OK, OK. So it’s really aural HEMATOMA. But what can I tell ya? I love the wordplay.

What is an aural hematoma, anyway? Well, it’s a bunch of blood inside the ear flap. Because your pet’s outer ear is basically a collection of blood vessels and a little cartilage with a skin lid, one wrong poke or a shake of the head can lead to a big ol’ pocket of blood in an otherwise normal ear.

There are about as many treatments for this malady as there are veterinarians in the world. Each vet will have her own favorite treatment, but we often have to let the pet dictate which version we will use. Here’s a list of a few options:

*Surgical repair–This one is first because it’s hands-down my favorite. It involves anesthetizing the pet, clipping and aseptically scrubbing the ear, then slicing a full thickness crescent or S-shape into the middle of the inside of the pinna. The best part is when you make that incision, all the blood trapped in there comes spewing out in a very satisfying manner!

Now, you don’t close that incision because you want the inevitable oozing to continue to happen and not get all trapped in the ear again. That’s what got us here in the first place . . . But you DO place sutures from the inside of the ear to the outside in several places. This tacks down the extra space in the pinna and leaves just enough scar tissue to keep the hematomato from coming back right away.

Trust me–it’s cool.

And that’s why I like this repair so very, very much. IT FIXES THE PROBLEM. I mean, that’s what we love to do as doctors and as surgeons, amirite ladies?? I’ve yet to have a hematoma recur when using this method, so it’s A-OK in my book.

*Teat cannula placement–This guy is a solid second place. It often fixes the hematoma, but not always. It also takes 3-6 weeks of total time to resolve the problem.

This procedure involves poking the ear with a BIG needle–hello blood spewing!–and placing a little plastic tube in the piercing you just made. If everything goes just right, the plastic stays in for a few weeks, the tissue around it scars down, and you pull the cannula out when the time is right.

Downside: sometimes the cannula doesn’t get itself seated just right and it falls out too early. Or the owners let the dog go swimming. Or Mercury is in retrograde. Anything can upset our little friend the cannula . . .

*Draining and prayerAnd steroids.–OK, OK. Invasive procedures aren’t everybody’s bag. I get it, I do. So another option is to drain the ear and give a good, long dose of oral steroids. (Not the “we’re here to pump you up” kind. The “Dear Lord stop the itching” kind.) Or just give the steroids. This can be effective, but I do find the rate of success to be lower than the other two options.

So what to do, what to do?? First stop, ask your vet. She’ll do a physical exam and you two will have a discussion about what the best option is. Maybe your pet isn’t a great candidate for surgery. Or maybe giving daily oral medications is a real ordeal. Or maybe you’re going out of town for a week and won’t be able to monitor the ear. Lots of factors can play into this decision, and your vet will help you choose what’s right for you and your pet.

[P.S.: One item I have found super useful for initial hematomas, as well as post-op care, is the No Flap Ear Wrap (https://www.noflapearwrap.com) It’s such a cool invention that keeps the ear in place so it can heal. Because wrapping those ears is a real bastard . . . I don’t get any sort of subsidy from the company, I just think the product is awesome.]