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What is an Aural Hematoma?

Auricular hematomas, or aural hematomas, happen when blood accumulates in a dog’s ear flap or outer portion of the ear, causing the ear to swell. A dog’s ear flaps are thin, and the blood vessels can break easily, which causes a blood-filled pocket between the cartilage and skin.

Aural hematomas occur mostly in floppy-eared dogs because their ears are long and sometimes get in the way when they play. However, most cases occur when a dog scratches an itchy, infected ear or shakes their head rapidly. Read below to find out more about aural hematomas in dogs.

Aural hematoma causes

Although a hematoma seems to appear suddenly, it is often a sign of an ongoing ear infection. However, the shape of your dog’s ears may also lead to such conditions. The following issues may cause aural hematomas.

Ear shape

If a long-eared dog shakes its head, the whipping motion can rupture blood vessels, allowing blood to pool within the ear-flaps. Floppy ears also keep oxygen from entering the ear canal, which increases the risk of infection.


Ear mites are a tiny lice-like bug that thrives in a dog’s ear canal. There are a few ways a dog can get ear mites; animals pass mites through contact or between mothers and newborn puppies. Generally, by the time ear mites are noticed, they may already be gone. Most of them die off because of secondary ear infections caused by a bacteria or fungus.

Skin Allergies

Some dogs are allergic to certain airborne irritants such as pollen and ragweed. These irritants can cause the dogs ear-flaps to itch. When the dog scratches, it causes breaks in the skin, allowing harmful bacteria into the bloodstream. The trauma that stems from this action can lead to an aural hematoma.

Objects caught in the ear canal

Dogs may live both inside and outside, where all kinds of objects may find their way into the dog’s ear. Some of the most common objects that get caught in a dog’s ear are grass and plant seeds. The dog may paw at its ears or rapidly shake its head, trying to remove the object. In trying to eliminate the object, the dog can damage the ear, causing a hematoma formation.

Insect stings or bites

Most of the swelling from insect bites only lasts 24 hours. However, the sting may trigger the dog to shake their head or paw and scratch at their ears. This is not a common cause of aural hematomas.

Risk factors for aural hematomas

Dogs are more susceptible to hematomas if they have an outer or middle ear infection or a parasite infestation. The climate may also play a part in your pet’s risks; some veterinarians believe that dogs who live in hotter climates are at higher risk of developing hematomas. Dogs who love the water and swim often are at greater risk of hematomas because of the allergens that live in natural water sources.

Breeds at risk of hematomas

One of the biggest factors that predispose a dog’s risks of hematomas is their breed. Big, floppy eared dogs are at greater risk, simply because they have more ear surface to damage.  These breeds include

Just because a dog has a risk factor does not mean the condition is present. A risk factor is simply a common factor seen in animals with the same condition. It is also important to understand that a dog does not need to have risk factors to develop an aural hematoma. An aural hematoma can form on a dog of any age, with any sized ears.

Understanding symptoms of aural hematoma

Some hematomas can be painful. Others may cause less pain, but they can still be quite uncomfortable to your pet. A hematoma may make your dog feel as if something is in their ear, causing it to shake or paw at its ears.

The diagnosis of a hematoma is often simple because most dogs will display typical symptoms, such as cocking the head to one side, shaking the head, and pawing or scratching at the ears. A swollen ear flap that is painful to the touch or a cauliflower-shaped area on the ear are also tell-tale signs of a hematoma.

Hematomas can feel hard or soft to the touch, depending on the area of the ear. A hematoma can form anywhere on a dog’s ear, including the ear canal and ear-flap. Some may even cause swelling of the entire ear.

Diagnosing an aural hematoma

Veterinarians often diagnose an aural hematoma through a physical exam and by asking the owner to provide the dog’s medical and behavioral history. The veterinarian will usually inspect the ear canal and do a culture swab to check for signs of parasites or infection.

Aural hematomas are not often hard to diagnose. However, the veterinarian must make sure it is a hematoma and not an abscess, pocket of fluid or a cancerous tumor, to determine the proper treatment. The diagnostic process is centered around finding the reason for the dog’s symptoms.

Diagnostic testing

Most veterinarians will order routine blood work to determine the cause of the swelling. The blood work will include including blood count and serum profile. A urine sample is sent for urinalysis. If an aural hematoma is a problem, the results of the tests should be normal.

A thyroid function test may be ordered. In order to identify allergies that may be causing the dog’s condition, food and environmental trials may be necessary. To check for middle or inner ear infections advanced testing may be needed, such as computed tomography (CT scan) or electromagnetic radiation (X-rays).

Ear examination

An ear examination is also necessary, which usually requires sedation or general anesthesia to keep the dog still and reduce discomfort. This veterinarian looks for signs of swelling and infection of the inner ear, which could be the cause of the dog’s pain and their reaction to the symptoms. The veterinarian looks for signs of infection and foreign objects within the ear, like a blade of grass, seeds or ear wax build-up.

Treating an aural hematoma

There are no known home remedies for an aural hematoma. Do not try to treat a hematoma at home; the results could be detrimental to your dog’s ear health.

The objective of treating an aural hematoma is to drain the blood from the affected area so that the skin can attach to the cartilage with minimal to no ear scarring or deformity.

The most common treatment for an aural hematoma is surgical drainage. This procedure is done by thoroughly flushing the incision site with sterile saline, then reattaching the skin of the ear to the cartilage with stitches.  The vet may use temporary drainage port until the wound completely heals.

For floppy-eared dogs, the surgeon may support the ears with a bandage or other material to help prevent further injury and promote healing. He or she may place a plastic cone-shaped collar around the dog’s neck to prevent them from scratching their ears or accidentally bumping them against furniture and other objects.

In some cases, the veterinarian may inject glucocorticoids to help promote healing and minimize infection.  After the surgery, the doctor may send a course of oral anti-inflammatory drugs to be given to the dog at home to help reduce swelling.

Follow-up treatment

Healing time takes anywhere from 3-14 days. The vet will schedule a follow-up visit for removing the bandages and stitches after the healing period is over. In more severe cases, the stitches may be left in longer than the usual 14 days. If there was a drainage hole put in, it might be left to heal on its own. The veterinarian will also check for signs of new ear infections to avoid the reoccurrence of new hematomas.

Determining aural hematoma prognosis

If left untreated, an aural hematoma may lead to scarring and deformations, sometimes called cauliflower ear. Surgery can only help if the hematoma cause has also been found and treated. However, with proper treatment and aftercare, full recovery is successful.

Preventing aural hematomas

To prevent your dog from getting an aural hematoma, monitor his or her ear health. Regularly check your dog’s ears for blockage or signs of inflammation.  Talk to a veterinarian if the dog paws or scratches at its ears often, as this could be a sign of an aural hematoma. Seek medical attention if you suspect your dog has a parasitic infestation, ear infection, or allergies.

Most aural hematomas are easy to diagnose and treat. Getting your dog prompt care will help minimize pain and may reduce recovery time. 

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