Complications Of Auricular Hematoma Surgery

Sarah writes:  My 9 year old golden retriever just went through Auricular Hematoma surgery as described above, http://www.mypetsdoctor.com/auricular-hematoma-in-dog-cat, with the incision in the middle and the sutures throughout the whole ear. These were left in for a little over two weeks. This was an expensive surgery and we did all the things our veterinarian told us to do. Four days after the sutures were removed his hematoma is back! Same ear, same place! I cannot afford another surgery, so we have him on high doses of corticosteroids hoping this may treat it.  Did my veterinarian make a mistake in surgery? What could  be the reason of the quick return?

Side view of Junior's hematoma showing how thick the swelling is

Side view of Junior's hematoma showing how thick the swelling is

As I mentioned in the Auricular Hematoma post there are as many ways to perform this surgery as there are veterinarians doing them.  I had the same experience many years ago and changed my protocol to leave the sutures and the staples in longer, usually 3-4 weeks.  Unfortunately, that makes it more difficult to remove both the sutures and the staples, but that is preferable to repeating surgery.  Fortunately, my patient did not require additional surgery, probably because the initial hematoma was small.

Why does this happen?  It is probably a combination of a patient who heals slowly combined with a little longer bleeding time (taking longer for blood to clot) than the average dog.  Without preoperative clotting tests one would not have an index of suspicion about excessive bleeding time, so we don’t run those tests preoperatively except in certain breeds predisposed to bleeding problems.

The odds are in this pet’s favor that he will heal just fine on medical treatment.

See you tomorrow, Dr. Randolph.

2 thoughts on “Complications Of Auricular Hematoma Surgery

  1. amanda

    Doctor, my cat went in for surgery on Sunday night (I’d never seen a hematoma and the emergency veterinarian was eager to make it sound worth doing at that moment, so we did). He’s recovering now, but has swelling around the edges of the stitches and in the top of the ear where there are no stitches. The swelling at the top of the ear is nearly as big as the original hematoma. Should I be worried about this? He’s shaking his head a lot, which I’m concerned may be making matters worse. He’s had itchy ears for a few years – no bacteria, yeast or mites, but has thick black ear wax often. How long before we have the stitches removed?

    Reply
    1. Dr. James W. Randolph Post author

      Amanda, I dislike sounding useless, but I won’t be able to answer ANY of your questions. As I said in the original post, click here, there are as many different protocols for auricular hematoma repair as there are veterinarians doing them. That means we take sutures out at different intervals. As to the amount of swelling, I would need to SEE the patient to answer that one. One thing I CAN tell you is that your kitty needs for you to find the source of his ear itchiness. That’s important for two reasons. One, imagine your ears being itchy for several years; it’s very uncomfortable for him. Two, he’s likely to cause another hematoma if he keeps being itchy and shaking his head. If your regular veterinarian cannot find the cause, ask him to refer you to a board-certified veterinary dermatologist. In the absence of infection and parasites there is usually an allergic cause. However, most of those allergic patients have secondary infection, and that needs to be addressed, too. Best wishes, Dr. Randolph.

      Reply

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