Hematomas are blood clots. In the case of ear flap hematomas, for reasons that aren't exactly clear, the fragile little capillary beds in the ear flaps become inflammed or injured and leak blood and/or serum into the space between the skin and and the cartilage of the ear flap. This makes the flap swell and is quite uncomfortable.
This is a fairly common problem in both cats and dogs, but especially in Retrievers and dogs with floppy ear flaps.
Often, but not always, there are underlying ear infections, ear mites, excessive wax, foxtails, porcupine quills, or chronic allergies that help explain why there is more than normal vascular pressure and irritation. Frequent head shaking (due to itchy or painful ears) seems to be one possible underlying cause.
If left untreated, the ear will be painful and to different degrees is likely to scar up in what is referred to as a "cauliflower ear" or sometimes as a "boxer's ear" This refers to human boxers (fighters), not the K-9 type of Boxer.
Medical Treatment without surgically draining the fluid and clot under the skin usually fails but sometimes we can successfully treat hematomas with medicine and time. Possible treatments your vet might try include:
1. Topical solvents like diluted DMSO that help draw out the fluid from under the skin. The DMSO is often mixed with antibiotics (gentocin) and steroids (dexamethasone). We vets are used to using this unapproved treatment quite successfully for snake bite swellings, and it sometimes works for ear hematomas.
2. Injecting cortisone directly into the ear flap works in a percentage of cases. The injection is usually repeated weekly for 1- 3 times til better. If not much improved withing a few weeks, then surgery is recommended. This treatment is often combined with oral prednisone for about 10 days.
3. Underlying ear infections, mites, etc, if present are treated at the same time. Also expect your vet to send home medications to ease the pain and irritation. Your vet may also consider putting your pet on acepromazine (tranquilliers) for a short period for two reasons: to stop your pet from shaking his head so violently giving the ears a rest...and because one of the mild side effects of this particular tranquillizer is to lower the blood pressure to the extremities (in this case the ear flaps) which helps the problem to resolve.
4. Exotic Treatments. There are some off beat treatments for ear hematomas out there they just might be legitimate, but I'm dubious. These include high tech and low tech stuff such as laser therapy and message therapy which share in common the goal of improving circulation health to the region and thereby allowing the clot and problem to resolve.
If medical treatment fails...or if the hematoma is too large to expect medical treatment to work well, your pet will need surgery.
There are quite a few different, and sometimes creative, techniques for this surgery, but all involve getting the clot out through slits or perforations, devising some sort of drainage, and suturing or tacking the ear flap skin down to the underlying cartilage until healing takes place.
I usually leave the drains in place for 2-4 days and remove the sutures 10 days after that. I also treat these patients medically post surgery with antihistamines, short term prednisone, and pain medications in addition to treating any underlying ear infections etc.
Expect at least some scarring of the ear flap. but at least your pet will be comfortable again.
Also, don't be surprised if the other ear flap gets a hematoma within a year or so.
In general, we practicing vets don't have a fancy scientific test for pets who we think have impaired hearing. Usually this is a problem noticed by the owners and we simply make noises behind the pet to see how they react. The more sophisticated of us use tuning forks or pitched whistles to test the degree of deafness.
But, while most normal practices don't have fancy equipment, it does exist. It's a neurod test called a Brainstem Auditory Evoked Response or BAER. It's usually used by a specialist to determine if a young pup or kitten is congenitally deaf.
I don't know the details of the test other than that is is done under sedation or anesthesia and can also be used to help determine brain damage if present after trauma.
11 September 2001
"Less we forget"
Notice to people who visit my home:
1. The dog lives here...you don't.
2. If you don't want dog hair on your clothes, stay off the furniture.
3. Yes, he has some disgusting habits. So do I and so do you. What's your point?
4. OF COURSE he smells like a dog.
5. It's his nature to try to sniff your crotch. Please feel free to sniff his.
6. I like him a lot better than I like most people.
7. To you he's a dog. To me he's an adopted son, who is short, hairy, walks on all fours, doesn't speak clearly, and I have no problem with any of these things.
8. Dogs are better than kids: they eat less, don't ask for money all the time, are easier to train, usually come when called, never drive your car, don't hang out with drug using friends, don't smoke or drink, don't worry about whether they have the latest fashions, don't wear your clothes, don't need a gazillion dollars for college, and if they get pregnant you can sell the pups.
9. Same applies to the cats, except they will ignore you...until you're asleep.