Aural hematoma is a very common condition in dogs but it can, unfortunately, be quite expensive to fix. It occurs when blood vessels are damaged in the pinna and the leaking blood causes the flap of the ear to swell up. The pinna is the cartilaginous portion of the ear that protrudes from the head. The usual cause of this condition is thought to be vigorous shaking of the head.
Dogs may initially shake their head when they develop an ear infection or when something else is irritating them such as fleas. Once the blood leakage begins, the ear flap will become distended and heavy which will aggravate the dog even more. He will continue to shake his head and paw at the ear, potentially making it worse. If left untreated, it will probably heal on its own after the blood vessels stop leaking and the blood is reabsorbed. Not treating is generally not recommended however because of the discomfort to the dog and also because an untreated ear flap will develop much scar tissue and will be crinkled up after healing. Sometimes, if allowed to heal without intervention, the ear will be very malformed and the opening will be permanently blocked which can be conducive to subsequent infections.
The usual treatment for an aural hematoma is surgery. Any underlying conditions such as infection will also be treated.
Simply draining the ear is not effective because it will only fill up again. Usually an incision is made under the ear flap to drain the blood and clean out any clots or debris inside, then both sides of the ear flap have to be sutured together until scar tissue forms which adheres them together and prevents refilling. Multiple sutures are used and sometimes the veterinarian will use a two-sided bandage over the flap to keep it flat. It is sometimes necessary to place drainage tubes in the flap. The dog will require general anesthesia.
The dog should be able to go home the same day of surgery once the anesthesia wears off. An Elizabethan collar or E collar may or may not be necessary. This is a cone shaped medical device that is worn to cover the animal's head like a lampshade to prevent them from scratching or rubbing their incision. They can be bought at a pet store, from the vet or online. The standard type is made from plastic and can usually be trimmed to fit the dog. There are other more expensive types as well, some made from quilted cloth or from inflatable material. The dog will probably have stitches for at least 2 weeks and will have to wear the collar during that time. Keep in mind that the incision will continue to drain while healing and may be messy. The E collar will have to be wiped down often too since it will become soiled with blood and possibly things that the dogs drags it in outside.
If no infection is found during the dog's initial examination, the veterinarian may offer the option of treating the condition with steroids, rather than surgery. Short term steroid treatment is considered to be safe providing the dog is in good health. Steroids may temporarily cause the animal to show increased hunger and possibly aggression. They also tend to drink large amounts of water and will need to relieve themselves more often. Steroids can make them more susceptable to infection as well. Sometimes the hematoma will resolve with steroids alone and without any further treatment, however the ear may be malformed when it heals. Since surgery is expensive, steroid treatment may be the owner's best option.