What is an ear hematoma?

An ear hematoma, or aural hematoma, is a condition caused by broken blood vessels within the ear flap, causing the ear flap to swell like a balloon. Most often these small blood vessels break due to vigorous headshaking. The extra weight of the fluid-filled ear flap can cause pain and discomfort and can lead to permanent damage to the cartilage of the ear. Both cats and dogs can be affected by this condition, and the ear flap can be partially or fully filled with fluid. Depending on the size and location of the hematoma, not all cases need direct veterinary treatment. However, more often than not, one or more interventions are needed to treat a hematoma, therefore a veterinary consultation is always recommended.

When should we treat or repair a hematoma?

• If an ear infection cannot be treated because the hematoma is so large that it blocks the ear canal. Ear infections are often the predisposing cause of hematomas because they are itchy and cause headshaking, especially in dogs. 
• If the hematoma risks narrowing the ear canal. Scar tissue in the wrong place can cause the canal to narrow, promoting infections and making cleaning difficult. This problem particularly affects cats and small dogs.
• For cosmetic reasons. An untreated hematoma can lead to a wrinkled or deformed ear flap (commonly referred to as a “cauliflower ear”). For owners that are concerned with the look of the ear flap, surgical intervention is usually needed to decrease the chances of scarring.
• If there is significant pain and discomfort caused by the hematoma.

What are the available treatment options?

• Aspiration: fluid is removed with a needle and syringe. This procedure can be done quickly and is usually inexpensive. However, fluid can easily leak into the empty space left behind, which means the fix is often only temporary. Repeated attempts may be needed, and infections can occur from multiple needle insertions.
• Teat cannula: a draining device is inserted into the ear flap to allow draining of fluid over time. Teat cannulas are usually used in bovine medicine to treat udder inflammation and infections. They can also be used in small animal medicine if the ear flap is thick enough to allow insertion of the cannula. The treatment is usually successful; however, the animal must tolerate the device for potentially several weeks. Additionally, the drained fluids can be messy.
• Surgical correction: the hematoma is drained and then the ear flap is sutured in multiple areas to prevent fluid from reaccumulating. A bandage may be applied after surgery and sutures are left in place for several weeks to allow healing. This method is more often used for cats, as their ear is more prone to scarring leading to a narrowed ear canal. 

In conclusion, ear hematomas are relatively common in dogs and cats. They arise from vigorous headshaking often secondary to ear infections. A veterinary consultation will help determine which treatment option is best for your pet. 

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Many people expect this appointment to focus mainly on a physical exam, vaccinations, and deworming treatments. While those are certainly key elements, this first visit is about so much more than that!

A complete physical examination: the foundation of care

The visit begins with a thorough physical examination. This allows the veterinarian to check your puppy or kitten for any signs of concern, such as heart murmurs, dental issues, or other subtle abnormalities that are not always noticeable at home. Identifying these early helps ensure appropriate follow-up and care. 

Vaccines: why are multiple doses necessary?

The first visit also marks the start of your pet’s vaccination series. Typically, the vaccination protocol involves three appointments

• at 8 weeks
• at 12 weeks
• at 16 weeks.

You may be wondering why vaccinations are repeated monthly. The reason is simple: puppies and kittens receive antibodies from their mothers that protect them, but these antibodies can also interfere with the vaccine’s effectiveness. Since maternal antibodies can persist until about 16 weeks of age, multiple doses are necessary to ensure to ensure optimal efficacy.

Conversely, in some animals, these maternal antibodies disappear as early as 8 weeks of age. Multiple doses help the immune system respond properly and give your pet complete protection.

Deworming and fecal examination: an essential step

Your veterinarian will likely ask if your pet has been dewormed and recommend a fecal examination. Even if your puppy or kitten was dewormed before adoption, they may still require additional treatments. Depending on the time of year, as well as the age and lifestyle of your pet, different parasite treatments may be suggested.

Pet insurance: worth considering early

Since animals don’t come with health insurance cards, pet insurance can be extremely helpful if unexpected medical issues arise. Insurance is generally more affordable and offers better coverage when purchased early, before any health problems occur.

Your veterinary team can explain the different options available to help you make an informed decision. That said, veterinarians do not sell insurance themselves.   

Nutrition and dental care: getting off to a good start

Nutrition plays an essential role in your puppy or kitten’s growth. During their first visit, the veterinarian will review their current diet and offer recommendations tailored to their needs.

This visit is also an excellent time to talk about dental care, an aspect that is often overlooked but crucial for preventing oral disease. Yes, even puppies and kittens can start getting their teeth brushed!

Behaviour: all questions are welcome

Behavioural questions are very common at this stage, such as:

• How do I manage biting or mouthing?
• How should I introduce my pet to another animal?
• How can I help my kitten or puppy get used to nail trims?

Take advantage of this visit to ask your veterinarian anything that comes to mind: that’s what they’re there for.

Spaying/neutering, microchipping, and recommended tests

Your veterinarian will also discuss the ideal timing for spaying or neutering and explain the benefits for your pet’s health. They will also recommend microchipping. For each procedure, the veterinarian will provide you with a cost estimate to help you plan ahead. 

For kittens, your veterinarian may also offer an FIV/FeLV blood test, which screens for two contagious feline diseases. Kittens can be carriers even without showing signs of illness, and knowing their status allows for more appropriate care.

In conclusion: building a relationship of trust

Your puppy or kitten’s first visit to the clinic is about more than medical care: it’s the beginning of a long-term partnership between you, your pet, and your veterinary team.

There is no such thing as a silly question!

Our shared goal is simple: to give your new companion a long, happy and healthy life. We look forward to meeting you both soon!

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Catherine, how did you choose to pursue veterinary medicine?

As far back as I can remember, I’ve always loved animals. I grew up in the countryside, in the small village of Lac-Etchemin in the Chaudière-Appalaches region. My parents owned a fish farm. We had several dogs, and I loved observing animals in the forest. The recent passing of Jane Goodall made me realize just how much of an inspiration she had been to me. This British primatologist and anthropologist, who dedicated her life to studying chimpanzees, sparked two major dreams in me: becoming a veterinarian and going to Africa.

Why was she so inspiring to you as a child?

I found her research fascinating. In fact, when I started veterinary school, I wanted to work with wildlife. After completing several internships related to wildlife, I found myself with two options: practicing exotic/zoo medicine at the Ecomuseum Zoo, or pursuing a master’s degree on ticks.

And you chose ticks?

Yes! (laughs) Two years earlier, I had done an internship in Africa, in Kenya and Tanzania! With two fellow students, we noticed that the most heavily parasitized cows were often blind. Local veterinarians explained that their blindness was caused by a blood parasite transmitted by ticks. The economic consequences were major for local residents, whose subsistence herds were severely affected. That’s when I realized the impact that the work of a veterinary epidemiologist can have on both animal and human health.

Now that you work as a veterinary epidemiologist at the Public Health Agency of Canada, do you still go into the field to collect ticks?

Of course! I’m an adjunct professor at the Faculty of Veterinary Medicine at the Université de Montréal, and I sometimes accompany master’s or doctoral students in the field. However, I now devote a larger portion of my time to designing and managing research projects, in collaboration with Canadian university professors, other researchers, and various government organizations.

When you talk about your work as an epidemiologist studying ticks, how do people react?

It depends! (laughs) Some are fascinated and ask me tons of questions, while others struggle to hide their disgust. In short, ticks leave no one indifferent! And that’s a good thing, because they are a real public health issue. Ticks can transmit bacteria, viruses, or other pathogens to humans through a bite. The most well-known of these diseases is Lyme disease, caused by the bacterium Borrelia.

Is there a link with climate change?

Yes, absolutely. When I began studying ticks during my doctoral studies in 2008, I worked in the field from June to October. Today, tick season lasts longer in many regions. With more time for exposure, their life cycle also lengthens, increasing increasing the risk of infection in the population.

Are there any misconceptions about ticks that need to be debunked?

Yes! Many people believe that ticks fall from trees, jump, or even fly, but that’s not true. They actually stay on low vegetation, where they benefit from the moisture of the soil, until an animal or a human brushes by, so they can latch onto them and later bite them.

Finally, what should we be monitoring from an epidemiological perspective in Quebec?

One of my current projects focuses on monitoring anaplasmosis in Quebec. It’s a bacterial infection transmitted mainly by the blacklegged tick. For now, human cases have been reported mostly in the Eastern Townships—the region that also has the highest number of Lyme disease cases. We have therefore developed master’s-level research projects to identify which natural reservoirs explain the regional emergence of this bacterial infection.

Psst…
Catherine Bouchard is a veterinary epidemiologist (scientific researcher) at the Public Health Agency of Canada. She manages the Ticks and Tick-borne diseases unit within the Public Health Risk Sciences division and she is a professor adjunct at Université de Montréal.

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Oral health: when the veterinarian visits the dentist

This week, I went to the dentist. My usual dentist had retired, so I met her replacement. While she was examining my X-rays, I naturally wanted to talk about them—a vet’s reflex! Very quickly, the discussion turned to the differences between human and animal dental health.

The tooth roots of dogs and cats are longer, and fractures and abscesses are more common but often go unnoticed for longer than in humans, since animals cannot verbally communicate their pain.

I showed her an X-ray of one of my patients (I have everything on my phone: cute patients, wounds, fractures, my teenagers, my family…).

She smiled, fascinated, and exclaimed, “You don’t see that often in humans!”

And I replied, “Maybe, but how many owners tell me, ‘He can’t be in pain, he’s still eating well…’”

She nodded, “Keep raising awareness among your clients, it’s so important.”

Before she left, I invited her to subscribe to the Flair & cie newsletter. Invitation accepted!

Eye health: the veterinarian at the optometrist

A few weeks earlier, on a Saturday morning, I had to rush to the optometrist because of a stye—a real, big, painful one. I was sincerely grateful to get an appointment so quickly, even with an emergency fee.

I was seen by a brilliant and passionate fifth-year intern. Since I had just welcomed a fifth-year veterinary medicine student to our team at the Hôpital vétérinaire de Montréal, we compared their programs, their learning experiences, and their career prospects.

The intern then performed a fluorescein test on me. I took the opportunity to explain how this same dye is used in veterinary medicine to detect and diagnose corneal ulcers, especially in outdoor cats. These adventurous felines fight, scratch each other… and then rub their eyes after their misadventures.

Anesthesia and care: conversations between caregivers

I regularly have brunch with a friend who is an anesthesiologist… Our discussions revolve around anesthesia, protocols, pain management, and stress management for families. As a specialist, she obviously knows much more about anesthesia than I do. As for me, a veterinary general practitioner, I am fortunate to be able to refer my highest-risk patients to specialty or emergency centers where veterinary specialists, including anesthesiologists, practice. Our discussions are always fascinating and remind me how similar the principles of care are: prepare carefully, understand the case, dose accurately, provide attentive support, and be gentle and vigilant until recovery.

The same vocation, beyond species

These exchanges with my peers remind me that, beyond species, we belong to the same community of caregivers.

We share a common curiosity, a desire to relieve suffering, a commitment to preserving quality of life, a dedication to informing, and a conviction that we must never stop learning.

Because medicine, whatever form it takes, is constantly evolving… and our vocation remains the same: to care for humans and animals with compassion and expertise.

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Of course, my hair has taken on a lighter shade, and some of my younger employees have started addressing me with a formal “vous.” A few clients have even dared to ask if I’m thinking about retirement. I do think about it, I’m planning for it, but I’m still having fun, so I keep going.

The early days

I was born on a dairy farm. We had beautiful, gentle little Canadienne cows that I loved accompanying out to pasture when I was a child. I loved them so much that I would wake up earlier than my father to go meet them in the field just before milking time. I loved my childhood years. There was always a dog to follow us to the field or during playtime, we were surrounded by a dozen cats, we had a horse, rabbits, goats, geese… I learned about life, illness, and death as well. We grew attached, then had to let go, often with tears. We never forget, but we keep moving forward and keep on loving.

A natural continuation

I chose to become a veterinarian because it felt like the most natural continuation of my childhood.

I received my veterinary license in June 1987 and became the owner of my current clinic in July 1995. The clinic has moved, we’ve expanded, and I went from having two employees to twenty. From one client to several thousand. I’ve performed many surgeries thinking someone else might have done it better. I’ve treated animals without being able to precisely identify what was wrong. Twenty-five years ago, specialists were few and far between, and practices were smaller, so we often felt alone. Thankfully, the veterinary world has evolved and now allows us to care for animals and support their owners in a much more appropriate way. It’s hard to believe we once practiced without all the communication tools we now take for granted. How could I ever walk away from this amazing profession, especially now that we have so many ways to keep improving?

Love for the profession

I love practicing veterinary medicine more and more because I now work alongside other veterinarians who are skilled than I am in some areas or with certain procedures. And sometimes I’m the one who’s more experienced in other situations. It’s a beautiful example of teamwork. We also now have quick access to excellent specialists who support us when cases get more complicated. I’m never alone anymore. Earlier in my career, I often felt isolated when facing difficult cases. That’s no longer the case, and it’s one of the reasons I appreciate my work so much.

I’ve always loved animals. Over 35 years of veterinary work, I’ve had to say goodbye to countless furry or not-so-furry friends. Some losses have stayed with me more than others. But I’ve learned to accept defeat in moments where I knew I couldn’t have done more. It wasn’t my failure, but that of the body I was trying to heal. I was able to carry on by focusing on the victories and on the support I can bring to my clients. My presence and my guidance remain valuable and meaningful to them, even after their pet has passed.

Over the years, the affection I feel for my clients has become almost as great as the love I feel for their animals. I love people who love animals. After more than three decades, many clients now come to me with their third or fourth pet. We often reminisce fondly about the very first animal that started our relationship. Life went on, and it continues still. This long-standing bond of trust nourishes me every day.

What helped me keep going?

Every victory over illness, every thank you from a client, every smile from an employee happy to see a patient recover gives me that wonderful feeling of having fulfilled my purpose. It’s not easy every day, but overall, the balance is excellent.

In recent years, we’ve heard a lot about veterinarians leaving traditional practice, that branch that cares for your small companions. For some, this is more a career shift than a departure. There are many needs in other fields, and so many opportunities, that it’s only natural for some to seek a better fit, whether it’s for their schedule, location, and quality of life. A new challenge can be stimulating and help reveal other aspects of our personalities and skills. However, in other cases, it’s truly heartbreaking to see colleagues leaving the profession with discouragement or sadness. It is such a beautiful profession. Let’s hope that the organizations involved in reflecting on this troubling trend will find real solutions. In the meantime, please be patient and understanding with your family veterinarian. Your smile and your kind words always make a difference in our day.

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The right tools and collaboration

We created the Flair & cie webzine, offered for free, to provide you with reliable tools and trustworthy information. It serves as a helpful source for better understanding animal health.

I am very sensitive to the pain and stress families experience when faced with treatment costs that are beyond their means and feel overwhelming. Most veterinarians are. What I’m advocating for is respectful dialogue between clients and veterinary teams.

Harassment, a troubling reality

I have a friend who is a veterinarian I deeply admire, a truly dedicated professional. Since the pandemic, one of her colleagues has been on medical leave awaiting surgery, and her team has been operating with reduced staff. Despite the added workload, she insists on keeping her veterinary hospital open on weekends. Being open on Sundays is increasingly rare for general practice clinics, as emergency centers usually take over. We are talking about a committed, hardworking, and skilled team.

Recently, on a day when their schedule was already packed, a regular client couldn’t be seen that same day. Asking more from the team that day simply would not have been acceptable. The disappointed client left a negative review online, and dozens of people piled on, publicly criticizing the clinic and its veterinarians. The entire team was shaken. After all their efforts to serve clients seven days a week, they were met with a wave of hostility.

Let’s choose dialogue instead

Please, I implore you, don’t take part in this kind of behavior that has gone on for far too long. If a friend is unhappy with their experience at the vet, encourage them to call the clinic’s manager. Did you know that due to medical confidentiality laws, veterinarians cannot explain a situation publicly on social media?

It happened to me once, someone left a very harsh Google review about me, personally. I was never able to share my side of the story or that of my team. The woman had brought in a pregnant dog that should never have been bred in the first place, and wanted me to sign false papers to sell the puppies for more money. She didn’t pay her bill and had opened her file using fake personal information. I refused her request but still gave advice to help the dog and puppies. Online, she claimed I only cared about money. Two days later, she had convinced several of her friends to also leave negative reviews on the clinic’s Google page. Even though this incident hurt me deeply, I was never able to share the other side of the story. Legally, I still cannot.

So again, I ask you to please not contribute to this kind of thing. It helps no one, least of all the animals. Animals need strong, fulfilled veterinarians who feel valued in their work. Those are the professionals you want to build long-term, trusting relationships with.

I also want to thank the clients who work hand in hand with their veterinary team for the well-being of their pets. It is largely for them that veterinarians continue to practice.

Let’s choose kindness in 2024. That is my wish for all of us.

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Caring for farm animals

The idea of becoming a rural bovine veterinarian came to me relatively late in my studies. In fact, I had to try out different areas of veterinary medicine before figuring out what I liked and what I didn’t. That’s the beauty of veterinary medicine: there are so many paths to explore. There’s truly a “hoof for every claw,” so to speak.

I knew I wanted to work in a rural setting, to be on the road and independent while still being part of a team. I also wanted to work with large animals that would challenge me both mentally and physically. I hoped to build genuine relationships with clients who value the work I do. So, I did internships in bovine practice, what we affectionately call being a “cow vet,” and I discovered the amazing world of agriculture. I fell in love with it, and it became my career.

To be a good vet in the dairy world, you need to be a people person and enjoy collaborating with farmers and others in the field. You must be humble enough to know you don’t have all the answers, and not be afraid of getting dirty (especially when you’re 5 foot 3 like me!). And while you don’t need to be an Olympic athlete, you do have to enjoy being active.

Rural veterinarian: a dream job

I quickly fell in love with my work. With my trusty toolbox in hand and wearing my farm-scented overalls, I hop into my car each morning like I’m heading off on a new adventure. I love that my days are planned yet still full of surprises, big and small. This pushes me to be adaptable and develop good stress and time management skills. In summer, I love driving with the windows down, listening to country music, and picking up a basket of fresh raspberries along the way. In winter, I love knowing I can always call one of my loyal clients if I ever end up in a ditch! Joking aside, farmers are incredibly generous people, always ready to lend a hand. Many have become friends. They know how devoted and passionate I am about my job, and they also know my feisty Jersey bull attitude.

And being a bit of a foodie, I’ll admit that having access to fresh meat, cheese, and maple products straight from the source is a definite perk.

In short, I’m incredibly lucky to have found a profession I’m passionate about. I get to be part of a tight-knit and dynamic team. We always have lots of projects, team activities, and continuing education. Like any workplace, it’s important to feel supported and know you can count on your colleagues when needed. Even when I’m out on the road, all it takes is a quick phone call to chat with a teammate or ask for help. I really am so fortunate. I truly hope that all of you get to do what you love and feel just as fulfilled.

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As veterinarians, we always strive to avoid these situations, even though it’s not always possible. Veterinarians are not infallible, and medicine, along with how patients react, can be full of surprises.

Here are some thoughts and suggestions to help you navigate these often worrying moments, and to guide you toward the appropriate next steps.

Medical error or poor response to treatment?

Just like you, your veterinarian wants every medical or surgical treatment to work perfectly every time. But each patient is unique: some respond beautifully to treatment, others only partially, temporarily, or not at all. Side effects or unexpected reactions, such as allergic reactions, can also occur.  All of these factors are important to consider during follow-up care.

The same applies to diagnostic procedures. Whether it’s a physical exam, blood tests, or imaging (like X-rays or ultrasounds), these tests might simply not reveal the cause of your pet’s health problem. However, the information they provide is far from useless. On the contrary, these results help rule out possible causes and guide the next steps in the investigation. In medicine, knowing what your pet doesn’t have is very useful as we’re figuring out what they do have.

Medical error or professional misconduct?

Does a medical error automatically mean the veterinarian has violated the code of ethics or committed professional misconduct?

Not necessarily. A veterinarian is not expected to guarantee results, but must use all necessary and reasonable means based on current scientific knowledge; it is a duty of means, not a duty of results. Guaranteeing an outcome for every intervention would be humanly impossible.

According to the Code of Ethics of Veterinarians, the vet must take all necessary steps and communicate the procedures and available options to the client in order to “formulate their diagnosis with great care.”

The veterinarian must “seek to have a complete understanding of the facts before giving an opinion, providing a service, or offering advice, and must clearly and objectively explain to the client the nature and scope of the problem based on the facts available.” A veterinarian must not “make a diagnosis, begin a preventive program, or prescribe medication without personally conducting an appropriate examination of the animal or group of animals.”

So, while an error may occur, it is not automatically considered professional misconduct. However, the Code of Ethics requires that a veterinarian inform the client as soon as possible of any incident, accident, or complication that could have or has had significant consequences on the health of the animal.

What should you do?

You’ve received some information but still aren’t sure what your options are?

All licensed veterinarians are required to carry professional liability insurance, in the event of a problem that occurs during the course of their professional practice. If you wish to make a claim, the veterinarian will need to forward it to their insurer, who will conduct an investigation. The outcome does not guarantee compensation, but if applicable, the insurer may reimburse all or part of the expenses.

You can also contact the Ordre des médecins vétérinaires du Québec (OMVQ). Like all professional orders, its primary mission is the protection of the public. The Order can inform you of your rights as a client and the veterinarian’s professional duties, including your right to file a complaint with the Office of the Syndic. This office can conduct a separate professional investigation to determine whether breach of professional ethics has occurred.

Communication is key

It’s important to remember that most difficult situations between pet owners and veterinarians arise from poor communication, just like in any other relationship.

If you have doubts about your pet’s condition, the outcome of a treatment, or if you’re unsure whether you fully understood what was explained to you, don’t hesitate to first reach out to your veterinarian. Express your questions or concerns, or simply ask for clarification.

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Most AHTs are women.

A typical day

Surgical admissions, updating medical records, preparing equipment and supplies, reassuring pet owners, and comfortably settling patients: this is often how AHTs begin their day. Then it’s the veterinarian’s turn to step “on stage.”

Throughout the day, they take part in patient care and assist the veterinarian with many other tasks, much like a nurse on a human healthcare team. Blood draws, lab analyses, medication preparation, surgical assistance, anesthetic monitoring of little furry patients… their days are full!

In the evening, while veterinarians finish charts and return calls, AHTs also wrap up their files, prepare everything needed for the next day, and continue administering care and treatments to hospitalized patients.

What to know about the AHT profession

The AHT diploma is a Diplôme d’études collégiales (DEC), earned after a 3-year program. The program is offered at the following institutions:

• Collège Lionel-Groulx (St-Thérèse)
• Vanier College (St-Laurent)
• Cégep de La Pocatière
• Cégep de Saint-Hyacinthe
• Cégep de Sherbrooke
• Cégep de St-Félicien
• Cégep Beauce-Appalaches (St-Georges)
• Collège Laflèche (Trois-Rivières)

AHTs are trained to work with companion animals, farm animals, and laboratory animals. They also study animal nutrition, behavior, and grooming. They’re trained to assist professionals in surgical care (anesthesia, monitoring, sterilization), as well as to perform blood and urine sampling and laboratory testing.

AHTs are trained in cardiac resuscitation. Working alongside veterinarians, they can make a real difference in the success of such procedures.

Job prospects for AHTs are excellent: 90% of students find full-time employment immediately after graduation. Some go on to university studies in related fields such as biology or agronomy, or pursue veterinary medicine.

At the end of their third year, AHTs must complete a 5-week full-time internship in a veterinary facility, as well as one or two additional internships (depending on the college and their interests) in research labs, equine settings, exotic animal care, etc.

As a veterinarian, I am extremely proud to work every day alongside AHTs with such big hearts; skilled, dedicated women who place animal well-being at the center of everything they do. ❤️

Pour (ré)écouter ma chronique sur le sujet, au micro de Geneviève Pettersen, c’est ici :

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