HematomaCAT

HEMATOMA OF THE EAR
Whitecourt Veterinary Clinic
Box 1769
Whitecourt, Alberta T7S 1P5
Telephone: 780-778-5767 - Fax: 780-778-5452
wctvet@telusplanet.net

An aural (ear) hematoma is a collection of blood, serum, or a blood clot within the pinna (ear flap). When present, the pinna will appear very thick and spongy. The swelling may involve the entire pinna or it may involve only one area.

How is it caused?

wpe1.jpg (7465 bytes) When something irritates the ear canal, the cat responds by scratching or shaking its head. Excessive shaking causes blood vessels to break, resulting in bleeding. An understanding of the ear's anatomy makes the sequence of events more logical.

The ear flap is composed of a layer of skin on each side of a layer of cartilage. The cartilage gives the ear flap its shape. Blood vessels go from side-to-side by passing through the cartilage. Violent shaking causes the vessels to break as the skin slides across the cartilage.

What is the treatment?

Because the success rate is so low with conservative treatment, most ear hematomas are treated with surgery. If surgery is chosen, there are four commonly used steps. However, different situations require different surgical techniques.

1. The blood is removed from the pinna. This is accomplished by making a small incision in each end of the hematoma. A drain tube is passed through the hematoma and sutured to the ear. This assures drainage of any more blood or serum that accumulates in the area. Alternatively, the skin over the hematoma may be incised and opened completely. This is more likely to be used for more serious hematomas and for those in which the blood has clotted.

2. The space where the blood accumulated is obliterated. Since the skin over the hematoma has been pushed away from the cartilage, it must be reattached to it to prevent another hematoma from occurring. This is accomplished by a series of sutures that are passed through the ear flap.

3. Sometimes the pinna is stabilized to prevent further damage. The presence of the drain tube will cause the cat to shake its head even more. Shaking at this time may cause further damage to the pinna. Therefore, the pinna is laid on top of the cat's head and bandaged in place. Although the bandage may be somewhat cumbersome, it will prevent further damage to the pinna and allow proper healing to progress.

4. The cause of the problem is diagnosed and treated. Another important aspect of treatment is dealing with the cause of the shaking. If an infection is present, medication is prescribed to treat the problem. However, some cats have no infection but have foreign material lodged in the ear canal such as a tick, piece of grass, etc. Any foreign material is removed. It is also possible that a foreign body initiated the shaking but was later dislodged. If that occurs, and no infection is present, further treatment of the ear canal is not needed.

wpe2.jpg (6878 bytes) What follow-up treatment is needed?

The drain tube and bandage are generally removed in about 3-14 days. At that time, the hematoma is usually healed. There will be two holes in the skin where the drain tube entered. They will close within a few days. If discharge occurs from the holes before they close, it should be cleaned off with hydrogen peroxide. In some cats, the stitches through the ear flap will be removed, and in others they dissolve.

If an infection was present, it will be necessary to recheck the ear canal to be sure that the infection is gone. Otherwise, another hematoma may occur.