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October 14, 2020

Aural Hematomas in Cats

Aural Hematomas in Cats

What is an aural hematoma? 

An aural hematoma (also known as an ear hematoma) is a blood-filled pocket that develops between the skin and cartilage of the “pinna” (ear flap). It’s not very common in cats, but it does happen sometimes — especially in felines who are prone to ear infections or allergies.

The condition occurs when trauma or an injury to the ear flap causes the small blood vessels inside the pinna to break and leak internally, resulting in a blood-filled swelling.

What does an ear hematoma look like?

With an aural hematoma, your cat’s ear flap will be swollen.

If the lesion is confined to just one part of the pinna, the swelling may be small. For larger hematomas, the whole ear flap will be engorged, and the weight of the hematoma may cause the ear flap to droop.

An aural hematoma may feel squishy or taut to the touch. More than likely, your kitty will object to you touching it since the pressure can be painful.

 Suspect your cat has an aural hematoma? Book a vet visit.

What causes ear hematomas?

In almost all cases, some sort of trauma or injury is to blame — that’s what causes the blood vessels inside the ear flap to break and leak.

Examples include:

  • Your kitty repeatedly ear scratching or head shaking, due to an ear infection, ear mites, an allergic skin condition, or a foreign body present in the ear canal.
  • Scratches or bites to the ear flap. This could happen during time outdoors or from fights with other cats.
  • Less commonly, health conditions that cause blood clotting abnormalities could be to blame.

Since ear infections and ear mites are very common in cats, your vet will take a close look inside your pet’s ears. 

Can ear hematomas be prevented?

Keeping your kitty indoors can help to prevent a lot of potential injuries from sharp plants, scuffles with other cats, and other instances where your pet’s ear could be injured.

It’s also important to keep your cat’s ears clean and healthy. Ear care instructions vary from cat to cat, so ask your vet guidance. 

Some kitties might go their whole lives without regular ear cleanings, but others — especially those who are prone to allergies or ear issues — may need frequent ear cleanings and checks. 

How is an aural hematoma diagnosed?

Diagnosis is usually straight forward. Your vet can learn a lot just by examining and feeling your cat’s ear. This is especially true if an ear infection is also present.

In some cases, your veterinarian may take a needle sample to confirm there is blood in the swollen area, and to rule out other conditions, like a skin mass, that would require a different treatment. 

What is the treatment for an aural hematoma?

Your vet will very likely recommend surgery. Surgery provides a permanent solution for the hematoma, and it prevents scars.

On top of an aural hematoma surgery, it’s crucial to treat the underlying cause of the hematoma. So, if your cat has an ear infection that caused a hematoma to develop, that will need to be treated, too. 

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Is surgery really necessary? 

If the hematoma is mild or if your pet is unable to undergo anesthesia for the surgery, your vet may try to drain the hematoma with a large needle.This isn’t the ideal route to care for your pet’s ear, though. Without surgery, aural hematomas usually come back (they can even come back within just a few hours).

Additionally, if blood clots have formed, it will be difficult — if not impossible — for your vet to drain the hematoma with a needle. The blood clots will be too big to fit through it.

What does the surgery entail?

Aural hematoma surgery involves surgically opening the ear with a small incision and then draining the blood pocket.

Once fully drained, your vet will place many small sutures (stitches) to close the pocket, which will prevent blood from accumulating again. 

To complete the healing process, your vet will bandage your cat’s head in a way that places pressure on the ear. This will prevent the pocket from filling again.

Surgery may result in some scarring and changes to your cat’s ear, but it will result in significantly less scarring than if the ear hadn’t been treated properly. 

And, the good news is, surgery provides a permanent solution, since the odds of a hematoma happening in that ear again after surgery are very slim.

SEE ALSO: Aural Hematomas in Dogs

What’s recovery like after aural hematoma surgery?

A cat may have some soreness for a few days following surgery, but your veterinarian will give you pet-safe medications for them to address pain and inflammation, as well as antibiotics if indicated.

An Elizabethan collar is also needed, to prevent your pet from scratching their ear—this reduces the risk of inflammation, bleeding, or accidentally removing the sutures too soon. And, most pets will have a bandage on their head to help protect the ear and place gentle pressure.

Your vet will let you know how to monitor and care for your pet at home after surgery, and when to come back in for rechecks and for suture removal.

My cat’s hematoma just popped on its own. What should I do?

Sometimes, hematomas burst on their own (you’ll know when this happens because blood will issue out of your cat’s ear as they shake their head from side to side). Initially, your cat will feel relief since the pressure will be released from the area. Unfortunately, there’s a high chance the hematoma will return. Without a vet visit and surgery, hematomas are very prone to filling back up. And, additionally, the open wound could lead to an infection. 

If you can’t see a veterinarian right away, here are some home treatments you can do in the meantime:

  • Gently clean the area with warm water and a mild, non-stinging cleaning solution (like dilute chlorhexidine or povidone-iodine). If your kitty is resisting, though, don’t force the cleaning. Also, avoid getting the solution near their eyes.
  • If your cat allows, place gentle pressure on the area to help it fully drain.

Remember, these are just short-term solutions. You’ll still need to visit a vet as soon as possible so your pet can heal properly. 

What happens if my cat’s aural hematoma is left untreated?

Without treatment, a hematoma will eventually decrease in size and form scar tissue on its own. This isn’t recommended though. If left untreated, the following will likely occur.

  • Your pet will be in pain. Until the hematoma heals, the swelling, pressure, and weight of the hematoma will likely cause discomfort.
  • If the ear flap is very swollen, it could block access to your kitty’s ear canal, preventing you from treating an underlying ear infection, if present.
  • An aural hematoma can take over a month to shrink down on its own, and even longer for an especially large one. During this time, your cat will be in pain. 
  • The hematoma can reoccur. Even if the swollen area appears to be shrinking, it can fill up again at any time.
  • Letting a hematoma heal on its own will result in “cauliflower ear” due to an excess of scar tissue.

For all these reasons, it’s much better to seek treatment for your kitty.

While a hematoma isn’t an emergency, it should be addressed as soon as possible.

Faster treatment will minimize scar formation and prevent the discomfort of pressure and a heavy ear flap.

In addition to treating the hematoma, your vet can also talk to you about what caused the hematoma and how to prevent it from happening in your cat’s other ear.

If you suspect your cat has an aural hematoma, bring them to Bond Vet. We’ll diagnose your pet, treat the condition, and address any underlying issues that may exist.

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