Hello! Dr. Christina Martini here again. This month I want to make you aware of a painful condition that commonly affects dogs, and sometimes cats too!

It is called an aural hematoma. Aural as in ear, not oral as in mouth, although they are pronounced almost the same. In this condition fluid accumulates between the two layers of cartilage in the ear flap, causing them to painfully separate and the ear flap to appear swollen, like a pillow. This is usually the result of the pet shaking its head excessively, causing separation of the cartilages. It can also occur from trauma, similar to the human term 'Cauliflower ear' that is common in wrestlers or boxers. Excessive head shaking can be the result of an ear infection or something stuck in the ear canal such as a foxtail (plant foreign body). Sometimes, they just seem to pop out of no where and we can not find the cause.

There are several available treatments for aural hematomas. The least invasive, and usually the first line of treatment at SWVH is draining the fluid out of the ear flap using a needle and syringe. Then, if appropriate for the particular pet's health, we will instill a steroid injection into the ear flap where the fluid previously was. This helps reduce inflammation to allow for quicker healing. Next, we use cold laser therapy on the ear to speed healing and further reduce inflammation. The treatment usually has to be repeated several times over the course of a few weeks, and gradually the fluid accumulation will lessen, and the ear cartilages will heal back together.

If, after several of the treatments described above, the aural hematoma does not resolve, we consider surgery. The surgery has to be performed under general anesthesia. The ear flap is shaved, cleansed and prepped for a sterile surgery. An incision is made on the underside of the ear flap and the fluid is removed. The two ear cartilages are then sutured together to facilitate healing. After surgery the ear is wrapped snug against the head of the pet to prevent damage to the surgery site from shaking the ear again. The wrap is usually changed frequently but worn for a total of 3 weeks, at which point the sutures can be removed. The success rate of surgery is very high.

Unfortunately, no matter what treatment is used, the ear usually has some degree of permanent scar tissue and never looks "quite right". Luckily for our pets, this is merely cosmetic and the ear will no longer cause them pain! It is possible for the condition to reoccur though. Bringing pets to a vet right away if excessive shaking of the head is noticed is so important so that the underlying cause can be identified and treated in order to prevent this painful condition.