Aural Hematoma in dogs?

[McGurk]

I have a much beloved, very active 5 1/2 yo Lab. 3 months ago, she had an aural hematoma that was hot and tender to the touch, so we had the vet drain it, put her in a hood to prevent head shaking (miserable), and prescribe a course of steroids.

The same vet cultured her ears multiple times and couldn’t find an infectious reason for the head shaking.

Same vet doesn’t like the “quilting” procedure that I’ve seen used in other retrievers with limited success.

My question? The hematoma keeps recurring. Sometimes more aggressively, sometimes less so. No heat, no tenderness, no sign of discomfort from the dog…

Said Lab is a farm dog who will jump in a pond, a water trough or a puddle at any opportunity.

Do I 1.) ignore it since it isn’t bothering her 2.) investigate the causes of the head shaking, assuming it’s not from laying down in any body of water larger than a teacup 3.) drain it myself (I have large bore needles she would absolutely hold still and allow me to do it if there were treats on offer) or 4.) take her back to the vet for something that’s bothering me and not her?

Additional data point - having her on steroids is difficult. She gained a lot of weight, and we had to revise the feeding, watering and walking schedule.

When she is lean and fit, she is 110#. Post steroid treatment last time, she’s 115#. NOT fat at 110#, just a big da&* dog. But not losing the weight from the last go round with steroids either.

WWYD?

[Lizrd]

My Boxer dog had recurrent hematomas in one ear. For him, it was because of allergies. All of the head shaking and scratching would make his ears get hot and red and uncomfortable. We repeatedly had his hematoma drained. Many times it would stay flat for several months and other times it would bubble back up. We did not do oral steroids, rather I think steroids were possibly injected between the layers of skin on the ear flap (if I remember correctly). He ended up developing enough thickened skin from repeated draining that I think his layers of ear flap were just bonded together.

Now I have an adopted puppy mill Boxer and she is missing half her ear. The “breeder” elected to amputate her natural ear flap rather than treating an ear hematoma. Sooooo I guess for some people that’s a cost-saving option. Unfortunately they also took away her ability to move that ear so now she’s plagued with infections. Poor pup.

… and if I were also looking for sympathy I’d share that even my freaking cat has gotten an ear hematoma. I had it drained once and now he has quite a jaunty “Scottish fold” look, without the adorable squishy face.

Not sharing any advice - just stories. Ear hematomas are no fun!

[chestnutmarebeware]

My late ACD developed a hematoma during a yeast infection in his ear. The vet drained it once but warned that draining rarely worked long-term and the hematoma almost always came right back. Surgery, he said, was the only permanent fix.

Sure enough, the hematoma filled back in, Blue had the surgery (I think they go in and cauterize all the damaged blood vessels—it’s been about 10 years now) and he was back home a few hours later. I think it was about $150 total back then.

Blue had prick ears and the surgery did damage the cartilage slightly so that the ear didn’t stand up straight ever again, but we never had another issue with a hematoma.

[Bonnie2]

First take her off the steroid. They are apparently not helping her shaking and they are definitely not helping healing. Agree IME quilting offers mixed results at best. I had a lab years ago, spent most of her life fetching balls out of the pond. She had an aural hematoma that the vet drained. Then we reopened it every night with a scalpel blade and ‘milked’ it. We wrapped the ear as lightly as we could but not tied to her head. It got better and did not recur. I don’t know that even a large needle would work since the hematoma fluid is thick. My current lab has had head shaking not responsive to treatment with no obvious cause. 3 weeks ago she got her first treatment of Claro and it has tremendously reduced the shaking. Good luck!

[ratherberiding1999]

Unfortunately, as others have said above, draining is usually only a stop-gap measure, they almost always come back. Surgery is usually the only permanent fix- in addition to solving the underlying issue (usually ear infection causing them to shake head frequently). The surgery is pretty quick and easy and has worked very well in my experience, pretty fast healing time for the patients and very low risk of reoccurrence. Some vets suture the pinna together, some use an external rubber bit that braces both sides then gets sutured through to provide more support.

If you don’t want the surgery and would rather keep draining them if they come back, rather than oral steroids, ask the vet if they can do a local injection. After the drain the blood out of the pinna, they inject a small amount of a steroid directly into the ear flap. It works right there and has less systemic effects than an oral one would.

Regarding the cause, I see they did a culture of the ears- did they find any bacteria at all, even if typically at a level that wouldn’t cause issues? Or tested a swab for ear mites? Have they done a culture and sensitivity as well? The sensitivity tests what antibiotics would be most effective for whatever they determine is the infectious agent.

Maybe they could try an otic medication just in case? They have ones that you put in at home (entederm, animax, otomax, zymox, etc) or one that they put in at the vet that last for a month (claro, simplera, BNT ointment). With the long lasting ones, you don’t have to do anything at home, not even clean the ears- the medication sort of sticks to the walls of the ear canal and they often work very well.

[candico]

There is a clinic around here that uses leeches to treat them. Might be worth investigating. I think there was even a place you could mail order them since they had to be a special kind.

[McGurk]

This is great info, thank you.

So even with a large bore needle, I’m probably annoying the dog and not getting a good result?

FWIW, I don’t notice extreme head shaking in this dog. Yes, of course she shakes when she gets out of the pond, but it doesn’t seem to be more than that.

[McGurk]

Also good suggestions, thank you.

Love the idea of injecting a steroid locally, rather than having her on oral steroids.

115# lab on steriods - yikes! The food alone!

Also love the idea of the otic ointment. Something’s going on in this ear that’s causing this, that seems like a simple, non-invasive thing to try

[chestnutmarebeware]

@McGurk

FWIW, I don’t notice extreme head shaking in this dog. Yes, of course she shakes when she gets out of the pond, but it doesn’t seem to be more than that.

It’s not the shaking that makes the hematoma keep coming back—it’s the original damage to the blood vessels. They keep leaking without any further trauma.

Good luck! It’s just my opinion, but surgery ends up saving time, money and vet visits in the long run.

[Bonnie2]

Give it a try. See how she tolerates it and how much it helps.