Aural (ear) Hematoma (in Non-grey)

[Guest Greensleeves]

Our coonhound Nelly recently had surgery to correct an aural hematoma.

 

I had computer trouble (electrical surge blew out the power supply) the three days we actually dealt with the hematoma--the Sunday night we discovered it, the Monday we took her to the vet, and the Tuesday she had the surgery... but we're about 10 days post surgery and wondering if our experience is normal. The vet has seen her twice and tells us everything is fine, but I'd love to hear from others who've been through this.

 

Basically, the hematoma formed deep near the base of her ear, either from scratching or rubbing her head too hard (she's an allergy girl). The vet performed surgery to slit open the site of the hematoma and let it drain... and then put something like 40 stitches through the ear (using a piece of X-ray film as a splint), so that a network of scar tissue would form throughout the ear flap, holding the two sides together. He said it would probably be 19-21 days before the stitches came out. We've had a lot of oozing and blood (which the vet warned us to expect, and tells us is normal), and today we've noticed that there is some ooginess right beneath the edge of the X-ray film.

 

If anyone has been through this with their dogs (I can't imagine that it would be common in greys... but I know goldens are very prone to this), I would really appreciate hearing what the recovery was like.

 

Here are a couple of pictures I took right after her surgery:

Picture of X-ray film splint

graphic pic of underside of ear

 

Thanks!

[Neighsayer]

I went through this with my old chow mix a few years ago. Hers was closer to the tip of the ear. She had the surgery with lots of stitches and much oozing. A few months later she had the same problem on the other ear. She has lots of scar tissue in both ears. She had been going deaf before the surgeries and has very little hearing left. I'm not sure if the surgeries had anything to do with it. She is almost 14.

She has so much fur that I didn't notice the ear problem til the tip was so heavy from fluid that the ear no longer stood up straight. She had one ear up and one ear down. It took several weeks after surgery for her ears to stand up again. Good luck.

[Guest FireHorse]

I have no experience with aural hematomas in dogs, but have had several cats treated for it-it sounds like pretty much the same procedure. Well, minus the x-ray film. Nixon's ear looked like a button-tufted chair by the time the vet was done, but he said the same thing yours did, that it helped the ear to scar in such a way that it wouldn't happen again.

 

As for the ooginess, I'd keep an eye on it. If it gets to smelling bad you might be developing a problem, but otherwise I think it's probably to be expected. Nixon certainly oozed for what I thought was a long time.

 

I hope that helps. Dogs=/=cats, but ears are ears.

[iluvgreys]

I had a black lab that had a couple of hematoma's in her ears. Vet did not use x-ray film for splinting, but did do the incision and a whole bunch of stiches through the ear to hold everything in place. Healing took a couple of weeks at least. Hope there's not an infection in that ear... Sending prayers that all is well.

[Guest Tenderhearts]

I have no personal experience with this, but thanks for sharing the pictures. When Amber was in foster care, she shadowed a vet for career day, and watched a dog with a hematoma like your dog's and was trying to explain to me how they used a piece of the xray film to stabilize the ear after surgery. Now I understand

[Guest LynnM]

I wouldn't get too awfully worried... there is going to be a little bit of oozing, but it sounds like the edge of the x-ray film is perhaps irritating the skin a little bit... that's an awfully thin edge. I've always seen a button (yes, like one from the sewing section at Wal-Mart) sewn on to give stability, since it is round and has thicker edges. You might try lubing the irritated area up with some Neosporin so that it doesn't chafe quite as much. If you're changing the bandages at home, you might also want to reevaluate your technique (too loose, too tight, etc). You may be doing everything right and it's still rubbing, so don't beat yourself up too much over technique. Lastly, use something like the waist of a pair of old pantyhose or an old sock (depends on the size of the dog's head) and place it around the head and ear to keep the ear immobile. The less it moves, the less it can rub.

 

Do you know anyone active in Dobermans, Boxers or Great Danes? If you do, CALL THEM UP IMMEDIATELY and ask for their wisdom on posting ears. It's as much art as it is science and aficionados of these breeds are the experts. Of course, you won't need to stand the ear up, but the act of bandaging it is the same. As a funny aside, we once DID post and stand the ears on a Golden as a joke when the owner picked him up. Of course we cut the tape as soon as the owner quit laughing but it did make for a very cute photo

 

Hope this helps a little... as I said before, there is as much art as there is science to dealing with ear hematoma repair.

 

Lynn

Edited October 6, 2007 by LynnM

[Guest Greensleeves]

Oh, whew. Thank you guys so much! This has been one of the strangest ongoing things we've had to deal with, and even with vets we trust it's nice to hear some stories from the other side of the exam table. Our vet has an awesome bedside manner, and he's so gentle and soft-spoken that it's really hard to know just how serious anything is--he's always so cheerful when he explains things!

 

Nelly is in really good spirits, but you could tell for several days that the smell of blood (and the blood accumulating on the side of her face! ) *really* bothered her. Heck, I found it faintly nauseating, and my sense of smell is a thousand times worse than hers. :/ I think she'll be very glad to be done with all this.

 

Lynn, no bandages--just the splint and an e-collar. We've had some (much more minor) ear injuries here before, and we've actually used legwarmers to immobilize the ears... but on this I think it might be way too painful--plus the ear is pretty stiff with the X-ray film on it. Do you guys normally bandage after these?

[Guest Giselle]

Wow, I've never seen our vets perform that kind of surgery on hematomas. Usually, we just puncture two holes, drain out the blood, and tie a drain through the two holes. Is this not a normal procedure? (Lynn, maybe you can answer this )

[Guest Greensleeves]

Giselle, our vet was concerned that the drains don't really prevent a recurrence of the hematoma. He said he prefers to do the more radical surgery with all the stitches.

[Brooker914]

The way the ears are done with all the stitches are in hopes of getting scar tissue to fill in. If there is scar tissue there is much less chance of the ear getting another hematoma from head shaking/etc. Without the scar tissue, you basically just have a pocket there ready and waiting for more blood to fill it if the dog starts shaking or itching again.

[Guest LynnM]

Yes, the large amount of stitches are normal.... her dog is a big dog with big ears, so there are going to be even MORE stitches. An ear hematoma on a greyhound would require far less than one for a cocker spaniel, for example. Your vet is right on in wanting to suture it the way he did (or some variation of his technique). Simply draining it and bandaging will keep the dog comfortable for a day or two (say it happened on a Friday at 4PM and your vet couldn't do surgery until Monday morning), but isn't adequate for a permanent fix.

 

My vet normally bandaged after repairing an ear hematoma, but not ALL the stitches were affixed to the stiffener. She used a button, and sutured through the holes in the button, and then additional sutures were placed in the ear where needed. After that, we would bandage in the same manner as you would if you cropped a puppy's ears, with the exception that we'd let the ear hang naturally, rather than standing it/them up. That's why I mentioned learning posting ears from a person knowledgable in the cropped breeds. It's an art and in this case, the bandage does some of the job of the x-ray film on your dog... acts as a splint/stiffener to help give the ear a natural shape. Without it, the ear winds up sort of strange and bumpy looking, though still functional.

 

Lynn

[Guest Giselle]

Hmmm...that's very odd. I'll have to ask the vets why they choose to do the drains next time we see a hematoma. Do you think it could just be that the owner of the dog makes the final call and that a pie suture would be more expensive - thus, most people opting to do the drain?