Harper and Drew got into a fight over a rawhide chew on
the 7th of February. I was unable to get to them with a spray bottle to
break it up, so it lasted longer than an ordinary fight. Toward the end I
heard yelping. Not a good sign. As usual after a fight I checked the
both of them over really well.
While Drew was fine, Harper had a number of minor lacerations to the outside of his ear or pinna. He shook his head before I could clean him up and stop the bleeding. I later found blood on my bathroom mirror and the top of my toilet from a 23 lb dog shaking his head. But the shaking did more than dirty up the bathroom.
I checked Harper's ears the next day and found a squishy but painless swelling the size and shape of a lima bean on the underside of Harper's pinna. Hmmm... lima bean. I planned to let it go, and if it was still there when my dogs went for their annual visit in March, I'd let the vet know. A week later it was still painless but it had the thickness of large baby carrot and extended about 2 1/2 inches down to the tip of his pinna. The weight of it caused his ear to hang low. The next day the vet pronounced the swelling an aural hematoma.
The pinna is composed of cartilage sandwiched between two layers of skin. If a capillary is injured it can leak out stretching and filling the space between skin and cartilage. For most dogs, repeated head shaking causes the injury.The usual cause for this shaking is an ear infection or ear mites. Harper's ears were free from infection and mites. Trauma was the cause of his hematoma. His head shaking must have busted a fight-injured capillary or increased bleeding from one that was already ruptured from the fight.
My vet explained three methods of treatment, two of which she would not do.
1. Aspiration- Removing blood via syringe. My vet said she would have to sedate Harper to do this, or he would shake his head and make a mess of the place. Apparently, blood will also come right back to fill up the empty space in the pinna. Vet did not recommend this approach.
2. A Teat Cannula- Originally developed to drain infection from a cow's udder, this cannula can be put into a dog's pinna and held in place with a stitch. It will allow the blood drain slowly over time, but it requires a dog (or cat) that will tolerate a plastic tube in its outer ear, and an owner willing to check it daily to keep the tube unclogged. By preventing clot development, it is supposed to prevent cauliflower ear. The vet said that the practice does not do teat cannulas because they have mixed results and require just the right dog and owner.
3. Surgery- The vet makes a crescent moon shaped incision in the ear, drains the fluid, removes any clots, and then places stitches in a quilt-like pattern to avoid leaving an empty pocket that may just fill back up with blood. The incision isn't stitched; it heals like a cut since the two layers of skin and cartilage are held together tightly from the broadly spread stitches. My vet recommended this as the only way to get rid of the hematoma and prevent the dreaded cauliflower ear. Oh, and it would cost $1,300!
I've also read of aspiration followed by an injection of cortisone into the hematoma or a dog being placed on only oral steroids like prednisone.
The final option is to do nothing and let it go away on its own. It is essentially a huge blood blister; the body will eventually reabsorb the blood. But there is the specter of cauliflower ear. As the hematoma ages, the blood forms clots. During healing the skin will adhere to the cartilage surrounding the clot first while the clot may take months to reabsorb. Once the clot is gone, it leaves bubbled, wrinkled skin behind. This is a concern for show dogs and feline fashion models, but unless the pet is in pain or the hematoma is massive, this is a condition that doesn't have to be treated.
Since Harper was not in pain, the hematoma did not continue to grow, and my dog has been through more than his share of surgeries, I opted to let it go away on its own. Had he been in pain, I would have gone to a different vet to get a teat cannula. To see if I can prevent cauliflower ear, I've been massaging it a minute or two every evening. At the beginning the skin was very taut so I did the best I could trying to move the blood around a little. I'm pleased to say that twenty days later its size has decreased by three-fourths, and it is much more malleable than before. I haven't noticed any scarring or deformity so far.
While Drew was fine, Harper had a number of minor lacerations to the outside of his ear or pinna. He shook his head before I could clean him up and stop the bleeding. I later found blood on my bathroom mirror and the top of my toilet from a 23 lb dog shaking his head. But the shaking did more than dirty up the bathroom.
I checked Harper's ears the next day and found a squishy but painless swelling the size and shape of a lima bean on the underside of Harper's pinna. Hmmm... lima bean. I planned to let it go, and if it was still there when my dogs went for their annual visit in March, I'd let the vet know. A week later it was still painless but it had the thickness of large baby carrot and extended about 2 1/2 inches down to the tip of his pinna. The weight of it caused his ear to hang low. The next day the vet pronounced the swelling an aural hematoma.
The pinna is composed of cartilage sandwiched between two layers of skin. If a capillary is injured it can leak out stretching and filling the space between skin and cartilage. For most dogs, repeated head shaking causes the injury.The usual cause for this shaking is an ear infection or ear mites. Harper's ears were free from infection and mites. Trauma was the cause of his hematoma. His head shaking must have busted a fight-injured capillary or increased bleeding from one that was already ruptured from the fight.
My vet explained three methods of treatment, two of which she would not do.
1. Aspiration- Removing blood via syringe. My vet said she would have to sedate Harper to do this, or he would shake his head and make a mess of the place. Apparently, blood will also come right back to fill up the empty space in the pinna. Vet did not recommend this approach.
2. A Teat Cannula- Originally developed to drain infection from a cow's udder, this cannula can be put into a dog's pinna and held in place with a stitch. It will allow the blood drain slowly over time, but it requires a dog (or cat) that will tolerate a plastic tube in its outer ear, and an owner willing to check it daily to keep the tube unclogged. By preventing clot development, it is supposed to prevent cauliflower ear. The vet said that the practice does not do teat cannulas because they have mixed results and require just the right dog and owner.
3. Surgery- The vet makes a crescent moon shaped incision in the ear, drains the fluid, removes any clots, and then places stitches in a quilt-like pattern to avoid leaving an empty pocket that may just fill back up with blood. The incision isn't stitched; it heals like a cut since the two layers of skin and cartilage are held together tightly from the broadly spread stitches. My vet recommended this as the only way to get rid of the hematoma and prevent the dreaded cauliflower ear. Oh, and it would cost $1,300!
I've also read of aspiration followed by an injection of cortisone into the hematoma or a dog being placed on only oral steroids like prednisone.
The final option is to do nothing and let it go away on its own. It is essentially a huge blood blister; the body will eventually reabsorb the blood. But there is the specter of cauliflower ear. As the hematoma ages, the blood forms clots. During healing the skin will adhere to the cartilage surrounding the clot first while the clot may take months to reabsorb. Once the clot is gone, it leaves bubbled, wrinkled skin behind. This is a concern for show dogs and feline fashion models, but unless the pet is in pain or the hematoma is massive, this is a condition that doesn't have to be treated.
Since Harper was not in pain, the hematoma did not continue to grow, and my dog has been through more than his share of surgeries, I opted to let it go away on its own. Had he been in pain, I would have gone to a different vet to get a teat cannula. To see if I can prevent cauliflower ear, I've been massaging it a minute or two every evening. At the beginning the skin was very taut so I did the best I could trying to move the blood around a little. I'm pleased to say that twenty days later its size has decreased by three-fourths, and it is much more malleable than before. I haven't noticed any scarring or deformity so far.
