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Aural hematoma - If left alone, what's most likely and worst possible outcomes?

My dog Samwise appears to have an aural hematoma. I have not taken him to the vet, but I estimate that this layperson diagnosis is 98+% correct. My best guess is that he got this by scratching his ear, he has seasonal allergies. There is no pain involved, and he is not scratching more than normal or that ear in particular. This is day 5, and initially it came on suddenly, full blown.

My instincts are this does not require surgery, just careful watching. I am a minimalist as far as these things go, for him and myself too. My income is severely restricted, and I just today got a $1300 car repair bill, 1/3 of my savings. But if he requires treatment he will get it. So I am wondering what are the most likely outcomes if I continue to leave it alone (unlanced, no aspiration, no surgery). That is what I would want to do if I had money, but I don't and I wonder about my judgment.

Samwise is eight years old, a lab shepherd mix, and extremely healthy otherwise. But things have been stressful for him recently. During the last six months we had to move three times (prior to that he lived in one place, with a big yard, for seven years), and during the move I hurt my Achilles tendon, so our walks are woefully curtailed. We lost our wonderful vet during this move, and I don't yet know of a vet here that I can trust.

If you have any useful advice we would both greatly appreciate your thoughts, especially before we see a new vet.

Thank you!
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Avatar universal
I knew absolutely nothing about ear hematomas, so  I never responded. It was good to see what options there were for her in case this ever happens to my dog.  I'm glad she responded back, not many people do.  
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Avatar universal
Agh. The software here is primitive and my comment was accepted before it was finished and I cannot edit it or delete it.

Since no one responded but someone in the same situation may find this post, I will give a brief follow up.

My dog did have an aurul hematoma, a large one in fact. That is basically a blood blister. It felt like one of those plastic bubbles which come in sheets, that we used to be able to pop (a lot of fun) which are used as packing material. In his case the hematoma was about 3 inches long and three quarters of an inch in diameter

At any rate, this is my layperson's understanding. There were three basic options. The least invasive would be to leave it alone, which had the danger of infection, especially if the dog scratched it and opened it up when you weren't looking. The second, more invasive, treatment would be aspiration - to stick a needle into the blood blister and draw out some of the blood and clots. If you read on the Internet about this, unfortunately if you do this the hope is that the body will then reabsorb the remaining blood on its own, but the blood can return, with the hematoma swelling back to the old size. The third, most radical treatment is surgery, which is expensive and involves stitching the skin, which is stretched, back onto the year. This is an extremely imprecise description - I was not considering surgery because of the expense, but there are precise descriptions out on the Internet.

I chose the middle option, aspiration. It cost me $170. The reasons that I chose that were because the cost of the operation is $650++, because my dog's ears internal ears were in great shape, squeaky clean and no infection in the outer ear, according to the vet, because my dog does not have a habit of scratching his ear, and because he is always with me -- I can monitor how he is going. He aspirated the hematoma, gave my dog a cortisone shot in the earflap, and gave me ear drops to use for 14 days in case he had an inner ear infection that we could not see. My friend has a dog in the same situation, with the large hematoma on his ear. She chose to do the surgery, because she was told that the less invasive options would leave him with a cauliflower ear, misshapen. Both of our dogs are over eight years old, and it seems to me that they can live with a misshapen ear. My.vet did not guilt trip me about choosing not to have surgery, but he did let me know that this could go wrong and surgery may be necessary.

Because no one responded to my post, I will not be returning here and so will not be answering any comments. But you can talk to each other via comments on this post, and I hope that this helps someone.
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Avatar universal
Since no one responded but someone in the same situation may find this post, I will give a brief follow up.

My dog did have an aurul hematoma, a large one in fact. That is basically a blood blister. It felt like one of those bubbles which come in sheets, that we used to be able to pop (a lot of fun) which are used in packing.

At any rate, this is my layperson's understanding. There were three basic options. The least invasive would be to leave it alone, which had the danger of infection, especially if the dog scratched it. The second, more invasive treatment, was to aspirate some of the blood out of the hematoma ( Schticking a needle into the hematoma but in trying out some of the blood clots
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Avatar universal
Forgot to say that he is shaking his head more than usual.
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