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Aural Hematomas

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Aural Hematomas

An aural hematoma is a soft swelling of the ear flap due to an abnormal accumulation of blood between the skin of the ear and the underlying ear cartilage. This fluid is made up of blood or bloody fluid; sometimes it can also contain infection. In theory, blood leaks from the ear vessels when the vessels become weakened. This can be due to either chronic disease or ear trauma.  Aural hematomas can occur in a variety of animal species including dogs and cats.

Self-inflicted chronic trauma is the number one cause of aural hematomas; head shaking or ear scratching are the culprits. Underlying health conditions often lead to increased susceptibility to aural hematomas, such as allergies, skin and ear infections, external parasites, ear tumors, bleeding disorders, and endocrine diseases. Genetic inheritance may contribute to the tendency to develop this condition in regard to ear shape. Dogs with long, pendulous ear conformation (ex. hounds) seem more likely than dogs with erect ear conformation (ex. shepherds) to get an aural hematoma.

Medical management and surgical management are both potentially viable treatment options. Broad knowledge of this condition helps pet owners and the veterinary team make medical decisions regarding both prevention and treatment to best fit the lifestyle of individual pets.

Medical Management vs. Surgical Correction

  • Conservative treatment with medications and prevention of continued trauma to the ear can be curative if identified and treated early and if the ear swelling is less than ⅓ of the ear surface area and does not occlude the ear canal.
  • Ears that have been abnormal for a longer period of time may require surgical drainage. Surgical correction is also recommended in patients where a more cosmetic outcome of the ear is desired. Your veterinary team will determine the best options for your pet.
    • Simply draining the ear with a needle is unlikely to be a successful long term solution. The pocket in the ear will likely refill with blood within a few days. This method can also introduce infection into the ear.
    • Surgery involves creating an incision to remove trapped fluid and blood clots followed by suturing to help cosmetically and functionally fix the ear deformity.


  • The exact procedure and appearance can vary based on veterinarian preference as well as the size of the hematoma.
  • Healing after surgery can take several weeks and continued seepage of fluid from the surgical site is expected for several days post surgery.


  • Chronic aural hematomas that do not receive treatment can cause prolonged pain and a permanent deformity of the ear due to scaring.

Irregardless of the treatment type pursued, careful monitoring and follow-up care will help keep your pet comfortable. Catching head shaking or ear scratching behavior early will help eliminate this ear complication from reoccurring or even happening in the first place. Don’t overlook your pet’s symptoms of discomfort hoping symptoms will dissipate. Treatment of the underlying health condition(s) is a requirement for successful long term cure of aural hematomas.


Amanda Burow, D.V.M. (Dr. B), is a graduate of Iowa State University’s College of Veterinary Medicine. Dr. Burow’s patient list includes hunting dogs of all varieties, as well as several field trial dogs and full time sporting guide dogs. In addition to practicing general veterinary medicine, she has special interest in the areas of preventive care, emergency medicine, and dermatology. In her spare time, she enjoys being outdoors and on the lake, staying active, reading, and spending time with family and friends.

Mud River is proud to share these tips from Dr. B with our customers. Keep in mind it is best to work with your local veterinarian to determine the needs for your animals.