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Could Allergies Have Caused This Big Ear?
Two weeks after Annie’s sutures were removed, the hematoma returned in the same ear. This time, she had brown debris in her ear and was diagnosed with a bacterial infection as well. Annie was treated for the ear infection and the hematoma was fixed again. This time the sutures were left in place for 5 weeks to ensure the ear was completely healed before removing them.
Annie’s ear was treated and the bacterial infection was gone, but the ear did not look any better. After a couple weeks, her ear was rechecked under anesthesia and it was determined that Annie may also have an underlying allergy causing the inflammation in her ear and the itchy skin.
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Annie Poeppleman, a 10 & 1/2 yr old black lab mix, greeted her owner with a swollen ear. When the owner brought her in to Paws of the Rockies, the doctor explained that Annie had an aural hematoma; aural, meaning, “ear” and hematoma, meaning, “swelling filled with blood.”
Aural hematomas occur where there has been some type of trauma, either from another source (dogs playing or cat scratch) or self-initiated. It is common for dogs, (and some cats) to get aural hematomas when there is already an ear infection or irritation in the ear because your pet’s ear flap is so thin. The blood vessels are close to the surface of the ear, and if your pet scratches or shakes their head hard enough, those blood vessels can break, causing a blood blister, or hematoma. We are unsure what caused Annie’s hematoma because she did not seem bothered by her ear when the owners brought her in initially. 
Hematomas typically do not go away without treatment. They can be drained, but usually refill within days or weeks. The most effective way to fix an aural hematoma is to drain it, and then tack the ear together with suture to close the voided space the blood was filling. This does not allow the ear to refill with blood, and allows the ear to heal properly. Annie’s owners had surgery performed and the ear healed nicely. Unfortunately, Annie was one of the few patients whose hematoma came back.
At the time of Annie’s suture removal appointment, there were only a few of the three-dozen sutures still in place. There were red bumps all over the ear where the sutures had been, which is not normal. Were the bumps due to a suture reaction or infection, or did Annie scratch the sutures out? The owner confirmed that Annie had been wearing the e-collar consistently and did not have access to scratch at her ear. The bumps were tested and a culture was sent off. It was confirmed that there was a bacterial infection in Annie’s ear.
Annie is now on a diet trial to see if her allergies are food related and her case continues. This is an interesting case study because it touches the typical reason why dogs can get aural hematoma, but with a twist at the end. Annie’s case ended up not being so typical after all. There were probably underlying skin allergies that led to Annie’s hematoma, but we will never know the true cause. Did the hematoma occur because of her allergies and scratching, or did we find her allergies because of the hematoma? In any case, if you see your dog licking or scratching skin frequently, it would be a good idea for you to have a veterinarian examine your pet to determine if there are other issues that can be treated, and potentially prevent further problems- maybe even a hematoma!