Aural hematomas are thought to be secondary to trauma. Vigorous head shaking in animals with external ear canal irritation causes the miniature vessels that pierce the internal cartilage to rupture and bleed. Although pressure building up under the skin will stop the bleeding, continued head shaking will cause the pocket to enlarge until it becomes a very obvious and sometimes painful.

 What is an aural hematoma?    

Aural hematoma, the main source of "cauliflower ear," is a collection of bloody fluid under the skin or between the cartilage layers of the pinna, the upright or floppy skin attachment above the ear canal.

Not all dogs that have aural hematomas have ear infections; in fact, some animals may have no evidence of external ear canal disease. Because head shaking is thought to be the underlying traumatic event that leads to hemorrhage, any ear and skin examinations should be performed by a veterinarian on all affected animals to rule out or diagnose predisposing conditions. Allergies to food or reaction to chemicals in the environment may be underlying causes in many dogs.

Treatment of aural hematomas can either be medical or surgical. Surgery will rapidly shrink the size of the fluid pocket, but may result in some disfigurement and usually requires 2-3 weeks of bandaging or drain care. Medical management requires the use of steroids to reduce pain and inflammation and to control the underlying cause of the ear canal irritation.

Steroids should never be given to dogs that are receiving medication such as Rimadyl or Deramaxx for arthritis or other painful conditions, since dogs on these drugs are more prone to gastrointestinal ulcers and upset. Your veterinarian will help you decide which treatment is best for your dog.   

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