Aural Hematoma (GSD Bitch)

Our 8 year old GSD bitch has recurring ear infections which the vet we have been seeing has said is likely caused by an allergy of some kind. The infection flared up again so I made an appointment to see the vet. That evening we noticed her ear flap was swollen up.  When we saw the vet she immediately said it was an aural hematoma. The ear infection was quickly checked antibiotics and steroids prescribed. The vet then tried to drain the hematoma but the dog was having none of it. The vet said she would need to be sedated and I was to leave her with them. When I collected her I was presented with a bill for early £400 and told that there was a high probability that the ear would refill. It did as soon as the bandage came off. I spoke with the vets and was told it would need to be surgery at a cost of approx £1000. I said I simply don't have that money but they insisted that was their recommendation and they wouldn't discuss any other scenario. So, sorry for the long preamble but my question is: Is the surgery the only option or could we treat the infection and let the hematoma run it's course (keeping her comfortable with pain meds) and accept there is likely to be some resulting scaring and deforming of the ear?

Hello.  I hope that you understood the cost implications and prognosis of this procedure in advance of it recurring.  Indeed, it is not uncommon for dogs to go through life with a wrinkled ear; it does make the ear canal difficult to access in the event of further problems.  Anecdotally, many vets seem to inject steroid into the ear-flap which can apparently help to prevent recurrence, but I have been unable to find any scientific support (literature, papers and so on) for this, which is surprising considering how common heamatomas are in practise.  Another anecdotal choice may be to place a cannula in the ear-flap.  It might be helpful to ask your vet whether they are able to find any hard evidence comparing different treatments for aural heamatoma and I will do some research also and report back if I find anything useful.

A quick search of the vet social media found that some clinicians are recommending medical leeches for this - again, by anecdote rather than research.  It may be worth looking into.

The use of steroids has to be offest against potential side effects.

I really appreciate the quick response. It is reassuring to know that other options exist and if necessary the hematoma can be allowed to run its course naturally.

Time to find another vet I think!

No problem.  I am sorry not to be more helpful on this one.

You were a great help reassuring me. Thanks again.

Hi, Follow up question(s) if I may.... If her recurring ear infections are caused by some sort of allergy (my wife is sure there is a yeast like smell when the ear infect takes hold), can she have antihistamines, if so which type, and will they help? Our vet also mentioned steroids either drops or tablets, would they help to prevent a recurrence? Thanks for any advice.

Hello!  There seem to be as many opinions aboug antihistamines as there are clients, but I dont think theyre brilliant as they often cause drowsiness at a dose high enough to impact the itching.  I don't know of much evidence supporting them at the present time, but its worth asking your vet.  I certainly dont know any vets recommending them as a sole agent.  Steroids are cheap as chips and very strong / effective,  but be sure to ask about systemic side effects and make a balanced decision.  Topical steroids (straight onto the skin / into the ear) may be better because the rest of the body may not need steroids? - worth asking about.  There are also some more specialised drugs that are recommended for skin disease now. Anti-yeast ear drops may help in situations where yeast infections get out of control. As ever, your vet will be the best person to talk to abput this.  Its ways ok to ask a vet why theyre doing something / not doing something else - on the whole, we appreciate it.  I hope that something there is useful.

Thanks for the info, I'm seeing them tomorrow so I'll discuss.