Auricular Hematoma In Dogs And Cats

Auricular hematoma: Let’s break down the words. Auricular is an adjective referring to the ear. “Hema” is a prefix referring to blood. “Toma” means swelling, and is the root for our word tumor.

Junior's auricular hematoma before surgery
Junior’s auricular hematoma before surgery

Auricular (or aural) hematoma occurs when blood collects between the skin layers and cartilage of the flap of the ear, known as the pinna. Blood can be released when the ear is traumatized, such as an ear that’s itchy from infection, parasites or allergy. The patient scratches at the ears, or shakes his head in an effort to relieve the itchiness and the resulting pounding breaks a blood vessel inside the pinna.

Sometimes dogs and cats in automobile accidents suffer blows to the head, leading to hematoma of the ear.

There are a number of ways to repair auricular hematomas, mostly surgical. A non-surgical treatment has been described that involves high doses of corticosteroids, some administered into the hematoma and some oral. I have tried it a few times in cases where budgetary limitations excluded surgery, but have had little success.

A decade or so I published a variation of the traditional surgical repair that has given me impressive results while also reducing anesthesia and surgery time for most patients.

My modification of traditional technique is to first “support” the area that has not yet begun to swell by using surgical staples to stapling the “inside” (least-haired) layer of skin to the cartilage underneath. The amount of surgical time saved is dramatic, because the next step in closure of the hematoma is extremely tedious and time-consuming.

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

Now we drain the blood from the hematoma. Pet owners frequently ask why this step alone is not sufficient. The reason goes back to why the hematoma first developed. With the skin separated from the cartilage by the pressure of the bleeding, a space was created. When the body has space in it, the body is going to fill that space with something. If we simply drain the hematoma with a needle and syringe, bleeding may continue, and/or fluid will collect in the space unless the space is surgically obliterated. Therefore, even if the blood is removed, more must be done.

Removing the blood requires an incision the length of the swelling, which allows clots and fibrin threads to be removed effectively. A thorough cleaning reduces post-operative scarring of the pinna.

Surgical closure can now begin. Slowly and methodically sutures are placed from the least-haired side of the ear, through the skin and cartilage and through the skin on the other side. Then the same suture is passed back through the pinna, about ½ inch from the initial placement, and a knot is tied. The procedure is repeated again and again until the entire hematoma space is closed.

Cartilage is a relatively inactive tissue, healing slowly, so sutures and staples are left in for three to four weeks to allow complete attachment.

Ears are a very sensitive part of the body, so we prefer to remove the sutures and staples under general anesthesia so as to minimize discomfort.

Outside of Junior's ear after auricular hematoma surgery
Outside of Junior’s ear after auricular hematoma surgery

It is imperative that the underlying cause of the incident be discovered and appropriately treated. We have covered the principles and importance of proper ear cleaning and proper ear treatment .

Your pet’s doctor would prefer to prevent ear problems rather than treat them. Your dog and cat’s comfort and health are his primary concerns. Clean your pet’s ears weekly and after every bath. When medication is dispensed for an ear problem follow the veterinarian’s instructions exactly to prevent pain and complications, including prevention of auricular hematoma.   MMAHEM

Junior's ear immediately after Dr. Randolph's technique of staples and sutures for Auricular Hematoma surgical repair
Junior’s ear immediately after Dr. Randolph’s technique of staples and sutures for Auricular Hematoma surgical repair


  1. My Lab, Jake, had hematoma surgery Monday. When we picked him up, he wasn’t bandaged. The incision has stitches on both sides of it, like they are holding it open while being stitched for the cartilage and to also drain. I am giving him antibiotics twice a day, but Jake will not let us near his incision to clean it. I am only able to mist the Chlorhexidine on it from a distance. Will this be ok for now? I can tell he hurts and he has a little swelling where the ear bends. Is this normal after surgery?? Please comment. Thanks

    • This is going to be a question only your attending veterinarian can answer. It’s possible he may need a different or supplemental pain medicine, too. Praying for you and for your baby. Thanks for reading, Dr. Randolph.

  2. I’ve wrote a question mths back Abt my dogs hematoma surgery it’s been 3 months and still not healed and stays opened..what needs to be done? Did my vet screw up?? Her ear has got to heal..I’ve been taking her to the vet every week since 9/1/22 and still gaped open please tell me what to do..this is rediculous..suppose to be a fairly easy surgery now it will not…she’s a pitbull and still cannot have any physical activity and she’s a runner…I’m so upset

  3. Dr. Randolph, my 8 yr. old lab-mix had a hematoma on his right ear about a month ago (no signs of infection). I took him to the veterinarian as soon as I noticed it and they performed surgery that day. They left a small open wound (for draining) and placed sutures on the the majority of the ear (from the tip to ~ 1 in. before the fold). After about 1 week post-op I noticed a large, hard mass where the sutures stopped (just above the fold). I then took him in for a followup (saw a different veterinarian than the one who did the surgery) and was told it was just scar tissue and not to worry. One week later, took him to get some of the sutures out and his original veterinarian took notice of the mass (now even larger), and decided to do a needle aspiration to “see what comes out”. Nothing came out, so we don’t think it’s another hematoma or an abscess. The veterinarian put him on Deramaxx, to try to reduce swelling, but after 1 week on the meds the size has not decreased and he cries when I touch it, so I know it must be painful. I should also mention, he has a prominent crease in this ear and the blood vessel at the crease been very dark and inflamed since the surgery. Have you seen anything like this before and/or have any ideas what this could be? His veterinarian and I are at a total loss about this. Thank you in advance.

    • Very interested to know what happened.
      I have the same thing happening to my dog now.

  4. Our puppy just finished his operation same as you did for your patient. When the infection began there was no wound or even a rash in the ear. Now his sister in also having this. My uncle is a veterinarian and this past few days there are numerous dog patients experiencing this auricular hematoma. Is this a seasonal disease? Or maybe a new strain evolved? Thank you so much :))

    • TS, this could be a jillion things, from a hematoma caused by a blow, to a cancer caused by blood vessels, and anything in between. Whatever it is, it needs to be seen by a veterinarian as soon as possible. Best wishes, Dr. Randolph.

  5. My dog part-German shepherd and part-Labrador retriever had a hematoma . My dog got a bad bite on the ear from a bigger dog. My dog had a hematoma on the other ear not the dog bite side. It has been a 7 months but she is slowly healing.

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