By Christie Long
Those who follow boxing are likely familiar with the phenomena known as “cauliflower ear," which starts when the fighter repeatedly gets his or her ear punched. Blood vessels break inside the pinna of the ear, which is the part of our ear that sticks out from the head, and which is filled with a sheet of cartilage to give it form. Bleeding occurs and blood clots form inside the pinna. When the clots resolve and are reabsorbed, the cartilage is left scarred and misshapen.
Please note that this injury is in no way related to what happens to your ear when Mike Tyson gets you in a headlock and actually bites a piece of it off. I recently saw Evander Holyfield in a restaurant and his ear looked pretty normal, no doubt courtesy of a good plastic surgeon.
Dogs and cats can sustain similar injuries, although under different circumstances. In our pets the blood clots form inside the pinna of the ear typically when the animal violently shakes its head, essentially beating the pinna against the skull until bleeding occurs inside the pinna. This bleeding and subsequent clotting creates what is known as an aural hematoma, which is very painful and makes the ear swollen and puffy. Without intervention the pet’s ear will look something like the boxer mentioned above.
What makes your dog or cat shake its head violently enough to cause an aural hematoma? The most likely answer is an itchy, painful infection in one or both ears, caused by yeast, bacteria, or parasites, or the presence of a foreign object, such as a grass seed head. With any aural hematoma, there are two main treatment goals. The first is to deal with the hematoma itself, to reduce or remove the chances of scar tissue formation, and the second is to get rid of the irritation.
We’ve talked about treating ear infections before, so let’s focus on getting rid of the hematoma. If the bleeding is recent, the blood can be drained out of the ear, and steroids injected into the space left behind to reduce inflammation. Many times, because the draining leaves a pocket between the skin and the cartilage that can easily refill with blood, the hematoma readily recurs.
If the pinna is large enough a device developed to provide drainage for the infected udders of dairy cows can be used to provide continuous drainage of the hematoma while it heals over several weeks. This method requires a tolerant pet and a patient owner.
Surgery often provides permanent relief from the problem, and usually involves making cuts into the pinna to provide drainage and then placing stitches through the pinna to close up the space that the hematoma occupied between the skin and the cartilage. The stitches are left in place for two to three weeks for complete healing to occur.
Regardless of how resolution is reached, pain control must be used to make the animal comfortable while healing occurs.
Christie Long is a veterinarian at the VCA Animal Hospital in Fort Collins, CO. Long left her job in software sales in 2000 to travel for 13 months. Along the way, she was touched by the plight of the animals she saw and somewhere in the Nepalese Himalayas she vowed to return to school to become a veterinarian. While she often finds end-of-life situations heart-wrenching, she considers herself blessed to be called upon as a trusted advisor to families during difficult times. Dr. Long’s family includes her husband and travel partner, Wiley, their 5-year-old son, Wiley IV, their dogs Pancake and Gizmo and cats Sneaky and Sidh.