Photo reference.
This is called an aural hematoma. That hot pocket in the ear flap is full of blood. The pinna (ear flap) has 2 layers of cartilage, and a hematoma happens if a blood vessel bursts and separates the layers of cartilage.
Why Does This Happen?
Often, these dogs have a chronic history of ear issues. Sometimes they have an ear infection and marked inflammation, causing them to shake their heads, scratch, and rub. Other times, their ears may look completely fine, and the hematoma just happens unexpectedly.
Is it an Emergency?
It is not a life-or-death emergency, no. But it is uncomfortable, and your pet should be checked out as soon as possible so we can ensure there are no other issues within the ears.
How Do We Fix It?
Our method of choice is to place a teat cannula (yes, a teat cannula for a cow) into the hematoma so it can be drained multiple times a day. We prefer this method because our success rate is high, the complication rate is low, and it can often be placed without sedation, depending on the personality of the patient! It DOES require some home care. The hematoma needs to be drained, initially twice a day, then once a day. It is often in place for 4 weeks or so. The two layers of cartilage need to heal together, and there must be no significant discharge for a week before we pull the cannula. And yes, we want these patients to go home with an E collar on, at least initially.
Are There Other Methods?
Yes! There is surgical repair, which involves general anesthesia and placing multiple holes in the underside of the ear flap, followed by suturing the top and bottom of the ear flap together.
There is also medical therapy—usually a 6-week tapering course of prednisone (steroids). Most vets feel this works 50-60% of the time, but it does take some time. There may be side effects from the medication, and not all dogs are candidates due to preexisting conditions.
What If You Just Drain It?
Well, it fills back up again!