Home / Health / Conditions / Aural Hematoma
Body system: Ears, skin and allergies. One of the core guides in our dog health conditions library. If your dog has worrying signs right now, start with our symptom triage guides.
The pinna, the ear flap, is a sheet of cartilage sandwiched between skin on both sides, with small blood vessels running through it. An aural hematoma, also called an auricular hematoma, is a collection of blood that has pooled between the skin and the cartilage, usually on the inner surface, turning a flat flap into a swollen, pillow like bulge that can involve part of the ear or the whole of it. It feels soft and fluid filled in the early days and firmer as the blood clots and organizes.
A hematoma is almost never the original problem. It is the mechanical result of a dog shaking its head violently or scratching hard at an itchy, painful ear: the whipping motion bursts a small vessel inside the flap. Ear infections, ear mites, allergies and foreign bodies like grass seeds are the usual drivers of the shaking. That is why every hematoma consultation is really two consultations: what to do about the swelling, and what made the dog shake, because a repaired ear attached to an untreated infection is a hematoma waiting to happen again.
The immediate cause is trauma from the dog own head shaking or scratching, which ruptures vessels within the flap. The underlying cause is whatever made the ear itch or hurt: most often otitis externa (outer ear infection), frequently allergy driven, and also ear mites, a foreign body, or a growth in the canal. In allergic dogs the hematoma can be the event that finally reveals the allergy, since the ears are inflamed even when infection comes and goes. Dogs with pendulous, heavy flaps give the flap more swing, but any dog shaking hard enough can burst a vessel.
Breeds and dogs at higher risk: Any dog can develop one. Dogs prone to ear infections and allergies, including Cocker Spaniels, Labrador and Golden Retrievers, Basset Hounds and other heavy eared breeds, present most often, because they do the most head shaking.
Diagnosis is by appearance and feel, confirmed by your vet examining the flap and, more importantly, the canal beneath it with an otoscope. A sample of canal discharge is checked under the microscope for yeast, bacteria or mites, so the underlying cause is named in the same visit. The vet distinguishes a hematoma from an abscess, a tumor of the flap, or simple swelling from an insect sting, occasionally by drawing a tiny sample of the fluid: a hematoma yields blood. If the hematoma is one of several, or the dog has had them on both sides, the allergy conversation becomes the main event.
Treatment has two halves. The underlying ear disease is treated first and always: cleaning, medication for the infection found, and an allergy plan where relevant. For the swelling itself, options range from draining the blood with a needle and instilling medication into the pocket (simple, but with a real recurrence rate as the pocket refills) to surgery, in which the pocket is opened, the clot and debris removed, and the skin stitched down to the cartilage in a pattern of sutures that eliminates the space and lets the layers scar together flat. Drains and bandages are used in some techniques. Left entirely alone, most hematomas eventually scar down by themselves over weeks, but the result is often a crumpled, thickened ear and weeks of discomfort, so treatment is recommended rather than patience.
After surgery the ear is usually bandaged against the head and a collar is worn to stop scratching while the layers bond; rechecks remove drains and stitches on the vet schedule. Long term, the hematoma diary is the allergy diary: keep ears clean and dry as directed, keep up any allergy management, and act on the first day of renewed head shaking rather than the tenth, because each day of shaking is load on both flaps. A dog that has had one hematoma has demonstrated it shakes hard enough to burst a vessel, so its ears deserve checking at every routine visit even when they look fine.
See also: symptom triage guides | All conditions A-Z | Health hub
Eventually most will scar down without treatment, but slowly, uncomfortably, and often leaving a permanently thickened, crumpled ear. Treatment shortens the course, relieves the discomfort and gives a flatter result.
Because the flap injury was caused by shaking, and the shaking was caused by the ear. Drain or repair the flap without treating the infection, mites or allergy underneath, and the dog keeps shaking and the hematoma returns.
It is not usually a same night emergency in an otherwise well dog, but it should be seen promptly, within a day or two: it is uncomfortable, it can enlarge, and the underlying ear problem needs starting on treatment.
Surgery that closes the pocket is the most durable fix for that ear, but a new hematoma can form in either ear in the future if the underlying itch returns. Controlling the ear disease is the real prevention.
No. Home draining is painful, unsterile, and almost always refills because the pocket and its cause remain. It also delays the canal examination that finds what started the shaking.
This page is general information drawn from the published guidance of the organizations listed under Sources below. It is not veterinary advice, and it does not replace your own veterinarian, who knows your dog. If your dog may have eaten something toxic, contact your veterinarian, the ASPCA Animal Poison Control Center on (888) 426-4435, or the Pet Poison Helpline on (855) 764-7661 straight away. A consultation fee may apply on the helplines. If your dog is struggling to breathe, has collapsed, is having a seizure that will not stop, or has a swollen belly with retching that brings nothing up, go to an emergency veterinarian now and do not wait to finish reading.
Last updated: November 2026. Facts on this page were checked against the sources listed above. How we work: our methodology.