but it can take more.

    Your veterinarian has also prescribed Carafate (generic is sucralfate). This compound forms a gel that patches into any ulcers in the stomach lining. High doses of cortisone occasionally predispose the dog to ulcer formation, and your doctor is trying to protect against this.

    It sounds as though your doctor is being pretty conscientious. You should share your concerns with him/her. Also ask him/her what to expect if the dog is having problems with treatment, and when to get the dog rechecked, and so forth.

    Prednisone is a synthetic form of cortisone and it is a potent drug. Even when the patient does well on it, there are side-effects to deal with , and after taking high doses for a while, you have to taper off slowly. You cannot safely quit “cold turkey” if you have been taking big doses for a long time (weeks).

    Stay in close touch with your veterinarian. He/she is best equipped to help you, as he/she is actually seeing your dog.

    Good luck.

  78. Tammie Faircloth says:

    My Scottish Terrier received a small bite on the ear by a raccoon, I immediately gave him a bath and got him to the vets. His vaccination had expired so I now have him at an in home voluntary quarantine. I am very confident that he is free from the disease but the bite has caused some major problems. The vet seemed reluctant at first to prescribe antibiotics but after 48 hours and a very swollen ear he started the medicine a couple of days ago. It seems to have helped it is not as painful but the hematoma is so large the ear is drooped over. It does not appear to be draining anymore but a large ‘pocket’ is still there. Is there a home remedy that I can use to get it to drain? I was using warm Epsom salt poultices, peroxide, neosporin, etc. Any advice would be greatly appreciated. Thank You.

  79. Sasha says:

    My 9 year old lab appears to have an Aural Hematoma. I noticed it about a week ago, it was the size of a dime. He did have a yeast infection in his ears about a month ago. The infection cleared up wonderfully, during that time though there was a lot of excessive ear shaking. As well he, being a lab, is a water dog and naturally will shake those water filled ears. Since noticing the start of it I immediatly began to limit his activities that would make him shake more and started apply a cold cloth to his ears about four times a day. I also spoke with my great uncle who happens to be a retired vet. He said that it could dissipate on its own or grow large and require surgery. About a week later I noticed it had grown more, a few milimeters a day. Now it is roughly the width of quarter and pillow like. Other then apply pressure direcly to the hematoma, there does not seem to be any discomfort (no excessive shaking, you can touch the rest of the ear). This being Labour Day weekend I began to grow increasingly apprehensive because I would not be able to get him into my doc until Tuesday and my uncle no longer practises so he can not assist, just offer advice. When I called our emergency service the vet that answered (not mine) was very rude and refused to give me a straight forward answer. I described the size and the speed it is growing (slowly according to the research I have seen) I asked if this was a matter that could endanger his life if not taken care of immediately, he informed me no, but when I repeated it back to him, he started to change what he was saying and made it clear that in order to take him away from his long weekend was going to cost a lot more then just the standard emergency rate. After feeling like I do not trust my dog in his hands, I declined service and left a message with my vet to call me first thing tuesday to set up for either surgery or drainage depending on her recomendation. My very roundabout question to you is, did I just critically endager my dog’s life by not taking him to that emergency vet?

  80. Doc says:

    Hello, Sasha,

    Aural hematomas are not life-threatening, just uncomfortable and unsightly.

    If untreated, they eventually do heal, but the way in which they heal naturally is quite slow and long-term, and tends to cause pretty severe deformity of the ear flap (pinna).

    The longer they are untreated, the bigger they tend to get. The bigger they are, the more troublesome they are to heal with a cosmetic result.

    I have never heard of an aural hematoma bursting or otherwise causing severe problems, other than the discomfort of the swollen ear.

    Thanks for reading and writing.

  81. Maria says:

    Just wanted to say thank you very much for sharing your expertise!!! You are very insightful and offer many opinions, which is rare to find among vets –> the main concern tends to be the numbers on the bill they hand you at the end of it all…. ( it is sad to say, I have pretty much zero respect for 98% of vets I have encountered and I have seen plenty )

    Thank you again – I have read the entire thread of posts and decided I will be asking my vet for the prednisone treatment or simply leaving it to heal on its own. Dyce’s ( my APBT) other ear is deformed from an attack as a puppy, I care very little for her aesthetics — much more so for her stress level, and not having to cause her unnecessary pain and discomfort of a surgery. She seems fine and shows no signs of being in any pain. I think I am more distressed over the whole thing than she is.
    She does have skin allergies and I have recently started giving her oral homeopathic allergy drops. Could this have had anything to do with the sudden hematoma?

    Again, thank you very much!

  82. Cheyne says:

    Is it possible to have the ear repaired to look normal after it has shriveled up and healed itself? I recently took over care of a dog who had a hematoma in both ears, both of which healed. Any information or suggestion would be great. Thanks!

  83. Melissa says:

    My golden retriever had the surgery for a hematoma in her left ear about a month ago. Everything went smoothly, but there was still a pocket of what the doctor called “fluid” where the hematoma once was. After a month and a couple attempts to drain the pocket via a needle, it still continues to fill up! Our doctor told us the next step would be to lightly sedate her and suture the area flat. Does this seem like a reasonable solution? Will this ever go away!?

    Thanks for your help and advice! 🙂

  84. Doc says:

    Hello, Melissa,

    I think that your veterinarian’s plan is certainly reasonable. This should give you a permanent solution (though nothing is ever 100%– you know, never say never, etc.)

    Suturing the pocket flat eliminates the pocket, and if it is only a small area, this would not be too tough on the dog. When one has to use this technique to secure an entire ear flap, it’s a pretty major surgery.

    The other thing to consider would be the possibility of the immune-mediated vasculitis, especially if you didn’t see another underlying cause for the hematoma (like an ear infection).

    Your dog may or may not be a candidate for the prednisone therapy. Your veterinarian (who is actually seeing your dog) is your best resource, but don’t feel bad about asking questions.

    It’s okay to open a discussion. Do remember that most doctors groan (at least inwardly) when a client starts with “I was reading on the internet…”.

    Good luck.

  85. bugleg says:

    My dog developed a hematoma over the weekend–we went to the vet and he suggested surgery. Unfortunately, we are traveling soon and are worried about recovery in our absence. In addition, the dog has a history of ear wounds healing very very slowly, so I am reluctant to open the ear.

    In the meantime, the vet prescribed prednisone to knock down the dogs allergies, so he doesn’t shake his head and make things worse.

    The prednisone tablets are marked 100 (mgs?) and the bottle says to take three tablets twice a day for three days, then three tablets once a day for three days, then three tablets every other day.

    Is this a long enough course to help with the hematoma? Should I discuss spreading out the dosage so it runs longer? Thanks!!

  86. Doc says:

    Hello, Bugleg (an old family name, I presume),

    It is unlikely that your dog is taking 300mg of prednisone. I think there must be some misunderstanding about the labeling.

    Prednisone is a synthetic form of cortisone. It is not an innocuous drug. Don’t alter the dosing on your own. That is not a safe thing to do.

    If you want to see if your dog can benefit from the immunosuppressive dose, then you need to talk with your veterinarian about that. You’ll have to tell him/her you read about it on the internet, and he/she will groan (maybe not out loud, but we ALL groan when we hear that).

    If the prednisone dose is being given for allergic symptoms, then it probably is not enough to suppress the immune response that damages the blood vessel in the ears.

    You really need to communicate with your veterinarian who actually sees your dog on this. I can only speak in general terms about medical problems. Each patient has different needs.

    Good luck.

  87. Rachelle says:

    Dear Doc –

    Zoe is a 10 year old Am Staf/Sheppard mix with a fairly large sized hematoma in her ear. She is on antibiotics and ear medicine to help treat her possible infection and her consistent scratching.

    I have discussed with the vet the surgery option but can not afford it no matter how much I love my dog (I am not a bad owner just a poor school teacher).

    The vet told me it will take time to heal — my question is how much time? What can I do in the mean time to help her “feel” better. When I touch her ear, she does not flinch and she is eating and playing normally.

    I am a worried Mommy and do not know what to do. If you tell me 6-8 weeks – then I know to be patient –

    Please advise – and thank you so much for your blog it does certainly help.

    Zoe’s Mom!

  88. Doc says:

    Hello, Rachelle,

    If Zoe has an ear infection, then it is certainly important to treat that. The hematoma will not get better any faster if she is constantly scratching, shaking, etc. because her ear canal hurts inside. So, good job on that.

    If you are planning to let this resolve on its own, then it certainly will probably take six to eight weeks. What has to happen is that the clotted blood stops the bleeding. Then the body has to dissolve the blood clot, which will take quite a long time. In the process, the ear pinna (floppy part) will tend to crinkle up and look pretty weird. This will be a permanent situation. That won’t be painful, just funky looking.

    In the meantime, if your dog has constant scratching, you might ask your veterinarian if she might have allergic problems that need to be addressed.

    As far as the swollen ear pinna is concerned, if it is not painful, then there is really nothing to do for it except be patient. If it were painful (due to pressure from the swelling), then pain medication would have to be addressed. Since aspirin inhibits platelet function, aspirin would NOT be a good choice. If you believe that Zoe’s ear is painful, you should talk to your veterinarian about that. It sounds from your description as though the ear is not painful.

    It is important to let you veterinarian recheck the ear when you finish your meds to be sure that the canal is now clean and healthy. If it isn’t, then additional evaluation and treatment would be needed.

    Good luck.

  89. kate buttling says:

    Dear Doc,
    My companion of 13 years, Lucy, a black lab mix, has what appears to be an aural hematoma that suddenly has blown into this huge swelling, like her entire ear flap. I am ashamed I have not noticed the swelling, but I care for my daughters 3 kids and barely had time to spend with her. What can I do until I can find a vet for her and hopefully get the funds to help her?

  90. Doc says:

    Hello, Kate,

    First of all, these can come up really fast, so don’t blame yourself for being busy.
    There really is no good home remedy for this condition. If the dog would allow a cold compress (a cloth soaked in ice water, NOT ice), it would be good to apply cold for 20 minutes three times daily.

    These are often painful due to the pressure created by the swelling. Aspirin is not good, as it inhibits platelet function, which would make the bleeding worse. Over the counter NSAIDs, like Aleve and Ibuprofen are not really safe to give to dogs.

    Most dogs can tolerate Tylenol for short periods, but this could be a problem if the dog has other medical problems, such as a pre-existing liver condition.

    You really need to get her to a veterinarian.

    Good luck.

  91. Danny says:

    Dear Doc, I’m so glad I found this site. I have a much better understanding of what my dog is going through now. I have a five year old American Pitbull Terrier, and a hematoma showed up in his ear a few hours after a bath. At first it was about an inch and half around, and he didn’t seem to be in any pain. I knew what it was but not how to treat it, so I began researching online. I read that ear infections were the most common cause, and that aspiration, drainage tube, or the surgey requiring quilted stiches were the vet treatments. I also read that if the underlying cause was taken care of, the hematoma would go away on its own (I read anywhere from 2-4 weeks, I had no idea it could take longer). And like many who have written here, I am ashamed to admit that I cannot afford to take him to the vet, so I was hoping home remedy type stuff would do. I used tea tree oil drops to treat a bacterial ear infection (because there were no symptoms of yeast infection or mites) but later began to suspect it may have been a food allergy (as we’ve just moved about six weeks ago and i can’t find his old food brand anywhere), I used a hot compress twice daily (as I read was recommended), and I gave him baby aspirin. You are the first to mention that the hot compress or the aspirin might make it worse, but that makes sense because here we are a week and two days after the hematoma began and it now encompasses his entire ear flap. It doesn’t seem to be painful, as he allows me to touch it, but it is obviously bothersome as he lowers that side of his head and sneaks in a head shake when he can. I tried tying his ear in place so that he couldn’t shake it, but that appeared to put more pressure on it. I am wondering how to get ahold of prednisone, or if that would even work at this stage… Is that something I can purchase or have prescribed without having to undergo surgery? Any advice will help! Thanks.

  92. Doc says:

    Hello, Danny,
    Prednisone is a prescription medication. It has many effects in the body and it is a drug that should not be used without medical supervision.
    If you were able to buy it over the counter (and you shouldn’t be, legally) you really don’t have the expertise to use it safely.
    It can certainly be prescribed without surgery. It would have been more likely to be effective when the hematoma was not so large.
    It might still work, but it would take longer term therapy.
    I wish I could offer you some great home remedy, but I just don’t know of any.

  93. Chris says:

    This is all very good information. I would like to know more about a compression bandage. I have read that after aspiration, some vets use a compression bandage but I hve never seen an example of the bandage.

  94. Paulena says:

    Hello Doctor,
    This is the best site for information and truly a gift from you, thank you!
    My GSD, 8 yrs, has had a hematoma for 2 mos, twice drained by his vet and refilled. The vet, God bless him, doesn’t see the need for surgery, as the hematoma is in the tip of the ear, doesn’t seem to bother my dog unless pressed, and advised I let it heal naturally. Ribbons of scar tissue are forming; his beautiful stand-up ear is flopped over and crinkling at the end. Would soft massage on the scar tissue help? Would a paper cone to hold the ear upright help drain it? Would prednisone at this point help? Many thanks for any advice you can give.

  95. Doc says:

    Hello, Paulena,

    With scar tissue already forming, I fear that some deformity of the ear is inevitable. Massaging and stretching the ear can help keep adhesions from forming, and might minimize the deformity.

    Taping the ear around a soft cone would basically be putting a splint on to keep it straight. Also, the tape would keep the layers of the ear pressed together, which sometimes works to prevent fluid from refilling the ear.

    I really couldn’t say whether Prednisone would be helpful at this point. It is something you would need to discuss with your veterinarian. It is not an innocuous drug, so you have to be prepared to monitor and deal with the side effects.

    Good Luck.

  96. says:

    So funny to read years of comments /questions about this problem. Our vet didnt drain it completely. is this the reason it filled up so quickly?I was very frustrated that she said we could try draining it more once we got him home but with such small punctures she couldnt guarantee how long it would be before they sealed up.She gave us the quote for the quilting process and no other options. Max is a golden mix at 68lb. He had yeast, bacterial infection. She put him on antifungal-Ketoconozole 200mg and antiobiotic-cephalexin 1,000mg 2xday for a month, baytril eardrops,prednisone 30mg 2x day for three days then taper to 20 mg for 3 days then 20 mg every other day. Will this dose of prednisone help as you suggested or does it need to be given at higher doses? We are working on switching food and started fish oil caps. Any other reccomendations?

  97. OnMy3rdGolden says:

    Dear Doctor,

    Lots of good information here, thanks for the site!

    My 9 year old male golden retriever just had surgery for an aural hematoma. He does have allergies and is on a maintenance dose of Vanectyl-P, but also periodically gets ear infections, the scratching of which we believe led to the hematoma. I normally catch and treat his ear infections quickly, but this one snuck up on us. It is now being treated with the usual anti-fungal ear drops.

    The hematoma first developed last Wednesday, and we knew immediately what it was because another golden we had previously got one when rough-housing with another dog. The first dog had the surgery (including the x-ray film stitched to the outside of the ear) and the hematoma never returned. There was some scarring and his ear was a bit stiff and crinkly afterwards. I do not remember the incision being left open in that surgery.

    In this case, my veterinarian drained it with a needle last Thursday morning. We increased his dosage of the Vanectyl-P to increase his Prednisone level. The hematoma returned on Saturday night, but I was unable to get him back into the veterinarian until this morning. Having already tried the draining, we opted for the surgery. She said she would be making an S incision, leaving it open and doing the “quilt stitching” of the affected area. They weren’t able to do the surgery until early afternoon, so he is remaining at the clinic overnight. She stated she’d be bandaging his ear up over the top of his head tonight, but removing the bandage tomorrow to allow drainage. Since the first dog’s incision was closed, I’m wondering how much drainage to expect post surgery.

    I am hoping to never have to deal with another aural hematoma, but am wondering if you’ve heard anything about the use of medical leeches for the treatment of aural hematomas. I read a little about it on line, and it looks like a really interesting option to me. I’d be interested in hearing your observations on it as a possible treatment.

  98. Doc says:

    Hello, Anna-from-the-heart,

    It sounds like your Golden Retriever, Max, must have an infection in his ear canal, also known as “Otitis Externa”. The treatment you have described sounds completely appropriate for a mixed bacterial and yeast infection with a lot of inflammation.

    That dose of prednisone should really help with inflammation in the ear canal. I doubt that it will have any effect on the hematoma, though. It usually takes much larger doses.

    Again, I haven’t seen your dog or his ear, and I really can’t prescribe for you. You might ask your veterinarian about the higher doses of prednisone once the ear infection is controlled.

    Good luck.

  99. Doc says:

    Hello,”On my 3rd Golden”,

    It is usually recommended to leave an open incision when the ear is “quilted” together. This allows fluid to escape so that the layers of the ear can adhere to one another. An “S-shaped” (also called sigmoid) incision is commonly used. Some people use a straight incision with a thin sliver of skin removed so that it doesn’t heal together to quickly, causing fluid to accumulate. Parallel incisions have also been used.

    By the time your veterinarian leaves your dog un-bandaged, the drainage will probably be pretty minimal.

    In re medical leeches, it would be interesting to try. I am skeptical that they would be very helpful, however.

    Leeches are the state of the art when dealing with severed fingers that have been re-attached. When the microsurgery is done to re-connect the blood vessels, only the largest arteries and veins can be repaired. Since arteries have more pressure, they typically allow more blood into the appendage than the damaged veins and lymphatics can remove. The re-attached finger becomes so swollen with stagnant blood that it often gets infected and does not do well because of the poor circulation.

    The leech produces a natural anti-coagulant. This keeps the pooled blood from clotting, allowing the leech to feed at leisure. The leeches remove the blood slowly and continually. Of course, you have to keep using fresh, hungry leeches. This allows the finger to heal without being full of stagnant clotted blood. It’s amazing to realized that with all our modern techniques and medicines, the lowly leech is the best solution.

    In the case of an aural hematoma, you’ve got a lot of fluid in a big pocket. Draining it with a needle empties it completely, but without some compressing pressure (and often even with it), the hematoma will usually refill within 12 hours. The problem is that a blood vessel is leaking.

    I think that if you used leeches, this big pocket would still refill. There is no compression on the vessel to stop the flow of blood. There is also nothing to stop immune mediated damage to the vessel (the reason we use the prednisone).

    Someone would have to keep the dog from shaking or scratching off the leeches. The leech spit apparently has some local anesthetic properties. You usually don’t feel their attachment, but I’d be surprised if the dog didn’t notice they were there and go to work on them. Even if the dog cooperated, someone would have to keep adding new leeches as the old ones filled up.

    I can’t say it wouldn’t work, but it would certainly be a logistical challenge to keep applying fresh leeches and getting the dog to tolerate it over a period of several days.

    Thanks for reading and writing. Good luck.

  100. OnMy3rdGolden says:

    Thanks for the reply.

    Doggie is home and doing well. There was a fair bit of drainage the first 24 hours, so she actually ended up keeping him at the clinic until the end of the day after the surgery, figuring I would far prefer the mess to be in the crate he was in there than all over my walls and carpets at home. After the first night she had him bandaged with the ear flipped back over his head, but bandaged in such a way that the incision is exposed to allow further drainage. He’s also got an e-collar on to keep him from fussing at the wound and bandage. He’s also had an injection of antibiotic that she says should be good for 14 days, to prevent infection at the incision site. The incision ended up being a straight one instead of the S.

    Now that he’s home he’s still bandaged and e-collared in the same manner and there’s been very little discharge from the incision site, even when I massage the area to help the drainage. The hematoma was fairly high on the ear flap, so keeping it folded back also helps keep the incision open and applies pressure to the area. He’s the worlds most compliant dog and doesn’t appear to be in much pain, even when I have the bandage off to massage the hematoma site to encourage drainage out through the open incision. He hasn’t been trying to get the e-collar of the bandage off, but did try to go after the ear before I put the collar back on after re-bandaging, so I guess he’s in the collar until this has run it’s course.

  101. Leticia L. says:

    My dog has just been diagnosed with an aural hematoma… and I am the paranoid parent. I just wanted to say that after googleing to learn more, your site brought me a sigh of relief. I, like many owners am unable to afford the surgery (cost of $560.00) suggested by my vet; yet I hate to see my baby in discomfort.

    Do you know of any non-profit organizations that assist with the cost of pet required surgeries? I live in California (city of Merced) and any information on financial resources would be greatly appreciated.

  102. Terrie says:

    I just discovered an aural hematoma on my 7 year old lab mix yesterday. This guy is a rescue that was seriously abused as a small puppy and as a result is on prozac daily and Xanax for extreme situations. He has always had a habit of shaking his head and pawing at his ears. We have had his ears check extensively under sedation (he doesn’t do well during exams) and the doctor said he was fine. We made a joke out of it that his crazy little brain was itchy, I had no clue something like this could happen. My question is, do we put him through the stress and anxiety of treatment for the hematoma or just let it heal on it’s own. This guy deserves the best of everything after all he has been through so the cost of surgery is not an issue, the psychological impacts however worry me. Any advice?

  103. Doc says:

    Hello, Terrie,

    It is always difficult to make any kind of long-distance diagnosis and recommendation. There are so many things that I cannot see and do not know about your dog. However….

    One of my concerns here is the dog’s long-standing head-shaking and pawing at the ears. This has not really been handled. It may or may not be the cause of the hematoma, but it is bothering the dog.

    Using psychotropic drugs can change you mood, but not your situation. It is not uncommon for allergic animals to itch inside their ears. This can happen with no other apparent allergic signs. Food allergy patients have been documented who itched ONLY inside their ears, and sometimes only in ONE ear. Psych drugs are not going to help itching very much.

    Not even considering the hematoma, I would be concerned about the dog’s ear situation. Despite the fact that the ear canals appear clean and normal, you could have an un-handled allergic condition. You could also have a middle-ear problem. to rule that out, you would need to take X-rays of the tympanic bullae. This requires anesthesia so that an X-ray can be taken “looking” straight down through the open mouth.

    Allergic problems could be tested for by giving the dog anti-inflammatory doses of some type of corticosteroid (prednisone, for instance). A cortisone-containing ear drop may also give relief of allergic ear-itch when you see no yucky stuff in the ear. If the dog has food allergy, it requires a long-term dietary elimination trial (4 to 16 weeks), eating a special diet which the dog has never eaten before. It has to be new ingredients, not just a different brand of food.

    Since there is no evidence of ear infection (providing that the X-rays of the middle ear are normal), this dog might be a candidate for the immuno-suppressive doses of prednisone, rather than surgery. If it doesn’t work, you can still do surgery.

    Again, while the hematoma would eventually resolve on its own (though this may take weeks to months, and will not be very cosmetically appealing), in the meantime, the dog is uncomfortable. In addition, you really need to get a better handling on the head-shaking, ear-pawing thing.

    I think it is unlikely to be a prozac deficiency.

    Good luck.

  104. cristina says:

    Dear Doc,

    Our 9- or 10-year old Labrador has aural hematoma for weeks now. I remember him having a much milder version of this condition before therefore I chose not to do anything about it as it resolved by itself then. Yet his ear is now around 2 inches thick. We are worried now. The last time he had anesthesia for stitches, he was out for a day. (And although he is a Lab, he is not so friendly or warm especially with new people so seeing vets can be stressful as well. We suspect that he had a bad childhood of some sort since we got him when he was more than a year old). So my questions are:

    1. Will it still resolve by itself?
    2. Is there anything we could do besides surgery?
    3. Will he tolerate anesthesia at his age?
    4. What local anesthetic could I ask for the vet if ever we choose to have it drained?

    Thank you so much in advance.

  105. Doc says:

    Hello, Christina,

    Without seeing the dog and examining him, I can’t even be sure that a hematoma is the correct diagnosis. There is no substitute for an examination by your veterinarian. I can only speak in general terms.

    1. Eventually a hematoma will resolve. The ear may be deformed and wrinkled in the process, but the ear doesn’t explode. It just looks weird. In the meantime, if there is pressure, then that is uncomfortable. Also, the ear canal needs to be examined to be sure that there are no other problems that you can’t see from the outside. nothing hurts like an ear-ache.

    2. If his ear canals and eardrums are normal, and he really has a hematoma, it is possible that the dog might respond to the high dose prednisone therapy I mentioned in the original post. Again, you need to discuss this with your veterinarian.

    3. Modern anesthesia allows us to do some major procedures on some mighty old dogs. Pre-operative risk factor assessment will tell you more: blood tests for liver and kidney function, chest X-rays to assess heart and lungs, and perhaps an ECG for the heat as well. With that information in hand, if there is any doubt, your veterinarian can consult with an anesthesia specialist to help with the case management.

    4. It is hard to numb the whole ear by injecting the hematoma. The medication gets diluted. A skilled anesthetist could perhaps numb the whole area by injecting nerves that supply it. Injecting local anesthesia can be a little difficult sometimes: even when buffered with sodium bicarbonate, it still burns a little.

    I find that when hematomas are under a lot of pressure, a calm dog actually experiences relief when you drain it, and he doesn’t act up much. A nervous dog would probably need at least a tranquilizer. There are some tranquilizers which have antagonists (“reversing agents”) so that your pet doesn’t stay sedated so long.

    Your dog needs a checkup. His ears may be more painful than you know.

    Good luck.

  106. Bonnie says:

    Hi, my dog has an aural hematoma. We found him as a stray about two months back. He’s such a sweet dog, but we can’t afford to get him the surgery, as we already have to get him worm tests, treat his mange, and get him healthy. I don’t want him to be in pain, so is there a cheaper prescription medicine that would make having that thing easier on him? He’s such a good sweet dog, and I feel like such a crappy person because I can’t get him the surgery. Also if there is a cheaper way to fix his hematoma I love to know. Please help, I don’t want him to suffer.

  107. Doc says:

    Hello, Bonnie,

    If the hematoma is long-standing (two months or more), use of prednisone (the medicine described in the post) probably won’t help much. At that point, the hematoma is probably not painful any more, though.

    If it is a recent development, it is important to see whether or not he has a problem in his ear canal. If there is an ear infection causing him to shake his head (and rupture a blood vessel, producing the hematoma), then that IS painful and needs to be treated. The ear canal would need to be examined,and a swab examined to see what’s causing the infection. the canal would then need to be cleaned and appropriate medicine used. An ear canal infection probably hurts worse than the hematoma.

    If the canal is clean, and the hematoma is recent, your dog might be a candidate for the prednisone treatment. It doesn’t work for every dog, but does work in a surprising number of cases.

    I really cannot prescribe for your pet “long distance”. You need to work with your veterinarian. Don’t be afraid to ask him/her questions, or to ask what alternatives are available.

    Good luck.

  108. Paulena says:

    Dr. Mobley is absolutely right about the usefulness of an anti-inflammatory. After 3 mos. of periodic draining of my dog’s ear (by aspiration) and trying everything to keep it from scarring, the scarring set in anyway and I finally returned for the 4th time to my vet for another consultation about surgery. This time I got his partner (both in veterinary practice ~ 25 years) and his partner recommended an injection of an anti-inflammatory (not prednisone, something else), which worked wonders to internally drain the earlobe in 3 days. The hematoma has not come back (more than 1 month later). My German Shepherd’s beautiful perky ear is bent over and bumpy, but it is only cosmetic and the ear itself is unaffected. A long ordeal which could have been shortened and the scarring avoided had I insisted on an anti-inflammatory at the outset.

  109. Doc says:

    Hello, Paulena,

    I am glad that you are having good results now.

    In defense of the first veterinarian, it is often difficult to predict what the best treatment will be for a particular case.

    It’s easy to “Monday-morning-quarterback” these things. Not so easy to always be right the first time.

    Good Luck.

  110. Bomber says:

    Dear Doc,

    I have an american bulldog who had a hematoma in his right ear. He recently underwent surgery (9 days ago). My question is, Should the pinna look like it should be healing yet? It doesn’t look like there is any growth or change in the incision. He somehow managed to get to the sutures despite having a giant cone on his head. We are doing all the post care advised by out vet including a hydrogen peroxide solution spray, an antibiotic for the infection which caused him to shake and a cleaner to keep the ear free of dirt and germs. there is no redness or puffyness, I am just concerned because it doesnt look as though the incicsion is healing

  111. Doc says:

    Hello, Bomber,

    If the surgeon made a larger opening by actually removing a sliver of skin (rather than just slitting it open), then it will take more time for that gap to fill in. This is often done so that the opening will not close too fast, sealing up before the rest of the ear layers have grown back together. This would allow fluid to re-accumulate, and prevent the ear layers from growing back together.

    You should share your concerns with the doctor who is treating your dog. I am sure that he/she will want to know how the healing is progressing, especially if things aren’t going according to plan.

    Good luck.

  112. Malcolm Stove says:

    Hello, I have a 9 year old Staffordshire with this problem. This is about the 4th time, on alternate ears. It usually heals up after treatment, 1st time the left ear which has some inner scarring but the 2nd time it was treated, this time with Prednisone. It’s the 2nd time on the right ear now, there was no scarring after being drained but it did heal up. This condition has been happening over the years. I could not see the vet this time but I got more prednisone which he’s been on for 5 days now. It does not seem to have stopped the swelling and I’m not sure whether to take him back and have it drained. I do not want to do this as I have to put him to sleep as he will not let the vet touch it. this is day 5

  113. Doc says:

    Other than trying the prednisone for a few more days, I don’t see too many more options than drainage.

    Your veterinarian is the best person to advise you here.

    I am concerned about the recurrences. It makes me wonder if he has other immune-related problems or allergic problems that are predisposing him to this.

    You might discuss this with your veterinarian, and consider referral to a dermatology specialist.

    Good luck.

  114. grace says:


    Gus is a 11 year old weimeraner that just underwent surgery for his 5 or 6 hematoma (I’ve lost track its been so many). The vets sent him home in an ecollar and the ear bandaged with a soft core that kept it in place, and 50mg of tramadol to be given 3 times a day. I removed the bandaging as advised the next day but he is definitely flapping and shaking his ears a fair amount and the ecollar bumps into the wound a bit from the side to side movement when he trots around. I am wondering if keeping some sort of bandage on might be a option to help the healing process or if there is some reason not to have the ear bandaged up. Also shouldn’t he be on some sort of antibiotic? I’m just very concerned about it healing properly without recurrence or infection.

    Thanks for all your help! There is obviously a demand for advice and discussion regarding aural hematomas! It’s good to know we are not the only ones that continually struggle from this.

    Grace and Gus

  115. Doc says:

    Hello, Gracie,

    I am sorry you are having such difficulty. Without knowing what procedure was performed and knowing your dog, it is difficult for me to give you specific advice. Your veterinarian who is treating the dog is your best resource.

    That being said, if there is a large open wound (as with some techniques) I personally do like to keep them on antibiotics. If they are not used, then careful monitoring of the open incision is necessary. You do need to watch for drainage, swelling or discoloration.

    With a guy who is shaking that head a lot, it is sometimes helpful to bandage the ear flap across the top of the head (with some padding on both sides of the flap). This is a little difficult to do if you haven’t had any practice and you don’t have something to make the tape extra sticky so that it will stick to the ear flap.

    Please discuss your concerns with your veterinarian.

    Good luck.

  116. stacy says:

    Dear Doc,

    I hope you can help, I have read everything & it has provided me with a lot of information. First I must tell you that my boxer mix was adopted from a shelter as a puppy 10 years ago. She has never had an aural hematoma, so when one appeared suddenly we rushed her to the vet. They confirmed that it was a hematoma, & gave her Betagen Otic 15 MI, 3-4 drops each ear 2 x’s daily (I think for bacteria they found), they also gave her Metacam oral liquid, 1.4cc once every day for five days. They said they ONLY do surgery for aural hematomas, & that there was no other acceptable option. They said we needed to bring her back after the 5 days of meds for surgery. We drained our small savings to take her 4 days ago. The ear is not getting any smaller. She shows some discomfort when you touch it. Because of her age & an overnight stay, etc. they said it would cost almost $500 for surgery. We drained our savings for the first visit, & would have to spend our rent money to get the surgery.If she could die from this I would have already spent my rent money on her (she is much loved). Thankfully she can not die from this condition.
    Finally to get to my questions…Would it help to find another vet who would drain the ear by aspiration? Or would it most likely refill & be a waste of money? She is so adorable I would hate for her to have “boxers ear” but I also do not want to endanger our housing. Considering everything I have told you would you recommend for the the ear to be left alone to heal with the care we have already provided.Or find another Dr. who will drain it (by aspiration). As I just don’t know how we can afford such an expensive surgery. I feel like a bad pet Mom, I want to do the right thing for my dog & my children. Sad,stressed,& I can’t sleep, please help. Thanks for your time!

  117. AJM says:

    Hi, My 7 year old black lab recently had surgery on her ear hematomas. Her left ear had a huge one and the right one was beginning to develop so we were able to catch that one before it ballooned up like the other one. We’ve had her home for about a week and the first half she had her head bandaged and wore a cone. Then the vet took her bandages off after about a week. She still has her stiches in as well. My question is: her left ear (the larger of the hematomas) looks to be swelling again but not like when she had the hematoma. Is it natural for her ear to be swollen looking after the surgery?

  118. Doc says:

    Hello, AJM,

    That kind of swelling is not exactly desirable. It could just be some scar tissue thickening. On the other hand, you may have some infection present.

    You really should let her veterinarian take a look at the ear to be sure everything is okay.

    Good luck.

  119. Doc says:

    I posted a reply, but I’ll be darned if I can see where it disappeared to. I usually email directly, also, but you did not supply your email address.

    Anyhow, I don’t think that aspiration is likely to be successful. Even when I wrap the newly drained ear around a soft core to try and keep it from refilling, it usually refills anyway. Repeated aspiration may introduce infection, also.

    From your description, it sounds like putting in the small drainage tube (as illustrated in the post) might be an option. This procedure is usually done on an out-patient basis, often requiring very little or no sedation (depending on the individual dog’s temperament and pain tolerance). It should be much less expensive than the major type of surgeries.

    If you just leave it alone, there will certainly be some discomfort while the ear is swollen, due to the pressure. As it heals, the discomfort disappears, but the ear pinna does crinkle up, like the old “cauliflower” ear of the professional boxer.

    Sorry about the delay. I hope this is helpful to you.

  120. kernow says:

    Have just picked up my darling girl boxer, age 11 from the vets. She developed a large hematoma. I noticed it Friday and took her straight down and had it drained, it refilled by Saturday evening and she was so uncomfortable sunday that I rang and booked her in for the “quilting” surgery today. This was a big decision as she had a large surgery for lump in her cheek, tooth and epulis removal only in November and because of her age was hoping not to put her through further procedures.
    She has had a good recovery from the surgery and is sleeping comfortably as i write.
    My question is on the timescale for healing, the vet has said stiches out after 3 weeks, have you ever known them to be able to come out sooner. In 3 weeks we will be on holiday and I have to check if kennels can take them with Brandy in a collar and possible stiches or find a kindly neighbour to dogsit, thankfully it is only a week away but i am so worried what stage she will be at, i will question my own vet when i see him for re-exam next week, just trying to get a feel of recovery in your experience

    I know it is probably a bit pointless because every case is different but thanks for any reply.

    Have not yet told her that she can no longer play head shake games with her toys 🙁

  121. Doc says:

    Hello, Kernow,

    As you have surmised, yours is a difficult question to answer. If sutures are removed too soon, the layers separate. If left in too long, they begin to fester. They are foreign objects, after all, and once healing has occurred, the body starts trying to get rid of them.

    I would think the kennel would be okay with the E-collar and sutures. This first week is when the discomfort would be the worst, and I suspect that your veterinarian has prescribed pain medication.

    Patience is not one of my virtues, so it’s hard for me to prescribe it to others. Unfortunately, that is what is needed. Your veterinarian will be able to give you a much better answer when looking at your dog.

    Good luck.

  122. Stacy says:

    To Uber Patient Doc,
    I have a three month old puppy. My boyfriend and I have had her about a month now. When we first got her she had ear infection in her right ear and the ear was pretty inflamed and on top of that she had this bite right at the base of her ear that got infected as well. She is the biggest puppy out of the litter we got her from (at the shelter) and she was definitely picked on the most. She also had a rough environment apparently she comes from a home of over 40 dogs. So her living space was definitely dog eat dog when it come to food I assume. Anyways, she is a Lab/Husky mix. Body of husky and the brains of a lab. It’s been a week and a day or two that she has had an aural hematoma. Took her to the vet as soon as we noticed it. Tried witch hazel (which we found for a homeopathic remedy) and it did nothing. I think it started growing too big for it to do anything. It’s starting to grow faster and I can tell it’s starting to really bother her. She’s a trooper and lets us both feel it and doesn’t whine or pull away but she’s not as playful or at least as willing to play and she sleeps on the same side so the hematoma ear is laying on top to relieve the weight. So now I get to my question or I should say questions. (I do understand the necessity to see the dog, but general advice is appreciated. This is my first dog I have personally owned.) The vet mentioned that since she has no present ear infection that she can tell at all that the cause of the hematoma is obviously a concern as well as relieving it. It seems that some form of surgery is going to have to happen. My concern is the putting her under part. Is she too young and what could be any health risks? (Oh and the vet we see works Mon-Thur which is why I’m prompting you.) And than is the tube thing a legit option for her? We want something inexpensive as the cheaper the better. But I just heard of this procedure in my findings. It sounds highly effective and I’m willing to clean up the mess. And she listens pretty good about being still so she doesn’t shake. And to the last part. The vet did mention that an idea for the cause under her conditions that it might be cause of some form of autoimmune something a rather. And so I ask a third opinion on this. I’m just super worried for my little girl. And if she does have any autoimmune thing life might be a little rough for her when it comes to rougher playtime. But I want my little girl to be better so I’m seeking my third opinion. (We did take her to another vet and he seemed to think the same just minus the autoimmune, but I really don’t like the idea of the cauliflower ear.) I AM calling the vet tomorrow. Thanks for any advice you have for me in advance!
    One SUPER Worried Dog Owner/Mom

  123. Rick Harman says:

    First, thank you so very much for this stupendous resource.

    My 13.5 yr old cattle dog mix (she’s half hound; ears floppy, not erect) developed a small aural hematoma (quarter-sized; her first to date) over the period of a week. She’s always been a vigorous head-shaker. I realized what it was and when it started getting hard to the touch, I lanced it with a sterile needle and squeezed out the blood to relieve the pressure. As expected, it began to slowly fill again in about 24 hrs; I researched the options in great detail. I decided on a specific course of action (drain; local steroid injection; tight wrap) before calling my vet. The vet refused to consider anything but surgery and I made an appointment with a different vet who would do as I wished.

    This went fine except for one thing: I believe they botched the bandaging.

    After draining and injecting the steroid (methylprednisolone), they wrapped the ear around a rigid cylinder (a hypodermic syringe body); but then they taped the ear to the cylinder with nonelastic adhesive tape (I had suggested an elastic wrap to provide uniform pressure to keep the evacuated blister cavity collapsed, but they didn’t do that). A few hours later I could tell the blister was filling with fluid again (the adhesive bandage was beginning to bulge slightly and the bulge was spongy to the touch). If this is the standard bandage for this procedure, it is no surprise that these drain/inject/wrap solutions often fail. How could it possibly work reliably if the evacuated blister cavity is not completely collapsed during the recovery? Any runner understands this.

    Rather than struggling with the vet over how to do their job, I am going to just re-bandage it the way I think it should be done: with a self-adhesive ace-type wrap, under tension, compressing the ear against the cylinder. This elastic wrap will be applied directly over the fur, with an adhesive tape wrap over that to keep everything in place.

    I guess I’m just looking for an independent confirmation that I have analyzed this thing correctly and am doing the right thing. Sadly, I don’t feel I have a local vet resource that will listen and respond to my concerns.

    Sorry this is so long…


  124. Sudha says:

    Hi doc,
    My 10 years old bull mastiff/labrador had aural hematoma. We took him to the vet on Friday and the surgery was done. He has stitches done. He has a collar on now to prevent him from scratching his ears. The thing is he’s refusing to eat. He seems to be very weak. He only drinks water. He hasnt barked since we came home. It has been close to 48 hour. Is this normal? Could he develop a fever or any infection our of this?

  125. Doc says:

    Hello, Sudha,

    Sorry to be so late on this. We have been changing over our practice management computer software in the last week and it has been killing me.

    You’ve probably already handled this by now. Infections can certainly develop, because you have an open wound. The big thing right after surgery is probably just post-operative pain. You should ask your veterinarian for some additional pain control, I suspect. Also in the first 24 hours, some dogs (particularly older patients) may have some lingering effects of the anesthetic.

    I hope things are going well now.

  126. sudha says:

    hi doc,
    thank you for your kind reply. we took him to the vet and thankfully, he did not develop any infection. he’s doing so much better now. everything is back to normal.
    thank you again for your time.

  127. Carla says:

    Dear Doctor:
    You have repeated almost word for word what my veterinarian has told me about my Black Lab’s ear hemotoma. It feels good to know that he knows what he’s doing. My question is: Do you know or recommend Doc Ackerman’s holistic allergy remedies? We are hesitant to put him back on Pred.
    Carla in PA

  128. Doc says:

    Hello, Carla,

    Of course, you assume that maybe I myself know what I’m doing.

    I looked at the herbal product you asked about, but I really have no expertise in that area. I’ve forwarded your question to a veterinarian trained in traditional Chinese veterinary medicine and the use of herbs.

    I’ll let you know what she says.

    Thanks for reading and writing.

  129. Doc says:

    Hello, Carla,

    Here is what the herbalist(traditional DVM, Missouri Vet School, later training in traditional Chinese veterinary medicine, herbal, etc.)says:

    “I never advise getting oral herbs online no matter how good they look. They are unregulated. These people need to find a practitioner who has investigated and trusts a line of products and knows what herbal formula specifically to use for a specific patient’s condition. Herbs are not something for people with no training to be monkeying around with. I wouldn’t recommend that any more than I would have someone search for antibiotics online to treat a bladder infection.”

    So, good luck with that.

  130. Mandy Perez says:

    Hi Doc,

    My Great Dane is 7 months old and was very sick with worms, bacteria in his stomach, and and ear infection when we got him. Now after about $1000.00 everything is finally clearing up. But when I started using the ear wash and ear medication to clear up the infection he started shaking his head alot, which I think caused an aural hematoma. I havent had the money to take him to the vet and today he shook his head and blood went everywhere. I tried wiping his ear to get the blood off and some hard flesh came off with it. I was wondering if this will heal itself or should I take him to the vet? I really cant afford more vet bills. Should I put a triple antibiotic cream on it?

  131. Doc says:

    Hello, Mandy,

    Triple antibiotic ointment on the sore place certainly will not hurt. I doubt that you can actually get it inside the ear canal effectively, though. It is a little hard for me to visualize what is happening here.

    Infections in the ear canal do usually require removal of the debris in order for the medicine to be effective. Some ear washes contain acetic acid. This inhibits the growth of bacteria and yeast, but also will really burn if the ear is sore. Just flushing the ear with plain water or hydrogen peroxide would probably be better and less painful.

    Continued shaking of the ear usually makes the hematoma worse. Ideally, we would put a padded bandage to wrap the ear over the top of the head, leaving the opening of the canal open for treatment.

    Will this heal itself? If it does, there will probably be pretty severe scarring and wrinkling of the ear flap. If you have an open, infected wound, it could be a really long time healing.

    I would definitely recommend a return trip to the veterinarian. Sorry I can’t fix it “over the phone”.

    Good luck.

  132. Rex says:

    Dear Doc,

    I am from Manila, Philippines.
    My 4year old black male lab had surgery for aural hematoma Dec 2009. I remember the vet telling me that he did a procedure where later on, the fluid would be drained by itself without having to go back to the vet.

    Well last week, I started noticing a familiar smell from my dog. My suspicion was confirmed. There is a smelly liquid that is coming from the ear that had been operated on months before. I inspected the ear and there is no swelling, no redness at all… but it seems as if the ear was draining some fluid. I am cleaning his ear to make sure there were no wounds and I could not find any.

    Why does the ear drain like that? I unfortunately moved away and the vet who did surgery is now about 3hours away. I still have to look for the vets in this area where we are now and I am afraid that it is going to be expensive.

    Would you mind giving me some ideas what is happening? My lab does not seem to be in pain. As a matter of fact, I was teaching him tricks last night. Everything seems normal. His appetite, playfulness etc except for that fluid down the ear. This morning I put some ice packs near the ear and he probably remember how we treated him after his surgery. I would put icepacks covered with towels on his ear and he would sleep like a baby.

    Please help.

  133. Doc says:

    Hello, Rex,

    I cannot visualize exactly what’s going on here.

    Is the ear pinna (the floppy part) swollen?

    If so, how much of the pinna is involved, percentage-wise?

    If there is swelling, is it closer to the tip or to the base?

    Apparently you cannot see the opening where the fluid is coming from. Does the pinna stay moist?

    Just the inside or both sides?

    Is it possible the fluid is coming from inside the ear canal?

    If you massage the ear canal below the ear opening, does it feel squishy?

    Can you hear fluid moving?

    If you blot the fluid with a white tissue, what color is it?

    If the ear pinna is not swollen, I would be inclined to think that there is an infection in the ear canal. This requires treatment, but probably no surgery and no major expense.

    Good luck.

  134. Damian says:

    Hmmm this is good to know my dog got an aural hematoma 2 days ago and we took her to the vet first thing the next morning. My dog is a Boston terrier and has allergies the vet gave have her a steroid shot, ear drops, and antibiotics. Then told us what we already know that it was a aural hematoma, but said since it is a small one (just a bit bigger than a quarter) that he wants to leave it and let it drain on it’s own. It hasn’t gotten bigger and she shows no discomfort from it not even a bit of scratching so i wasn’t to worried. I just wanted to know how long i can expect for it to take to be reabsorbed and get and estimate on how bad the scaring will be. Now i know that it will be a few weeks so i will stop feeling it ever day to see if it’s gotten smaller lol. Still a bit worried about the scarring but i think she will still look as adorable with one ear straight up and one bent down as she would with both standing up.

  135. Doc says:

    Hello, Damian,

    So, who knew the prince of darkness would have a little dog?

    It sounds like you guys have a plan, but I would continue to check the dog’s ear daily. While you don’t want to go nuts looking for microscopic shrinkage, you do want to be aware of it if the hematoma starts to enlarge. That would mean you need to re-evaluate your treatment plan.

    Good luck.

  136. Damian says:

    lol a little dog not be appropriate for the prince of darkness. Have you never met a Chihuahua those dogs are vicious if you aren’t their owner or maybe they just don’t like me. I almost lost a finger to a 6 week old pup that’s head was only about as big a babies fist.:D I will be sure to keep a watch on it, and take her back in if it starts getting bigger. Thanks for the advice.

  137. Erinn says:

    Hi Doctor,

    One of my ferrets seems to have developed what I think looks like an aural hematoma (I’m a veterinary technician so I’ve seen plenty of them in the past.)

    Being the weekend, the ferrets’ vet is out of office, and I plan to phone on Monday to get him looked at, but I’m curious what your thoughts are. Having much smaller ear pinnae than dogs or cats, can ferrets benefit from the drainage surgeries used to treat hematomas? Or is my option pretty much aspirating it and hoping it heals up?

    Thanks for your opinion.

  138. Doc says:

    Hello, Erinn,

    I’ve never seen such a thing in a ferret, but I don’t see many ferrets.

    I have emailed your question to people who are more in the line of being ferret experts and I will relay their answer to you.

  139. Doc says:


    Here’s what the ferret doc has to say:

    “Ferrets will often aggressively bite at each others ears (especially intact males or ferrets with adrenal gland diseases), and I have seen these become pretty swollen. I have never seen a primary aural hematoma. I would want to rule out traumatic bruising before recommending treating a hematoma.”

    Looks like you’re going to need somebody there with “boots on the ground” for this one.

    Good luck.

  140. TroubledCat says:

    I’ve been reading a lot of these comments, my parents have a 7 yr old cat they adore that appears to have a large hematoma in his left ear.

    They really don’t have the money for any type of surgery, and have asked me to do a little research. Does anyone have a range of how much this would cost them if we can get it together? We have no idea what to expect.

    It’s been getting worse and has increased in size over the past few weeks. The cat doesn’t seem to be in pain and doesn’t mind if you touch around the area. I understand they can go away on their own, but if there is an underlying infection which could be caused by a number of things are there any signs we could look for to know it’s more than just fluid filled?

    I appreciate any advice on this topic!

  141. Doc says:

    Hello, Troubled Cat,

    Signs of ear infection usually include excessive wax or other material in the opening of the ear canal, odor from the ear canal, one ear looking more dirty than the other, and sensitivity if the ear canal is handled.

    If the cat responds to prednisolone treatment, that is dirt cheap.

    Surgery costs will vary considerably with the type of surgery performed. With an exam/consultation, anesthesia, hospitalization, medicine for pain and infection, and minimal surgery, it would be hard to get out for less than $150, even in the rural boondocks where things tend to be cheaper (like where I am).

    The hematoma will eventually resolve, though the pressure is uncomfortable in the meantime, and the ear will probably crinkle up quite a bit in the healing process.

    You really need to get the cat to a veterinarian to at least examine the ear canals. If you have an untreated ear infection, that is painful, and you will have other problems down the line.

    Good luck.

  142. jennifer Baxter says:

    Dear Doctor,
    My lab had a very large Hematoma his whole hear filled up and felt like a tomato.( it only took like an hour. At 4pm he was fine at 5pm huge ear!) I took him to the family vet who put a valve in that was similar to what you describe.( $600) For the next week his ear kept refilling, maybe only a quarter of what it did originally.Every night i would gently drain it and it would be a clear liquid maybe a little pink. On our week check up we take him in and the doctor is shocked to see that he is still building up fluid. He says that we are going to need another surgery to make it stop. One where they filet open his ear and put something on the inside and something on the outside?? I didn’t really understand why they couldn’t have let it continue to drain. he did have the second surgery yesterday and when my husband went to pick him up Cole shook his head and part of whatever they stitched on fell off. They had to keep him another night to fix it. Shouldn’t they bandage him? and how are we going to stop him from shaking his head? and how much pain is he in now that they have sliced open his ear. I’m really angry at my vet right now over this and feel like i should go to some one else.
    Thank you for any information that you can give me

  143. Doc says:

    Hello, Jennifer,

    Sorry to be so late in replying. I have been out of town for a few days, no internet.

    It’s a little difficult for me to give you specific advice. Your doctor is seeing the dog and I am not.

    That being said, I do think that it would be fine to call the doctor and tell him about the head-shaking, and ask them how you might bandage the ear across the top of his head with some padding.

    Also, you could tell them that the pain medicine he has doesn’t seem to be adequate, and ask them to prescribe an additional medicine or stronger dose.

    Good luck.

  144. Janelle says:

    Dear Doctor,

    My 12 year old lab/hound mix has a large hematoma in her ear. We took her to our normal vet today and they prescribed an anti-imflamatory and an antibiotic. They want us to bring her in to have a drain put in tomorrow. The cost of this procedure is going to be $450 (not including the office visit and meds today). This seemed really high to me in the research I have been doing since I got home. Can you give me any advise as to if this pricing seems in line?

  145. Doc says:

    Hello, Janelle,

    I really cannot advise you about cost in this matter. I don’t know what type of procedure is planned, what type of anesthesia and monitoring is planned, what type of pre-anesthetic risk factor testing is planned, how much bandaging and/or aftercare is included, etc.

    You could ask the doctor for an itemized estimate. You may be better off to stick with someone you know and who knows your dog, rather than trying to price-shop the cheapest deal. It’s often difficult to compare “apples to apples” when shopping it over the phone.

    Good luck.

  146. Adria Hernandez says:


    I have a lab names Pita. Pita had surgery for a ear hematoma about six months ago. Today I noticed another small hematoma in the same ear. I took her to the vet and she has an ear infection as well. The vet aspirated the ear and gave her medicine for the infection. Our hope is to have surgery again. The last hematoma was very large and covered most of the ear. She also had today a cortisone shot because of allergies. Is a cortisone injection the same as giving her prednisone? If not can I ask for some prednisone or will that interfere with the cortisone? In your experience would it be ok to let this hematoma heal on its own. She has had many surgeries. She had a leg amputated due to a arterial venous plexus. So I am trying to avoid any other surgery for those poor dog.

  147. Doc says:

    Hello, Adria,

    We often give a single injection of some form of cortisone when dogs have an ear infection. It reduces the swelling and helps ease the dog’s discomfort when we have to clean and medicate the ear.

    Prednisone is a synthetic form of cortisone. The form injected by your veterinarian is probably a different form, but your veterinarian can speak with you about what would be appropriate in continuing cortisone-type therapy for the ear.

    If the hematoma is small, the discomfort would be small, also, I believe. If she seems to be doing well with her ear infection healing up, there should not be a problem with seeing how the hematoma does on its own, without further intervention.

    You really need to share your concerns with your regular veterinarian.

    Good luck.

  148. Angie K says:

    Hi, I have a 9 year old Pitbull mix,Chaos, who has had a hematoma on the left side, healed within a couple of months with steroid injection in to the “bubble” and oral steroids. Now he has had one develop on the right ear. Given his age and last time we put him to sleep for a procedure he did not do well at all. Like a lot of your post I don’t have a lot of money for the surgery either.

    To date he has had this one for about 2 1/2 months. We have done oral steroids and injection in the “bubble” again. The injection and keeping pressure on the area worked well for about 2 weeks reducing the size. It has “bubbled” back up and we have just drained fluid out one other time.

    Was wanting your opinion, since Chaos is not a good surgical canididate and I have heard horror stories of recovering from the procedure itself we want to do the same as we did on the other side and “leave it alone”. Should I take him in for more aspirations or just let it do it’s thing. His “bubble” is kinda tight but we have been trying to keep compression on it.

    The deformity, as he has one on the other ear is not an issue, can barely tell it is there. Since it has already been 2 1/2 months will it be much longer before this thing absorbes?

    Sorry to ramble on, just stressful more for us than him I think. He seems to be more annoyed by us messing with his ear but loving the extra attention. lol Any idea on time frame would be great.

  149. Doc says:

    Hello, Angie,

    If I had a patient like this, I might be tempted to put the little teat-cannula drain in. That often works pretty well, and can often be done with minimal or no sedation (depending on how calm the dog is).

    If he is not painful, and not bothering it, and acts okay, and you can live with the deformity, then I don’t see a problem with just letting nature take its course. I don’t have a good answer for you on the time-frame, but I would think at least a couple of months after you quit draining it.

    Good luck.

  150. Angie K says:

    Thanks so much for your help. We went back to the vet last night, drained it again and did another Dexamethasone injection. Fingers crossed.

    He is getting aggrivated with the dressing, as long as we watch him it stays on but every am he has wiggled his way out. We are trying this time to keep as much pressure on it as possible.

    We are gonna give this one more try after that, I think I am just going to leave my poor baby alone and let it do his thing. Thanks so much for your input.


  151. Angie Kinley says:

    Hi, I have one more question to get your input on. As you can see above what we did at the last visit drained the ear, another shot of Dexamethasone and have been keeping compression on the ear.

    To date it has been about 1 1/2 weeks since we had it last drained. kept is wrapped up round the clock for the first 3 or so days after the last drainage/injection. He have now cut back to keeping it wrapped atleast over night and may be a few hours during the day to prevent it from “bubbling” back up.

    Now we have noticed a raw place that has a little drainage on the gause we use to wrap the ear, he does shake it off occasionally so I wasnt sure if this was raw from the dressing or something else. We have been keeping the area clean of course but wanted an opinion if we should stop wrapping it and just let it heal on its own, or if the wrapping and putting compression is still a good thing.

    Thanks again in advance for your help.


  152. Doc says:

    Hello, Angie,

    I am afraid that I am just too far removed from what’s going on here to give you meaningful advice. You really just need to consult with your veterinarian.

    Sorry that I cannot be of more help to you.

  153. Samary says:

    I have a miniature schnauzer, he is 4 years old and he has aural hematoma, the vet prescribed prednisone, but my question is for how long I have to wait until I can expect his pinna to look better? It has been 5 days now and the swollen area is still the same size. The prescription was for 2 for the first 5 days once a day and 1 for the next 5 days once a day and then one ever other day. Thanks for all the information!!

    Thanks in advance.

  154. Doc says:

    Hello, Samary,

    I have found that it can take 7 to 10 days for the swelling to begin shrinking, but that it usually shrinks rapidly after that. I have usually kept them on the higher dose of prednisone until the swelling shrinks quite a bit.

    On the other hand, Schnauzers seemed predisposed to developing pancreatitis, and some folks believe that prednisone can also contribute to that.

    Your regular veterinarian is in the best position to advise you on this. You should contact him/her and let them know what is going on.

    There are patients where this does not work, but it works well for a lot of them.

    Good luck.

  155. Tayler says:

    My 7 year old Havachon, Gucci, is having surgery tomorrow morning to remove a rather large hematoma on her right ear. I read through all of the comments and your answers are so helpful, but I was hoping you could tell me a little bit more about the recovery process. Will she be in a lot of pain? What can I do to make her as comfortable as possible during recovery? Will I clean the wound, or will it be bandaged until the stitches come out? She has an extremely calm disposition and doesn’t scratch her ears, so will the e-collar be necessary? And finally, is this surgery risky and how common are hematoma recurrences? Thank you so much for your help!
    Gucci’s mom

  156. Doc says:

    Hello, Tayler,

    Will she be in a lot of pain?
    If she is having the really major surgery, then I am sure your veterinarian will be sending home pain medication.

    What can I do to make her as comfortable as possible during recovery?
    Follow your veterinarian’s instructions. Ask about pain medication, cold compresses, warm compresses, and so forth.

    Will I clean the wound, or will it be bandaged until the stitches come out?
    Many veterinarians bandage the ear across the top of the head to prevent shaking of the ear and scratching of the ear. The bandage would have absorbent material to wick drainage away from the ear.
    Again, you need to be sure that you take your list of questions with you for your veterinarian.

    She has an extremely calm disposition and doesn’t scratch her ears, so will the e-collar be necessary?
    This really depends on her reaction afterward. Frequently I will send home the E-collar, but suggest that the owner try leaving it off when the dog can be closely supervised. For the first few days, you will probably want to leave it on when you cannot supervise the dog.

    And finally, is this surgery risky and how common are hematoma recurrences?
    All surgery requiring general anesthesia involves an element of risk. If anesthetics were good for you, you wouldn’t lose consciousness.
    The surgery itself does not approach any vital organs, nor would we expect any significant blood loss, so I do not consider it a particularly risky surgery.

    If you are having the major type of “quilting” procedure, recurrence would be extremely unlikely. If the hematoma is due to the immune-mediated vasculitis (where the body’s defenses goof up and damage its own blood vessels), then you might later see a problem with the other ear.

    These are all good questions, and you really should ask your veterinarian, since he/she is actually seeing the dog and has the best knowledge of what is going on there.

    Thanks for reading and writing.

  157. Tayler says:

    Dr. Mobley,
    Thanks again for your response. I have encountered a very strange situation this morning… My vet called to inform me that it is not an aural hematoma, so the surgery will not be necessary. She displayed the symptoms, but they actually discovered a rubber band around her ear. I got her groomed this past Tuesday, and for some reason I cannot fathom, the groomer placed the rubber band for the bow around the base of her ear. It caused the ear to lose circulation, and she almost had to have it amputated (I did not see the rubber band on her ear because the hair is quite long in that area). I’ve been researching this for hours trying to find out if it has happened before, but I haven’t found anything. Have you ever encountered this in your practice? I’m not really sure how to handle it. Thank you so much for your time!
    -Tayler Lewis

  158. Doc says:

    This is indeed unusual. I suspect the rubber band may have been placed elsewhere and slipped into this unusual position, though I’m not sure how.

    I have seen several dogs who chewed up a newspaper and got a rubber band around their lower jaw. Sometimes the rubber band has cut clear down to the bone, just by gradual contracting pressure.

    I would let the groomer know what the veterinarian found, and let them know that she is still being treated.

    Take the high ground, rather than being accusatory. Give the groomer the opportunity to express his/her view of the matter. You may find that they are eager to do their best to make things right. Give them a chance.

    Good luck.

  159. Angie says:

    Hi my dog has had the hematoma surgery. He had a lot of trauma to his ear b/c the swelling went down the side of his neck. He is about 1 month out from surgery.

    He does have a very thick area at the base of his head where his ear is. The vet says this is scar tissue from the trauma he had since it got so big so fast. Monday he looked at it looked in his ear and said all looks well, just a little red at the top of the ear canal. We are cleaning and using tri-otic.

    This am I noticed he was sleeping on that ear and my husband says that the canal has swollen some. We have put cold compresses on it today to help with the swelling. I guess my question is does this sound normal to you?

    He doesn’t see to be in too much pain, I mean he did sleep on it. Only time he wimpers is if you put pressure on the area, still eats, sleeps, drinks, just doesn’t play too much and sleeps a lot. The vet did tell me this was scar tissue and would be painful for a while but not to worry. Now it is the weekend, they are closed, and he has this swelling. We have been dealing with this ear for quite sometime so I do get “anxious” about every little thing.

    Sorry to ramble just wanted to give you some details on his actions, etc. Like I said other than a little swelling at the ear canal he seems to be fine. Just wanted to make sure that the cold compresses will help and we are not aggrivating the situation.

    Thanks in advance for your reply.

  160. Doc says:

    Hello, Angie,

    That does sound like a lot of swelling, and a long time after the event to still be having problems.

    Cold shrinks blood vessels, so a cold compress (not ice, too cold, injures skin) helps to stop swelling when something has just been injured (or had surgery). If something has been swollen for days, then heat opens the blood vessels, bringing more circulation to the area.

    I doubt that the cold compresses have done anything to harm the situation. Twenty minutes two or three times daily for a couple of days is probably as much as could help. More is probably time wasted.

    Sorry to be so late in replying. I have been gone to a meeting.

    Stay in touch with your veterinarian on this.

    Good luck.

  161. Angie says:

    Thanks for the response. I got him some prednisone over the weekend and got him in at the vet on Monday. Said it looked like an allergic reaction to something. Ear is good and the prednisone has actually helped with the thick part behind his ear that I was told was “scarring/cartlidge”. I am just so glad his ear is improving. Thanks for the response back. I do appreciate all your info on this site!!

  162. Nicole Byron says:

    Hi Doctor,

    My 7 year old dog, Rosie, had an aural hematoma drained today at the vet. She has never had an ear infection, she does not currently have an ear infection or any other health issues. She has never had an aural hematoma before. She also got the steroid injection, and we have begun to give her prednisone. The vet did not instruct us to keep pressure on her ear at all, and said to call back in a couple of days so we can assess the situation and decide whether we should proceed to insert a drain. My question is that her ear still appears to be swollen and I am unsure if it is actually full again already (it has only been 6 hours since the draining) or if it just appears puffy because of the open area. How can I tell? I need to be able to give the vet an accurate assessment on Monday. Also, will we be able to tell if the prednisone is working in only two days? The prescription we have will cover Rosie for 12 days. Is there a reason why the drainage tube treatment would not have been advisable initially? I want to do whatever will help my dog to be free of this as quickly and painlessly as possible and reading these posts it sounds as though what she went through today is likely to be unsuccessful. The vet did say that Rosie’s did not appear to be a severe case and Rosie did not appear to be in pain unless we were actually touching her ear. Rosie’s behavior on the prednisone has been different, she has been sleeping all day.

    Thank you,


  163. Doc says:

    Hello, Nicole,

    Dogs on prednisone can certainly experience alterations in mood. This may be responsible for the napping.

    When the prednisone works, placing a drain is unnecessary. You would make a hole in the ear to no good purpose. It could also serve as an entry point for infection. I reserve the drains and more severe surgery for cases where the prednisone does not work.

    Very few cases will show dramatic improvement in 48 hours. I wouldn’t wait forever, but you will have to be more patient than that.

    My best advice to you is to stay in frequent communication with your veterinarian. Unless he/she hears from you, he/she will have to assume that everything is going great.

    My experience in successful prednisone treatments is that after the hematoma resolves, I have to taper the dog off slowly (over weeks) or it comes back. I suspect your veterinarian is planning to refill your prescription, but may have to change your dose in the process.

    Good luck, and stay in touch with your veterinarian.

  164. Paige says:

    I have a female Old English Bulldog who is 11 years old. She has developed an aural hematoma on her right ear. She showed no signs of any issue with the ear, no head shaking, scratching or pawing at the ear before I noticed the ear bubble. I checked both ears and she did have some mild wax and hair that had been shed in both ears, but no sign of any infection or mites (she’s solid white so her ears are very easy to spot anything that shouldn’t be present). I used an ear wash to clean both ears twice a day and that is when she started shaking her head – not before. I’ve been aspirating the hematoma with a needle and syring once a day and getting about 1 – 1 1/2 cc of fluid out of it each day. I’ve also been giving her an injection of 8/10 of a cc penicillin I.M. (3,000 units per pound of body weight)as she weighs 80 lbs. She doesn’t appear to be in pain and she lets me aspirate it once a day, but it fill up again and needs drained again in 24 hours. I have no income, lost my job and had to give up my home and move in with a friend in another state, or I would be on the street and homeless with my dog right now. I have no $ for a vet visit, let alone surgery. I hesitate to use steroids on her as she has a history of Demodex when she was a puppy that was brought on my steroid use when she arrived from the breeder with pneumonia. I can’t understand why she has this hematoma when there is no sign of infection, mites or any issue with the ear leading up to this. 3 years ago this month, she was diagnosed with hemangiosarcoma and had surgery to remove her spleen and a small area of metastasis on her omentum where the tumor was lying against it. The tumor and spleen were removed before any rupture of the tumor had occurred, however the vet gave her a poor prognosis. He said I could expect her to survive 3-6 months after surgery. It’s now been 3 years and she’s still going strong, still playful and has had no health issues since her splenectomy. Have you encountered or heard of dogs with hemangiosarcoma being prone to aural hematomas? Could it be caused by trauma from a tumor growing somewhere in the head or ear? I’m really at a loss as to what to do. I’m doing all that I can with the tools I have to work with, but with no income and no way to pay for veterinary care, I’m just at a loss and frustrated. Is there anything more I can do to help her?

  165. Doc says:

    Hello, Paige,

    Repeatedly aspirating the hematoma runs the risk of introducing infection into this cavity filled with bloody fluid – a great place for germs to grow.

    Dogs who develop hematomas and have no trauma at all are frequently the ones who have the vasculitis – inflamed blood vessels that are leaking fluid. We don’t understand why this happens. It is often steroid-responsive.

    I understand your reluctance to use steroids with the history of demodex.

    Hemangiosarcoma is usually really bad about metastasizing to other organs. You have really dodged a bullet on that one. When I did the splenectomy on my own Golden Retriever, he died of metastatic disease in less than one month. I doubt this is related to the hematoma on the ear pinna.

    You could try wrapping the ear around a spongy core to put pressure on the cavity and try to keep fluid from re-accumulating after drainage. This sometimes works. You have to be careful to overlap your tape by half its width to avoid tight and loose spots. Very important not to wrap TOO tight, as you can cut off circulation to the ear – very bad.

    If you just let the hematoma take its course with no treatment, they eventually resolve, causing the ear to “cauliflower” – they wrinkle up and deform the ear flap. This can take months.

    I’m sorry that I don’t have magic answers for you. I hope your situation improves.

    Best wishes.

  166. K. Lagory says:

    My daughters cat developed a hematoma in one ear, the dr placed a tube in the ear to drain it. When we picked him up, the nurse only said to keep the tube clear but gave us no idea on how to keep it clear or any other care of the site. Should we wipe it off with peroxide? I told my daughter where i read on here to milk it but she didnt like the idea….lol. Told her to bring the cat to me, i paid for his vet care i wasnt gonna risk anything that might help heal him… he is like my grandcat…

  167. Doc says:

    Hello, K.,

    We send home a sterile hypodermic needle to open the end of the tube if it clogs up. You could flame a sewing needle and do the same thing.

    Blotting gently with a cotton ball soaked with hydrogen peroxide should be okay.

    Don’t use much pressure when you squeeze out the fluid. If it takes much pressure, the tube is not open.

    I recommend you call the office tomorrow and ask for more explicit instructions. My instructions are good for my tube, but I haven’t seen your cat or your drain tube. Call your veterinarian.

    Good luck.

  168. Stephanie says:

    I have a 10 year old mixed breed female dog. She presented with a hematoma on 2/3/2011 and had the quilting procedure done the following day. 2 weeks later she had her sutures removed and it has been down hill ever since. After the stitches came out I had her home from no more that 15 mins when her ear filled and then exploded. She has been on Rimadyl for 7 days 3X now and has had around 15 laser treatments in this 6 week period. After surgery she has always maintained a small pocket of mostly serum in the tip of the ear, Is that normal? The vet worked very had to get the incision to close but now it seems as that may have been a bad idea. It closed on 3/11/2011 and the next day her ear “blew up” to twice the size of the original hematoma. The vet drained it with a needle which seems to have aggravated it more as it was a temporary solution. On 3/15/2011 the Vet decided to use rubber tubing to “thread” through her ear to allow drainage, Only to find out once the tubing was in place that about 50% of the swelling was inflammation of ear flap. Do you have any idea’s for treatment?

  169. Doc says:


    I would ask for referral to a dermatology specialist or surgical specialist. This sounds like your veterinarian has been working very conscientiously, but the results are just not what you need.

    I would not attempt to advise you on the specific treatment of this case from a “long-distance perspective”.

    I wish I could be of more help.

  170. Stacy says:

    Hi. My roommate’s cat has what looks like an ear hematoma. He’s out of town and the earliest that I could get the cat to the vet is Friday. I know the ear is uncomfortable for the cat, so I’m a little worried leaving it go for a couple of days. How soon should this be treated? Is it an emergency?

  171. Doc says:

    Hello, Stacy,

    This is not an emergency. It will be uncomfortable, but not intolerable.

    The sooner the better on treatment, but it’s not critical.

    Thanks for reading and writing.

  172. Mariah says:

    Hello doctor my 10 yr lab has an ear hematoma that was drained a couple of the times. The second time her doctor gave her an antibiotic but the hematoma is still there even seems fuller. She does not have an ear infection, I check her ears on a daily basis, i can touch her ear (hematoma) and does not seem to hurt, she has had the hematoma for about 15 days… i think it wont get any fuller and are totally afraid of surgery, how long does it take to disappear on its own?

  173. Doc says:

    Hello, Mariah,

    Over a period of several weeks, the hematoma will clot, organize, and finally shrink. This will deform the ear flap considerably. Have you ever heard of human fighters who have “cauliflower ears”?

    It shouldn’t be painful, but it won’t be pretty.

  174. Mariah says:

    Thanks for your quick answer. I took her to another clinic to get a second opinion. The doctor says that she does need surgery and mentioned that the recovery period can be between 2 to 4 weeks, and that is not dangerous to sedate her, he will do blood work before.
    What i want to know is what can i do to make her recovery less painful and quicker. are there any post-op risks? do you recommend leave her at the clinic?
    will she need a special diet? can i take her out for walks? can she be near my other dogs?

  175. Doc says:

    Hello, Mariah,

    You should really ask your veterinarian these questions, as he/she will be following up the procedure and is actually seeing your dog.

    I feel sure he will be prescribing post-op pain medications, so be sure to follow the directions. Also, if you feel that pain control is not adequate, be sure to let the doctor know. If he/she does not hear from you, they assume everything is going okay.

    Once she is fully recovered from anesthesia, her regular diet should be okay.

    Talk to the doctor about acceptable activity levels after surgery. I would think that walking on a leash would be fine, but ask your veterinarian.

    If the other dogs do not lick or bite or otherwise get rough around her head, ear or just in general, I don’t see a problem. You do NOT want a lot of rough-housing, and especially no further trauma to the ear.

    As far as post-op risks, we are always worried about infection, additional trauma, and so forth. Keep your veterinarian posted as to the dog’s progress. If something doesn’t look like it is doing well, CALL THEM. They need to know what is happening, and they are not psychic.

    Good luck.

  176. Marzmeetsvenus says:

    Dear Doc, I have a 7 year old German Shepherd/Wolf Hybrid who appears to have an aural hematoma. He’s had issues with his ears since he was a puppy. He frequently gets yeast infections, and even when he doesn’t have a yeast infection he’ll scratch his ears & shake his head.

    Like others on here, I just don’t have the $ to afford surgery. And from what I’ve read it’s no guarantee that he won’t just get another one later. Of course I don’t want him to be in pain, he cries when we touch his ear.

    What I wanted to know is more about this Prednisone treatment. Will the prednisone only work if the cause is “immune-mediated?” In my dog’s case I know the cause is likely from trauma, so for him should we not even consider asking about the prednisone therapy?

    I noticed he does have another yeast infection, so we’re going to take him to the vet to at least get that part taken care of. I doubt we’ll be able to do any surgery. I’m wondering where all these people who are aspirating their own dogs ears are getting these syringes?

    Oh, also I was going to ask what you mean by taping their ears to their head? I was wondering if this was something we should do to him? As soon as we put him outside he starts shaking his head & scratching. We might get him an e-collar, but that won’t prevent him from flopping his ears around.

    I really don’t want for my dog to have to suffer, but I don’t know what else to do. First I read to put on a hot compress, then I saw your page and was like uh oh. So now I’m putting ice packs wrapped in towels, but he won’t let me do much. I wish I could find pictures of what the deformed “cauliflower, boxer ears” look like. So I know what we’re dealing with here in the aftermath, but all I can find are pictures of humans with ears like that 😉

  177. Doc says:

    Yes, the prednisone is only helpful for the immune-mediated problem, not for trauma-induced hematomas.

    After the ear has been drained or had surgery performed, we sometimes lay the ear over the top of the head, inner surface UP, and bandage it in place. This wouldn’t be practical while the hematoma is full of fluid.

    If no surgery is performed, ask your veterinarian about pain medication to make your dog more comfortable ( in addition to treating the era infection, of course).

    The “cauliflower ear” or cicatrized ear pinna looks like you wadded up the ear and stuffed it in your pocket. It opens up a little, but still looks pretty wrinkled up.

    I could have taken a picture of one today, but he is black and it wouldn’t show up that well anyway.

    Best wishes.

  178. Melinda says:

    Thanks Doc, That’s what I figured about the prednisone. We have an appointment with a vet for him tomorrow. I know we don’t want him to have the more drastic surgery. We’re hoping this vet can put in one of those drain tubes, it’s a local vet in a very rural area.

    We really want to cure what is causing him to get these recurring yeast infections. I read that changing his diet to a grain free dog food would help. I looked up these grain free foods at pet stores, and they are very pricey. But, then yesterday we were at Costco, and found one that is very reasonable, $29 for a 30 lb bag.

    Do you think a grain free diet will help with the yeast infections? I mean it makes sense. Plus I read that acidophilus would be good to give to him as well, or plain yogurt w/out sugar. I would think that the acidophilus couldn’t hurt?

  179. Doc says:

    Hello, Melinda,

    I don’t think the acidophilus will hurt at all. Grain-free may or may not help. A lot of dogs with recurring ear infections do have an allergy as the underlying problem. Food allergy is one of the more frustrating to deal with. Some dogs with food allergy don’t itch anywhere else BUT inside their ears.

    The thing is, the dog can be allergic to any component of the food, and probably the protein sources are more often the culprit (rather than the carbs, i.e. grain).

    Dietary elimination trials require feeding a diet composed of something the dog has no previous exposure to. We use things like foods made with duck and potato, or venison and green pea, or kangaroo and oats. There are also the hydrolyzed antigen diets like Purina HA or Hill’s Z/D.

    When you do a dietary elimination trial, you have to be really strict and not let the dog have any of his old type food, or treats, or even flavored heartworm preventive. These trials can take as long as three to four months before every last vestige of the old food has been “washed out” of the intestinal tract.

    Talk to your veterinarian about this.

    Good luck.

  180. Laura says:

    Hi Doctor!

    My seven year old english lab was just treated for an aural hematoma with the plug method you outlined here. Since I had to work, my wonderful husband took him to the vet first thing this morning and picked him up when they closed at noon (and might have forgotten to ask a few crucial questions). Being an overprotective pet-parent, I want to be sure we’re doing everything right. The doctor told him to drain the ear “ten times a day” by “popping the pimple.” Am I just supposed to squeeze any fluid out several times a day? Is there an open/close setting on this tube (it looks just like your picture!)? Not a whole lot seems to be coming out and I want to be sure we’re part of this 90% success rate. Any tips on how to keep bacteria from sneaking up that tube (aside from the anti-biotics)? Also, what should I expect for when the tube comes out as far as recovery from there?? Thanks so much for all the great info! Glad we stumbled upon your site!

  181. Doc says:

    Hello, Laura,
    The tube that I use is always open. If it takes a lot of effort to get it to drain, then it is possibly clogged. I send home a sterile hypodermic needle to open it. You could flame a sewing needle and use that. Talk to you veterinarian about this first, though.

    If the ear is not filling, then the fluid is draining on its own. If the ear is filling, then you do need to help the fluid drain out by gentle squeezing. A sudden “Pop!” is not a good idea.

    Even if you keep the ear flap clean, bacteria will still try to enter the wound. Be alert for any change in the drainage or filling of the ear, or thickening of the ear, or discoloration of the ear.

    Once the tube is removed, I find that most patients have a little scarring and crinkling of the ear, but it’s not bad.

  182. Rebecca Stroud says:

    Dr. Mobley –

    Your info/advice on aural hematomas has been so very helpful to us.

    Although my own vet is well aware of the situation – as a “nervous nellie” dog-mother – I still insist on “searching the internet” (and I’m glad I did).

    Our 15-yr-old Maggie, a border collie mix, presented with a hematoma two weeks ago. For what it’s worth, we are going to allow it to resolve by itself. Yes, it did seem to “grow” a bit in the last few days. But, for the most part, Maggie is not terribly bothered by it and we don’t give a hoot what her ear will eventually look like as long as she’s in no distress.

    As you can well imagine with an active BC who spent years flying in the air chasing/catching balls, Maggie has many arthritis issues and our hope is just to keep her as comfortable as possible for as long as possible. She also has multiple lipomas so a “cauliflower ear” will just add more “beauty to my beast” as she is the dog from hell when it comes to vet visits.

    Anyway, just thought I’d let you know how much you’re appreciated. And, btw: Maggie’s ears are upright and now the one is starting to “crinkle” some. So I find it rather nostalgic that her ear is looking exactly like it did when we brought her home from the shelter 15 years ago…:-)

  183. julie sellenberg says:

    I would advise anyone who is using rimadyl to stop immidiatly it will kill your animal if it hasnt had blood work for its liver
    I think thats what killed my dog.

  184. Doc says:

    Most dogs can take Rimadyl safely long-term. However, they should be monitored at least twice yearly for liver and kidney damage. It actually isn’t that common, but it certainly can occur. This is true with any of the NSAIDs (non-steroidal anti-inflammatory drugs), including Deramaxx, Previcox, Metacam, etc.

    Human NSAIDs like Ibuprofen and Naproxen (Aleve) can also cause severe bleeding ulcers even with very short-term use, so they should really be avoided in dogs.

  185. Todd Foy says:

    Hey Doc,

    My great Dane’s right ear appears to be swollen. It’s is thicker than the other one. Is this an ear hematoma. There isn’t really a visible swollen area or an appearance of a bubble… What do you think? Should I ice it and keep it compressed or is this serious enough to get drained?

  186. Doc says:

    Hello, Todd,
    If you want to email photos to, then feel free. Photos are not always adequate, but your description is a little vague, and I really don’t feel I can give you any advice, other than to see a veterinarian (the best advice, anyway).
    You can get mild swelling with insect stings, other inflammatory conditions, trauma, etc.
    Even if I look at a picture, this could easily be something that requires some “hands on”.
    A cold compress is unlikely to hurt anything. Don’t use ice, as it’s too cold. A rag soaked in ice water is okay.
    Best advice: examination by your veterinarian.

  187. Traci says:

    I have read all the posts and I think I have a pretty good handle of what the options are. I have but 1 more question I know that the #1 concern with aspirating is introducing infection if the injection site is cleaned prior to aspirating and the area is cleaned regularly between aspirations should that keep the possibility of infection down or should antibiotics given just to be sure.

  188. Doc says:

    If you just aspirate, they usually refill rapidly. I have had poor success with aspiration, even when I wrapped the ear around an absorbent core pretty tightly. Introducing an infection is certainly a concern, but mostly I just find the results disappointing.

  189. stacy martone says:

    Hi There, We noticed an aural hematoma on labs ear about 9 days ago… i feel my story is a pretty successful one or luck, not sure which but I wanted to share this with you, just in case you were hesistant on surgery options to correct it as we were. We saw the vet on the 2nd day of the hematoma, it felt firm,like an air pocket in the flap of his ear. The vet wanted to do sx to drain it but couldnt guareentee that it wouldnt refill again, only to pay another $500 each time to do this. To aspirate it would only be about $150 but she was against it, cause it would most likely refill and I read on sites about the option of prednisone but she wouldnt try this for us with our dog. So we were stuck.. we really didnt have the money to try the sx and have it fail. So I did warm compresses on the ear everday for 8 days /2x a day and held the warm wet washcloth on my dogs ear flap for as long as he would let me (15mins) and I also gave him one dose of Claritin 30mg a day, (every other day) in a peanut butter cracker so he wouldnt notice the medicine inside it. The vet said we could do the claritin everyday, but i personally dont like the idea of giving my dog medicine. The swelling in the flap at first went down a little bit and then around day 5/6 it significantly went down to almost nothing, its softer and smaller. I have to say that its working and I had success without the invasive surgery and healing process my dog would have gone through. Hope this helps and of course always ask a vet for dosage on meds. My dog is 85 pounds and 7 years old. good luck

  190. Doc says:

    Hello, Stacy,
    Thanks for sharing your experience. If the hematoma had begun to organize (fully clotted, bleeding stopped) then I can see how the warm compresses would help it resolve.
    I would be a little concerned about applying heat to a fresh one. Heat makes blood vessels open up, cold makes them close down. In the initial stages of a bleeding or leaking process, you don’t want to apply heat.
    I’m not sure how the claritin would affect things. Dogs generally don’t respond much to it when it is given for itching and so forth.
    I’m glad you had a good experience, and thanks for sharing.

  191. Tink's Mama says:


    I have a 2-yr-old Shepard mix named Tink. Last Tuesday she very quickly developed a puffy ear which we identified as a hematoma and made an appointment with our vet. They couldn’t see her until today, the following Monday. They anticipated doing surgery so we didn’t feed her last night, and today the vet said she had a yeast infection that needed to be cleared up first so the surgery would need to be rescheduled. So I have $50 medication and a surgery they said would be about $300. Unfortunately between time off work and the overall cost I just cannot afford this as I had a very sick kitty last month. Are the injections effective once the ear is quite puffy? I don’t want Tink to be in pain, but I honestly don’t have $300 right now. I want to be a good petparent, I just wasn’t prepared for two big pet catastrophes so close to one another. I guess
    I’m just wondering if there is a cut-off point in puffiness/time elapsed for the effectiveness of some of the lower-cost treatments?

    Thanks so much!

  192. Doc says:

    Over a period of time (days to weeks), the blood vessel leak stops, and the blood inside the swelling clots and becomes solid. At this point, you are unlikely to reduce the swelling without surgery.
    Eventually, the hematoma will organize, and the fluid part will reabsorb. The ear flap will get somewhat crinkled up during the healing process at that point (the “cauliflower ear” of the professional boxer).

    While the contents are still liquid, placing a small drainage tube, or using prednisone may be effective.

    You do need to clear up the ear infection as your veterinarian advised. If the dog is shaking and scratching its ears because of the infection, none of the treatments for the hematoma will help very much.

    Good luck.

  193. Doc says:

    Hello, Feli,

    Quite frankly, I had never considered that. However, if a dog had recurring problems, it might be an approach to consider. He certainly wouldn’t have much ear to flop around after that.

    We treat most of these with prednisone now, but still there are dogs that require surgery.

    Thanks for reading and writing.

  194. Sandy Lear says:

    Wow, my 13yo Border/Lab just developed an aural hematoma and off to the vet we went. She prescribed the prednisone to start 5 days after stopping her NSAIDS. I just counldn’t understand the steroid treatment ( which unfortunately she didn’t explain and I didn’t ask) Thanks for the great info, hope it works. We start in two days. Dosing is 10mg BID x 5 days then 10mg daily x 7 days and 10mg every other day x 7 days. She doesn’t appear to be in pain and her arthritis doesn’t seem to be bothering her either. At 13 surgery seemed a poor choice anyway. Again thanks for the education. Well appreciated Doc.

  195. Doc says:

    Hello, Sandy,
    I hope things go well for you. The prednisone is a potent anti-inflammatory, so your dog should be comfortable with the arthritis while taking it.
    It’s really not safe to give the Rimadyl and the cortisone type drugs together.
    Good luck.

  196. Gwenn says:

    My foxhound just had the aural hematoma surgery last Tuesday ( 6 days ago). I could see the mattress stitches on the surface of her ear and was not too alarmed by the surgery because, though my dog was clearly very uncomfortable (and she tolerates pain well!), she was was obviously healthy enough. But on the 3rd day I noticed the size and depth of that drainage incision on the underside! It is a good 2″ long and so wide that I can see things that look like some whitish spots of fat (?) here and there over the cartilage and in between pretty wide lines of red flesh that is exposed! EWWW!
    I had hoped that by today it would look a little better, but I noticed that that incision is still just as open. I’m not due to revisit the vet till the three weeks is over. Is that what it is supposed to look like? I know it is supposed to have a “slit” cut out between the incision for drainage, but that is so frightening to see. I know it takes time for the ear to heal and drain, but this “slit” seems so deep! Funny enough, it is not really bleeding, but I do know this is hurting her right now.

  197. Doc says:

    Hello, Gwenn,

    In this type of surgery, the recommend actually removing a thin sliver of skin (rather than just making a slit) so that the incision WILL stay open for drainage.

    If you feel that your dog is still painful, you should contact your veterinarian and let them know that you need more pain meds. There should be no problem with that.

    I know it looks rough, but when a dog requires that more extensive surgery, that’s the way it is done.

    Please share your concerns with your veterinarian.

    Good Luck.

  198. Gwenn says:

    Dear Dr. Mobley,

    I took my foxhound to the Vet because the drainage incision just didn’t sit well with me and it was draining so much fluid a week after the surgery. The news was that the incision is normal and the slit is purposely wide to allow the drainage that would have made that ear look like the pillow it looked like before! They still want me back in two weeks to take the sutures out! No pain meds were ever given nor any antibiotics and they see no signs of infection! It is just one ugly thing to look at! I wanted to thank you for your link to at least educate me and to help alleviate some of my fears during my anxious hours! You are very kind to us all.
    I am keeping her cone on and her activity level is still low. You are right, this affliction is not the easiest thing to treat.
    xo, Gwenn

  199. Liz says:

    Hi My 10 year old GSP bitch has developed a hematoma. She has been to see two different vets. The 1st one gave her rimadyl & suggested surgery. The 2nd drained the ear & said if he had to drain it again & it didn’t work would be the only option. She has been through surgery already this year (biten by another dog!) & was a poorly girl for several days. Reaction to anaesetic! Her ear is still swollen but she lets me touch it & rolls on it & she is not in any discomfort. Should I bandage her ear up as suggested in other blogs. How long will this take to resolve itself back into her body? Thanks for taking the time to read this.

  200. Doc says:

    Hello, Liz,
    I’m not sure what you mean by bandaging the ear. I have had rare success by bandaging the ear around a soft core after draining it. The idea is to keep the ear from refilling after drainage by applying light pressure to it. It is difficult to get “enough, but not too much” pressure when doing this. Success rate is pretty low anyway, at least in my hands.
    Bandaging the ear across the top of the head keeps the dog from flopping it and making it worse, but won’t make the hematoma resolve any faster.
    The only thing that I can see Rimadyl helping would be the dog’s discomfort. That’s worth doing, but it won’t resolve the hematoma.
    There are certainly dogs that require surgery.
    Before we started treating most of these medically with prednisone, I did a lot of the little drain tubes, as illustrated in the blog entry. I rarely have to perform the major surgeries anymore.
    Hematomas take weeks to re-absorb on their own, and the ear flap is usually disfigured in the process.

    Each case is different, and I really cannot give you specific advice the way a doctor can who has actually seen and examined your dog.

    Good luck.

  201. Laura says:

    Hi Dr.

    My 7 year old GSD had aural hematoma surgery 3 days ago. She has had long standing issues with yeast infections and we have tried all the prescribed ear washes/drops etc. The vet also prescribed prednisone for her and that made her very sick, so we quit the prednisone. She itches and shakes her head a lot and the other day her ear became floppy and we noticed the top half was very fluid filled. I called the vet right away and was told to bring her in immediately for surgery. She had the “quilting” surgery and after was prescribed Gerizol for the yeast and some antibiotic pills. No pain meds. They put gauze in the ear and taped it up. All we were told to do is take the bandage off in 3 days and come back in 30 days to get the stitches out. Today was day 3 so we took the bandage off and the ear looks very good but the top is a bit flopped over still. My questions are:
    1. Is 30 days too long to leave the stitches in?
    2. What are the chances her ear will be erect after healing and is it a good idea to “prop” it up with something in the mean time??
    3. Is there anything to help with her yeast infection in her ears, as it seems we have tried everything!!!
    Oh one more question, she had real issues with the cone, so I bought her a “soft collar”, is that suffice?
    Thanks a ton!!!!!


  202. Doc says:

    Is 30 days too long? I would have to defer to the doctor performing the surgery. I am sure he will want to stay in touch with you to be sure things are going okay.

    The ear is quite likely to be somewhat deformed in the long run. If you decide to prop it, let your veterinarian know and get some help. You don’t want to make things worse by putting pressure in the wrong place at the wrong time.

    The point of the e-collar,cone, etc. is to keep the dog from damaging the ear. If what you are using accomplishes that, then it’s fine.

    It is unfortunate that she doesn’t tolerate prednisone. Yeast infections are considered to be secondary to some underlying problem, usually an allergy of some sort.

    Prednisone suppresses the allergic reaction. If she cannot take it, then you can ask your veterinarian about antihistamines (rarely very effective), omega 3 fatty acids (help some dogs), or Atopica (works well, but expensive).

    Many of these dogs are food allergic, and require a dietary elimination trial. This means feeding a special limited antigen diet for 12 to 16 weeks.

    When a yeast infection is present, it DOES need to be treated. However, you also need to look for the underlying cause.

    Good luck.

  203. cj says:

    I have a 10 year old Weimaraner that just had surgery for ear hemotoma 5 days ago. His ear continues to bleed and now we just took him back to the vet and he has another hemotoma above the one that was operated on. I am beside myself. I don’t know if this is common or if the vet simply didn’t address all of the issues the first time. Now, back for more surgery? I’m at a loss as to what to do?

  204. john okeefe says:

    hello doc,
    my 7 yr. old golden has a hematoma. we took him to the emergency vet to get it drained saturday and it filled back up within hours. e.r. vet also gave us meds to treat infections in his ears. today we went to our regular vet to schedule surgery, or so i thought, to correct this. our vet said we could either do the surgery or wait it out and see if meds help him and hematoma subsides on its own. (hematoma is not alarmingly huge, btw…)
    even after telling my vet that $ was not really an issue he suggested on bandaging his ear up to his head and see how he is.
    we took his professional opinion and went this route.
    its been 2 hours since he has been home and seems miserable with this bandage. vet assured me it is not too tight. ( i can fit three fingers between bandage and neck)
    his breathing is more labored than usual but he doesnt seem to be “struggling to breathe”. hopefully it’ll take him a little time to get use to this bandage and relax a bit more.
    the vet did leave a hole in the bandage allowing us to continue with his eardrops (otomax). in your opinion, did i do the right thing here?
    $ isn’t a problem but if hematoma will clear up on its own i can live with my dogs ear being a little disfigured- as long as he is not going to be in pain.
    thank you in advance for your response!
    john- staten island, n.y.

  205. Doc says:

    Hello, CJ,

    Sorry about the late reply. I was out of the country for two weeks visiting my daughter who is a Peace Corps volunteer in Zambia. We had not seen her for 17 months.

    I would not say this is common. If things are not going well, I would suggest asking for a referral to a veterinary internal medicine specialist to rule out underlying medical problems.

    Good luck.

  206. Doc says:

    Hello, John,

    Sorry to be so late in replying, but I have been out of the country for two weeks visiting my daughter. She is a Peace Corps Volunteer in Zambia, and we had not seen her for 17 months.

    I hope your buddy is feeling somewhat better by now. It certainly is important to treat any underlying ear infections (the Otomax).

    When this is cleared, if you are still having trouble, you might ask your veterinarian about the treatment with prednisone for the hematoma. I have really been surprised by how often this works, and surgery has not been necessary.

    Your veterinarian is actually seeing your dog, so his/her recommendations are more important than mine. Having said that, it doesn’t hurt to ask about alternatives if you’re not having the results that you expect.

    Good luck.

  207. MKalin says:

    Wow – I just drained a hematoma on my 12 yr old dog last night. I couldn’t have found a better sight to help me handle what may come next. Her ear has some more fluid today but I am going to try an ice pack – will Rimadyl help?? We are pretty cash strapped and can’t really afford to go to the vet unless it’s an emergency . I just happen to have some Rimadyl on hand….Thanks!:-)

  208. Doc says:

    Hello, MKalin,

    Rimadyl may help with the discomfort, but it won’t have the same effect on the blood vessels that the prednisone would have. Also, you cannot give the two together.

    Remember not to put ice directly on the skin. It is too cold and will damage it. Towels soaked in ice water and replaced as they warm up are much safer. Apply cold for 15 to 20 minutes at a time, no more. You can do this several times daily, though.

    We are treating most of our hematomas with oral prednisone now, which is really inexpensive.

    You should at least call your veterinarian about this.

    Good luck.

  209. Sara K. says:

    Hi, thanks for the great site! My cat had a hematoma drained Tuesday, his ear was quilted, and he came home with a gaping straight incision and a collar. The first few days fluid kept draining out. On Friday I noticed the incision scabbed over and today I noticed the ear getting puffy and the sutures look extremely tight. Is this normal? Or should I try to reopen the scab to drain what looks like fluid accumulation? Thanks!

  210. Shilo says:

    Hello. My husband and I just brought our pitt mix in for a large hemotoma on Sunday and had it drained. We were told he has a fungal infection and we were given cleaning solution and meds to help the infection.

    Tonight he gets his bandage removed and my concern is that he will start to shake his head and stratch his ear again. We are going to keep the e-collar on until we see that he’s not trying to scratch as much.

    We have never had any issues with his ears, besides the scratching and shaking and I just don’t want him to end up in pain again. On average how long does it take for a fungal infection to heal and how do we keep him from shaking and scratching?

    Thank you,

  211. Doc says:

    Hello, Sara K.,

    Sorry to be late replying, but I have been covered up.

    Let your veterinarian know what is going on. I would expect the sutures to be snug, but I wouldn’t expect the ear to be getting puffy.

    I would be concerned that the ear might be getting infected. Also, the scab might be preventing fluid drainage, but I’d be more concerned about infection.

    It’s very difficult to give you a good recommendation without seeing the cat. I do not think picking at the scab will be a great idea.

    Do contact your veterinarian and let him/her know what is happening. Without feedback, we assume everything is going okay.

    Good luck.

  212. Doc says:

    Hello, Shiloh,

    Depending on the amount of swelling and how long-standing the problem is, AND whether there are other underlying problems (like allergy), I would expect the ear infection to be much improved in 5 to 7 days, and pretty well healed by 14 days.

    It is really important to keep the debris out of the ear, and to use your treatment medicines as directed, putting them deep into the canal.

    This sort of thing is almost impossible to follow without an otoscope and looking deep into the canal, so a couple of follow-up visits to your veterinarian will almost certainly be necessary.

    You also have to rule out other underlying causes, such as allergies. Yeast are usually secondary invaders. They need to be treated, but you need to find out what opened the door for them.

    Let your veterinarian have the opportunity to recheck and re-evaluate the progress of the condition. It’s really hard to handle something like this in just one or two visits.

    Good luck.

  213. tyler says:

    Hi My lab has an hematoma yet again. the vet has said thay will put a button in her ear. I dont see how this will help? She cant have a drain as the problem is caused by her son hanging off her ear when thay play we try to stop him shes 5 hes 2. Shes also pregnant by another lab so surgery is out of the question. She dosnt seem to be in any pain and we will try the cold pack on her ear. Would it be save to leave her treatment till after the birth?

  214. Doc says:

    Hello, Tyler,

    The longer you wait to treat, the more likely it is that the ear will have a worse cosmetic appearance after healing – all crinkled up.

    Ask your veterinarian to explain the button procedure to you. I have seen a technique where buttons (like shirt buttons) are placed on either side of the ear, and used like a washer on a bolt to compress the layers of the ear together.

    In that technique, the surgeon makes a drainage incision, then puts several buttons on both sides of the ear (inside and outside) and sutures one button to the other, going through the ear. The button on each side spreads the force of the suture to a wider area.

    Your veterinarian may be referring to this, or to something else entirely. Ask them to draw you a picture, or demonstrate with a stuffed animal or something.

    Also ask if anesthesia is needed, how long the procedure will take, what aftercare will be needed, etc.

    The prednisone treatment is not appropriate for a pregnant dog. It might cause her to abort.

    I am sure that your veterinarian will be happy to explain further. He/She may have been in a hurry that day.

    Good luck.

  215. Jenn says:

    My cat just had this done and i am unsure of the doctors advice . He has my cat wearing a bandage for two weeks and it smells awfully bad . Is there cause for concern ?

  216. Doc says:

    Hello, Jenn,

    If it smells bad, something is not right.

    Do return your cat to the veterinarian for a recheck. It may just need a fresh bandage.

    If a lot of drainage has accumulated, it will support bacterial growth. Even if it’s just in the bandage and not the ear, it should be re-dressed.

    Let your veterinarian know what is happening. When he/she doesn’t hear from you, they just assume everything is going okay.

    Good luck.

  217. tori says:

    Dear doc, per my vets advice…I did pop it myself because I really dont have any money since my husband threw me and her out….she is my baby so i had to do it…anyways Ps I did sterlize everything…um my ? Is when i poped it it looked like old faithful and drained for a long time…but it is to me alittle swollen still is there more in there and should I keep tring to pop whats left….when I poped it the first time she didnt seem like the needle hurt..but i have tried to pop again and now she doesnt want it it seems to hurt…does that mean that shes ok?that its all out and i should leave it alone?I love her and shes all i got so i dont know what to do…first pop looked like blood and water now it just looks like blood…im sorry to ramble i am just scared

  218. Doc says:

    Hello, Tori,

    Opening the swelling with a needle relieved the pressure and discomfort, but could not address the problem of the continually leaking blood vessel.

    Once it is drained, it refills unless bandaged across the top of the head, or bandaged around a soft core, like a tampon.

    You have to be careful in bandaging to apply enough pressure that it keeps the ear from filling, but NOT so much that you damage the ear flap.

    I would not recommend that you keep poking the ear with a needle. If you cannot get professional care, I would just use cold compresses several times daily.

    Do not put ice on the ear. A therapeutic cold pack can be used, or you can use a hand towel soaked with ice water (and keep soaking it to keep it cold).

    The cold shrinks the blood vessels, slowing the leakage.

    The ear will heal slowly and be a little deformed, but it will eventually heal.

    Good luck.

  219. A says:

    We just got my lab operated for a hematoma on her left ear. We paid 250$ at the first vet only for visits and for evaluations they wanted to charge us 600 for the op. We then looked around and found a vet almost 2 hours from here but they charged 400 for the op and the visits were less costy, so we went there. Now, this morning (3days after op) I just found an other one on my dog’s left ear. And right now at home (because of health issues) no one is working exept me (and I’m a part-time babysitter, so I don’t get much). At first, my mom’s boyfriend(he refused to chip in or to lend money) wanted to put the dog down, I refused saying the op was worth it that it shouldn’t come back after so it was worth it, but now since it came back, we don’t know what to do… I never heard of it coming back. And the ear the got operated is pretty big too (but I guess it might be normal). We are going back to the vet soon, but I’m really worried we might have to put her down because of money issues.

  220. Doc says:

    Hello, A,

    This is not something that you should euthanize the dog over. If an additional surgery or other treatment is not an option, then ask you veterinarian about options to control the dog’s discomfort until the thing heals on its own.

    That will take a long time (weeks), and the ear will look goofy, but I certainly wouldn’t kill the dog over it. So she has funny-looking ears when it’s all over. Not such a big deal.

    Best wishes.

  221. Liz says:

    Hiya Doc! What a WONDERFUL service you are providing. I have a chow mix who had a hematoma in his ear. I took him to the vet and opted for the surgery on 10/26. He was put on antibiotics and prednisone. He just finished his prednisone two days ago, and his ear has swollen up again! Are we really going to have to do another surgery? Is is possible that stopping the prednisone caused it? Unfortunately I cannot dish out another 700.00 for surgery. Any ideas? Thanks!

  222. Doc says:

    Hello, Liz,

    Since I cannot examine your dog, it is difficult to give specific advice.

    I find that even on the dogs where prednisone alone is effective, I have to give a high dose until the swelling is down, then taper the dose off slowly over several weeks.

    You might ask your veterinarian about trying the high-dose prednisone treatment without surgery and see how he/she feels about that.

    Again, the doctor who is seeing your pet is best qualified to advise you. That being said, it’s okay to ask them about other treatment approaches. They can then tell you why they think it would (or wouldn’t) be helpful to your dog.

    Good luck.

  223. Liz says:

    Thanks for the advice. I took him back in this morning and he is doing the surgery again free of charge. Whew! Any advice on what to do preventatively? He says he’s going to leave the stitches in for a month this time instead of 3 weeks. Anything else I can do?

  224. Doc says:

    Hello, Liz,

    I really cannot advise you in a meaningful way at this point. Stay in close contact with you veterinarian and keep them up to date on the dog’s condition. When we don’t hear from you, we think everything is okay.

    Best wishes.

  225. Matt says:


    I just noticed last night my 1.5 yr old cats ear seemed to be slightly sagging down, and upon further investigation I am almost certain it’s a hemotoma.

    Is surgery going to require she be sedated twice (once for draining and once for removing stitches) and will I have to give her medicine orally and make her wear a neck cone?

    I am concerned about all this as I have never had good luck forcing her to take medicine or the likes.

    Also, I am suspecting she may have gotten the hemotoma from falling off the 2nd story balcony in the apartment, since she always jumps up on the railing. How can I get her to stop doing this?



  226. Doc says:

    Hello, Matt,
    I’m sure that your cat will require sedation for the initial procedure. Many cats do not require sedation for suture removal. It depends on their temperament.

    It is likely that she will need oral medication and a neck cone. Your veterinarian will help you with this.

    There is a great treat called a “pill pocket” that can really help with oral medication. Ask your veterinarian about it.

    Your veterinarian will also check for ear infections, which can be cause of the ear trauma that produces the hematoma.

    The only way I can think of to keep her from jumping off the balcony railing would be to keep her off it in the first place.

    Some cats don’t like aluminum foil and will avoid areas that are covered with it. There is also a product called a “scat mat” that gives a mild static electricity type shock. They sell the product to put on couches, but I suppose it could be draped over a railing.

    Sounds like you and your cat need to see your veterinarian.

    Good luck.

  227. Matt says:

    Thanks for the prompt advice. I took her to the vet today and as I expected she is going to need the surgery.

    At this point my only concern is the anesthesia, which my vet said consisted first of a pill, then IV, and I think she mentioned gas. Is this the most modern and safest method of sedation?

    She did mention all her vitals would be monitored during the procedure, but seeing that I know of two people who have had bad experiences with sedation & their cats I am just a little worried.

    Thanks for addressing my concerns.

  228. Doc says:

    Hello, Matt,

    I don’t know exactly which drugs your veterinarian will be using. However, the protocol outlined certainly sounds consistent with the best anesthesia.

    I understand your worries. If anesthesia were good for you, you wouldn’t lose consciousness.

    The constant monitoring of vital signs allows us to take action as soon as the cat shows any sign of a problem (if it does). The gas anesthesia can be adjusted rapidly to bring the cat lighter or deeper, as needed.

    One can never say that there is no risk, but it sounds to me like your veterinarian will be doing a great job for you.

  229. Matt says:

    This is the treatment plan I was given at the vet for her hematoma surgery. I have to take her in the morning, and was wondering if you could review this plan quickly for me. There are a lot of medications on here and my main concern is is it ok to have all these in her system at once?

    Treatment Plan:

    -physical exam
    -cefpodoxime proxetil (100mg tablet)
    -Ear Hematoma Surgery
    -Ear swab and microscopic exam
    -elizabeth collar

    General Anesthesia package
    -Acepromazine Injectable
    -blood cell count
    -blood pressure monitoring, anesthesia
    -blood sample collect/prep
    -Butorphanol 10mg/ml injectable
    -cefazolin injectable (per vial)
    -differential exam of blood cells (manual count/evauluation)
    -electrocardiogram monitoring
    -electrolytes (K,Na,Cl)
    -Fluid admin – lactated ringers solution
    -general anesthesia (up to 45 minutes)
    -hospitalization – doctors supervision, hospital team care, ward fee
    -internal organ function screen
    -IV catheter insertion
    -IV extension set
    -IV fluid administration set
    -IV fluids pump
    -Meloxicam 5mg/ml injectable (IS THIS SAFE IN CATS?)
    -pre-anesthetic examination
    -Propofol injectable
    -Pulse oximeter
    -recovery care after anesthesia
    -Tracheal Intubation
    -Monocryl suture with needle
    -Tramadol 50mg tablet

    ***I don’t recognize most these drugs, and I am worried that many different chemicals in her body cannot be good.

    Does this treatment plan sound like a safe and modern way of doing this?

    Thanks again for all of your assistance so far – I really appreciate it

  230. Doc says:

    Tramadol is for pain, lasts 6 to 12 hours. Cefpodoxime is an antibiotic, usually lasts 24 hours. Acepromazine is a mild sedative, lasts about 4 hours. Propofol is an anesthetic, given I.V. very quick acting, very short-acting (gone within minutes).

    Meloxicam (Metacam) is a non-steroidal anti-inflammatory. It is approved for cats in Europe, and used to be approved in U.S. Most feline specialists still use it for old arthritic cats because it’s the best we have. Cat’s don’t tolerate this class of drugs well, generally, but meloxicam is better tolerated than others.

    It sounds like your doctors have put together a really top of the line program for your cat to make things as safe as possible. I think you are in good hands.

    Best wishes.

  231. Matt says:

    Hello again,

    Well her surgery went well friday and the vet didn’t even have to use the sevoflurane, she was able to do the surgery with just the sedative. She made several small circular cuts in her ear and sutured it back to the cartilage.

    Now, 2 days after the surgery when I woke up this morning I noticed her ear was puffy again. I gave her some food and while she was eating she shook her head and the fluid in her ear went everywhere. I immediately wiped her ear clean with a dry napkin (as I have been doing the past 2 days).

    She is also on Tramadol and Cefpodoximine. She tries to scratch her ear but cannot because of the cone and ends up shaking her head instead – which I think is maybe stopping the actualy bursted vessel from healing?

    I’m concerned these small circular holes are healing over before the actualy clot heals over, and her ear will just refill again. What can I do?

    Thanks again

  232. Sue says:

    Our 8 year old lab has an aural hematoma. Vet said she is an excellent candidate for the prednisone treatment as a complete “pocket” of blood had not yet formed. She started treatment two days ago. No ear infection so still wondering how this happened. How long before we see any improvement?

  233. Doc says:

    Hello, Matt,

    I’m afraid I am not able to help you at this point. You really need to stay in close communication with your veterinarian. I am just too far removed from the case.

    Good luck.

  234. Doc says:

    Hello, Sue,

    The time to clinical improvement is variable. I usually look for improvement by 5 to 7 days.

    Stay in touch with your veterinarian and let him/her know what is happening. Share your questions with him/her. Since that doctor is actually seeing your dog, he/she is best equipped to advise you.

  235. Amanda says:


    The discussions here have been very helpful. I am cuddled up on my couch right now with my dog who had hematoma surgery two week ago. She had the surgery that puts the sutures to help prevent this thing from coming back. We went back to the vet 10 day after surgery to have the sutures removed, and were told to come back in a week because the incision had not started to heal. Well, it has been 4 more days and the sutures look like they are coming out. I cannot see the sutures from the inside of her ear anymore, like they have literally grown into her ear or something. What is this about? Also, just today her ear has started to puff back up and she seems like she is in a little more pain than she has been for the last 7 days or so. I am definitely the puppy parent that over reacts to everything, and I know my vet thinks I’m crazy, but I’m really concerned about the sutures and the puffiness in her ear. Are these things unusual for a dog that has had hematoma surgery?

  236. Shirley says:

    Thank you for your efforts and providing so much good information!

    Our seven year old Doberman, Sampson, does not have cropped ears and has recently developed an Aural Hematoma on one ear. The Hematoma has been drained five times over the last two months with an average of about 20cc’s of blood each time. The vet used cortisone three of the times the ear was drained and those times refilled much more slowly than without it.

    I know you don’t recommend owners drain their dogs ears themselves because of the risk of infection, very understandably. My husband drained it one of the five times with a sterile needle after cleaning with Chlor Hex Scrub, per the vet’s instructions. Without the cortisone the affected area, the bottom 1/3 of the ear, refilled by the next morning. At $150 per draining we have to do some of this ourselves and welcome any words of wisdom you may have.

    His ear is full again now and was just drained on Monday. We are considering draining it again and trying a compression wrap but are not sure how to apply it. Could you provide additional information?

    We are also wondering if Yunnan Baiyao given internally could be of benefit? Sampson has no other known health issues other than minor dermatological problems. His weight is at 92 pounds and we are also looking for dosage information.

    Thank you in advance for your help.

  237. Doc says:

    Hello, Amanda,

    Sorry to be late in replying. It sounds like the sutures are hard to see because the swelling is burying them. The swelling is not normal. If you haven’t taken her back to see your veterinarian, I recommend that you do so.

  238. Doc says:

    Hello, Shirley,

    My herbal expert says that there isn’t much data on using Yunnan in aural hematomas. She doesn’t think it would hurt, and it might help.

    If your dog doesn’t have an ear infection, you might ask your veterinarian what he/she thinks of the oral prednisone treatment for vasculitis. That really works for a lot of dogs.

  239. Sheila says:

    Thanks for this informative site. I have a year old female Doberman, uncropped, named Zasha (a rescue). Last night I noticed a swelling in one ear (this is Sun now). My Vet friend told me over the phone about the hematoma and the sugary that is generally performed. I have already left a message for my Vet that id be on the doorstep at 8am for surgery. But. I have to say after reading this site, it seems that a month of discomfort (while on pain meds of course), sounds much better than the pain and trauma of surgery, the trauma of the post surgery, cone and limted activity, etc… I’m now leaning toward a Vet visit for an ear check and ear meds if needed, some pain meds, and a future deformed looking ear (I love her no matter what her ear looks like). It is not the money, it just seems like the lesser of the evils. I really don’t want to consider high dose steroids, as I know the long term damage that can cause. I just want her happy and around for as many years as possible.
    Does this sound unreasonable to to you? Right now (and I know that can change fast), her hematoma is only about 1 inch in height, about 1/2 inch wide, and 1/4 inch in thickness. It is located close to the ear base and in the mid portion.
    Thanks a bunch, Sheila

  240. Sheila says:

    P.S. I have 2 other uncropped Dobermans and a little mutt. She would be beside herself to be separated from them while they play and it would be impossible to keep her ear from getting touched post surgery, if I let her around them.

  241. Sheila says:

    Zasha is at the Vet now. The Vet and I discussed and decided on the cannula. It is in place and she is doing well, but not happy about it. I’ll let you know how it turns out. She is coming home with pain meds and antibiotics. Oh and of course a cone.

  242. Doc says:

    Hello, Sheila,
    That will probably do well. I’ve treated a bunch that way with mostly good results.

    The high-dose prednisone sounds bad, but it’s not high for a long term, and a prolonged tapering off period is part of it. We haven’t had problems, other than the obvious side-effects of excessive appetite, urination (and compensatory water drinking).

    Good luck. Thanks for reading and writing.

  243. Sheila says:

    Just an observation. Zasha’s ear fills up with serous blood much quicker when she is really active. After she runs up hill to the back of the farm, her cannula needs emptied when we get in, and again about an hour later. If she just lays around, it doesn’t bleed hardly any and I can go all day without draining it (you can see when it needs emptied).

  244. Doc says:

    Thanks for sharing that, Sheila. For what it’s worth, I leave mine open all the time. The down-side is that this makes it an open wound, so they have to stay on antibiotics the whole time.

  245. Audrey Klock says:

    Our Weimaraner had an aural hematoma 2 weeks ago. She had a drain placed. Some days there seems to be a smaller collection that requires a lot of pressure and makes sort of a crunchy sound when I am draining it. Am I forcing out the part of the ear that is healing? The drainage is darker red than before.

  246. Doc says:

    Hello, Audrey,

    You aren’t forcing out anything that is healing. It is possible that you are breaking up some clotted blood, and as it is forced through there is some air bubbling along with it, making that sound.

    The best advice that I can give you is to call your veterinarian and see if they feel a recheck exam is in order (it might be).

  247. Audrey Klock says:

    I called the vet and they said as long as I’m not getting clots, and they agree it is probably air. I mentioned corticosteroids, and they are going to talk and get back to me tomorrow. Thank you for your advice. This just seems to be going on too long.

  248. Doc says:

    Hello, Audrey,

    I have never used steroids with the ear open and draining, and would have some serious reservations about doing so. In fact, when I have one open, I usually (rightly or wrongly) keep them on antibiotics, as I am afraid of that open bloody cavity getting infected.

    I’m thinking it’s time for a recheck visit. Good luck.

  249. Lee Turner says:

    Hello Doc,

    We just took my wife’s 6 year old lab to the vet and had the surgery done yesterday. We were told to remove the bandage today which we have done. We were also told to give him antibiotics every eight hours which we have also done. Here is my problem first of all this is a BIG lab with alot of energy and they gave us a tube of Entederm and instructed us to actually stick the end up in the openings of the stitches- this would yake about three grown men to hold him! Can we just spread the ointment over the wound? Just for reference even after they had drugged the dog when they came back from the surgery the vet and his asst looked like they had been in MMA wresting match. Any help would be appreciated



  250. Doc says:

    Hello, Lee,

    This certainly sounds like a difficult situation.

    If your doctor has instructed you to place it into the openings, that must be what he has the best luck with. On the other hand, if it is not possible, then you just have to do the best that you can.

    I have not used that type of medication in these situations. The ointment is oily, and if spread over the openings and massaged, should penetrate.

    I would call the doctor as soon as they are open again and tell them the difficulty you are having. He may have an alternative for you. I can’t imagine that this is the first large dog they have dealt with.

    You might also ask about some type of pain medicine, as that might make the dog more cooperative with the other medication.

    Good luck.

  251. Adele says:

    Hello Doc,
    My 8yr old Border Collie had surgery for his aural haematoma 5wks ago.
    However, the beginning of this week I notice the swelling returning in the same place under the scar incision, but it was not as large as it was before surgery.
    He has been back to the doc twice this week, both times the ear has been drained and steroids have been injected (last drainage and steroids treatment late yesterday).
    Today the swelling is back to it’s original size again!
    I’m guessing my poor dog is going to have to go through another round of surgery? Could this haematoma just keep happening in the same place over and over again?
    What other treatment / procedure can be done to stop this from recurring?

    Your advice is really appreciated!

  252. Doc says:

    Hello, Adele,

    At this point, I assume that the ear canal is healthy so that the dog isn’t scratching his ear because of an ear infection.

    With continued refilling of the hematoma, we must be having recurring leakage of the blood vessel.

    I really cannot prescribe for your dog, as I have not seen it. Your veterinarian is in the best position to advise you.

    Having said that, you might ask him/her if they have looked at using the oral prednisone treatment in any of these. Your dog might be a candidate.

    Good luck.

  253. Adele says:

    Hello again,

    Thank you for advice.

    Answer to your question, no my dog never had an ear infection before or currently.

    Monday, the Vet drained the ear and injected more steroids (DEPO MEDRONE 5ML). He said if this approach is unsuccessful this time, my dog will need more surgery!

    So far, his ear has remained relatively flat however, I have noticed my dog is needing to urinate more frequently over the past two days… this normal?

    I don’t want to take him back to the Vet unless it’s really necessary, he dislikes the Vet’s since going through all this treatment!

    Many Thanks,

  254. Doc says:

    Hello, Adele,

    I would suggest that you let your veterinarian know about the increased urination. It is very likely due to the depo medrol, but you should let him know anyway.

  255. Sandy Frank says:


    My 12 yr old male Golden Retriever has had two hematoma repair surgeries to his left ear and the hematoma has now come back a third time. My vet has “scoped” his ears and finds no reason why he is shaking his head and causing the hematoma to return. I’ve taken him to a dermatologist who found no ear mites and only two yeast spores in one ear. The dermatologist suggested changing his diet for 6 weeks which we started four days ago. He is also on Mometomax ear drops, Prednisone 30 mgs daily for 5 days, 20 mgs daily for 5 days and 10 mgs daily for 5 days and then 10 mgs every other day for 5 days–he weighs 70 lbs), Ivermectin (scabies? no sign but “just to be on the safe side”?), and Fluconazole (to treat yeast). She drained 3 ml of blood and injected 1/2 cc dexamethasone to decrease inflammation. compression bandange was also applied. I’ve scheduled him for his third surgery this Friday but hate the thought of repeated anethesia at his age. My question: do you think I should ask my vet to try the immumosuppressive dosage of prednisone (if my calculations are correct, the dosage he is on now is not high enough to qualify and must be intended to dispel itching) in conjunction with the diet change or continue with surgery? As with other folks who have posted to this thread, I have been getting differing opinions from my vet and the dermatologist and I know there is no one “right” answer so it may just continue to be “trial and error” but this has been going on for a month now and I would like some resolution so my best four-legged buddy can get some relief. Thanks for your time and guidance.

  256. Doc says:

    Hello, Sandy,

    Sorry for the late reply.

    In some respects it sounds like your dog might be a candidate for the big prednisone dosage, and it would be worth exploring this with your veterinarian.

    It is possible that there are other medical reasons why this would be a bad idea with your dog, considering his age. That dose of prednisone is a LOT of medicine and the side effects can be significant.

    It’s always worthwhile to ask the questions and talk about it, but the doctors who are actually seeing your dog are much better equipped than I am to help you with your decision.

  257. Beth says:

    Hi Doctor, I have an 11 1/2 year old natural eared female boxer. She developed a hematoma in her left ear 19 days ago. Due to her age, we want to avoid surgery. To make her more comfortable, her vet has drained the ear using needle aspiration 6 times. The last time he drained it he also wrapped the ear to the top of her head hoping the pressure may help keep the ear from refilling. Unfortunately it refilled. She tolerates the aspirations quite well but the ear fills quickly and within 48 hours needs draining again.

    I have a couple of questions. First, I know from reading that the hematoma would eventually heal, leaving the ear somewhat deformed. That is not a concern of mine. What I’m curious about is, will the hematoma take longer to heal if we keep aspirating it? Will it heal at all if we keep aspirating it?

    My second question is, after 19 days, would high doses of prednisone still be a viable alternative? Would you be able to tell me the dose of prednisone needed for a 75 pound boxer?

    Thanks so much for your time.

  258. Doc says:

    Hello, Beth,

    My personal experience with aspiration has been a low success rate.

    The healing that takes place when you just leave it alone is secondary to pressure building up and stopping the leakage, and then very slow reabsorption of the fluid. It’s pretty uncomfortable while it’s full of fluid, though.

    So, yes, continuing to aspirate it over and over again while it refills over and over again would keep enough pressure from forming to stop the leakage.

    As far as using the prednisone at this point, I’d have some concerns about possible contamination of the area by the repeated aspiration. Remember that the dose is immunosuppressive, so in addition to stopping the leakage (we hope), it would really keep the dog from successfully fighting an infection in there.

    This makes it difficult for me to tell you whether it would be viable under these general circumstances. If I were to do that, I’d cover with antibiotics,too.

    As to dose, I really cannot prescribe for a patient that I have not seen. This is something you need to discuss with the veterinarian who is actually seeing your dog. He/she is best equipped to advise you.

  259. Beth says:

    Hi Doctor, After posting my questions yesterday, I would like to ask another. My boxer had another needle aspiration yesterday before I read your reply – her 7th. At the first, second and third aspiration, the fluid seemed to me mostly blood. As we continue with the aspirations, the fluid is becoming more watery. With each aspiration there seems to be less blood in it and more clear fluid – but it continues to be filling at about the same rate. Is the fact that the fluid is becoming more watery a good sign?

    Thanks again for your help.

  260. Doc says:

    “Is the fact that the fluid is becoming more watery a good sign?”

    Beth, I really don’t know the answer to that. Something is still leaking fluid, which keeps the ear from healing. I’d say that leaking fluid is better than leaking blood, but I don’t know if it makes a lot of difference in the healing process.

  261. Lisa says:

    My dog was given the prednisone about 3 weeks ago. About 3 days after the shot, she started to have dried blood around her anus. She has never had this situation before. She is eating, drinking & having regular bowel movements (No blood visible in the stool). I am wondering it this is a side effect of the prednisone or does the body not reabsorb the blood from the ear?

  262. Doc says:

    Hello, Lisa,

    This would not be blood from the ear.

    If your dog is taking prednisone daily at a high dose, there is some possibility that this could cause intestinal bleeding.

    If she just had a single injection, then the blood is from something else.

    It is possible that there is an anal sac infection if you are seeing no blood in the stool.

    This sounds to me like you need to call your veterinarian and let him/her know what is happening.

  263. Marianne Ogg says:

    I’m hoping this gets seen, even though the post is older…

    I have a 7 year old chocolate lab. He got bit by a cat (we’re guessing) on one ear 2 weeks ago. He had 2 puncture wounds, they both went completely through the ear. I shaved it and cleaned it up and have been watching it. I just noticed tonight that there is some fluid starting around one of the bit marks. He doesn’t seem to shake his head alot or hard, but I’m not next to him 24 hrs a day. Its about the size of a quarter right now, and the skin is not tight. Do I take him in? I’m ok if it takes a while to heal as long as he’s not in pain (I have Rimadyl on hand actually). But I’m not wanting to do surgery unless its absolutely necessary. Just thought it was odd that 2 weeks later its a problem.

  264. Doc says:

    Hello, Marianne,

    Since this started with a bite wound, I would be very concerned that the ear is infected, rather than a simple hematoma.

    I definitely would take him in to your veterinarian to get this seen. His whole ear flap could become one big abscess.

  265. Doc says:

    The Larsen teat cannulas might be available at stores that carry livestock supplies. I purchase mine from a veterinary distributor.

    This is really not something that I would recommend you trying at home. The potential for complications is pretty great when you don’t have the medical expertise needed.

    I would certainly recommend seeing your veterinarian about this.

  266. Helga Sommer says:

    Just come across this site and so thanks full for reading all this advice
    my 8 year old Labrador who ended up 2 weeks on Monday know with , Hematoma in her left ear ,
    I took her to vet a week ago when I noticed it . I been at vet and she drained it and Was filled again by time we home , I say it got bit bigger after draining
    she gave her some Antibiotics. some ear drops for bit sore ears she has but have to go back the ear drops seem to make it very inflamed after I put them in her ear ,looks very red
    She would not have sore ears but even after I said to the young vet I do not clean her ears with that solution , it does make her ear sore . Sure enough we ended up with both inflamed
    She was talking about Surgery but I not keen on it due to her age .
    Oh yes she also is a Diabetic but I have it well under control, also has allergies we do not know to what it is only in the hot times , winter no problems

    so reading on different site and looking for other options , I read about the sea Salt , arnica and Witch hazel .

    you talking about predneson , is it to late for that with her ?

    She is not shaking her had or scathing he rear , she lays on it it does not seem to bother her unless y press on it , it has a blue shine to it know
    I do not want to cause her unnecessary pain and discomfort through surgery.
    She seems fine and shows no signs of being in any pain. I think I am more distressed over the whole thing than she is.

    I been putting Betadine an antiseptic solution on and Comfrey ointment what is good for swelling and bruises .
    I just do not know what else to do , I do not worry about her ear not being perfect anymore , I just want her to be not in pain and get better .

    What else can I do ?

    thanks Helga from Australia

  267. Doc says:

    Hello, Helga,

    If your dog is diabetic, then the large doses of prednisone could very likely get her diabetes out of regulation. I would be very leery of using prednisone in your situation.

    If the ear cleanser causes irritation, then I certainly would not use it. Sometimes we as doctors are sure we know best, but when you have had repeated bad experiences with something on your particular pet, you need to stick to your guns on that one.

    Just because something works well for most patients doesn’t mean that it works for all of them. Your veterinarian has probably had very good results with the treatment on other patients.

    I cannot imagine how sea salt or witch hazel would help. Arnica and comfrey at least should not hurt.

    If you do not wish to do surgery, you could ask your veterinarian about simply getting something to control the dog’s discomfort until the hematoma finally resolves on its own (with the resulting disfigurement of the ear, due to scarring).

    The little drainage tube technique (the tube that is left in place) is one other option to talk about with the doctor.

    I am really not in a position to give you any specific advice, as I cannot see your dog and know its history.

    You really need to spend more time talking with your veterinarian and asking questions until you are both “on the same page”. Cruising the internet just tends to get more confusing as you go.

    Best wishes.

  268. Helga Sommer says:

    Thanks for fast replay ,yes u right the more u read the less u know what is right.
    I have to go back again today due to drops I got for the ear infection making it more inflamed
    so we need different once . poor Serena seems to get more allergic to different things .

    I my talk about the drainage tube technique and see , just worried about infection but will talk to vet
    It really does not appear to worry here and I do not worry about looks , if u see her with all her skin irritation u know one little defect want matter
    I love her regardless , she is the most gentle loving dog
    winter coming her allergies will go heaps better, we only have problems through the hot times
    I do stress so much about her
    thanks again for u input Helga

  269. lauren otto says:

    Thanks so much for the info you are providing. I have a cat who had an aural hematomia last year. I got the surgery and he has cauliflower ear anyway. The concern I have is that his ear is sooo wrinkled that it appears to be blocking the ear canal. I clean it out weekly and the qtips come out black. Any suggestions for me of how to treat this or the need for vet care?

  270. Doc says:

    Hello, Lauren,

    I would be surprised if the scarring of the ear flap is closing the ear canal enough to prevent the ear was from leaving.

    I would be concerned that excess wax production is due to some other problem, like an ear infection, or a polyp in the ear canal.

    It is also possible that the normal “self-cleaning” mechanism of the ear isn’t working right, and you just need some ear-flush solution like Epi-Otic to use once or twice per week.

    You have to be careful with q-tips that you are actually lifting stuff out without packing stuff down into the canal (this is tricky).

    In your situation, I would recommend that you let your veterinarian examine the ear canal and determine the reason for the excess junk in the ear.

    This is something that we just can’t do “long distance”.

    Good luck.

  271. Daniel Whitton says:

    Hello Doc.
    Iam amazed by the number of contributers on this link who are financially strapped and cannot afford the surgery. Many are worried about the anesthesia and the aftereffects. Please consider and call 1-877-748-1414 or write me about the Aural Splint;
    I am making another push for it’s acceptance into the industry.
    Daniel Whitton
    Aural Splint

  272. Doc says:

    Hello, Daniel,

    You sent me some info on this some time ago, but I just couldn’t visualize how it works from the pictures.

    If you want to send me one to look at, I’d be happy to return it at my expense.

    The Kennett Veterinary Clinic address is 1704 Saint Francis Street, Kennett, MO 63857

  273. Doggy Dogg says:

    Hello – My dog is a 12 year old mutt-terrier. He weighs 38 pounds. He’s got a big old hematoma. I have some Prednisone leftover (from a different problem another dog had, a big old now-dead Rottweiler) and seeing as that I can in no way afford surgery or a vet visit, I’d like to give it to him. Just unsure of the proper dosage / schedule. These are 20mg pills.

  274. Doc says:

    Hello, Doggy Dogg,

    There is no way tha tI can advise you to do this without the help and supervision of your veterinarian. Prednisone is a powerful drug with side effects that can be major. While this treatment can help a lot of dogs, it is not something to screw around with.

    In addition, it would be illegal for me to prescribe a dosage for you when I have not seen your dog as a patient.

  275. Holly says:

    I have an 8 year old black lab/great dane mix, 2 weeks ago he had minor surgery to drain a hematoma. We went for the less expensive surgery & were told that there was a chance the hematoma would return. Sure enough last Friday my husband noticed it was coming back. I feel like a horrible pet owner but having the surgery again to drain it is not an option at this point. I have read where you said the hematoma will eventually reabsorb & cause cauliflower ear. The ear is not anywhere near filled up as it was 2 weeks ago but I’m trying to keep him as comfortable as possible & start appling a cold compress about 3 times a day. My question is, is it best to flip the ear on top of his head & apply the compress (I’ve been holding it in place with a bandage wrap) or keeping the ear down? I figured putting the ear up would help with pressure as well. Thank you so much for your help.

  276. Doc says:

    Hello, Holly,

    The best person to advise you is the veterinarian who has seen your dog.

    That being said, all things being equal, over the top would be better than hanging down. That gets gravity working for you instead of against you.

    Always keep a close check on bandages to be sure that you aren’t cutting off circulation.

  277. liz says:

    Hi I have a 8 yr old retriever who has just had an operation for his hematoma. He had several stitches in his ear, and after 10 days (yesterday) had his stitches out. His ear feels liuke it is filling up again. Could this happen, or is it just casued by the reation of the stitches being removed? I thought once this procedure had been done, then it cannot reoccur

  278. Doc says:

    Hello, Liz,

    You need to let your veterinarian take a look at this. It could just be inflammatory swelling.

    Unfortunately, it is possible for hematomas to reoccur.

    Sounds like you may have a more stubborn situation than in most dogs.

    Time for a recheck appointment.

  279. liz says:

    Hi thank you very much for your reply.
    I have checked this morning and his ear is slowley filling up agian to how it was before he had the operation.
    The stitches were very lose, ans i cannot see how they could have fused the two parts of the ear together in order for it to seal- could this be the case? I really dont know what to do as this was an expensive operation, and to have to have this done again within a week of the operation being done in the first place surely cant have been done properly ? Its not good either having to put my poor dog thru it all over again??

  280. simon says:

    Can you let me know what damage it would cause if a small hematoma in a Retriever’s ear if left untreated. How long does it take for the body to re absorb. I really do not wish for my dog to have another operation, especially if this type of injury can keep re occurin. He has already had a repair done on one ear last year, now the other ear had developed one.
    Many thanks

  281. Doc says:

    Hello, Liz,

    I understand your concerns. From your description, it does not sound like the healing is going according to plan.

    I still think that the first step is to let your veterinarian know what is happening. When they don’t hear from you, they think everything is going okay. Give them a chance to evaluate it and fix it.

    If you are unhappy with their recommendation, then I would ask for referral to a specialist. This may take some time, but at least you’ll have a better idea of what is going on.

  282. Doc says:

    Hello, Simon,

    While the hematoma is swollen, it is under pressure, and pressure is uncomfortable. The dog may traumatize it further, causing it to get larger.

    Eventually (a few months), a clot will form and be reabsorbed. This leaves the ear puckered up (like the “cauliflower ear” of a pugilist).

    Your dog might be a candidate for the prednisone treatment. Ask your veterinarian about this.

  283. Cathy says:

    My 9 yr old Lab was treated for a aurla hematoma yesterday. The vet drained it and he was given antibiotics. He suggested surgery, but surgery will cost me $700. and I cannot afford that. Is there anything that I can do to prevent this from happening again

  284. Doc says:

    Hello, Cathy,

    If there was evidence of an ear infection (in the ear canal), then keeping a regular weekly ear-cleaning routine can help prevent that.

    If the dog had no evidence of ear infection or trauma, the dog may be one of the patients who has an immune-mediated vasculitis (where the body’s own defenses cause the blood vessels to leak). These are the dogs that are likely to respond to prednisone treatment.

    You might ask your veterinarian about his recommendations in these areas.

  285. CJ says:

    My 8 year old lab has a hematoma on her right ear. 3 weeks ago it was small, about the size of a quarter. We took her to the vet and he discovered she had an ear infection which we have treated. She was never shaking or scratching her ear. The next day after the vet, hematoma doubled in size. It’s pretty much the whole lower flap of her ear. It’s very thick and firm to the touch. I really don’t want to do the surgery on her so I have left it alone. It’s been 3 weeks now and it’s not getting bigger or smaller. It doesn’t seem to bother her, she sleeps on her ear and lays on it. Is it too late for the prednisone? Has it stopped bleeding inside so I could try the cold compresses? How will I be able to tell when it’s finally starting to clot and heal? Do these hematomas always go away by themselves or have there been instances where they never went away?
    Thank you so much.

  286. Doc says:

    Hello, CJ,

    At 3 weeks, I am uncertain how much help the prednisone would be. One could try it, but I would be less optimistic at this point. You don’t know until you try.

    The only way that I know to tell whether the blood is clotted is to attempt surgical drainage and see what occurs. This is not something to try at home.

    Do they always go away? Sort of. They always resolve eventually, but that generally results in an ear flap that is sort of wadded and wrinkled up by the scar tissue that forms. This is similar to the boxer’s (pugilist’s) “cauliflower ear”.

  287. CJ says:

    Thank you for your answer. I’m not worried about the look of her ear. It’s been 24 days since it tripled in size. At this point what would you do if it were your dog? Wait it out since your already 3 weeks into it or take a chance and drain it and possibly have it refill and be back to square one? I’m really confused at this point.

  288. Doc says:

    Hello, CJ,

    Again, it is difficult for me to give you meaningful advice, as I have not examined your dog.

    What would I do? My job is taking care of these things, not ignoring them. I probably would still give the prednisone a try first. If that didn’t work, I’d put the little ear-drain tube in next. That’s in MY dog, that I HAVE examined.

    Hard to say what you need to do. If you’re not happy with the communication at your current veterinarian, you might ask him to refer you to a specialist.

    Good luck.

  289. Harriet says:

    Hi :),

    I know that you are talking about dogs in this article but what would be the options with a ferret that has a hematoma???

  290. Doc says:

    Hello, Harriet,

    I had a similar question about two years ago. The ferret gurus on Veterinary Information Network felt that primary hematomas in ferrets are rare:

    “Ferrets will often aggressively bite at each others ears (especially intact males or ferrets with AGD), and I have seen these become pretty swollen. I have never seen a primary aural hematoma. I would want to rule out traumatic bruising before recommending treating a hematoma.”

    That being said, the other treatment recommendations were the same as for dogs, though surgery would be much more of a problem, due to the small size of the ears.

    Some of the folks felt it best to just ignore it and let it heal naturally (though it might not be so cosmetic).

    The other concern is whether or not this is actually a hematoma, rather than a mass of some type. Tumor is certainly a possibility.

  291. Harriet says:

    Thank you for getting back to me 🙂

    See I have 7 and they do fight with each other as playing but I took one to the vets who had a lump on her ear and the vet said it could either be a hematoma or a cyst but the vet did not want to use any anaesthetic on her so she just told me to let it heal naturally

  292. CJ says:

    Just wanted to let you know that I wrote to you in December. My yellow lab had an hematoma and we were 3 weeks into it. I didn’t want to do surgery and we decided to just leave it alone. After 7 long weeks it went away. Yes, there is scar tissue inside the botom of her ear, and yes it’s a little crinkled up at the bottom but that’s ok! It saved our Molly from a lot of pain and me a lot of $$. It really does go away if you leave them alone.

  293. Doc says:

    Hello, CJ,

    Thanks for the feedback. As you have observed, they will heal eventually, but it does take a long time. Also, while the pressure is great, I am sure that the dog is in some considerable discomfort.

  294. Catherine Smith says:

    Hi Doctor. My lab/shepherd mix has his first aural hematoma. 🙁 I am interested in your drain technique with the teat tube, but wondering how to keep the drainage contained somehow so it doesn’t end up all over the house. I was wondering if there was somewhere I could buy a small surgical drain and attach it in a fashion similar to your teat tube. Thanks for any recommendations.

  295. Doc says:

    Hello, Catherine,

    You have seen the weak point in this (or any surgical) treatment plan. Stuff drips out for a few days. It is messy. You could bandage the ear over the top of the head with soft stretch gauze to absorb the drips. It has to drain to allow the pocket to stay empty and stick down.

    The only way I know to avoid drainage dripping is to use the prednisone treatment.

    I really don’t have a recommendation for a do-it-yourself model on the drain insertion. Some dogs don’t require sedation, but some do. It needs to be done with sterile equipment, and suturing it in place is not something you’re likely to get right on your first try.

  296. Tiara says:

    My 13 year old Weimaraner has a AURAL HEMATOMA and I heard that if I got the surgery and the incision did not close then I would have to put him down. I dont want to do this I just really want to know what to do. I dont want him to be in pain but I also am not sure if it is in his best interest to go through surgery because he is so old. Do you know of any cases where a dog did not survive from the surgery ? Can you please give me some advice as to what I should do?

  297. Doc says:

    Hello, Tiara,
    I cannot imagine why you would have to euthanize your dog if the incision healed poorly. It would ooze and be messy, of course, and be a bit prone to be infected at that time.

    Any general anesthesia carries with it some risk. If anesthetic were good for you, you wouldn’t lose consciousness. Most patients can be managed successfully with our modern anesthetic drugs and monitoring equipment.

    Have you talked to your veterinarian about this, or have you just heard a bunch of scary stories?

    Talk to your veterinarian about this. It is not the end of the world.

  298. Michelle says:

    My dog had a drain put it last Thursday and we were back at the vet today to have it unclogged. He said that if it filled up again to pick at it, but that isn’t reopening it. In one of your responses, you mentioned using a needle to open it up. What size would you use. Are there any liquids that would help to dissolve what’s clogging the drain.

  299. Doc says:

    Hello, Michelle,

    I usually send home a small hypodermic needle, but I don’t see why you couldn’t just use alcohol to sterilize a straight pin and use that.

    Don’t squirt anything up into the drain. You might move some clotted stuff, but you would certainly introduce contamination. Very bad.

    Stay in toch with your veterinarian. He is your best source of info, as he has actually seen your dog.

  300. Angela says:

    My black lab has a large aural hematoma, after consulting with our vet we decided not to do surgery but let the fluid reabsorb. We have been treating the ear infection so the head shaking has stopped, but this morning his ear was bleeding. It looks like the hematoma broke open and I am not sure what to do now!

  301. Michelle says:

    How different in treatment are aural hematomas from bursitis? I had another Rhodesian Ridgeback who used to get behind his elbow. Draining the sac only responded the symptom, but it always took steroid injections from the vet to keep the inflammation down. Would a similar treatment benefit Mac?

  302. Doc says:

    Hello, Michelle,

    The bursa is sort of an extension of the joint capsule. The elbow has no padding on it, so it is easy for these structures to become irritated in a big dog where there is a lot of weight on it.

    The aural hematoma is leaking blood vessels, and is often unrelated to trauma. There are doctors who do steroid injections in this area, but I have not had personal success with that.

    As in the article, we always used to put some type of drainage mechanism in place, but now find that many of them respond well to oral steroids (prednisone). Then you don’t have to do anything invasive.

  303. Michelle says:

    Have you had any success with the oral steroids? The hematoma wasn’t naturally occurring. It was caused from a bite by another vaccinated dog.

  304. Doc says:

    Hello, again, Michelle,

    With a naturally occurring hematoma, I have had good success. I would not expect to be successful in using oral steroids where the hematoma is secondary to trauma.

    I would guess that this would require some drainage. It’s always difficult to know what to do when you can’t see the patient.

  305. Doc says:

    Hello, Angela from April 3rd,

    Not sure how I missed this. By now I am sure that you have contacted your veterinarian about this. I have never seen a hematoma rupture, so I am unsure what is going on. This would have required a hands-on exam, even if I had seen your post in a timely fashion.

  306. Jessica says:

    Hi Dr. –
    Thanks for the information. My 12 year old baby has a hematoma. She had both a bacterial and fungal infection which was treated by packing the meds in her ear canal on 4/13. The hematoma was also drained on that day and it, of course, filled back up. It has also gotten bigger, involving practically the entire pinna. The past few days I’ve noticed her shaking and pawing at it more. I’m hesitant to have the surgery if it is simply for cosmetic reasons. I do not mind what her ear looks like, I’ll love her no matter what. I just want to do what’s best for her and easiest on her. I’d hate to have her go through a surgery and painful recovery for cosmetic reasons. I know the hematoma is uncomfortable to her now but am wondering if I can just let it heal itself and provide her with some Prednisone to help with itching while it heals. Any advice you could offer would be greatly appreciated.

  307. Doc says:

    Hello, Jessica,

    The doses of prednisone that are needed to stop a vasculitis are pretty big doses. This is something that you and your veterinarian would need to discuss, as it would require his/her supervision.

    She might be a candidate for one of the small drain tubes.

    That really big ear is under pressure, and it’s pretty uncomfortable, and will be so for quite a while.

    Talk to your veterinarian about less aggressive alternatives than the big surgery, such as putting in the little drain tube.

  308. Kristen says:

    Hi my 7 year old cat developed a hematoma on his ear yesterday. I took him to the vet and have an appointment for surgery in 2 weeks! That’s the best they could do. I looked up something called yunnan baiuyan or something of the sort. Comes in a powder form and you mix it to a paste and apply. Do you have any experience with this?

  309. Doc says:

    Yunnan Baiyao is a herbal preparation that enhances clotting function. It has sometimes been applied directly to open wounds, sometimes taken orally.

    I would not prescribe a herbal remedy without consulting a veterinarian who is knowledgeable in this field.

    I would be surprised if it helped with the aural hematoma. With cats, I have had to do a surgical drainage procedure.

  310. Jackie says:

    Hi my dog had an aural haematoma last year and the vet successfully operated and placed a tube through the ear and lots of stitches in the ear to seal it back together. We have since had it in her other ear and had surgery again but when they removed the stitches, immediately the skin was loose and filled up with blood and we were told to use a compression bandage which did not help. They have now redone the operation – I am trying to establish whether the stitches were taken out too early which in my opinion is the case. Have you come across an aural haematoma reoccurring immediately after stitches removed after surgery?

  311. Doc says:

    Hello, Jackie,

    I don’t do that extreme surgery very often, so I’m probably not the best person to ask.

    I have certainly had the experience of having a patient return for suture removal after stitching a wound and they have not healed as well as expected. Sometimes things look okay, but after suture removal, we find that healing has not been complete,and we have to re-suture.

    There can also be other causes of slow healing, and your veterinarian has probably already considered low thyroid, diabetes, etc.

  312. Anj says:

    I have an 11 year old german shepherd lab mix who has a hematoma. She has had one in her other ear a about 3 months ago. I took
    her to the vet and we talked about options but because of her age and the fact draining has a low success rate we opted to let it heal on its own. After about a month it did go away. Now she has a very large hematoma on her other ear. I noticed it has been painful for her and she has been trying to scratch it open. This morning I noticed blood coming from her ear. She has broken it open and it is slowly bleeding out. I have been trying to keep it clean by rinsing the ear with cool water and using antibiotic cream and a medicated ear cleaning rinse. I can’t get her in to the vet until Friday. Is this something to be concerned about since she has broken it open? I’m woried about an infection and wonder if it will refill again. Any help advice would be greatly appreciated. Thanks!

  313. Doc says:

    Hello, Anj,

    I have never seen one break open like this in 35 years.

    I wold defintely try to keep it clean. Using the antibiotic cream around the edges is good. Putting anything inside will more likely carry contamination in with it.

    More drastic surgery for the problem does leave the ear open, but the ear is bandaged, and oral antibiotic medicine is used.

    I know that you can’t get her in to see her doctor before Friday, but I would recommend that you call for advice in the meantime.

  314. desiree says:

    I have a older border collie and she has a large hematoma like big enough to bust. And my dad was wanting to use a needle and force it out because we cant afford a vet to do it should we do it or not. How would we do it and what meds does she need to be on just need info if not will have to put her down because we know she’s in pain and don’t want her to be in pain.

  315. Doc says:

    Hello, Desiree,

    If you don’t do anything about this, the pressure will shut off the blood leakage, and it will eventually heal. It certainly is uncomfortable while it is under pressure. Also, it will heal in kind of a wadded up mess. It won’t hurt then, but it won’t look very pretty.

    Don’t give aspirin, as it makes you bleed more freely. Don’t give ibuprofen or naproxen (aleve), as they can cause very bad bleeding stomach ulcers in dogs.

    I cannot really recommend any pain medicine for you without seeing your dog in person.

    Putting a needle into it to let out the fluid generally is not very effective. Unless the ear is tightly wrapped with padding to keep it from re-filling with blood, it just fills up again.

    Every time you put a needle into it, you run the risk of introducing contamination. A sack full of bloody fluid is a great place for germs to grow, and you really don’t want to introduce any germs into that.

    Sometimes cool compresses will help relieve the discomfort.

  316. Tammy says:

    Hello Doctor,

    Thank-you for having such an interesting blog. My 5 year old female German Shepherd had a successful operation for a large hematoma (located in the center of her pinna) in April 2013. The ear healed well but was slightly misshapen when compared to the other ear, but it still stood erect. She just had another surgery last week in the same ear for another hematoma, this time located at the side of her ear closest to her head. Before the operation her ear was floppy and did not stand erect, but I thought that it was due to the liquid in the ear weighing it down. It has now been a week, and the sutures have not yet been removed, but the ear is still floppy. Our vet says that it might never be erect again. I will still love her even with a floppy ear, but I was wondering if there is something that I can do now to help the cartilage recover while it’s still healing, or whether there is something that can be done afterwards. My vet mentioned that the only thing that could be done, once it is healed, is to have another operation to insert an implant to make the ear stand erect, but she did not seem very enthusiastic about this. I would be very interested in your views about this and what, if anything, can be done so that the ear recovers. Thanks for reading this.

  317. Doc says:

    Hello, Tammy,

    Sometimes you can wrap and splint the ear, as you would with a Doberman’s after ear-cropping surgery.

    Unfortunately, the condition can certainly result in a deformed ear cartilage that just won’t return to its original state.

    My experience with implants to make the ear stand has been pretty dismal. I would be looking for someone who has done a lot of them and is confident in his/her technique.

    This may take a LOT of looking.

    People sometimes recommend a calcium supplement, but this is useless, as the cartilage contains no calcium in the first place.

    Your veterinarian who is actually seeing your dog is your best source of information.

    Good luck.

  318. Tammy says:


    Thank-you so much for your answer. I understand that there is no guarantee that the ear will recover, but in your experience, if I asked my vet to try the wrap and splint method, can or should this be done even though the incision has not yet entirely stopped draining and the sutures are still in? If we wait until the sutures are out, which should hopefully be not more than a week, would that be too late (i.e. is there a better chance to save the cartilage if this is done earlier)? Is it possible to wrap it with the sutures still in, and in your experience, would the splint have to stay there for many weeks? Thanks again for your much appreciated assistance.

  319. Doc says:

    Hello, Tammy,

    I would not wrap this with an open incision. The drainage would get really soupy in there.

    When we tape dogs after ear-cropping we leave the tape on for four days and off for two. This because the taping method I use totally encloses the ear and it just gets a little too moist in there after 5 days.

    There are many different ways of propping the ears, which clues you in that there is no one best way. If there were, that’s what everyone would do.

    The chances of success are unpredictable in my experience.

  320. Piper's Mom says:

    Thanks so much for having this blog and your responses have been so helpful.
    My 8 year old, 60 lb. black lab has had a hematoma in her ear on and off for a couple of months. We tried the drain twice with short term luck. She has had no ear infection, so the Vet prescribed her prednisone and mentioned vasculitis. You talk about a high dose, but what would a high dose be? Also, she is prescribed this for three weeks at the same amount. Should I be concerned about tapering it off and do you think that the three weeks is long enough? If this works, would she need to be on the prednisone long term? Also, I just wanted to get your opinion on the side effects of the prednisone, should I be concerned?

    Thanks again for all your helpful advice!

  321. Doc says:

    Hello, Piper’s Mom,
    I really can’t give doses for dogs I haven’t seen.

    The dose that is used is high, and would be considered the “immunosuppressive dose”. That means it is enough to partially shut down your immune system so that the body’s defenses are not overreacting to stuff they shouldn’t. This is the type of dose that is used when the body’s defenses are attacking the bone marrow, for instance.

    This doses is usually continued until the hematoma is all shrunk down. Then I personally like taper off the dose slowly, reducing by 1/4 of the dose at no less than two-week intervals.

    I am sure that your veterinarian will be monitoring your dog’s progress. You need to keep your doctor informed as to the dog’s progress every few days.

    The side effects that are most noticeable are excessive urination (requiring lots of water to make it up), and increased appetite.

    The body can become dependent on the high dose of cortisone, so that is why we taper it off slowly, in order for the body to re-start its natural cortisol production.

    Prednisone does have other side effects, but they usually resolve as the drug is tapered off. Unless your dog is hypersensitive to the drug, I wouldn’t expect ay long term problems.

    You really should have this discussion with your veterinarian. We often think that we have done a good job explaining and answering all questions, when people really want to know a little more. Don’t feel bad about asking questions. Your doctor would much rather talk to you personally than have you trolling the internet.

  322. Mary Simmons says:

    My 9 year old Basenji had aural hematoma surgery two weeks ago today. S-incision. The vet used a plastic device that she tacked to his ear with multiple plastic tacks. This was removed yesterday as infection started setting in around a few of the tacks. The incision is healed and the back and front are adhered together. The ear is still lopped over. Do you think the appearance will be normal ever again? There is scabbing and it’s only been 2 weeks. He goes in for a re-check on Monday (it’s Friday) and I will definitely talk to her then.

  323. doc says:

    Hello, Mary,

    The fact that one can find so many different ways of handling this problem is a dead giveaway: there is no good way to handle this problem.

    The vast majority of dogs whose ears require a surgical remedy will wind up with some disfigurement. The scarring process that sticks everything together tends to pucker things.

    If you had left it untreated, it would have wound up looking much worse, plus the dog would have been painful for much longer.

    Try to think of it as “adding character”.

  324. Jessica says:

    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 Awful. 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.

    Based upon the care that we’ve received from this vet so far I would not consider him a reliable source of information nor the least bit open to consultation with me. I hesitate to even return to him for suture removal. Unfortunately I could not afford the traditional pricing to take him to another vet, however. I just don’t know what to do. Please advise!

  325. doc says:

    Hello, Jessica,

    I can only give you general advice, as I have not seen your dog.

    My personal preference when sending home a dog with an open, draining wound (standard for hematoma surgery) is to keep them on antibiotics until it closes.

    The head-shaking could be post-operative discomfort, or it could be an ear canal infection or inflammation.

    If there is an ear canal infection, the ear must be thoroughly cleaned to remove all debris before medicating. You can’t put medicine in on top of wax, dead skin and pus and expect it to do any good. This type of cleaning in a painful ear often requires sedation, sometimes anesthesia.

    Dogs who have chronic recurring ear infections usually have some other underlying problem, most often an allergy. This can be a food allergy or an environmental allergy.

    This can be difficult to sort out. Here’s an old post on food allergy:

    Allergies to environmental things often need systemic treatment with a form of cortisone. Ear canals that are swollen and painful often need this type of medicine to reduce the swelling to a point where you can clean out the ear canal.

    These situations frequently do not have simple remedies, unfortunately.

    If you do not have confidence in the doctor you are working with, you need to find one that you do have confidence in. This cannot be treated “long distance”.

  326. Blanca says:

    Hi, my dog developd a pretty big hematoma on one ear and half size on the other. Took her to vet and they gave her ear drops and antibotic. After a week of it not going down vet said that surgery was the best way. Spent $350+ when I went to pick her up her ears were less big BUT not completely flat. Vet said the swelling was coming back. Why do vets do surgeries then??? if they KNOW that its not thebest option! Now my dog is back to having huge ears and now has OPEN/bleeding wounds were the vet cut. How can I help my dogs ears heal?? Pls advice! thnank you.

  327. Doc says:

    Hello, Blanca,

    It is hard to predict the outcome of any surgery. Every patient is different.

    Surgery is the best option for many patients. When appropriate, we do try medical means, but that certainly does not always work.

    Usually when the hematoma is treated with a large incision, the ear is also sutured to eliminate the pocket.

    You say the the swelling is coming back. Usually the best person to advise you is the doctor seeing your dog. What did they recommend? Surely they didn’t just say, “swelling is coming back. Tough luck.”

    Get in communication with the doctor and let them know that you have unanswered questions.

    If the doctor who has treated the dog doesn’t have a good suggestion, then I would ask friends for referral to a doctor that they trust for a second opinion.

    This is not something that I can really help you with “long distance”.

  328. Stevi says:


    My 7 year old silver lab Max has aural hematoma surgery a few days ago. I was required to leave his bandaging on for 2-3 days to prevent infection and avoid any mess from extra drainage. I removed the bandage today after 3 full days and noticed the tip of the straight line cut in his ear had not fully clotted. Even with the lamp shade collar on he still manages to shake a little causing slight bleeding. Will the cut eventually close up fully or should I rebandage his head for longer?

  329. Doc says:

    Hello, Stevi,
    I think that it will eventually close up. However, this is the sort of thing that I really cannot advise you on without seeing your dog.

    You should really call the doctor you are working with. I am sure that he/she will want the feedback, and this is the person best equipped to advise you.

  330. Leanne says:

    Hi. My Golden Retriever shook his head close to a railing and smacked his ear. A day later I noticed him developing an aural hematoma.
    This happened 2 weeks ago today. Prednisone treatment was started 2 days after the incident. My vet said she hasn’t performed surgery on a hematoma in years now and gave me a prescription of prednisone .5mg/kg BID for 4 days then SID for 4 days then EOD for 4 doses. His hematoma is not necessarily responding to the treatment (it is about an inch big) I continued with once a day treatment for a longer period of time due to this. Just spoke with my vet and we are going back up to twice a day doses until I notice a difference. Can you tell me if you have seen the pred work in this kind of senario and if so is there a rough time period I should expect for resolution. Also how much scaring or disfigurement should I expect. Is it generally less with pred use as opposed to leaving it to heal on it’s own or with drainage and steroid injection. I noticed the dose I was given is not necessarily immunosuppressive but my vet said all but one she has seen resolved (or they never came back, so assumed they healed well) Have you had success with low dose pred rather than a high dose? Thank you in advance

  331. doc says:

    Hello, Leanne,
    I have not had luck with lower doses. My personal experience has been a need for the higher doses, but that doesn’t mean that every patient needs that.

    I have seen the best cosmetic results in the dogs that respond to prednisone. They often have zero scarring and deformation.

  332. Leanne says:

    Thank you for the response. At what point (how long) does one assume there is no response to the use of prednisone? I am contemplating having it drained and injected with a steroid. It’s so hard to know what to do. I’m hearing conflicting opinions. Many people on the discussion groups massage them 3 times a day and have success. I just want this to heal up quickly with the least amount of scaring.

  333. Dominique says:

    Hello my mother in law has a 16 year old cat with a ear hematoma .. we had it drained about 3 times by the vet.. and after discussing options they showed me how to drain it at home to save the 60$ vet visit each time… we are not interested in doing the surgery because of his age and also the cost.. and they have not idea about the ” prednisone treatment” or leaving a tube in… my question is.. how many times will i need to drain it before it starts to heal? or will it ever heal?.. he is on a steroid medicine that was given from the vet.. and they sold me the surgery 20gage needles that has a hole to drain… i don’t mind doing it and after i drain we hold the flap tight so that it has time to heal… and the cat seems alright and kinda happy to see me ( i guess it relives the pressure when i drain it) thanks so much i hope we can save him and not have to decide to put him down because of this ear issue…

  334. Leanne Tucker says:

    I keep checking back for a response to my second question. Please let me know your thoughts. Going in to the vet today for possible draining and injection with Depo medrol. I’ll see what she says but I would love to know your experience with just pred alone. Do I need to be more patient and give it more time.
    Krinkling of the ear is my main concern. Since I show this dog I really would be heart broken with a deformity like this. Again his hematoma is small in comparison to most (a big fat toonie -if you live in Canada you know the size ) or a 1″ in diameter bubble. I have had him on .5mg/kg pred BID for the past week.
    Thank you

  335. Doc says:

    Hello, Leanne,

    Sorry for the delay, I was out of town for a few days. I would give up on immunosuppressive dose of steroids after two weeks if no improvement(still need to taper off slowly).

    I really don’t have any experience with injecting them or massaging them.

    Sorry I can’t help you there.

  336. Doc says:

    Hello, Dominique,
    I haven’t had much luck with draining the hematoma. I used to do this, then try to wrap the ear around a soft core with tape to keep the layers compressed together. I rarely had success.

    If you just drain the fluid through a needle, my experience has been that they routinely refill.

    Doing this, you must be careful not to introduce any infection during the process. A blood-fluid filled sac is a great place for germs to grow.

    Nobody dies from an aural hematoma. If you let them stay full, they eventually organize and shrink up. This usually wads the ear up and disfigures it quite a bit, but it’s a cosmetic problem rather than a medical problem.

    The real difficulty is the amount of discomfort while the thing is swollen. Swelling equals pressure and pressure equals discomfort.

  337. dominique says:

    Thanks for the reply.. Well its been about 5 days in a row that I go and drain the ear myself.. So your telling me that you can leave the ear and it will heal and shrink.. But by doing so the pressure will be painful for the cat?..the ear won’t explodeand do a huge mess and damage? Urgh.. I’m also worried that it will form infection if I keep poking and draining every single day.. Would you leave it and hope that it heals on it own.. Or would you just decide to end this old cats life? We are not sure what to do anymore.. With no sign of healing and filling up so quickly.. Cat seems in good spirit.. Eats.. Drinks.. Purrs.. Such a tricky situation..

  338. Doc says:

    Hello, Dominique,

    It is always difficult to make an accurate prediction for a patient you haven’t seen, and your best advice should be coming from the doctor who has seen your pet.

    That being said…

    The ear will not explode, or if it does, it will be the first in history. Take pictures.

    But I don’t think it will explode.

    Yes, the pressure will be uncomfortable for at least the first week.

    Let me see… cat is in good spirits, will be uncomfortable for a week or so. Maybe I should just put him to sleep now? No, I don’t think that is what I would do.

    If medication doesn’t work and surgery isn’t an option, then I would let it rock on until it heals on its own. It will be slow, and the ear will crinkle up like a raisin, but it won’t be hurting at that point.

  339. Stephanie says:

    I had no idea there was such a thing as a dog having a hematoma on an earlobe until it happened to my dog. He is 15 years old and my second child.

    We took him to our family vet of over 30 years. They have told us that surgery would be best for him, however they are going to do blood work first to make sure he is up for the surgery due to his age. I have no problem spending the money for this surgery, I am just extremely nervous that the risks are high due to his age. They have told us that the risks are high due to his age and it would be like putting an 85 year old man to sleep for surgery.

    I am wondering if I should see about leaving it alone and dry up on its own??

    He is practically blind in both eyes, hard of hearing, and has a massive tumor on his stomach that is attached to his rib cage. That makes him sound like he is on his last leg, but actually he is in good health and I want him to live much longer.

    I don’t want to make this choice of surgery if it may cause him to die and I could have left it alone and him live with this also along with the tumor he has had for years.
    Any advice or comments would be greatly appreciated.

    Thank you.

  340. Doc says:

    Hello, Stephanie,

    If this is left untreated, there will be some significant discomfort due to the pressure of the swelling. It will take a long time (weeks).

    You may be thinking about the prednisone treatment. It takes a big dose, and your dog’s doctor would have to evaluate the advisability of using it in such an old dog.

    I cannot really speak to what I think is best for your dog without having seen him.

    The best advice I can give you is to keep asking your veterinarian your questions until you feel you have them answered to your satisfaction.

  341. Michelle Cone says:

    My 4 year old boxer had surgery 3 weeks ago for a hematoma. We woke up this morning to find she has it again. The vet suggested that she had a food allergy and change her to an all lamb diet so this won’t happen again. Is it common for the hematoma to be recurring? We unfortunately can not afford the surgery again so I’m not sure what to do.

  342. Doc says:

    Hello, Michelle,

    I can only speak in general terms, as I have not seen your dog.

    If there was no ear infection, and the surgery is well healed, then one could be suspicious of the immune-mediated vasculitis. This is where the body’s own defenses are damaging the blood vessels and causing them to leak.

    Treating these with prednisone is often successful, but requires large doses, and careful supervision by the veterinarian.

    If food allergy is indeed the case, it takes four to six weeks to see any improvement in most patients, with 12 to 16 weeks needed for full resolution of signs.

    Dietary elimination trials are simple in theory, but require very strict dietary management with no cheating. A lamb protein source may help, but if the allergy were to another dietary ingredient it may not help.

    I would suppose that your veterinarian has good reasons for the recommendation, having access to information about your case that I just don’t have.

    You might ask him about the prednisone treatment, or the possibility of consulting a veterinary dermatologist if one is within driving distance.

  343. Doc says:

    Hello, Jason,

    This is a difficult question to answer. Scar tissue shrinks as it matures. Taking out scar tissue will result in more scar tissue. It may be possible to achieve a more cosmetic result than you now have. However, I wouldn’t count on it.

    You really need to let a veterinary surgeon look at the dog to make any determination on what you can expect.

  344. Anne says:

    I have an 11 yr old boston terrier who had a hemotoma about 3-4 weeks ago. We did not have surgery or any treatment at the time as it seemed to rapidly get smaller. He now has a small deformity at the site. Is there any advantage to having surgery at this point? He does not seem to be in pain and does not scratch the ear or shake his head excessively. We have surgery scheduled for him in a couple days, but I’m not sure if it’s a good idea, as he is older and sensitive to some medications. The ear’s deformity is not all that bad. We would only have the surgery done if it is necessary to prevent future issues. I would like your opinion on any advantages or disadvantages to surgery at this time.

  345. Doc says:

    Hello, Anne,
    If the hematoma is shrinking and the dog does not show any discomfort, there would not be any advantage to doing surgery. Even with surgery there is usually some slight deformity of the ear.

  346. Michael Brown says:

    Good day Doctor; I’m happy to have found this page.

    My wife has a Labrador retriever guide dog who just had his tenth birthday. Perhaps four years ago, he developed an aural hematoma on his left ear. We brought him into the local vet, who performed the surgery as you describe in the article above. Even with the discount the clinic applies to guide dogs, the treatment ran us several hundred dollars (also, possibly due to premature removal of the drain tube, the procedure had to be repeated immediately, and he got a cauliflower ear on the pinna anyway).

    Two days ago, the dog showed us a hematoma on his RIGHT pinna. The vet clinic indicated that the financial outlay for performing the surgery now would again be substantial, and the doctor was supportive of our using a less costly avenue, should one present itself.

    It HAS presented itself; yesterday I drove the dog out to the school where he had been trained, and he is scheduled for surgery tomorrow.

    In our eagerness to find the most cost-effective solution, we may have neglected to consider everything we should have. My wife is now concerned that a three-day wait between the presentation of the hematoma and the treatment may have exposed the dog to medical complications.

    With the understanding that you have not examined this patient, could you please explain what the risks are of delaying surgery for this much time? Thank you for your time, and for making this resource available.

  347. Doc says:

    Hello, Michael,

    I would not be concerned about the delay. Some surgeons actually prefer to delay in order to let the clot organize, rather than having the ear bleeding freely at the time of surgery.

    I recommend that you rely on the advice of the doctor who will examine your dog for the surgery.

  348. Lori Cronshaw says:

    Hi Doc, my 9 year old pit mix has suffered from allergies and ear infections all his life. Yesterday morning a noticed a small hematoma on his ear and got him to a reduced cost vet instead of his regular vet cause money is tight. They put him on prednisone antibiotics ear drops and a antihistamine. They also recommended a hot compress once a day. After all my reading up on the subject, could me and the vet tech had a miscommunication? Since it is a reduced cost clinic it is very difficult to get answers on the phone. 12 years ago I went thru this with another dog and it was a 3 surgery nightmare. Not to mention the cost. What do you think, hot or cold? So far there is little change in the hematoma. But it has only been 24 hours. Thanks for all you do…..Lori

  349. Doc says:

    Hello, Lori,
    Cold makes blood vessel shrink, close down. That is what is indicated when the injury is fresh, to stop the leakage (or slow it down). Cold compresses ( NOT ICE, it’s too cold and will damage tissue) applied for 20 minutes three times daily can be helpful.
    Once the condition is chronic, heat causes vessels to open up, which usually speeds healing. I’m not too sure it will be all that helpful with an aural hematoma, as they are sometimes caused by a vasculitis, an inflammation of the blood vessels. Opening them up may increase the leakage.

  350. Lori Cronshaw says:

    Hi Doc, Thanks for your prompt answer. I have switched to cold compress 3 times a day. Needless to say my Duke does not appreciate the cold compress like he does the hot compress. Knowing my dog’s history as I do, and based on my reading all your posts on this subject I would have to guess his hematoma is related to his lifelong battle with allergies and his immune system.. But he is my buddy and my rescue. So I am currently thinking I am not going to subject this animal to the surgery. The surgery is brutal, as I previously mentioned I have been thru it with a past pet. Do you think I will have a difficult time getting a veterinary professional keep him comfortable till his ear turns to cauliflower? He is one of two dogs. And I have two cats. All of them are rescues from my career in Law enforcement. When I grabbed Duke, he was 4 months old, skinny as a rail and his name used to be Kilo. He had ear infections and skin infections. And husband and I have dealt with that from the day I brought him home. But OMG what a good boy! So what do you think? Out of fear over the surgical end of this mess and the expense, I sought out a cheaper solution. But now I am thinking he should see his same vet he has had since I brought him home. But I am adamant. I am not putting him thru the surgery. I just will not tolerate him in pain or discomfort. Just want him to be comfortable. A little advice will go a long way here! Thanks for your blog! I really educated myself here!..thanks again!….Lori

  351. Lori Cronshaw says:

    Hey Doc…sorry to bug you again. I really do not care if his ear turns into a piece of cauliflower. I just do not want him to suffer. He will always be handsome to us. Thanks again for your blog. ….Lori

  352. Doc says:

    Hello, Lori,
    I would definitely recommend seeing your regular veterinarian.

    Tell him your decision, and ask him to work with you in controlling your dog’s discomfort.

  353. Lori Cronshaw says:

    Doc, I know we are becoming a pain in the butt. After 3 surgeries on our previous dog that went thru this I complained to the vet that this was not acceptable. And they had me meet with the much older and more experienced owner of the animal hospital that talked me into one more thing. He drew the fluid out of my Dalmatians ear with a syringe. And after 3 very expensive surgeries that solved the problem. I believe that was because of the 3 previous surgeries. My husband thinks we should ask the vet for that course of action. Note previous surgeries were on a Dalmatian, so you know we are dedicated dog owners. That dog lived to be 14. I have noted drawing fluid out can cause further damage due to infection or further bleeding from already damaged blood vessels. I don’t see any reputable vet going for that course of treatment but have to indulge husbands idea of maybe we can save Duke’s ear. Should I explore that avenue? I am already satisfied with your previous answer. Just gotta deal with my better half…..Lori….ps after all we put you thru I will send you a picture of Duke. He is such a good boy, and handsome devil.

  354. Lori Cronshaw says:

    I noted Dalmation cause anyone out there that can survive 14 years of Dalmatian ownership can survive anything! He was not without issues, but WOW! By time he left this world he was brilliant!

  355. Doc says:

    Hello, Lori,

    My experience with simply drawing out the fluid has been unrewarding. They invariably fill back up with fluid. I have drained them with a needle and then wrapped them snugly around an absorbent core and had rare successes that way. Most of them required some sort of surgical drainage.
    Now we always try the prednisone first.

    If that’s a bust, then we use the drainage tube. Once in a very great while we have to do the more major surgery.

  356. Lori Cronshaw says:

    Hi Doc! Lori again! Today Duke has his ear drained by his regular vet. I wish I would have seen your post before we went for this treatment. But since we have been home he is doing much better than he has throughout this 9 day ordeal. I took all of his meds that were given from the low cost clinic. Dukes regular vet identified the steroids as being “a drop in the bucket for a 75 pound dog”. However his ear “drained like a champ” for a now 9 day old hematoma. Husband and I are still against putting our dog through the surgery. And by the way regular vet recommended cold compress for 5 minutes every hour and I am adhering to that direction. Now that his ear has been drained duke seems to love the cold compress. Regular vet also gave him a shot of steroids, reviewed all the meds he is on and recommended we keep him on the antihistamines and antibiotics,but discontinue the steroids. Keep your fingers crossed for us and thanks again for all your advice! I will let you know how this turns out!….Lori

  357. Lori Cronshaw says:

    Me again. Our much loved regular vet also informed me there is a 50 percent chance this will not work. So we are aware of the pitfalls. Just trying to avoid the surgery.

  358. Lori Cronshaw says:

    So in spite of our best efforts, Duke’s ear filled up again.. I just happen to be off for the next week because I have relatives coming from out of state. We have been in touch with Duke’s vet. Duke does not seem to be in any pain. But per vets instruction we are still applying cold compresses. Any advice?

  359. Lori Cronshaw says:

    So I have read everything you have written about a drain surgically implanted. So far none of my medical professionals have mentioned this course of treatment. Should I bring it up? I don’t want to seem like a know it all. And as you have said, it.can be irritating to have a patient that is researching stuff on the internet..any advice is welcome..thanks….Lori

  360. Doc says:

    Hello, Lori,

    It is possible that your veterinarian has tried drains and been disappointed with the results, or may never have tried them. When a doctor isn’t comfortable with a technique, doesn’t know its track record, and so forth, he/she is going to be reluctant to try it.

    If I were going to suggest it, I might just ask if they have ever seen it tried, and what they think about it.

    When somebody tells me something they have found on the internet, I want to know the source so that I can evaluate it. I am well aware that I don’t know everything. On the other hand, sometimes the source is so ridiculous that it gives the owner a new perspective on what they have read. A case in point being the heartworm article written by a person who is “noted for her articles on gardening”.

    I don’t have a problem with you providing them a link to my post. I got the technique from a veterinary journal article, and it has worked for me in a number of cases (NOT ALL, by any means).

  361. Lori Cronshaw says:

    I will address this with our vet on Monday morning. We are very interested in the drain that was illustrated in your earlier blogs on this subject. This is a rural Gulf Coast County in North Central Florida. For now it is cold compresses every hour for 5 minutes. There are many cows in this county. I find it hard to believe that my animal hospital (they do housecallsfor livestock) is unaware of this course of treatment. I will let you know what happens. Thanks for your guidance and support..Lori

  362. Lori Cronshaw says:

    On the upside Duke continues to rest comfortably. But after all this prednisone he has gained 6 pounds. His whole life he has maintained a constant 67 pounds and we are careful to maintain his weight. He is now 73 pounds. He is still playful with his 94 pound much younger brother, but takes to the couch more than usual. Other than yesterday morning he has not displayed any signs of pain. I say ear…And he jumps on the couch for his cold compress. Thanks again for your advice..Lori