Hema-What Now?

**This week’s educational blog will contain talk of blood and injuries. Though it will not be graphic and I will not include graphic pictures, if these things bother you, you might want to skip it!**

Hematoma. It is a word you have probably heard groomers, and maybe even your own doctor, use from time to time. It is often accompanied by a brief explanation of what a hematoma is. Many people still have questions though! So today, we are going to dive into what a hematoma is, how they form, what their relationship to grooming is, and how we can treat, or preferably, prevent them from happening.

What is a hematoma? By definition, a hematoma is a collection of blood outside of the blood vessels. In a way, it is similar to a bruise, however, a hematoma is much more serious. Bruises are caused by small breaks in small blood vessels which lead to minor leakage and the classic black/blue/purple/yellow discoloration of the skin. A hematoma is a much larger break in the larger blood vessels. This can lead to a pooling of the blood in the area near the break. Instead of turning into that classic nasty bruise, the skin will often be red and may appear to be inflamed. Many times, a hematoma is a serious issue that needs medical attention and sometimes even surgical drainage.

So how do hematomas form? What causes those blood vessels to break? In both humans and animals, they can be caused by injury. Generally, there has been some sort of trauma in the area. This can be caused by something like a car accident or a fall. They can also occur during things like blood draws, especially if the patient is on any sort of blood thinners or has an underlying medical condition.

When we talk about hematomas in grooming, they are generally caused by matted fur. The ears on floppy eared dogs are the most common place for hematomas to develop. When their ears mat up, the blood flow becomes restricted due to the skin being pulled tightly. As the groomer shaves off the mats, the blood rushes back in. This rush is not what causes the hematoma to form however it is a major contributing factor. As the blood rushes back in, the dog’s ear will then start to feel weird. Imagine your foot has been asleep for so long that you have gotten used to that tingly sensation. Suddenly, the sock that is too tight and causing the sensation is pulled off. Now you have the pins and needles feeling. You can’t help but twitch your foot around, trying to make it go away! The dog feels much the same way. They begin to shake their heads, often violently, literally trying to shake the sensation away. As their now super sensitive ears flap around, they smack against their own heads, causing further damage to an already compromised area. The blood vessels in the ears begin to pop through the combined centrifugal force and the blunt force trauma. This blood then either pools in the ear, causing a pillowy swelling, or it breaks through the flap at the tip of the ear and leaks out. This causes further irritation, causing the dog to shake it’s head even more. Neither scenario is one a groomer or owner wants to see!

In a non-grooming setting, hematomas can occur for a number of other reasons. The dog may have suffered from some sort of injury to their ears. They may have gotten water in their ears and have been trying to shake and scratch it out. They may also have an ear infection, mite, or flea infestation that is bothering their ears, causing them to shake their heads around. While it is not as common, even dogs with pricked ears like German Shepherds and Chihuahuas can suffer from hematomas. Cats can also develop hematomas as well!

How can we prevent hematomas from forming? It is a simple yet complicated task really. The simplest way to make sure your dog never ends up with a hematoma is to make sure their ears are as healthy as possible. Check their ear canals frequently for any signs of build up or strange smells. Yes, you should know what your dog’s healthy ear smells like! Strange odors can be the first indication of an infection. Treating an infection early can prevent a whole host of problems further down the road! Watch for excessive scratching of the ear and ear canal along with head shaking. These can also be an indication that something is wrong. Keep long-haired dogs’ ears brushed and combed to the skin. If you have trouble keeping up with longer ears, ask your groomer to style the ears shorter. Many long haired dogs look absolutely adorable with fluffy heads and short or shaved ears! This might be an option for your pup, especially if they enjoy running wild outside and come back with the whole world tangled in their ears!

At TLC Pet Services, if we think any matting on your pup’s ears might be tight enough to cause a hematoma to develop, we are going to ask you to consult with your vet for safe removal. We want everyone to be as safe as possible! If we do elect to shave off mats, there are still steps we will take. First of all, any shaving is done slowly, often in stages. By shaving the ear a third at a time, it gives the blood flow a chance to return slowly, lessening the risk of excessive shaking. Secondly, we will shave any matting off before be bathe your pup. This way, as soon as they are in the tub, we can rinse their ear flaps with cool water to help lessen the uncomfortable sensations. A towel or Happy Hoodie may then be wrapped around your pup’s head to hold the ears close to them. The light pressure from the wrap will further aid in the slow return of blood flow along with preventing them from flapping their ears all around. Thirdly, if at any point we feel that there is a risk of the dog shaking their head and developing something, we will not hesitate to wrap their head, give you a call, and ask you to please come take them to the vet! While a hematoma is generally not life threatening in most cases, early treatment will be best for faster healing and a better cosmetic outcome.

How are hematomas treated? Always consult your vet if you think there is anything wrong with your pets! In the case of a hematoma, the vet may take one of a few treatment routes. They may wait and see what happens if the hematoma is small. Sometimes, small pockets will reabsorb over time and require no further treatment. The vet may opt for drainage and placement of a drain tube to keep the area from refilling while it heals. If it is a large hematoma or it continues to reoccur after drainage, the vet may suggest the surgical option of opening the area, removing any clots, and finding and closing up any leaks to prevent further filling. The entire area is then sutured down, sometimes using buttons, to help the skin reattach and lay properly on the dog’s ear.

We strongly believe an ounce of prevention is worth a pound of cure. If you are concerned about your pup’s ears matting up between grooms, let us know! We would rather modify Fluffy’s hairstyle now to prevent any problems than find out she has been to the vet three times because she developed a hematoma that just won’t go away!