An ear hematoma (aural hematoma) is a pocket of blood that builds up inside the ear flap after a small blood vessel breaks. It makes the flap look puffy and swollen, and it often feels soft and warm, "like a water balloon."1,2 It is the most common injury of the ear flap in dogs.3 Most are caused by hard head shaking or scratching, usually because of an ear infection or an itchy allergy.4,5 Ear hematomas hurt, so get your dog seen by a vet soon.5,6 Treatment drains the blood, and the itch or infection behind it has to be treated too, or the hematoma may come back.4,5 This guide covers the signs, causes, breeds at risk, treatment options, recovery and cost.
Call your vet for an appointment if your dog has:
- A swollen, puffy or droopy ear flap6,1
- Head shaking, head tilting or scratching at one ear6
- A red, sore or irritated ear6
Don't try to drain it yourself.6 Getting it seen early gives the best chance of a good-looking ear.2
What the Research Shows
- About 1 in 400 dogs a year. In UK veterinary records of over 900,000 dogs, 0.25% developed an ear hematoma in one year.7
- Ear disease often comes with it. More than half of those dogs (55%) also had an ear infection recorded.7
- Some breeds are much more prone. Bull Terriers, Saint Bernards and French Bulldogs had about 7 times the odds of crossbreeds, and Golden Retrievers about 4.6 times.7
- Draining alone rarely works. In two small studies (Mikawa 2005 and Kuwahara 1986, as summarized in a 2022 evidence review), needle drainage on its own resolved none of the hematomas (0 of 14 and 0 of 4 dogs).8
- Surgery had fewer recurrences in one study. 4% of hematomas came back after surgically made drainage holes, compared with 33% after a steroid injection into the ear. Most of those cleared with more injections.9
What Is an Ear Hematoma?
When a dog shakes its head hard or scratches its ear, a small blood vessel in the ear flap (pinna) can break. Blood then collects within or just under the ear cartilage.1,2,10 The swelling usually appears suddenly, on the inner surface of the flap, and can involve all or part of it.6,4,5 One research team has proposed that the way ear cartilage folds may play a part, which could explain why some ear shapes are affected more often.7
Signs of an Ear Hematoma
- A soft, fluid-filled swelling of the ear flap, often on the inside4,1
- An ear flap that looks thickened, puffy or hangs lower than usual5,6
- Warmth and tenderness when the ear is touched2,5
- Head shaking, head tilt, or scratching and rubbing the ear6
- A red, sore or irritated ear6
Over time, an untreated hematoma shrinks as scar tissue forms, leaving a thickened, crumpled "cauliflower ear."2,1
Causes
Almost every ear hematoma starts with trauma from head shaking or scratching.4 The usual reasons a dog does this are:5,2,6,4
- Ear infections (otitis externa)
- Allergies, including atopic dermatitis and food allergy
- Ear mites and other parasites
- Something stuck in the ear, such as a grass seed or tick
- Bite wounds or a knock to the ear
Conditions that make blood vessels fragile, such as Cushing's disease, or that affect blood clotting can also lead to a hematoma, sometimes without obvious trauma.2,5 A role for the immune system has been suggested, but it hasn't been proven.11,10
See ear infections in dogs and dog allergies.
Which Dogs Get Ear Hematomas?
Any dog can get one. In the large UK study, the breeds with the highest odds were the Bull Terrier, Saint Bernard, French Bulldog, Irish Staffordshire and English Bull Terriers, and Golden Retriever. Greyhounds, Chihuahuas, Miniature Dachshunds and Pomeranians were rarely affected.7 Dogs with V-shaped drop ears (folded ears that hang down, as in the Vizsla) or semi-erect ears that tip over (as in the Rough Collie) had higher odds than dogs with upright ears. Dogs with long, pendulous ears, like Basset Hounds, had lower odds.7 The risk rose with age up to about 8 to 12 years, and was higher in heavier dogs.7
Diagnosis
Vets can usually recognize an ear hematoma by its look and feel. They may confirm it by drawing a little fluid with a fine needle.10,2 Your vet will also examine the ear canal, and may take an ear swab, to look for an infection, mites or other causes of itching.10,2 Some dogs need allergy or hormone tests to find the underlying cause.2
Treatment Options
Whatever method is used, treating the cause of the itching or infection is essential. If it isn't treated, another hematoma may form.4,5,1
- Draining with a needle alone: quick, but the hematoma usually refills.8,5
- Draining plus a steroid: steroid medicine placed into the drained space, given by mouth, or both.4 In a 2016 survey, drainage with a steroid placed in the ear was UK vets' most common first choice.12 It often needs repeating, and in one study a third of hematomas came back after a steroid injection.5,9
- Steroid tablets alone: may be used for some smaller hematomas. In one small study without a comparison group, most dogs improved within 4 weeks, though some needed their dose lowered because of side effects.5,3
- A drain: a small tube left in the ear so the fluid keeps draining while it heals.13,14 In one study of 53 dogs and cats treated with a drain alone, about 15% came back, and about a third had some ear deformity.13
- Surgery: the vet opens the hematoma, removes the blood and clots, and places stitches through the ear flap to close the space while it heals. The stitches usually stay in for about 3 weeks.1,4 UK vets surveyed considered surgery the option most likely to fix the problem for good, and they used it for about two-thirds of repeat cases.12 In one study, surgically made drainage holes had fewer recurrences than steroid injections.9 Surgery can leave the ear flap noticeably misshapen.14
Ask your vet about pain relief, and which option suits your dog's hematoma, health and budget.
Will an ear hematoma go away on its own?
The blood may slowly reabsorb, but large hematomas are often painful. Healing without treatment usually leaves a thickened, wrinkled "cauliflower ear," which can partly block the ear canal.5,1,6 Your vet may suggest letting it heal on its own if your dog isn't a good candidate for anesthesia.1 Even with treatment, some ears still end up thickened or misshapen.4,13
Recovery and Aftercare
- Keep the cone (e-collar) on at all times until the ear has healed, so your dog can't scratch or shake it open.6,14
- Some dogs need a bandage or head wrap, which protects the ear and reduces swelling.2
- A little blood or fluid leaking for a few days after draining is normal.6 Your vet can tell you how to keep it clean.
- Drains or bandages usually come off after 3 to 14 days. Stitches may stay in for 2 to 3 weeks.5,1
- Give all the medicines for the ear infection or allergy, and go to your recheck appointments.4,14
Many dogs are much more comfortable within one to two weeks,6 but after surgery or a drain, healing usually isn't finished until the stitches or drain come out, often around 2 to 3 weeks.5,1,14 How often a hematoma comes back depends on the treatment used and on keeping the underlying ear problem under control.2,11,9,13
Cost
Costs vary widely by area, clinic and method. Published estimates from pet-insurance and pet-care sites are rough guides only:
- Needle drainage: about $50 to $150 per session15
- Drainage with a steroid: about $100 to $30015
- Surgery: about $300 to $2,000, and anesthesia, hospital stay and rechecks may cost extra16,17
Repeat drainage is often needed and can add up,5 and treatment can become expensive if surgery is needed.6 Ask your vet for an estimate that includes rechecks and treating the underlying ear problem.
Can You Treat an Ear Hematoma at Home?
No. Please don't try to drain or lance it yourself.6 An open wound in the ear can become infected,2 a home puncture usually refills, and it doesn't treat the infection or itch that caused it. What you can do at home is stop further damage: gently prevent scratching and head shaking, use a cone if you have one, and get a vet appointment as soon as you can.
Frequently Asked Questions
What does an ear hematoma look like on a dog?
A puffy, soft swelling of the ear flap, usually on the inner side, that can feel warm and like a water balloon.
Is an ear hematoma an emergency?
It isn't usually life-threatening, but it is painful, so see your vet within a day or two. Go the same day if the ear is bleeding heavily, your dog seems unwell, or you notice bruising or bleeding elsewhere, which can point to a clotting problem.
Can a dog live with an ear hematoma?
Yes, but it is uncomfortable, and without treatment it usually heals into a thickened "cauliflower ear."
Can a hematoma fill back up after draining?
Yes. Hematomas often refill after needle drainage, especially if the ear infection or itch isn't treated.
How much does ear hematoma surgery cost?
Roughly $300 to $2,000, depending on the clinic and area, plus possible extra costs for anesthesia and rechecks. Ask your vet for an estimate.
How long does an ear hematoma take to heal?
Many dogs are much more comfortable within one to two weeks, but after surgery or a drain, healing usually isn't finished until the stitches or drain come out, often around 2 to 3 weeks.
Can I massage my dog's ear hematoma?
No. Massaging won't remove the blood and may hurt your dog. See your vet instead.
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Sources and further reading
This article was written and fact-checked on October 17, 2026 against current veterinary references and specialist guidelines:
- Roman N (reviewed by Hess L). Disorders of the Outer Ear in Dogs. Merck Veterinary Manual (pet owner version), reviewed April 2026.
- American College of Veterinary Surgeons. Aural Hematoma. ACVS animal owner resource, last modified December 2023.
- Rüfenacht S, Schellenberg S, Borio S, Summerfield A, Ricklin ME. Non-blinded treatment of aural hematoma with oral prednisolone as a monotherapy in privately owned dogs. Schweizer Archiv für Tierheilkunde 164(6):447-455, 2022. doi:10.17236/sat00358.
- Tomich L (reviewed by Carney P). Auricular Hematomas in Dogs, Cats, and Pigs. Merck Veterinary Manual (professional version), reviewed June 2026.
- Weir M, Williams K, Llera R, Ward E. Aural Hematoma in Dogs. VCA Animal Hospitals, updated April 10, 2026.
- PDSA PetWise Pet Health Hub. Aural haematoma in dogs. PDSA, August 2020.
- O'Neill DG, Lee YH, Brodbelt DC, Church DB, Pegram C, Halfacree Z. Reporting the epidemiology of aural haematoma in dogs and proposing a novel aetiopathogenetic pathway. Scientific Reports 11, 2021. doi:10.1038/s41598-021-00352-0.
- Church R. In dogs with aural haematoma does draining and injecting corticosteroids versus drainage alone reduce the risk of recurrence? Veterinary Evidence 7(1), March 31, 2022. doi:10.18849/ve.v7i1.438.
- Itoh T, Kojimoto A, Kojima K, Mikawa K, Shii H. Surgical creation of multiple drainage holes versus local injection of corticosteroids for treatment of aural hematomas in dogs: 51 dogs with 71 aural hematomas (2000-2017). Journal of the American Veterinary Medical Association 260(S1):S15-S23, 2021.
- Griffin C. Dermatologic Diseases of the Auricle. World Small Animal Veterinary Association World Congress Proceedings, 2006 (VIN).
- MacPhail C. Current Treatment Options for Auricular Hematomas. Veterinary Clinics of North America: Small Animal Practice 46(4):635-641, 2016. doi:10.1016/j.cvsm.2016.01.003.
- Hall JL, Weir S, Ladlow JF. Treatment of canine aural haematoma by UK veterinarians. Journal of Small Animal Practice 57(7):360-364, 2016. doi:10.1111/jsap.12524.
- Chadzimisios K, Papazoglou LG, Tsioli V, Kouti V, Basdani E, Farmaki O, Anagnostou T. Management of aural haematoma with Penrose drainage in dogs and cats: a retrospective study of 53 cases (1996-2016). Hellenic Journal of Companion Animal Medicine 8(2), 2019.
- Pavletic MM. Minimally Invasive Surgical Management of Aural Hematomas Using a Vacuum Drain System. MSPCA-Angell Animal Medical Center, March 12, 2026.
- Team Lemonade. My Dog Has a Lump on Their Ear, What Is It? Lemonade Pet Insurance (commercial), updated October 17, 2026.
- MetLife Pet Insurance. Dog Ear Hematoma Surgery Cost. MetLife Pet Insurance blog (commercial), May 29, 2025.
- Radosavljevic V (reviewed by Bonk C, DVM). How Much Does a Dog's Ear Hematoma Surgery Cost? (2026 Update). Dogster (commercial), updated September 18, 2026.
About this article
Last updated : new page, written using Merck Veterinary Manual, ACVS, VCA and PDSA guidance and published research, including a VetCompass study of over 900,000 UK dogs and studies comparing ear hematoma treatments.
This page is for general information and is not a substitute for an exam by your veterinarian.
