Aural Haematoma in cats

Overview
- An aural haematoma is a blood filled swelling in the earflap.
- The swelling is usually soft, hot to touch, and depending on size, can cause the ear to droop.
- Your cat is most likely to have developed an aural haematoma if they have been shaking their head, or scratching their ear too hard because of an ear infection, ear mites or a skin problem.
- Contact your vet if your cat has an aural haematoma, they will be able to reduce the swelling and treat the underlying cause.
What is an aural haematoma?
An aural haematoma is a blood-filled swelling in an earflap that develops when a blood vessel is damaged. Most aural haematomas develop because of an underlying problem that causes extreme head shaking and/or ear scratching (such as an ear infection, ear mites or itchy skin). As blood fills the earflap, it becomes swollen, heavy, hot to touch, and uncomfortable, this often happens very suddenly. Occasionally, aural haematomas form due to a knock or injury, but this is much rarer than the other causes listed above.

An aural haematoma is a blood blister in the ear flap.
Symptoms
- A painful red, hot, swollen, droopy ear flap
- Head shaking
- Ear scratching
- A head tilt (holding the head to one side)

This cat has a large aural haematoma in his right ear flap
Diagnosis
Aural haematomas are nearly always because of another problem such as ear mites, an ear infection or itchy skin. Your vet will need to examine your cat and his/her ears to find out what has caused the problem.
Treatment
Your cat will need pain relief, to have their ear drained, and treatment for the underlying cause.
Pain relief
Aural hematomas are often very uncomfortable so your cat may benefit from pain relief.
Draining the swelling
Some small, painless aural haematomas can be left to heal by themselves, but most are painful and need to be drained. Some can be drained with a syringe and needle, but if the swelling comes back (which is common); your vet may advise surgery to open the earflap, remove the blood, and leave a drainage hole to stop it refilling.
If a large aural haematoma is left to heal by itself, it’s likely to cause pain, scarring and eventually, a thickened, crinkly earflap (just like a rugby player with ‘cauliflower ear’). Never try to drain an aural haematoma at home.
Treatment for the underlying cause
your vet will prescribe medication to treat whatever has caused your cat’s aural haematoma to form in the first place. This could be antibiotics for an ear infection, an anti-parasitic for ear mites, or perhaps anti-itch medication for a skin problem.
Ongoing care and outlook
After your cat’s haematoma has been treated, you will need to keep their ear clean and protected. If they are sent home with a head cone you will need to make sure they wear it 24/7 (until your vet says otherwise). You will need to keep their ear clean, give all prescribed medication and monitor them for pain, swelling and redness.
It’s normal for an aural haematoma to leak a small amount of blood after being drained, but if it bleeds a lot, or for longer than expected, call your vet for advice. Your cat should be fully recovered within a week or two if they heal without any complications.
Cost
Treatment for an aural haematoma can be expensive, especially if your cat requires surgery. Consider insuring your cat as soon as you get them, before any signs of illness start. This will ensure you have all the support you need to care for them.
FAQ's
Can an aural haematoma heal itself?
Some small aural haematoma swellings can heal by themselves, however, there is nearly always an underlying cause that needs treatment (such an ear infection). Ear problems are usually very painful so it’s always best to contact your vet if your cat has developed an aural haematoma.
Can I drain my cat's haematoma?
No, never try to drain your cat’s aural haematoma at home - you could cause further injury or infection.
What causes aural haematoma in cats?
An aural haematoma is caused by a burst blood vessel inside an earflap - usually due to self-trauma because of irritation caused by ear mites, an ear infection or skin disease.
Published: December 2020
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Written by vets and vet nurses. This advice is for UK pets only.
Illustrations by Samantha Elmhurst