When it rains, it pours or so the saying goes.  Unfortunately its been one of those “pouring” weeks for us.  My poor black lab Zeus just can’t win for loosing it seems.  Last Tuesday I took him into the vet to have his stitches removed from his lipoma excision.  Stitches were removed, they said he looked great and was healing very nicely…  Well we were in the waiting room to have a prescription filled he apparently shook his head and gave himself a giant hematoma in his left ear.  I was rubbing his head and noticed his ear felt warm and as I moved my hand further down his ear and OMG it felt like a huge marshmallow as in it.  I went up to the receptionist and asked if someone could look at it.  I thought he had been bit by a spider or some other insect and he was having a reaction.  The vet tech came out and immediately knew it was a hematoma and said I would need to have him seen by the vet.

The vet saw us and and explained what an aural hematoma is – a collection of blood in the ear from a broken blood vessel.  Most likely caused by head shaking and usually associated with ear infections.  Labradors are apparently very prone to getting them, of course.  She explained the treatment options

• Drain the fluid from the ear and inject with steroids.
• Surgically removed the hematoma, insert multiple drains and sutures throughout the ear to keep it from filling back up with blood.
• Do nothing and let it resolve itself.

While option three is of course the cheapest and least invasive, it is actually a non-option.  Aural hematomas are very painful for the dog and take months to resolve on their own.  Unfortunately a significant amount of tissue damage is done which in turn creates a significant amount of scar tissue.  The ear usually ends up quite disfigured.  Sometimes this is the only option for dogs that can not tolerate anesthesia due to other health issues or age.

Option one, draining it and injecting steroids would have the ideal choice however… why does it always seem like there is a however?  However Zeus is currently taking Novox (generic form Carprofin, the bio-equivalent of Rimadyl®) for arthritis and steroids are contraindicated (should not be used in conjunction) due to possible bleeding issues.  So of course that option is out.

We decided to go with option two.  Zeus stayed the night there and they performed the surgery that night.  I picked him up around 2:00 am and I have to tell you I was totally unprepared for what they had done to him.  I really thought they would just put a small incision in the ear flap, drain out the blood and stitch it up.  NOPE!  They made a 3 inch incision in his ear and drained out all of the blood, inserted drains on both sides of the ear and secured them with sutures.  The actual incision is not sutured and left open to drain and prevent another hematoma from forming.  It heals from the inside out.  The sutures stay in for 3 weeks and he will have to wear a cone of shame while the sutures are in.

He had a really hard time maneuvering around with the cone and was in a tremendous amount of pain the first two days.  I was not prepared for the amount of blood/drainage.  When I took off the bandages around his head of course he shook his head and blood went EVERYWHERE.  It looked like a crime scene in my bedroom.  It made me feel sick to my stomach.  I just had no idea that it was going to happen.  Its my sincerest wish that anyone who has to go through this in the future and reads this post will be prepared for the first few days post surgery.  I wish they had prepared me.  The first two or so days are the hardest.  Its bloody and messy and painful.  Its normal for there to be alot of drainage and for the incision to bleed and for it to be left open.  But don’t be disheartened, it does get better very quickly though.

He was not sent home with any oral antibiotics, just a topical one for inside the ear.  The next day while in my panic over the blood, I asked them to call in an oral antibiotic for me.  I had a feeling it would get infected and of course by the afternoon it started smelling manky so I’m really glad I did.  By the next morning the infection started clearing up and the smell went away.

Tomorrow will be the one week mark and there is almost no drainage coming out now.  It is healing up nicely.  Zeus is doing very well and seems very happy go lucky again.  He does wear the cone all the time except when I clean the incision once a day with warm water and will continue to wear it as long as he has sutures.  We will be going back on Tuesday for our first post-op check up.  Im hoping they will remove the drains at this visit.  The sutures will stay in for a total of 2-3 weeks.

Icanhavecheeseburger certainly had it right when they said “Its all fun and games til someone ends up in a cone,” the cone of shame is no fun!