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April 21, 2014

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Janell

Tried to subscribe to your feed, but the link takes me to a code copy of your most recent blog post.

Doc

Hello, Janell,

I am not posting very regularly, though I answer questions daily.

Geri Taran

Hello Doc. I also have a 7 year old Golden with an aural hematoma. Just yesterday I took him to my regular vet who drained the ear (two large syringes of blood) but today it is filling up again. I tried to find online info on heparin without much success. As I am pretty adept I'm considering just sterilizing a large needle such as an upholstery needle, and piercing it myself, making sure that after it drains I clean it with H202 and watch it carefully.
What do you think about that?

Doc

Hello, Geri,

Heparin keeps blood from clotting. Placing it in the hematoma would most likely increase the bleeding. I cannot think of any good reason for you to need heparin.

Poking holes in it repeatedly and squeezing it out is pretty useless. Even when carefully drained under sterile conditions, you would need some type of compression bandage to keep it from refilling. It is difficult to get enough pressure and not too much (which would cause injury).

If you do this repeatedly, you are very likely to introduce contamination and have a rip-roaring infection in that sack of bloody fluid.

Hydrogen peroxide is great for cleaning blood stains. It breaks up the protein bonds and really helps get the blood off.

It is not much of a disinfectant.

So, to answer your question, I think you are most likely to do harm with your proposal, rather than help your dog.

Call your veterinarian and let them know that it is refilling already. See what they say when they receive your feedback.

Sharon

I'm sorry if this comment/question doesn't directly relate to the post, but I have been researching online and was led to this post. I'm seeking advice for a rather complicated situation. My cat was a healthy, energetic 2-year-old Maine Coon mix rescue cat but after having her ears flushed she came home from the vet with vestibular disorder and total bilateral deafness. The vet that did this to her was not helpful or accountable, so after a terrible week of suffering, I took her to a vet neurologist who did an MRI and found ruptured ear drums and one tympanic bula completely clogged. She was put on an antibiotic and 5 mg daily of prednisone. After about a month she seemed to respond to sound a little (only loud sounds and she still couldn’t localize them – also, her ears have not moved in response to sound since the cleaning ten weeks ago.). When the vet recommended fading the prednisone, we went from 5mg daily to 5mg every other day, but after a week of this she didn’t seem well (lethargic on the “off” day) and she also seemed to revert back to total deafness, so the vet has recommended going not only back up to daily but to increase to twice daily and see if it helps the hearing return (perhaps it’s inflammation blocking the hearing). The other strange thing is I have not increased yet (still debating) and she seems lethargic and has reverted back to deafness. I don’t understand how her hearing can fluctuate from total deafness to partial deafness and then back again. I want to do everything I can to try to help her return to her previous state prior to this terrible incident. She is recovered from the vestibular syndrome but I feel the prednisone is making her lethargic and she seems to have trouble swallowing (she just makes gestures with her mouth like she has a lump in her throat). She does drink more, but nothing excessive, and urination and food intake seem relatively normal. I’m nervous to increase the dose and really want to start fading to get it out of her system but on the other hand it’s the final attempt at recovering her hearing. If we continue, including the fade-out time, it will probably total about three months on the medication. Is it dangerous to continue for another month? My gut tells me not to do it, but on the other hand, it is the last option to help her. What should I do?

Doc

Hello, Sharon,

I have been told by a specialist in ear disease that ANYTHING is potentially toxic to the inner ear, even saline solution.

Flushing that gets into the tympanic bulla always has the potential to damage hearing, though this rarely happens. We are always cautioned not to use certain medications if the eardrum is not intact. However, if the ear is full of gunk, you cannot see if the eardrum is intact or not. 90% of the time it is not, but you cannot successfully treat the ear if you leave it full of gunk. You are between the proverbial "rock and a hard place".

Most of the time, there is no hearing damage, but sometimes there is. Bad luck.

Has the clogged tympanic bulla been addressed? Has it been flushed out or surgically drained? If it is still full of crap that isn't going to help the hearing situation. It could also be full of a tumor instead of just inflammatory exudate (though this is less likely in a 2-years old cat).

Taking the prednisone for a longer term is usually a manageable situation which the cat will tolerate okay.

You ask what you should do. At this point, my advice would be to give the neurologist who has actually seen your cat as much feedback as possible, and follow his/her advice.

Sharon

Thank you so much for the feedback. We were treating the clogged bulla with antiobiotic, which she took for about six weeks. It's hard to know if it's cleared without doing another MRI and they are just so expensive. Her balance improved and she wasn't shaking her head anymore, so I think it helped, but I have no evidence that it's cleared. The neurologist wants to do 5mg of prednisone twice a day (instead of once a day as we've been doing). I actually started this yesterday and so far so good. I suppose we will try this for a couple weeks and see what happens, but your comment does make me worry that perhaps the hearing loss is permanent. The neurologist is pushing the prednisone, but I felt unsure. Thanks for providing another perspective and (cautious) assurance that the prednisone is relatively safe given the context of this situation.

Doc

Hello, Sharon,

Thanks for the feedback. Cats can tolerate a lot of steroids, compared to people and dogs.

Good luck.

Caroline

I have a staffie and his ear has just come up like a ballon. His ear doesn't look infected and he doesn't seem bothered about it, this might seem like a silly question but just before this happened I had prepared my hall for decorating and he discovered an electric cable and had chewed it . The electrition said he was very lucky that it didn't kill him or give him a nasty shock poor boy. Could this have been the cause of it

doc

Hello, Caroline,
What is usually seen with electric shock are burns in the mouth, and (with bad shocks) fluid in the lungs, which can be fatal.

Those things usually happen within an hour or so of the shock, so you shouldn't have to worry about it now.

It doesn't seem likely to me that the shock caused the hematoma.

Annie

Successfully treated my dog's aural hematoma firstly with Arnica oil I bought on Amazon. I religiously put it on her ear daily and there was no shift. Then I read that if it is caused by internal trauma then you need the homeopathic remedy lachesis, if it is external then the remedy is arnica. My dog's hematoma occurred through head shaking so the remedy for hematoma reduction is lachesis (homeopathic remedy). I gave her a low dose of 30c for about 5 days twice daily and I noticed a reduction in her swelling. I continued with arnica oil. I could not touch her ear in the beginning when it had ballooned but gradually it went down. The whole process has taken 6 weeks and required patience and perseverance. Glad I waited as she had surgery on her other ear and she cried so much afterwards that I did not want her to go through that again. The cost was about £300 in the UK. She has a few bumps where the hematoma was but she seems happy. I will continue with arnica oil and see if I can get rid of the two small bumps that remain. I particularly wanted to continue with the Arnica as it stops lumps in the blood. I am a qualified homeopath in the UK. My Staffordshire Bull Terrier is 10 1/2 has severe arthritis of the knees so I did not want to put her through surgery for her ear as she may need a double knee replacement on both knees. I treat her with supplements and homeopathy and she has remained mobile and her surgeon says he will not operate at the moment as he cannot make her any more mobile than she is now. I have successfully treated my dog's hematoma with homeopathy. Lachesis was very deep acting and the indicated remedy for her condition.

Doc

Hello, Annie,
Thank you for sharing your story. I must confess that I have little experience with homeopathic remedies, and have not found any controlled studies that make me confident in them. I am glad that you have had a good outcome.

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