"My dog has a swollen ear, it feels like a marshmallow"
"My dog's ear has ballooned to extreme proportions"
"My dog's ear seems filled up and squishy"
These were actual descriptions by owners with dogs affected by a condition called Aural Hematoma in other words "blood accumulated inside the ear".
If we look carefully at these dog's ears, we will see that the actual swollen part is the underlying surface of the pinna. Upon palpation most dogs will display a pain signal.
An aural hematoma is pretty easy to diagnose, most dogs will show the following symptoms:
A swollen pinna (ear flap)
Pain upon palpation
Head held to one side
Pawing at the ear
A history of head shaking
A history of ear scratching
Not surprisingly, most owners that bring in a dog suffering from a swollen ear will also say that their dogs were shaking and scratching their head a lot lately.
An aural hematoma develops when there is an excessive accumulation of bloody fluid within the dog's ear flap. When a dog subjects their ear lobe to excessive scratching and shaking, tiny blood vessels rupture causing the accumulated blood to fill up the space in the ear flap. The ear flap therefore swells under pressure causing the typical "ballooned experience" many owners may witness.
An aural hematoma must not need confused with an ear abscess. The basic way to differentiate the two is by doing a needle aspiration. In an aural hematoma, the needle will aspirate a bloody fluid, in an abscess the aspirated substance will be of a yellowish, green tint suggesting pus.
However, even though an ear hematoma diagnosis may be pretty straight forward, the underlying cause of the itching and scratching needs to be addressed. If only the aural hematoma would be taken care of, very likely the dog will return back to the itching and scratching causing again major damage to the delicate pinna.
Underlying causes may be various, here are a few to be looked into:
Wax built up
Proper treatment will involve taking care of the underlying cause. If there is a bacterial infection antibiotics will be prescribed, if there is a foreign body stuck in the ear canal they vet will work it out, if there are ear mites topical ear medications are given, if there is a history of allergies, the triggering cause needs to be found and finally if there is ear wax a proper cleaning is performed.
However, the aural hematoma needs to be taken care of as well. If left untreated, even though the ear may heal on its own, your dog may risk exhibiting a very cosmetically unsightly and damaged ear. The ear may develop thickness and wrinkles or worse assume a "cauliflower appearance" due to scarring.
Treatment of the hematoma would consist of a surgerical procedure where a small cannula will be inserted to drain the blood out. In a more invasive procedure, the pinna will be cut open allowing the fluid to drain out, and then the area will be sutured back.
Accumulated fluids within a dog's pinna needs a veterinarian attention. Please do not wait too long or your dog may develop a very unsightly ear. If money is an issue, think that waiting for it too heal on its own may have a much higher price: your dog's ear may never look normal as before.