An aural hematoma, often referred to as an ear hematoma, is a condition where a blood-filled pocket forms between the skin and cartilage of a cat’s ear flap (the pinna). While less common in cats than in dogs, it can still occur, particularly in felines predisposed to ear infections or allergies. This condition arises when trauma or injury to the ear flap causes small blood vessels within the pinna to rupture and bleed internally, leading to a swollen, blood-filled sac.
Recognizing the Signs of an Ear Hematoma
The primary visual indicator of an aural hematoma is swelling of the cat’s ear flap. The extent of the swelling can vary; a localized injury might result in a small bump, while a more significant hematoma can cause the entire ear flap to become engorged and droop under its weight. To the touch, the swollen area may feel either soft and fluctuant or taut. It’s important to note that pressure from the hematoma can be painful, so your cat will likely react negatively if you attempt to touch the affected ear. If you suspect your cat has an aural hematoma, seeking veterinary attention is recommended.
Causes of Aural Hematomas
In the vast majority of cases, trauma or injury to the ear flap is the root cause, leading to the rupture of internal blood vessels. Common scenarios include:
- Excessive Scratching or Head Shaking: Cats may repeatedly scratch their ears or shake their heads vigorously due to underlying issues such as ear infections, ear mites, allergic skin conditions, or the presence of foreign objects in the ear canal.
- Direct Trauma: Scratches or bites to the ear flap can occur during outdoor excursions or altercations with other cats.
- Underlying Health Conditions: Less frequently, certain health issues affecting blood clotting ability can contribute to hematoma formation.
Given the prevalence of ear infections and ear mites in cats, a veterinarian will conduct a thorough examination of the ear canal during diagnosis.
Prevention Strategies for Ear Hematomas
Preventing injuries to your cat’s ears is key. Keeping your cat indoors can significantly reduce the risk of injuries from sharp vegetation, fights with other animals, and other potential outdoor hazards. Maintaining good ear hygiene is also crucial. The specific ear care routine will vary depending on the individual cat; consulting your veterinarian for guidance is advisable. While some cats may not require frequent ear cleaning, those prone to allergies or ear problems may benefit from regular cleaning and check-ups.
Diagnosing an Aural Hematoma
Diagnosing an aural hematoma is typically straightforward. A veterinarian can often make a diagnosis based on a physical examination of the cat’s ear, especially if an ear infection is also present. In some instances, a needle aspirate may be performed to confirm the presence of blood within the swelling and to rule out other potential conditions, such as a skin mass, that would necessitate a different treatment approach.
Treatment Options for Aural Hematomas
Surgical intervention is often the recommended treatment for aural hematomas as it offers a permanent solution and helps prevent scarring. In addition to addressing the hematoma itself, it is critical to treat any underlying cause. For example, if an ear infection led to the hematoma, that infection must also be treated concurrently.
Is Surgery Always Necessary?
In cases of very mild hematomas or when a cat cannot undergo anesthesia, a veterinarian might attempt to drain the hematoma using a large needle. However, this is generally not the preferred method. Aural hematomas treated this way have a high recurrence rate, sometimes even re-forming within a few hours. Furthermore, if blood clots have already formed within the hematoma, needle drainage may be difficult or impossible due to the size of the clots.
The Surgical Procedure
Aural hematoma surgery involves making a small incision to open the ear and drain the accumulated blood. Following drainage, numerous small sutures are used to close the pocket, preventing further blood accumulation. A head bandage is typically applied to provide gentle pressure on the ear, aiding the healing process and minimizing the chance of re-accumulation. While surgery may result in some scarring and changes to the ear’s appearance, it generally leads to significantly less scarring compared to an untreated or improperly treated hematoma. The good news is that surgery offers a permanent solution, with a very low chance of the hematoma recurring in the same ear.
Post-Surgery Recovery
Following surgery, your cat may experience some soreness for a few days. Your veterinarian will prescribe pet-safe pain and anti-inflammatory medications and, if necessary, antibiotics. An Elizabethan collar (cone) is essential to prevent your cat from scratching the surgical site, which could lead to inflammation, bleeding, or premature suture removal. A head bandage is also common to protect the ear and maintain gentle pressure. Your veterinarian will provide detailed instructions for home care, including monitoring the surgical site and when to return for follow-up appointments and suture removal.
What to Do if a Hematoma Bursts
If an aural hematoma ruptures on its own, you may notice blood draining from your cat’s ear, often accompanied by head shaking. While this can provide temporary relief by releasing pressure, there is a high likelihood that the hematoma will return. Without veterinary intervention and surgical treatment, hematomas are prone to re-filling, and an open wound increases the risk of infection.
If immediate veterinary care is not possible, you can perform the following temporary measures:
- Gentle Cleaning: Clean the area gently with warm water and a mild, non-stinging cleaning solution (such as diluted chlorhexidine or povidone-iodine). Avoid forcing the cleaning if your cat is resistant, and take care not to get the solution in their eyes.
- Apply Gentle Pressure: If your cat tolerates it, apply gentle pressure to the area to encourage complete drainage.
It is crucial to remember that these are only short-term solutions, and a veterinary visit as soon as possible is necessary for proper healing.
Consequences of Untreated Aural Hematomas
If left untreated, an aural hematoma will eventually decrease in size and form scar tissue on its own. However, this is not recommended due to several potential negative outcomes:
- Pain and Discomfort: The swelling, pressure, and weight of the hematoma can cause significant discomfort until it resolves.
- Obstruction of Ear Canal: Severe swelling may block access to the ear canal, hindering the treatment of any underlying ear infections.
- Prolonged Healing Time: Aural hematomas can take over a month to shrink, with larger ones taking even longer, during which the cat remains in pain.
- Recurrence: Even if the swelling appears to be diminishing, the hematoma can re-fill at any time.
- “Cauliflower Ear”: Allowing a hematoma to heal naturally often results in significant scarring and a thickened, deformed ear flap, commonly referred to as “cauliflower ear.”
Therefore, seeking prompt veterinary treatment is highly advisable. While not typically an emergency, addressing an aural hematoma as soon as possible minimizes scar formation and prevents prolonged discomfort. Your veterinarian can not only treat the hematoma but also discuss its underlying cause and provide strategies to prevent recurrence in either ear.
If you suspect your cat has an aural hematoma, bringing them to a veterinarian is the best course of action. They can accurately diagnose the condition, provide appropriate treatment, and address any contributing factors.
