Today, Karma-Kat visited the veterinarian for his annual wellness check. He’d lost a little over a pound (yay!), and the doctor said Karma looked like a two- or three-year-old kitty rather than a mature nine-year-old man-kat. He’s a senior kitty now, but doesn’t know it or act like it. We celebrated a great exam until I got home–and discovered the swollen ear flap, or aural hematoma on Karma’s right ear.

Aural Hematoma Cat Care

Hematoma refers to a swelling beneath the skin that contains blood. A blow or bruise causes hematomas, and they usually resolve by themselves. But large hematomas may require surgical drainage.

Aural hematomas, those occurring in the skin of the ear flap (pinna), often appear because of ear mite parasites or ear infection. They more commonly affect dogs with floppy ears, but cats also can develop the condition.

Bruising prompts seepage of fluid, which separates the ear cartilage from the skin. The pocket between fills with blood and fluid. This soft swelling usually develops on the inside but can be on the outside surface of the ear flap. Treatment requires addressing the cause for the injury, such as an ear infection or ear mites that prompt scratching.

Aural Hematoma Treatment

To prevent scarring of the ear cartilage, the veterinarian removes the trapped blood and serum. Drawing out the liquid with a syringe works for small hematomas. Firm bandaging of the ear aids healing and helps the ear keep a normal shape. But often, the ear simply inflates again in a day or two with more blood and serum.

Our veterinarian said Karma’s ear hematoma was the smallest he’d ever seen. Neither of us saw or felt it during the exam, and yet less than an hour later, it appeared. Karma has no ear infections, and hasn’t scratched his ears. Our best guess points to rough-housing with Shadow-Pup. They take turns play-attacking each other.

Without treatment, the fluid eventually reabsorbs. However, it also often leaves behind scarred, damaged cartilage, sort of a doggy or kitty “cauliflower” ear.

Aural Hematoma Surgery

Aural hematoma surgery provides the best results. Once anesthetized, the veterinarian makes a small incision in the inside surface of the cat’s ear to remove collected blood and other debris. Then the separated flaps of tissue get stitched together, leaving a narrow opening at the incision line. This opening allows fluid to drain as the incision heals and prevents the wound from re-ballooning with fluid. For large hematomas on big dogs, a drain may also be needed.

Another technique employs buttons to help keep the ear flap from re-inflating. You can see the two surgical techniques in this video (caution…a bit graphic for some viewers, showing the stitches).

Because of the small size of Karma’s ear hematoma, our veterinarian suggested removing the fluid with a syringe to see if it would resolve on its own. He said in this special case, surgery would cause as much (or more) ear cartilage scarring as if left to heal by itself. In fact, he drew off only 1/2 cc of fluid. We’re to watch Karma-Kat for the next day to monitor if fluid returns, which could mean further surgical treatment.

Followup Care for Aural Hematoma

In severe cases, a soft padding of bandage minimizes deformity and helps the ear keep a normal shape as it heals. Typically, cats that undergo this surgery must wear a collar restraint like an Elizabethan collar to prevent them from scratching at the wound.

UPDATE July 30, 2021: Ten days post diagnosis and draining of his hematoma, Karma-Kat’s ear swelling resolved. The cartilage remains thickened, and the ear slightly tips over, but the man-cat sez, “Makes me look tuff.” What do you think?