More than one way to fix dog’s hematoma

Dear Dr. John,

About a year ago, I lost my Pitbull that I had for many years. He developed a swollen ear (hematoma). It was drained a few times without much success until I found a vet who suggested surgery to fix the problem. It worked! Why didn’t the other vets do the same? Recently, I adopted a young male Pitbull who is an absolute love. Just by chance, he recently developed a swelling of the left ear reminiscent of what my old dog had. It was smaller than what I experienced with my other dog and since it was the weekend, I took him in to a large emergency hospital. I think they drained a small amount of fluid and then sent me home with a steroid, and antibiotic, and some pain meds to calm him down. It seems to be healing but what is the right way to address this kind of problem?

Dear B.T.,

The condition that your dogs had is what is known as aural hematomas. They arise often from shaking their heads a lot secondary to an ear infection.

By shaking their heads, the flaps of their ears hit against the side of their head. Vessels located in the ear between the skin and ear cartilage, usually on the inside of the flap known as the pinna, rupture and create a blood-tinged fluid filled cavity. It is not uncommon to try draining the ear hematoma once or twice before resorting to surgical repair. One approach is to drain the ear and then infuse the drained area with a corticosteroid. This is done more commonly now than previously when veterinarians often opted for surgery more rapidly. The surgery usually involves creating an opening or drainage and then “tacking down” the ear skin to the cartilage thereby inducing it to adhere and heal.

Another is treating the dog with several oral medications. One needs to address the ear infection, if one is present, and then use corticosteroids to reduce the swelling and inflammation. While surgery is still commonly used for this problem, it is usually reserved for recurrence of the problem.