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LacysPop

Aural Hematoma

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LacysPop

I have been out west hunting for a week and this past Friday I noticed a rather large lump on the flap of my 10 y/o ECS' ear.  After self diagnosis I determined it is an Aural (or ear) Hematoma.  The dog is not in pain, and it really doesn't even seem to bother her.  I am certain this isn't from an ear infection, rather from her smacking her ear on something while hunting.

Has anybody had any experience with these?  What route have you taken?  I aspirated it yesterday with a hypodermic needle, and that went smoothly.  This morning there is some blood in there, but not nearly as large as it was.  I know that a lot of times this happens with aspiration.  I know there is a surgical route, but that seems like overkill.  

Has anybody just left one of these alone?  Seems like a lot of vets are going that route (assuming the dog is not in any pain/discomfort).  Sounds like the only downside to that is that the dog might have a slightly deformed ear after the blood is absorbed in the body.

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shoot-straight

very common in labs. mine have had them. some were left alone, and went down with no side effects, one was operated on to drain it. it was pretty darn large. with the bigger ones, its not just as simple as sticking a needle in. they acually make a large inciscion and let it heal from the inside out.

if big ones are left alone, permament thickening of the ears can occur. i have seen some really nasty ones on labs.

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LacysPop
Thanks for the reply.  I aspirated it again last night.  It was quite a bit smaller this time.  I pulled out about 15 mls of blood.  My vet recommended that I try it a few more times and if it keeps coming back we can try injecting some steroids in the ear to help it heal.  Nasty things.  Looks like she is on the bench for a few weeks anyway.

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Speedgoat44

Bumping this thread due to the same condition in my dog.  Any additional suggestions on how to handle this?  Thanks!

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Dogwood

Show me a dog with an ear hematoma and I'll show you a dog with an allergy, which in turn causes itchy ears, then head shaking/scratching, then the hematoma from the trauma.  So you need to address the allergy with ear meds in the canal if needed, oral allergy meds, and the hematoma itself.  Smaller ones less than 1/4 the area of the lobe can be addressed with aspiration only. Larger ones require more aggressive drainage, my favorite technique via a sterile plastic teat tube drain.  Your vet would need to place it, not for the faint of heart or the ham fisted.  Can be done without anesthesia and is relatively cheap and highly effective, no bandages and the like needed. Leave it in for about 2 weeks and voila!  No ugly secondary cauliflower scarring either.

 

Now, LacysPop, what say ye become a Contributing Member?  Splendid.

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SxSetter

It appears in some cases there's an immune mediated vasculitis, or inflammation of the blood vessesls, along with the allergic condition that contributes to the bleeding with or without trauma.  There's also a protocol for high initial and gradually tapering doses of oral steroids (prednisone) for treatment without surgery.  You should consult your Veterinarian for their opinion.  The steroid treatment also has short term side effects but can result in a good cosmetic outcome.

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Dogwood
7 hours ago, SxSetter said:

It appears in some cases there's an immune mediated vasculitis, or inflammation of the blood vessesls, along with the allergic condition that contributes to the bleeding with or without trauma.  There's also a protocol for high initial and gradually tapering doses of oral steroids (prednisone) for treatment without surgery.  You should consult your Veterinarian for their opinion.  The steroid treatment also has short term side effects but can result in a good cosmetic outcome.

 

I've heard of vaculitis as a hypothesis but studies so far don't support it that I know of; care to share them?  You can try oral pred alone but will need to taper over 4-6 weeks, deal with the water/urine issues, and the success rate is not as high as other techniques, particularly for large lesions.

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SxSetter

You're right, I can't find any current references.  It was something presented at a Conference several years ago.  I have had a pretty high resolution rate without surgery with just the prednisone as long as the ear is relatively comfortable otherwise.  For the really turgid one's draining certainly gives relief.  I assume the teat dilator continues to drain for awhile after placement. Is there not an issue with the blood and serum drainage making a bit of a mess around the house?

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Dogwood
19 minutes ago, SxSetter said:

You're right, I can't find any current references.  It was something presented at a Conference several years ago.  I have had a pretty high resolution rate without surgery with just the prednisone as long as the ear is relatively comfortable otherwise.  For the really turgid one's draining certainly gives relief.  I assume the teat dilator continues to drain for awhile after placement. Is there not an issue with the blood and serum drainage making a bit of a mess around the house?

 

Surprisingly little after 12-24 hours tops.  And the cosmetics long term  are quite good.  I leave it in for 10-12 days then pull it.  Surgical prep the site, quick lance with a sterile 10 or 12 ga harpoon needle, drain the fluid, remove the needle and slip in the teat tube. Really slick and clever technique IME.   For larger hematoma's I used to do  the mattress suture/incisional drain etc; ugh.  No more.  Smaller ones I still aspirate, plus oral pred.  

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SxSetter

I'll have to give that a try.  Is it the Dr Larson teat tube you're using?

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Dogwood

I’ll post a pic Tuesday when I’m at work

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Dogwood
On 6/8/2018 at 10:05 PM, SxSetter said:

I'll have to give that a try.  Is it the Dr Larson teat tube you're using?

Yep here you go

 

41C3AC08-5B50-4E23-963B-FE1EE8004EDC.jpeg

E3F423C1-AD9F-42EE-BF46-8E43154A9B67.jpeg

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SxSetter

Thanks

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