An aural hematoma is a pool of blood that collects between the skin and the cartilage of a pet’s ear flap…essentially a big blood blister. Trauma to the head, scratching at the ear and shaking the head are the most common reasons for blood vessels to rupture leading to the haematoma.

Owners will often notice a fluid-filled swelling of the ear flap. This is especially noticeable in dogs with erect ears as the ear flap will often hang down. Other signs might be odour from the ear, head shaking or pawing at the ear.

Unless obvious trauma to the head was seen (for example dogs mouthing and biting during play), the aural haematoma is a symptom of a dog that has an itchy ear.


Otitis externa (ear infection), ear mites, fleas, biting flies and allergies are the most common causes of itchy ears.

Our veterinarians need to examine your pet’s skin and ears, and possibly do ear swabs to determine the cause.


The best treatment is surgical correction of the affected ear as well as treatment of any underlying ear problems. We use a punch biopsy technique to drain blood from the ear and then suture in a diamond pattern to ensure the skin adheres back down onto the cartilage to limit recurrence. These sutures are left in place for 2 weeks and your dog will be prescribed antibiotics and need to wear an Elizabethan collar to prevent scratching for this entire time.

Occasionally, medical management through draining and bandages may be attempted, however, in most cases the haematoma recurs.

Without treatment, the ear will contract as the haematoma scars up, and take on a crinkled, cauliflower-like appearance.

Aural haematoma punch biopsy technique

Punch biopsy technique of treating aural haematoma.
Black dots—punch biopsies
Yellow area – the haematoma