Aural hematoma is a condition that mainly affects small pets, like dogs and cats. In dogs we observed increased diagnosis that require to focus on the correct clinical approach to prevent permanent damages and a long-lasting condition that could lead to imperfections of the ear and, more importantly, to develop ear infections like otitis.
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The aural hematoma presents itself as a blood-filled swelling of the ear caused by a blood vessel rupture.
Generally, the accumulated blood leads to a separation of the skin from underlying cartilage that causes a detachment of the tissues and thickening of the pinna, often warm at the touch and erythematous.
One other symptom to look for is the violent head shaking that expresses the animal’s discomfort.
This disease, which could manifest itself as unilateral or bilateral on both ears, can be caused by many factors: violent head shaking, trauma, bite marks or wounds, foreign body in the ear, ear scratching and autoimmune diseases. It is important to rule out immediately other possible causes like cancer, cyst, or otitis so that the appropriate treatment can be implemented.
The diagnosis should be assessed through an otoscopic examination and, when possible, ear cytology.
Before starting any treatment is advised to perform an ultrasound of the area to establish whether the hematoma has been broken into more than one chamber.
In the chances of a multi-chambered hematoma the treatment should concern every single one of them. Additionally, by performing a colour-doppler ultrasound we can assess whether there are blood vessels still bleeding in the area.
It is recommended to intervene even if the animal’s discomfort has lessened with time, which is an element that despite not proving any full recovery has led to hope for an autonomous resorption of the hematoma. This tendency has been proven to cause sever morphological changes of the pinna and the ear canal underneath, not only a permanent curling of the pinna, but has exposed the animal to recurrence of otitis.
The first step to take is to drain the aural hematoma, after that more than one treatment is available.
The most common procedure, especially in the early stage of the condition, includes draining the hematoma and administering a steroid treatment.
Just after the first drain, with a butterfly needle (19 or 21 gauge), an installation of an intralesional steroid with daily oral steroid treatment is administered. The injections help not just by reducing secretion, but also by increasing the anti-inflammatory effect.
This treatment is usually combined with a course of antibiotics or painkillers.
After the otoscopic examination, the clinical approach requires to sterilize and prepare the concave surface of the pinna damaged by the hematoma, which helps prevent any bacterial contamination or the outbreak of an abscess.
The use of a butterfly needle eases the drainage as well as the installation of the steroid treatment and alleviate any discomfort.
Professionals usually suggest a check-up in a week after the first drainage.
However, clinical studies have shown 50% chances of failure in patients whose treatment was dealt with the drainage and the combination with steroids. This approach has led to recurrence of the aural hematoma that have worsened inflammation and required surgery.
Surgery appears the most common treatment for recurrence of aural hematoma, especially in dogs and cats.
It is imperative to assess beforehand what the surgery might implicate, given that the procedure is performed under heavy sedation or general anaesthesia.
The procedure starts by
A surgical approach, which on one hand might help to restore the adherence of the skin to the underlying cartilage, on the other hand calls for a long and challenging post-op that is painful and intrusive for the patient as well as recurrence of the aural hematoma and curling of the pinna. In critical cases a surgical treatment might request a permanent drainage, very uncomfortable for the animal. Other disadvantages weight on the pet-owner who can be advised to administer medication on the chances of an active infection.
PRP, plasma with a high concentration of platelets, has been shown great benefits in the treatment of diseases thanks to the release of growth factors. These growth factors help the process of regeneration of blood vessels, to repair tissues, to accelerate healing and release substances functional to reduce inflammatory states. The autologous PRP secure chances of any collateral effect.
The PRP preparation implies a closed and sterile system, that from a blood sample, in combination with anticoagulant solution and a double round of centrifugation, provides plasma with the highest platelets concentration enabling the PRP itself to be valuable for many regenerative uses.
The PRP preparation, as well as the protocols and the closed system implemented for the procedure, affect the overall success of the final product, the platelets concentration and, therefore, the therapeutic efficacy.
Once the PRP is prepared through a closed system kit, we should proceed by inserting two butterfly needles, of which one (19 or 21 gauge) in charge of the drainage, and the other one, already pre-filled with PRP, responsible for the intralesional instillation of the platelet-rich plasma. The procedure does not require heavy sedation or general anaesthesia, but it is advised to apply a pressure bandage with the purpose of pressing onto the damaged blood vessel.
Many clinical studies put PRP to the test in the treatment of aural hematoma and they have proved great success in the healing process of the pinna.
This data was confirmed up to six weeks after the first instillation of PRP was administered.
The use of PRP has helped to break the many recurrences that followed both the surgery and the steroid treatment. In some cases, a light recurrence was noted after the first instillation, but with a second one performed a week after the first one with the same procedure, the hematoma had reduced completely, with any inflammation or itching left. The patients were checked weekly, up to a week after full recovery.
Scientific literature, up until today, has recorded the use of little volume of PRP, which might lead to recurrence of the hematoma and then require to apply more than one drainage and up to three instillations, both increasing the patient’s discomfort.
By analysing these studies, it has been shown that higher volumes of PRP help to pressure on the blood vessel by reducing fluid collection in the pinna and by not requiring any other injection, a crucial aspect for cases in which pressure bandage was not applied for reasons related to the ear’s shape.
PRP treatment has proved to be less intrusive than any surgery, offering both the animal and the owner a more comfortable post-op. These advantages, piled with the lack of both heavy sedation and signs of curling of the pinna, usually an effect of blood coagulation, offer a more effective and complete response.
When choosing which PRP kit is best suitable, two factors should lead the decision:
These specifics prove the efficiency of the kit and, as a result, of the PRP preparation.
A clinic approach should pick the most effective, painless, and fast treatment available, with less recurrence risks to which the use of PRP answers.
Aural hematoma is a condition that mainly affects small pets, like dogs and cats. In dogs we observed increased diagnosis that require to focus on the correct clinical approach to prevent permanent damages and a long-lasting condition that could lead to imperfections of the ear and, more importantly, to develop ear infections like otitis.
Request the webinar, you'll find it in your inbox!
The aural hematoma presents itself as a blood-filled swelling of the ear caused by a blood vessel rupture.
Generally, the accumulated blood leads to a separation of the skin from underlying cartilage that causes a detachment of the tissues and thickening of the pinna, often warm at the touch and erythematous.
One other symptom to look for is the violent head shaking that expresses the animal’s discomfort.
This disease, which could manifest itself as unilateral or bilateral on both ears, can be caused by many factors: violent head shaking, trauma, bite marks or wounds, foreign body in the ear, ear scratching and autoimmune diseases. It is important to rule out immediately other possible causes like cancer, cyst, or otitis so that the appropriate treatment can be implemented.
The diagnosis should be assessed through an otoscopic examination and, when possible, ear cytology.
Before starting any treatment is advised to perform an ultrasound of the area to establish whether the hematoma has been broken into more than one chamber.
In the chances of a multi-chambered hematoma the treatment should concern every single one of them. Additionally, by performing a colour-doppler ultrasound we can assess whether there are blood vessels still bleeding in the area.
It is recommended to intervene even if the animal’s discomfort has lessened with time, which is an element that despite not proving any full recovery has led to hope for an autonomous resorption of the hematoma. This tendency has been proven to cause sever morphological changes of the pinna and the ear canal underneath, not only a permanent curling of the pinna, but has exposed the animal to recurrence of otitis.
The first step to take is to drain the aural hematoma, after that more than one treatment is available.
The most common procedure, especially in the early stage of the condition, includes draining the hematoma and administering a steroid treatment.
Just after the first drain, with a butterfly needle (19 or 21 gauge), an installation of an intralesional steroid with daily oral steroid treatment is administered. The injections help not just by reducing secretion, but also by increasing the anti-inflammatory effect.
This treatment is usually combined with a course of antibiotics or painkillers.
After the otoscopic examination, the clinical approach requires to sterilize and prepare the concave surface of the pinna damaged by the hematoma, which helps prevent any bacterial contamination or the outbreak of an abscess.
The use of a butterfly needle eases the drainage as well as the installation of the steroid treatment and alleviate any discomfort.
Professionals usually suggest a check-up in a week after the first drainage.
However, clinical studies have shown 50% chances of failure in patients whose treatment was dealt with the drainage and the combination with steroids. This approach has led to recurrence of the aural hematoma that have worsened inflammation and required surgery.
Surgery appears the most common treatment for recurrence of aural hematoma, especially in dogs and cats.
It is imperative to assess beforehand what the surgery might implicate, given that the procedure is performed under heavy sedation or general anaesthesia.
The procedure starts by
A surgical approach, which on one hand might help to restore the adherence of the skin to the underlying cartilage, on the other hand calls for a long and challenging post-op that is painful and intrusive for the patient as well as recurrence of the aural hematoma and curling of the pinna. In critical cases a surgical treatment might request a permanent drainage, very uncomfortable for the animal. Other disadvantages weight on the pet-owner who can be advised to administer medication on the chances of an active infection.
PRP, plasma with a high concentration of platelets, has been shown great benefits in the treatment of diseases thanks to the release of growth factors. These growth factors help the process of regeneration of blood vessels, to repair tissues, to accelerate healing and release substances functional to reduce inflammatory states. The autologous PRP secure chances of any collateral effect.
The PRP preparation implies a closed and sterile system, that from a blood sample, in combination with anticoagulant solution and a double round of centrifugation, provides plasma with the highest platelets concentration enabling the PRP itself to be valuable for many regenerative uses.
The PRP preparation, as well as the protocols and the closed system implemented for the procedure, affect the overall success of the final product, the platelets concentration and, therefore, the therapeutic efficacy.
Once the PRP is prepared through a closed system kit, we should proceed by inserting two butterfly needles, of which one (19 or 21 gauge) in charge of the drainage, and the other one, already pre-filled with PRP, responsible for the intralesional instillation of the platelet-rich plasma. The procedure does not require heavy sedation or general anaesthesia, but it is advised to apply a pressure bandage with the purpose of pressing onto the damaged blood vessel.
Many clinical studies put PRP to the test in the treatment of aural hematoma and they have proved great success in the healing process of the pinna.
This data was confirmed up to six weeks after the first instillation of PRP was administered.
The use of PRP has helped to break the many recurrences that followed both the surgery and the steroid treatment. In some cases, a light recurrence was noted after the first instillation, but with a second one performed a week after the first one with the same procedure, the hematoma had reduced completely, with any inflammation or itching left. The patients were checked weekly, up to a week after full recovery.
Scientific literature, up until today, has recorded the use of little volume of PRP, which might lead to recurrence of the hematoma and then require to apply more than one drainage and up to three instillations, both increasing the patient’s discomfort.
By analysing these studies, it has been shown that higher volumes of PRP help to pressure on the blood vessel by reducing fluid collection in the pinna and by not requiring any other injection, a crucial aspect for cases in which pressure bandage was not applied for reasons related to the ear’s shape.
PRP treatment has proved to be less intrusive than any surgery, offering both the animal and the owner a more comfortable post-op. These advantages, piled with the lack of both heavy sedation and signs of curling of the pinna, usually an effect of blood coagulation, offer a more effective and complete response.
When choosing which PRP kit is best suitable, two factors should lead the decision:
These specifics prove the efficiency of the kit and, as a result, of the PRP preparation.
A clinic approach should pick the most effective, painless, and fast treatment available, with less recurrence risks to which the use of PRP answers.
