Ear Hematoma in Bulldogs and French Bulldogs

By: Dr. Roy Kraemer |
DVM, Bulldog Specialist Veterinarian

Subject: Help Needed for Bulldog’s Ear Hematoma 🆘🐶

Dear Dr. Kraemer, Bruno, my beloved bulldog, is suffering from an ear that looks swollen and is bothering him quite a bit. 

Could you please shed some light on what causes an ear hematoma? And more importantly, what are our options for treatment? I’ve read a bit about aspiration and surgery, but I’m really looking for the most effective and least distressing option for Bruno. 🙏💉

Joan & Bruno 🐾#BulldogProblems #EarHematomaHelp #BulldogExpert

Ear hematoma, known medically as “aural hematoma,” is a frequent occurrence in bulldogs and French bulldogs. This condition manifests as a collection of blood within the ear flap, pooling between the external and internal layers of the ear flap cartilage layers.

Bulldog Ear Aural Hematoma 5 X MUST KNOW

  1. The ear flap hematoma appears as a soft, enlarged, swollen area on the inside of the flap
  2. That ear is blood-filled due to trauma to the flap due to an ear infection, bite, or other.
  3. Usually, surgery is required to remove the blood and sutures to prevent rebleeding
  4. Treatment includes pain relief, ear disease, and allergy care
  5. Prevention includes Dr. Kraemer’s Ear Hematoma Care Bundles 

Wellcome to our “Prevention Over RX” bulldog community

bulldog ear hematoma Bundle - Ultimate

Ear hematoma in bulldogs and French bulldogs / CAUSE:

  • INJURY: an injury to the ear flap vessels leads to the bleeding
  • TRUAMA: hitting the flap on a hard object.
  • BITE: a dog nipping on the ear flap
  • PAWING & RUBBING: due to ear infection or allergies
  • OTITIS: allergic otitis, yeasty otitis, infectious otitis

EAR HEMATOMA PAIN WARNING: 

Aural hematomas can be painful to the touch and may aggravate an underlying ear disease.

Bulldog cauliflower ear flap due to a ear hematoma

CULIFLOWER EAR: Left untreated, the blood clots, leaving the ear deformed, a so-called “cauliflower ear.”

Bulldog Ear Hematoma PRESENTATION

  • BLOWN UP PINNA (flap)
  • RED SWLLON SOFT INFMALED PINNA (flap)
  • HEAD SHAKING
  • EAR INFECTION (some times)
  • PAIN

Ear Aural Hematoma in Bulldogs / DIAGNOSIS

  1. Dr. Exam
  2. Otoscopic Exam
  3. Cytology of the blood if an abscess is suspected

Ear Hematoma in Bulldogs and French Bulldogs / PREVENTION

Weekly ear cleaning and wiping to prevent ear infections

BULLDOG EAR CLEANIN & WIPING

  • Bully Cleansing Ear Wipes
  • Bully WaxLess Drying and Acidifying Aloe Ear Rinse
  • Yeasty Bully Ear Rinse

BULLDOG ALLERGIES & ITCHING

Control the common allergies and associated itch

  • Bully ItchLess Shampoo
  • Bully ItchLess Conditioner
  • Bully ItchLess Spray
  • Bully Hypoallergenic Shampoo & Conditioner
  • Bully Fish Oil SKIN-IMMUNE-JOINT

BUSTER COLLAR:

If the dog shakes or/and rubs the ear and ear base

Bulldog Ear Aural Hematoma TREATMENT

Treat the underlying cause as well as the hematoma

EAR INFECTION Left alone a large hematoma will predispose the ear to infection and make it difficult to manage an ongoing one.

Bulldog Aural Ear Hematoma

CONTROL OTITIS:

You must control ongoing ear disease

  • Topical RX
  • Dr. Kraemer’s Bully Therapeutics Topical & Supplements
    • V4B Bully WaxLess Aloe Rinse
    • V4B Yeasty Bully Rinse
    • V4B Bully Cleansing Ear Wipes
    • V4B Bully Fish Oil EFA Chews
    • V4B Derma Care Tabs

v4b-bulldog-waxless-aloe-vera-ear-rinse-001.jpg

PAIN MANAGEMENT:

Large hematomas can be painful, so you should consider pain control

  • RX: analgesics and NSAID
  • Dr. Kraemer’s Non-RX Bully Comfort & Acheless Chews

Fr. Bulldog V4B comfort and Painless handout

BULLDOG EAR HEMATOMA TREATMENT

Bulldog Ear Hematoma Draining blood

ASPIRATION & PRESSURE BANDAGE:

Remove the blood with a needle and apply a pressure bandage for a few days.

This might work for small hematoma.

STEROID INTR-HEMATOMA INJECTION:

After aspiration, inject a steroid to reduce inflammation and itch. It might be effective for small, minor hematomas; a pressure bandage can be added for a few days

LASER THERAPY:

Class 4 laser sessions can help small hematomas by reducing swelling and inflammation.

BULLDOG EAR HEMATOMA SURGERY

 

Surgery is the gold standard, The procedure is very simple and involves removing the blood and then closing the dead space between the two cartilages, usually with parallel sutures.

BULLDOG EAR HEMATOMA POST OP

It’s best to fix it as soon as possible, once the blood clots, it will become fibrous, harden, and scar.

The cartilage will crumple to a cauliflower appearance, blocking Once this happens, it can’t be fixed except for amputating the pinna.

Ear Hematoma in Bulldogs and French Bulldogs: TIPS & WARNINGS

Below are selected ear hematoma tips & warnings, courtesy of Dr. Kraemer

EAR HEMATOMA SUTURE PLACEMENT TIP:

When suturing an ear hematoma or performing any ear surgery on bulldogs, the sutures mustn’t be too tight. Post-operatively, the ear often experiences swelling, so overly tight sutures can restrict circulation and potentially cause discomfort and pressure sores.

Additionally, since the sutures typically remain in place for an extended period, the surgeon needs to use a type of suture that is not irritating to the ear tissues. This helps minimize irritation and promote proper healing during the recovery process.

EAR HEMATOMA SUTURE REMOVAL TIP:

Unlike sutures in other types of soft tissue surgeries that are typically removed within about 14 days, sutures for ear hematoma repair should remain in place for a longer period, usually around 3 weeks. This extended duration is necessary to ensure the formation of strong adhesions between the external and internal layers of cartilage in the ear pinna.

These adhesions are crucial for the successful healing of the ear and to prevent the recurrence of the hematoma, ensuring that the ear’s structure is maintained and the fluid does not accumulate again.

EAR HEMATOMA E-CONE TIP:

Keep a buster collar for safety before and for one week after the sutures are removed

AURAL HEMATOMA CAULIFLOWER WARNING:

Cauliflower bully ear, a condition often resulting from untreated ear hematomas, can lead to a permanent, irreversible thickened, wrinkled appearance of the ear flap. This deformation can obstruct airflow to the ear canal, creating an environment conducive to dampness.

Such conditions are likely to predispose the ear to canal diseases by fostering a moist environment where pathogens can thrive. Additionally, if there is already an ongoing ear disease, the altered shape and reduced airflow can exacerbate the condition, complicating treatment and healing processes.

To prevent such complications, don’t delay ear hematoma repair

BULLDOG EAR HEMATOMA INFECTION WARNING:

Bulldog and French bulldog ear hematoma is typically a sterile accumulation of blood between the cartilage and skin of the ear flap. There are circumstances under which it can become infected and abscessed.

This is particularly true in cases where the hematoma is a result of a bite, puncture, or any other form of open wound that introduces bacteria into the area. In such situations, the body’s response to the infection can lead to the formation of an abscess within the hematoma.

This often involves the administration of short-term antibiotics to combat the bacterial infection, along with the standard treatment for the hematoma

BULLDOG EAR HEMATOMA TREATMENT FAILURE:

Draining the hematoma through aspiration, whether accompanied by a compressive bandage or a steroid injection, seldom yields long-term success.

Typically, the evacuated area quickly refills with blood.

This method may serve as a temporary solution before the surgical intervention or could be considered for treating very minor hematomas.

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