What Is Aural Hematoma in Cats?

Medically Reviewed by Amy Flowers, DVM on December 02, 2021
3 min read

An aural (ear) hematoma refers to the collection of blood in the cat's earflap or cartilage. It appears as a swelling that feels soft and hot. The primary cause of aural hematoma is a self-induced injury due to continuous scratching or shaking of the head.

Other underlying health problems can also lead to the development of aural hematoma in cats.

This condition makes your cat's ears droop. It's better to contact a vet immediately for an early diagnosis and treatment for the swelling.

When a blood vessel bursts within the cat's earflap, it fills the space between the ear’s cartilage with blood. This collection of blood develops into a pocket full of blood in the cat's ear flap, known as an aural hematoma in cats. 

The condition most often occurs when the cat responds to any underlying health issue, such as an ear infection or irritation. These problems can make your cat repeatedly scratch or shake its head, resulting in a wound or swelling.

In rare cases, aural hematomas in cats can also result from a knock or other injury.

Aural hematomas don't occur frequently. Doctors will treat the underlying cause of ear irritation, but surgery is typically needed to drain the swelling itself.

Some other factors can also cause aural hematoma in cats, including:

  • Increased capillary fragility, such as with Cushing's disease
  • Ear inflammation
  • Immune-mediated diseases
  • Ear allergies 
  • Parasites
  • Ear infections
  • A sudden trauma, such as bite wound or blunt trauma

If not treated promptly, the aural hematoma in cats can persist.

The swelling in aural hematoma is very easy to diagnose. But, your vet will do some tests to confirm if the blood collection in the ear is actually aural hematoma or not. They will perform a complete examination of your cat's ear to determine any underlying health condition causing the ear irritation.

These tests may include:

  • Cytology or fine needle aspirate (FNA)
  • Systemic testing identifies underlying causes, including ear swab tests (looking at ear debris under the microscope for bacteria, yeast, or mites), allergy tests, or endocrine tests

The vet may not recommend any treatment plan for your cat if they have small, painless aural hematomas. These hematomas usually heal or go away on their own, but painful swelling may need immediate medical attention.

Your vet will choose the best treatment plan for your cat depending upon their diagnosis. The options include surgery to drain cat ear hematoma and the treatment of the underlying cause of hematoma.

Surgery to Drain the Swelling

Most often, vets drain the swelling with a syringe or a needle, but often, the swelling comes back later. In such cases, the vet performs surgery on your cat. 

During the procedure, they open the earflap, drain the collected blood, and leave a hole for drainage to prevent future blood refilling. The ear flap is usually sutured flat to keep it from filling up while the ear heals flat.  

Treatment of the Underlying Cause 

If your vet identifies the underlying cause of aural hematoma, they can easily prescribe you the treatment. This may involve a course of oral antibiotics for an ear infection, topical medications for a mite infestation, or an anti-itch medicine for any skin problem.

If the hematoma is left untreated, it could result in the deformity of the ear. Your cat's ear may look like a "cauliflower" due to the collection of thick skin.

Some potential hematoma risks may include:

  • Necrosis (death) of the pinna (ear flap)
  • Recurrence of the hematoma 

Post-surgical care prevents the recurrence of the swelling. Some important steps that pet owners should take at home include:

  • Clean your cat's ear as directed by your vet.
  • If your vet uses a head cone on the cat, make sure they are wearing it all the time until you receive further instructions from the vet.
  • Keep an eye on their progress, such as the pain, swelling, and redness. Your cat's ear may bleed a little. Call your vet if there is heavier bleeding.
  • Make sure that your cat gets all their medication on time.

In most cases, cats with an aural hematoma recover entirely within a week or two.