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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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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