Otohematoma in dogs: Causes, symptoms and treatment


The otohematoma, or auricular hematoma, is a hemorrhage between the cartilage and the skin of the inner face of the dog’s ear (hematoma). Thus, otohematoma appears as a swollen ear , that is, a fluctuating and painful swelling of the inner face of the ear.

Otohematoma occurs due to trauma that causes rupture of blood vessels in the ear. Usually, the canine otohematoma appears only in one of the ears and causes pain.

Symptoms of Canine Otohematoma

The otohematoma can originate as a small lesion that increases in size, and over time it can lead to sequelae with deformation of the ear. Thus, the main signs of canine otohematoma are:

  • Ear swollen, bloody, hot, red;
  • A lot of discomfort or pain in the ear;
  • Scratching and shaking;
  • Head to one side;
  • Deformation and thickening of the ear.

Is it otohematoma when the dog’s ear is swollen?

The most likely diagnosis of a swollen ear is canine otohematoma. Differential diagnoses, i.e. other causes of swelling and pain in the dog’s ear include cysts, abscesses and neoplasms (cancer).

Does otohematoma cause pain?

Yes, the otohematoma is very painful for the animal due to the pressure caused in a sensitive area. Drainage of otohematoma by a veterinarian helps to relieve pain.

Causes of canine otohematoma

Canine otohematoma occurs due to trauma that causes rupture of blood vessels in the ear, due to rupture of the auricular artery or cartilage. Blood collects between the cartilage and the skin, forming a painful swelling.

Otohematoma is a pathology secondary to something that causes discomfort in the ear , which leads the animal to scratch or shake its head. Scratching or shaking can cause vessel rupture or cartilage fracture.

In an initial phase (acute phase), the blood passes into the tissues forming the hematoma. Over time (chronic phase), there is fibrin deposition with increased size and deformation of the ear.

A study in the United Kingdom showed that most cases of otohematoma were associated with external otitis (55%) and skin allergy (11%), which cause itching in the ear.

In summary, pathologies associated with the development of otohematomas in dogs include:

  • External otitis:  causes discomfort and itching;
  • Ear scabies:  caused by allergy to the saliva of ear mites ( Otodects cyanotis );
  • Allergies (hypersensitivity): Allergic dermatitis (atopy) and food allergy  can cause auritis and increase the permeability of blood vessels.
  • Ear trauma: can cause discomfort or even directly lead to the formation of otohematoma (eg fights, banging ears on furniture).
  • Others: autoimmune diseases, hyperadrenocorticism, hypothyroidism, capillary fragility, hematological alterations, and infections that cause vascular disease such as  Ehrlichia canis and  Ricketesia .

Factors that predispose to otohematoma

According to the study carried out in the United Kingdom , the risk of otohemtoma is low (0.3%). The main dog breeds that are predisposed to ear bruises are those with semi-erect and V-shaped ears:

  • Bull Terrier;
  • English Bull Terrier;
  • St Bernard;
  • Golden retriever;
  • French Bulldog;
  • Boxer;
  • Labrador retriever;
  • Dalmatian;
  • German Shepherd.

Otohematoma usually appears in adult or senior animals (average age 8 years), of medium to large size (average weight 24 kg), and that suffer from other pathologies that affect the ear (eg otitis media).

What to do when the dog has an otohematoma?

Otohematoma may disappear on its own (self-limiting), but it is painful and can lead to deformation of the pinna due to fibrosis and perichondritis. Early treatment has a higher success rate.

The diagnosis and correction of canine otohematoma should be carried out by a veterinarian.

Diagnosis of otohematoma

The diagnosis of otohematoma is based on clinical history, with pruritus and acute onset, and on physical examination , with palpation of fluid in the ear. Fluid may be collected from the otohematoma for cytology using a syringe.

The primary cause leading to the trauma must be identified. For this purpose, it may be necessary to perform an examination of the auditory canal with an otoscope, auricular cytology, radiographs, and dermatological examinations.

Other pathologies that can cause swelling in the ear, and should be ruled out, include cysts, abscesses and neoplasms (cancer).

Treatment of otohematoma in dogs

The treatment of otohematoma is symptomatic, that is, it tries to reduce the pressure and inflammation by draining the fluid and using anti-inflammatories.

The ear can be protected with dressings and bandages that maintain the proper position and the use of an Elizabethan collar to avoid trauma. It is also very important to treat the primary cause that originated the trauma, such as external otitis.

Needle drainage

Conservative treatment by drainage and treatment with corticosteroids (eg, methylprednisolone, triamcinolone, dexamethasone) does not require anesthesia, is less invasive , and is the fastest and cheapest .

If the otohematoma is recent (less than 7 days), the liquid can be aspirated with a needle and syringe . Success is greater if performed on the first day and can be repeated in the following days to reduce the risk of recurrence.

Corticosteroids are injected into the lesion or given by mouth to reduce itching. Administration of antibiotics, topical heparin, and platelet-rich plasma has also been described.

Surgery (incision and suture)

Surgical treatment may be necessary when needle and syringe drainage is insufficient (eg large or chronic) or in recurrent otohaematomas. It’s more expensive but it reduces recurrence , it’s quick, and it corrects cartilage problems.

The animal is sedated, the hair is cut and the ear is disinfected, an incision is made over the hematoma, the contents (clots, fibrin) are evacuated by massage , washed with serum, and closed with sutures. The incision is made on the concave (inner) surface of the ear and can have several shapes (line, crossed, elliptical, S).

Multiple sutures are placed parallel to the axis to eliminate dead space, maintain skin position, and allow healing. Sutures are removed after 2 to 3 weeks. The incision is left open to drain.

Sutures may be accompanied by other materials to compress and distribute pressure. You can use buttons, cotton, spatulas, staples, sponges, cardboard, plastic, adhesive, X-ray film. Buster sponges can also be applied to absorb fluids.

After surgery it is recommended to apply dressings and use the Elizabethan collar to reduce the risk of trauma.

Application of drains

The application of fenestrated silicone drains, cannulas, bovine mammary tubes, and catheters connected to a vacuum tank that allow drainage of otohematomas with little fibrin (which would impede flow). It has the advantage of being able to be applied without general anesthesia.

The tubular drain is applied in the major axis of the ear, leaving the tips outside to drain the fluid. It is fixed with a suture and maintained for 14 to 21 days. Corticosteroids are given by mouth to reduce fibrin formation.

Alternative treatment of otohematoma

Otohematoma may resolve without treatment if the primary cause is cured. There are home treatments (on an outpatient basis) that may be recommended by your veterinarian.

Drug treatment based on the application of dressings (compression dressings), oral corticosteroids, and topical treatment with DM Gel ointment can be instituted . DM Gel is anti-coagulant, anti-inflammatory and promotes circulation. This treatment can be

Antibiotic treatment may be recommended in surgery or in the treatment of the primary cause (eg bacterial otitis). The antibiotic itself will not have an effect on the drainage of the otohematoma.

Dressings with plasters protect the ear from infection, trauma, and can have a compressive effect . The bandage must prevent the ear from falling, being attached to the neck. Dressings should be changed frequently, as they are easily damaged.

In addition to injecting corticosteroids (such as prednisone) into the otohematoma, a fibrin sealant can be injected into the lesion, which reduces bleeding and complications from surgery.

Alternative incisions include using a biopsy instrument ( punch ) to make circular holes over the ear to allow drainage or applying two silicone pads that compress the ear ( Sutureless hematoma repair system ). Another way to make incisions that stay open longer is to use laser surgery.

Otohematoma prognosis

The prognosis of otohematoma is  excellent  as long as the primary cause (eg otitis) is treated. Without treating the primary cause, it may become a recurrent or recurrent otohematoma.

Does canine otohematoma go away by itself?

Otohematoma heals on its own (it is self-limiting), but must be treated as it causes pain and deformity of the ear . Early treatment has better results. It is also necessary to treat the primary cause, such as external otitis.

Can otohematoma kill?

The otohematoma is not serious and does not endanger the animal’s life, but it is painful and can lead to deformation of the ear. It may have complications such as perichondritis resulting in necrosis, infection, trauma and fistulation, cartilage calcifications, and obstruction of the ear canal.

Prevention of canine otohematoma

Prevention of canine otohematoma is done by avoiding trauma to the ears . The early identification and treatment of pathologies that may cause auricular itching prevents the animal from scratching and wiggling its ears.

You must maintain good hygiene of the dog’s ears. On the other hand, you should be careful with games that could cause trauma to the ears.

feline otohematoma

Otohematoma in cats is similar to canine otohematoma, but it is rarer. Cats can also injure their ears by scratching and shaking their heads, causing blood vessels to rupture.

The most common cause of feline otohematomas is the presence of mites in the ears of cats. Other causes are otitis, allergies, immune pathologies, and coagulation disorders.

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