Tuesday, October 13th2.5°C
Dr. Moshe Oz

Aural hematoma

Ear issues have always been a common problem faced by pet owners. Besides the typical reasons for ear infections in pets, such as allergies, hormonal imbalance etc, another very common reason for sudden ear ache and head shaking in this season is spear grass penetration.  Unfortunately on top of the ear infection, another abnormal outcome that can arise is a sudden swelling of the ear flap, which is known as Aural hematoma.

The ear flap consists of cartilage, small blood vessels, covered by skin and fur. When the ear is irritated, a normal reaction by pets is head shaking. When the pet shakes its head vigorously, it can often snap one or more of the blood vessels supplying the ear flap (pinna). As a result of the blood vessel breakage, blood accumulates under the ear flap skin. This pocket of blood in medical terms is called Aural hematoma.

Aural hematoma can occur in both dogs and cats, but significantly more common in dogs. Aural hematoma is typically characterized by a warm, painful swelling on the inner side of the ear cartilage. Depending on its size, the swelling can be either soft or hard. The swelling typically appears acutely (all of the sudden and not in a gradual manner).

Aural hematoma can only seldom heal on its own without medical intervention. It is not recommended to leave the hematoma untreated due to a few reasons.

The blood pocket itself can be a perfect medium for bacteria to overgrow, spread and cause a severe infection. The blood in the pocket tends to clot and its ability to dissolve and get reabsorbed into the body is very limited to non existent. Last but not least, it is important to remember that Aural hematoma in the vast majority of cases is secondary to a primary problem in the ear that caused the initial vigorous head shaking and scratching. If the primary ear problem is not addressed and treated the problem will recur.

There are a few medical possibilities to treat Aural hematoma. If the hematoma is addressed very close to its formation, it may be resolved by simple aspiration. However, unfortunately in most instances a short surgical procedure is required in order to treat the problem and reduce the likelihood of recurrence.   

Beside surgical drainage, the ear canal is tested for the presence of infection, foreign bodies or any other irritant that led to the head shaking. Very commonly, an oral antibiotic is prescribed to treat and prevent infection along with pain control medication and anti-inflammatory medication.

Sometimes the ear cartilage does not go back to its original shape and scar tissue in the form of wrinkling occurs. Treating the hematoma as close as possible to its formation reduces the chances of any secondary complication that may arise. Being diligent and addressing any ear issues that may manifest by repeated scratching, and/or head shaking, before the hematoma even forms can save both you and your pet a lot of grief.


Allergic reaction to insects

Camping season is in its prime. I am always fascinated how the nature of many of the cases I treat in my clinic is directly related to the season. With our patients running around in nature, naked, and fascinated by all things moving, insect bite allergic reactions are a familiar presentation for vets. Many of these unfortunate encounters between the family pet and the insect happen on a camping vacation, when naturally the variety of insects encountered is larger. However, a severe, acute allergic reaction can happen on the daily walk or even in the back yard.  Our desired area of living, with the hot weather and variety of greenery and fruits growing everywhere, is also popular amongst these pests. The list of the potential harmful insects is too long to mention in full but the most common pests that affect house pets are: bees, wasps, ants, biting flies and spiders.

An allergic reaction is actually the body’s defence reaction, that is out of control. When the pet’s body comes into contact with allergenic insect, the body recognizes it as a foreign material, triggering the immune system to react to this “invader”. Why this reaction goes overboard, impacting the pets in such tremendous way is still unclear.  

Due to the pets nature to explore things with their nose, most of the reaction usually starts with a significant swelling of the face, usually around the muzzle, eyes and even the ears. The swelling is typically accompanied by intense itchiness and redness of the skin. The skin redness is easily noticeable in the inner side of the ears, where the skin is apparent.

The reaction may also manifest systemically, affecting the whole body. This case is known as Urticaria and it is characterized by eruption of skin lumps, initially close to the bite site, then spreading over the body. These lumps are easily visible in slick coated dogs, however may go unnoticed if covered by long hair. Beside the dramatic physical symptoms of the face swelling and the skin lumps, pet owners will easily notice the mental changes in their pet. This kind of allergic reaction is very irritating and accompanied by signs of restlessness and distress. The pet will typically rub itself intensively and cry or yelp continuously. Beside the great inconvenience to the pet, other more serious complications may arise.

Severe swelling of the face and neck may lead to breathing difficulties.  This complication is not very common, however, it is important to be aware of it because the outcome can be tragic. Brachycephalic breeds, such as Pugs, Boxers, Pekingeses, Persian cats and more, that have “squashed” faces are at most risk to be seriously impacted. These breeds have such crowded throats, they can barely breathe when healthy, and any acute allergic reaction in short-faced pets should be considered a potential emergency.

Many pets owners are not in a hurry to go to the vet. If you look online you’ll find DIY advice on these kind of reactions. I have to admit that I am not a fan of any DIY attempts when it comes to pets. Many people will go straight to human Antihistamines (Benadryl). I don’t find this medication helpful when given on its own, let alone the dose adjustments from human to pets, and the side effects that may arise with errors in that area.

Most cases of insects borne allergies are fairly easy to treat if other severe complications have not occurred. Most veterinarians will suppress the allergic reaction by using steroids either on their own or by incorporating steroids with antihistamines. In most simple cases of allergic reactions, a single treatment, or a short course over few days of treatment is sufficient in completely eliminating all the symptoms. In severe cases, where there is a potential life threatening complication, the pet may be required to be hospitalized for intensive treatment.  Luckily these cases are not the majority. In any event, if your pet is showing any of the mentioned symptoms, I strongly recommend that you seek a veterinary assessment which will restore your pet's comfort and the peace in your house.   


For those of you unfortunate enough to have suffered from an ear infection, you know how terrible the pain and discomfort can be associated with ear aches. So can you imagine having tiny creatures living in your ear canal, constantly causing itchiness and inflammation?

One, or probably even the most common cause of ear infections in cats are ear mites. Ear mites are parasites that are called Otodectes cynotis. They live in the ear canal and feed by piercing the skin.

Ear mite infestation is a very common problem in cats. Unfortunately most cats that are adopted from animal shelters, or even cats with an indoor/outdoor lifestyle, will contract ear mites at some point in their lives. Ear mites spread rapidly and can be transmitted by even brief, physical contact with other animals. In pets, ear mites most commonly affect cats, ferrets, and to a lesser extent, dogs.

Ear mites are a serious problem and are deeply distressing and uncomfortable for your pet.

Infestation usually occurs in both ears and can cause intense irritation. Scratching, rubbing the ear, head shaking and ear twitching are the most frequent signs exhibited by affected cats. The degree of itching varies among individual cats.  Very commonly I find hair loss and damage of the skin behind the ears and on the neck due to the intense scratching. The most typical appearance of ear mite infestation is the presence of dark brown-blackish dry or waxy discharge in the ears. Many people are not aware of ear mites and their symptoms and mistakenly think that this discharge is just dirt.

If left untreated, ear mite infestation can spread to other parts of the body, or spread deeper into the ear, jeopardizing the ear drum integrity and putting the animal at risk of deafness.

Occasionally, a blood vessel in the ear can rupture due to the frequent head shaking, leading to a swelling that results from the blood accumulation. This condition is called Aural hematoma and requires surgical drainage.

Ear mites are diagnosed very easily by a microscopic exam of the discharge from the ear. This exam can be done in any veterinary facility, does not require sedation or anesthesia, only takes few minutes, reveals immediate results and is very affordable.  

Once the diagnosis of ear mites is established, the best course of action is to thoroughly clean the animal’s ears. The medication for ear mites comes in few different options of topical drops applied on the skin or directly into the ear canal.  Treatment should be repeated after one month to kill the next generation of mites that will have hatched by then. Relief, in terms of the animal no longer scratching at its ears, will be noticeable within a few hours.

Ear mites can be prevented by applying a topical product monthly against parasites and heartworm. Because ear mites are transmitted so easily from one animal to another, if one animal has it then all the other animals in the household should be treated as well.

Quite commonly I see people attempt to treat a problem at home based on advice from the Internet. I always recommend to my clients to be cautious about using the Internet for medical advice. Beside not knowing the source’s credibility, you should know that in some instances home remedies may cause other medical problems. It is always safer to receive professional veterinarian advice that includes a thorough exam, an accurate diagnosis and prescribing the medication that is best suitable for your pet’s individual condition.

Marijuana intoxication in pets

It was 4 AM and I was finally sleeping after a very busy weekend at the hospital when I got a phone call on my emergency line from a panicked dog owner. The owners are a young, bubbly couple.  They had just finished partying when they noticed their 10 month old puppy was acting very strangely. The dog suddenly became apathetic, non reactive, was stumbling and couldn’t bear weight and stand up, let alone walk. The oddest symptom of all was the dog's hunched back and his inability to control urination. The owners were terrified and had no clue what had happened to their dog. They left him in my safe hands to run some tests. 

Basic laboratory tests of the blood and urine did not reveal any remarkable abnormalities. Since I’ve seen numerous cases that were similar, before I proceeded to perform more expensive tests I called the owners and asked whether there was a chance that the dog had been exposed to Marijuana. The owners were shocked by my suggestion and they denied it completely. It was clear that the dog’s nervous system had been injured. My concern and aim was to locate the damage and assess its extent. X-rays showed no damage to the dog's vertebral column. I called the owners again and after gaining their trust they finally hesitantly admitted that there were some cookies containing pot at their party and yes, four cookies were missing. This information shed light on the dog’s condition and allowed me to treat him accordingly. The dog consumed an overdose 10 times larger than what is considered safe for his weight. The dog reached full recovery after spending  two days in the veterinary hospital.

Smoking illegal substances is one’s personal choice. It is natural to assume that weed smoking people exclude their under age children from the situation, and prohibit their access to the drugs. Pets are very similar to young children in many aspects. They also are very curious, they test everything by mouth and they have no good judgement whatsoever. This is very important to remember and you should protect your pets from substances that may harm them. Marijuana intoxication is quite common in pets, especially dogs. The drug affects the animal's nervous system and manifests by a very wide range of symptoms including depression, wobbliness, aggression, hallucinations, seizures and even coma. One of the most common phenomenon I’ve seen in these intoxication incidents is alternating episodes of depression and then excitement in which the dog seems normal to the owners. Other symptoms like vomiting and diarrhea may also appear.

There are specific tests that can detect the drug in the blood and urine, but in most of the cases the diagnosis is determined by the symptoms and the information given by the owner.  

Tell your vet if your pet may have been exposed to marijuana. YOUR VET IS NOT OBLIGATED TO INFORM THE POLICE. Your vet’s main priority is the pet’s care and well being. Sharing the information with your vet will allow your animal to receive the right treatment promptly and will save you time and money. The treatment of marijuana intoxication is only supportive. There is no antidote for marijuana. If the animal gets to the vet within 30 minutes from the drug ingestion, vomiting can be induced. After 30 minutes from the ingestion the drug absorbency can be prevented and measures are taken to decrease the effect of the drug to a minimum. This can be done by feeding the pet active charcoal which binds to the drug and inhibits absorption.  Fluids are also administered by IV. With the right treatment most animals will make a full recovery.

Remember, your vet is on your side. The vet’s job is not to judge you so disclosing all the information is crucial for your pet’s best medical care.

Read more Dr. Oz's Vet Advice articles


About the Author

Dr. Moshe Oz owns Rose Valley Veterinary Hospital, a small animal veterinary practice in West Kelowna.

Dr. Oz has deep love and affection for animals. It was his childhood dream to become a veterinarian, a dream that he has fulfilled when he graduated with honours from KUVM,on 2006. Dr. Oz's special interest is internal medicine and surgery.

In his free time Dr. Oz enjoys training and racing triathlons, including the legendary Penticton's Ironman.

Dr. Oz can be contacted through his website: www.KelownaVet.ca


The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet presents its columns "as is" and does not warrant the contents.

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