Vet Times

Aural haematomas: an alternative to surgery

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It occurred to me the other day I hadn’t seen an aural haematoma for some time. Saying that, I now expect three to come along in Monday-morning surgery.

I also recall a time when we immediately resorted to surgery as the primary treatment. However, lately we have drained the ear and injected dexamethasone into the space. If you do this, though, it is vital to inform the owner the ear will swell up again post-draining, but will resolve over the following week or so.

As long as we are treating any concurrent otitis externa (if present), I have found this a very effective means of treatment and very valuable in elderly patients with co-morbidities.

Greg Martinez DVM drains, injects and wraps an aural haematoma (source: YouTube).

Note: Greg uses cortisone rather than dexamethasone.

Comments

3 responses to “Aural haematomas: an alternative to surgery”

  1. Martin Squires Avatar
    Martin Squires

    What are you using as local anaesthesia for the procedure? It is rather painful and last two dogs I tried it out on failed to resolve and now hate coming to the surgery because they associate the visit with the previous insult!

    Reply
    1. Graham Finch Avatar
      Graham Finch

      Hi Martin,

      For local use we use (off-licence, as I believe it’s a human product) EMLA 5% cream – a topical local anaesthetic. I usually give this around 30 minutes to take effect. You might also consider EthyCalm (a freezing type spray), which acts much quicker but, in my experience, is less effective. We get both of these from our wholesaler. We will also consider Domitor/Torbugesic sedation according to the circumstances.

      You have also reminded me of a conversation I had with a pharmaceutical rep a while back, but one that has always stuck with me – to warn owners that the ear will refill initially but then if you leave around 7 days longer the majority will still resolve without adverse scarring or the need for surgery. Good advice I found.

      Reply
  2. Tim Avatar
    Tim

    Does the steroid injection works only locally or is it absorbed and have systemic effect?

    Reply

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