We see our pets shake their heads all the time and think nothing of it. This may be indicative of an ear infection or ear mites however, this behavior can also cause another problem known as an aural hematoma. A hematoma is swelling caused by a broken blood vessel after bleeding has occurred inside a tissue. A hematoma in the ear flap of an animal is referred to as an aural hematoma and is commonly caused by head shaking or trauma that causes a blood vessel in the ear to rupture.
If the hematoma is small it may not need any form of repair and it may resolve itself on it’s own! However, there are occasions where more drastic actions need to be taken and they need to be repaired. If the hematoma is extremely large and blocks the ear canal completely, this is huge issue as the ear cannot be evaluated for any infections or future blockages. This is especially problematic in our dog breeds that are prone to nasty ear infections! If the ear flap is healing naturally and scarring in a way in which the ear canal is narrow intervention is necessary since it can predispose some animals, especially cats, to a lifetime of ear infections. If the ear flap also becomes heavy and uncomfortable for the animal intervention is necessary since it is impeding on the quality of life of your beloved pet.
So this then leads to the question of how do we treat this? Luckily there are a variety of options open to veterinarians and your pet! The first and preferred option is to let it resolve on its own. This is ideal as the body will naturally reabsorb the fluid in the ear. However, there are several disadvantages to this option. The first is that this can take a long time, up to several months, and it may be uncomfortable for your pet during this time. This can also result in large amount of scarring aka cauliflower ear, which is not very cosmetically appealing. Another treatment option is to aspirate or drain the area. This option is relatively inexpensive and uses a syringe to remove the fluid from the area. However, there is no guarantee that this will work as the tissue can refill with fluid and several treatments may be necessary. Also, if the blood in the ear has clotted it is not possible to drain it as scarring has begun and a surgical method needs to be used. Another option for treatment is pre-crusting sutures. In this method of treatment an incision is made in the earflap and the clots and fluid are drained. Then sutures are placed apart in a vertical or horizontal pattern so that the ear flap is essentially quilted to prevent fluid from refilling into the tissue. The last more creative treatment is the insertion of a teat cannula into the area of the ear that is filling with fluid so that it can drain. This generally works if the space is big enough and the dog can tolerate the teat cannula in the ear for several weeks.
This diagnosis is a bit more pressing in regards to felines than canines due to the structure of feline ears. The cartilage in the ears of cats is more sensitive to inflammation and the scarring can be more severe. This results in a narrowed ear canal, higher risk for long term ear infections, healing deformities and more curling and softening of the thinner pinnal areas. Thus, most commonly a surgical solution is used for our feline friends while there is more leeway for our canine companions to have this issue resolve on their own.
Head shaking may not seem like a big deal; however, it can result in aural hematomas which can be a big issue especially for cats. That is why preventing this behavior or treating this early is important for our pets!