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7-22-2010
Shriveled Ears– Hematoma

Have you ever heard of a Pomeranian’s ear shriveling? Has this ever happened to your Pomeranian?  When anyone mentions “shriveling” of an ear, this most often means that a person is talking about Hematoma.

Hematoma is short for Aural Hematoma…. Aural means “ear” and Hematoma means “blood filled area”.  Therefore, when a Pomeranian has a hematoma, this means that a part of the ear fills with blood.  As this process takes place, it CAN lead to the dog having a “shriveled” ear, an ear that shrinks a bit and becomes smaller than the other.

It is sad (and we have heard from many owners unfortunately) who think that there was no way to stop this…They believe that it is “one of those things” that happens…and that there was no way for them to stop their Pomeranian’s ear from shriveling up!  However, this is not true. You can take steps to prevent this (in some cases) and to get the proper treatment in other cases to reduce the shrinking or stop it altogether!

Let’s take a look at this subject, to find out:
  • Why this can happen
  • Treatments
  • Prevention
Therefore, our new topic is: Shriveled Ear – Hematoma


















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What Causes This

There are several medical issues that can lead up to this, but the bottom line is that it happens when a Pomeranian shakes their head excessively and severely.  A Pomeranian will do this when they have an infection.  

This can be further broken down into a fungal infection, a bacterial infection or an infection of mites or fleas.

While rare, this can also happen if a Pomeranian scratches their ear severely…For example if your Pomeranian has a mosquito bite that is causing intense itching. Or sometimes, it can be a reaction to a bee sting, etc.

Another rare cause can be if your Pomeranian hits their ear on an object, such as on the corner of a table, etc.

What Happens

When a dog has mites or another type of ear infection, if they experiencing a lot of discomfort, they may feverishly shake their head.  When they do so, small blood vessels that are in the dog’s ear flap can rupture.  If those vessel rupture, blood then fills the ear that is between the skin and the dog’s ear cartilage.  You will know that your Pomeranian has hematoma when you notice a hard thickening of the ear (or just a section of it).  It that area will look larger than the rest of the ear.  It will look swollen (as it IS, since blood is pooling inside).  THIS is when steps should be taken to have your Pomeranian treated!  Do NOT wait to “see if it is going to go away”… If you do THAT, it will eventually go away, but it will be too late to prevent the ear from possibly shrinking!

How and When Does the Ear Shrink?

The dog’s ear can actually shrivel up and shrink if the hematoma is not properly treated.  When this happens, the ear will often have a wrinkled look that is dubbed a “cauliflower” ear.  Once this happens, it is permanent.  Therefore, identifying hematoma and making sure that your Pomeranian has the proper treatment is vital! And of course, in cases where it is possible, you will want to prevent this from ever happening in the first place!

Treatment

No matter what caused the Hematoma, as soon as it is noticed, treatment can prevent the ear from shrinking…

A vet should do 1 of the following:

Aspirate the ear – This is done with a sterile needle.  The blood and other fluids are taken out. The vet will then inject corticosteroid into the now-empty area. The ear will be wrapped so that outside pressure will keep the ear from refilling with fluid. This works best on a smaller hematoma

Surgically open up the ear flap – The blood is then drained, any clots are removed, and the ear is then stitched back up. A rubber drain is also sutured in the ear to drain fluid as it heals. The ear will be bandaged on top of the dog's head to reduce damage as it heals when the dog shakes its head from itchiness. The drain will be removed after only 3 to 5 days.

A cannula
can be placed into the ear to allow drainage of fluids as the ear heals.  This can take quite a while.

Risks & Choosing the Best Treatment


When aspiration is done, there is the possibility of a 2nd infection settling in…or of the 1st on re-occurring.  Also, …Fluid may return when the bandage is removed.

Surgery is the fastest way to resolve a hematoma issue and works best to stop the “cauliflower” wrinkling…but do be aware that SOME scarring may show due to the surgery and stitching.     If there is scarring, there may be some hard skin where the hematoma occurred. Slight shriveling of the ear may also occur as it heals, however in almost all cases, it will be MUCH less than if treatment was not given.

The cannula option is not often done, and this is because very few Pomeranians can handle such an disturbing feeling of constantly having something in their ear. Even if a cone is put on the dog, most Pomeranians will be feeling quite miserable.

More About Wrinkling

Without Treatment - As you can imagine, if a hematoma is not fixed,  the chances of wrinkling and shrinking are very high.  The pain can be quite severe for the Pomeranian.  As the ear eventually heals itself (which can take quite a while), the ear will begin to “crumble”. And one must know that this is not just a “cosmetic” issue of how a Pomeranian looks…Once an ear shrivels up, crumbles in and shrinks, it often leads to deformed ear canals…which then lead to more infections!

With treatment -
Any post-treatment wrinkling will depend on how large the hematoma was and how quickly treatment was given.
 
More on Treatment

While you are waiting for your veterinarian to give treatment, you can use warm/hot compresses 2 - 3x a day on your Pomeranian’s ear/s.

Treatment should be given ASAP for both medical reasons and appearance reasons.  Surgery is the best option in most cases.  Timing is very important,  the longer you wait to give your Pomeranian treatment, the longer your dog will be in pain and the higher the chances that shriveling will occur.

Aside from surgery, a Pomeranian will almost always also be given prednisone (or another corticosteroid) for about 30 days if the cause is an infection (More ahead on other causes).  Dosing is approximately .05 mg/kg once a day for a week and then every other day.

Repeat Treatment

In 10-20 % of cases, hematomas will re-occur.  However, with the surgery option of treatment, this number is lower.  In some cases, your Pomeranian may need to have a 2nd surgery, but remember that odds are that they will not.

Prevention

While you cannot stop all infections from occurring, an owner certainly has control over 3 of the biggest problems that lead to this:
  • Mites
  • Fleas
  • Ticks
These small parasites can live anywhere on your Pomeranian’s body and can cause skin irritation, sores, and infections.  Because mites are not as common as ticks or fleas, most dog owners don't even know they exist.

Types Of Dog Mites (Mange, Scabies, Walking Dandruff & “Common Ear Mites”)

Just like ticks, mites are members of the arachnid (spider) family. Here are the most common dog mite species: 
•    Demodex canis (commonly known as "Mange")
•    Sarcoptes scabei var. canis (or "Scabies")
•    Cheyletiella (also known as a "Walking Dandruff")
•    Otodectes cynotis, more commonly called the common "Ear Mites"

Mange

These mites are usually transmitted from a dog's mother to puppies in the first couple of weeks of their lives.
Mange live in hair follicles of virtually all dogs and whether they become a problem or not depends mostly on your dog's ability to keep them under control.

A disease will grow when mange population begins to multiply on young dogs with not fully developed, and older dogs with weak, immune systems.

Dogs sensitive to mange mites develop patchy hair loss and scaly red skin. Usually, the disease develops around the dog's face area and sometimes spreads to the whole body.  It can also be focused primarily just on a Pomeranian’s ears.
If the disease is localized, it will heal on its own as puppies get older and their immune systems get stronger. Most of the mange cases are localized, but if the disease spreads, your dog will need treatment that may consist of medicated lotions, shampoos and/or dips. 

Scabies

Unlike mange, scabies is highly contagious between dogs and can even be transmitted to cats and humans. The most telltale sign of scabies is constant itching and discomfort. Other symptoms include crusty sores and hair loss. Some dogs also develop skin infections. Until the condition is resolved, isolate your dog from other animals and members of your household. To treat scabies, your veterinarian will prescribe special shampoos and dips.  Medicated treatment sprays may be needed to treat the entire house.  Sheets, bedding, clothing...anything that CAN be washed in a washing machine will hot water, must be washed.

Walking Dandruff

Of all dog mites, these are probably the largest. You can see them with your eyes as little white specks on your Pomeranian’s fur or skin.

Though not as severe as scabies, these dog mites cause an itchy skin condition accompanied by dandruff along dog's back.  The scabies can go into a Pomeranian’s ears. Like scabies, walking dandruff can be passed on to people and other animals.  Treatment will consist of a series of medicated baths.


“Common” Ear Mites

Ear mites are the most common mite to infest dogs and they are VERY contagious, usually spreading to other dogs in the household.

Ear mites are tiny crab-like parasites that live in the ear canals and head of dogs, and sometimes their bodies. Imagine THOUSANDS of these tiny insects crawling around in your Pomeranian’s ears. The mites live on the surface of the skin in the ear canal, where they feed on tissue debris and tissue fluids, but they can also spread to the skin. When this happens, your dog's back, neck and tail areas will itch. The presence of mites can cause severe inflammation in your affected dog's ears…this leading to hematoma as your poor Pomeranian shakes like mad to try and stop the feeling of those horrible mites crawling around!

Although they can occur at any age, ear mites are more common in puppies.

The most noticeable sign that your Pomeranian may be infected with ear mites is if you see him constantly scratching around his ears. Another common sign is if your dog is shaking his head, which as we talked about, can lead to hematoma. A less obvious symptom is presence of blood INSIDE your dog's ear canal. If you notice a dark mass resembling ground coffee when you look inside the ear, that's probably dried up blood.

Dog ear mites are susceptible to several medications, but make sure that the medication you buy contains an insecticide. If it doesn't, it will not eliminate mites.  The most commonly used insecticide is Pyrethrins. Any product that contains this ingredient will do the job.

IMPORTANT


Never assume that “it is normal for a dog to scratch”.  It is NOT.  If your Pomeranian is scratching any area on their body (aside from a random scratch for a minor itch)…Take steps!   Bring your Pomeranian to the veterinarian to diagnosis exactly what is causing the problem and give your Pomeranian the proper treatment.  Do this ASAP, BEFORE hematoma occurs!
 
Ticks

There are several types of ticks. The most common are American and brown dog ticks. Usually, spring and autumn are two peak tick seasons. Depending on weather and environmental conditions, ticks may remain a problem throughout the whole summer. In some parts of the country, ticks remain a problem year-round.

American Dog Tick



This is the most common tick species in North America. It is one of the largest tick species. Its body is reddish-brown with white or yellow markings. The male tick is about 1/8 inch long, and the female is a little larger. Both will get much bigger after they feed on blood.  A bite CAN lead to  paralysis in some if a Pomeranian is has an American dog tick.




Brown Dog Tick


This is one of the most common tick species on the world. In the U.S., brown dog ticks almost always prefer dogs as their hosts. An adult tick usually attaches to the dog's ears or between the toes. Larvae and nymphs are more common in hair along the dog's back.  In the southern United States, brown ticks can be found outdoors during any time of the year. In the North, you'll find them outdoors only during warm months.

Adult male ticks are flat, about 1/8 inch long and red-brown in color. Before feeding, adult female ticks resemble the males in size, shape and color. As they feed, females become engorged and swell to 1/2 inch long and 1/4 inch wide. Males remain the same size.  Unlike American dog ticks, this species feeds on dogs during all its stages: larvae, nymph and adult.

Controlling Ticks

The best way to control ticks is to modify their habitat.  Ticks are common in areas of high humidity - grassy, brushy, wooded, and shaded areas.  To cut down on number of ticks, take the following steps around the house and outside areas…
•    Keep your grass very short
•    Don't let fallen leaves pile up
•    Clear bushes
•    Prune trees to let more sun shine onto your yard

Because ticks don't like water, do not allow puddles to form in your yard if at all possible.  For example, if you are washing your car in your driveway, when done, sweep away the water, to spread it out so that it does not form puddles.
Also, you can treat your yard and outdoor area with a tick spray. It kills ticks and fleas and it will not damage your lawn..And it will provide protection for you too!

Fleas

NOTE: For every flea that you see on your pet, there are likely to be HUNDREDS of eggs and larvae in your home and yard. Therefore, an effective flea control program ALWAYS includes treating the environment as well as treating your Pomeranian. The following is NEEDED:

•    Remove fleas from the indoor environment.
•    Remove fleas from the outdoor environment.
•    Remove fleas from your Pomeranian.
•    Keep immature forms of fleas from developing.

Flea Control Inside

Indoor flea control involves mechanically removing all stages of the fleas, killing any remaining adults, and preventing immature forms from developing.

1.  
  Start by vacuuming thoroughly, particularly below drapes, under furniture edges, and where your Pomeranian sleeps. Vacuuming can remove up to 50% of flea eggs. Vacuum daily in high traffic areas, weekly in others. Each time, seal your vacuum bag in a plastic bag and discard it immediately. Do NOT place mothballs or flea collars in the vacuum, since toxic fumes could result.
2.    Use a product that will kill any remaining adult fleas and also stop the development of eggs and larvae. You will need a product that contains both an adulticide and an insect growth regulator (IGR), such as Nylar (pyriproxyfen) or methoprene. This can be in the form of carpet powders, foggers, or sprays.

Foggers are especially good for large open areas. Surface sprays can reach areas such as baseboards, moldings, cracks, and under furniture where foggers cannot reach. Choose the product(s) you use with care, taking into account the presence of children, fish, birds, persons with asthma, etc. In severe infestations, you may need the help of a professional exterminator.

3.    Wash your Pomeranian’s bedding weekly and treat the bed and surrounding area with a product that contains both an adulticide and an insect growth regulator.

4.    Do not forget to also clean and treat your automobile, dog carrier, garage, basement, or any other place your pet spends much time.

Flea Control Outside

Flea control in the outdoor environment generally involves get rid of the habitat in the yard and areas where fleas are most likely to be. Fleas tend to like it where it is moist, warm, shady, and where there is organic debris. They will also tend to be where pets spend more of their outdoor time. So be sure to concentrate on areas such as patios, under porches, etc. Wherever your Pomeranian happens to enjoy their outside time.

Rake away any organic debris such as leaves, straw, grass clippings, etc., to disturb flea habitat.
Wild animals such as opossums, raccoons, chipmunks and other small rodents can carry fleas. Try to discourage these animals from entering your yard, e.g., do not feed them.

Flea Control on Your Pomeranian

Now that we've taken care of the fleas in your home and the "hot spots" in your yard, it's time to eliminate the fleas that are on your Pom. You can choose from flea control products for use on pets, including once-a-month topical products, sprays, dips, shampoos, collars, powders, oral, and injectable products. With any product applied directly to your Pomeranian,  please remember that you may see some live fleas on your pet for a short time after spraying, shampooing, dipping, etc. In order for the fleas to die, they must come into contact with the insecticide, and absorb it.

Keep in mind that until all of the fleas in your home have died, you will probably still see some fleas, even on a treated dog, since some immature forms may continue to develop. This is especially true if you had a big flea problem to start with. Determination is the key here. It is essential to keep following an effective flea control program for a long enough time to get rid of all of the fleas, in all life stages. This may take several weeks to 6 months or more, depending on your particular situation.

Flea & Tick Collars can be effective, but must be applied properly. To get the right degree of snugness, you should just be able to get two fingers between the collar and your Pomeranian’s neck. Be sure to cut off any excess portion of the collar after you have properly applied it. Otherwise a Pomeranian may try to chew on the end. Check the package for information on duration of effectiveness since some collars lose effectiveness when they get wet, e.g., if your Pomeranian swims a lot. Watch carefully for any irritation under the collar. If this occurs, you may need to use a different product
.
PREVENTION --- PREVENTION --- PREVENTION &....Prevention!

The best flea, mite and tick control is always prevention. Adulticides (products that kill adult fleas) are a cornerstone of prevention.  NOTE:  It is NOT “normal” for a dog to have fleas, ticks and/or mites.. While it IS common, it is NOT alright to allow your Pomeranian to live with any of this.  And it is NOT okay to allow hematoma to be unchecked and untreated.  It is VERY painful for a Pomeranian.   Aside from the hematoma that we have talked so much about, fleas can cause HORRIBLE allergic reactions…leading the coat to fall out, trouble breathing and much more!   ALWAYS use PREVENTION medication to keep ticks, fleas and mites away from your Pomeranian, your home and you!

Ear Infections

If your Pomeranian has an infection and you are being directed to clean the ears out by your veterinarian, then follow his/her directions closely and consistently. We see recurrent infections a lot because an owner has not followed the directions, not given medication as directed and has not finished the course of treatment.

Once the infection has cleared up, all the regular maintenance needed should be wiping out the ear periodically. What is an easy yet effective maintenance to keep ears clean?  Fragrance free baby wipes!

Also, if your Pomeranian swims, you can purchase drying agents that will help keep water from settling in his ears and causing infection. Use these sparingly, especially if they have alcohol in them. Using alcohol in the ear too often can cause the ear drum to become brittle. As far as cleaning the ears out at home goes, the less you mess with them the better. Don't forget to be very gentle any time you are putting something in your dog's ears.

If your Pomeranian has 'dirty' ears on a regular basis beyond what a quick cleaning with a wipe can take care of then you are probably dealing with a mild overgrowth of yeast or bacteria which is not normal and should be checked out by a veterinarian.

Prevention So a Dog Does Not Hit Their Head/Ears

Hitting their ear hard on an object CAN cause hematoma. Puppies, as you know, are very hyper!  Part of owning a puppy is to puppy-proof your home.  And when you do this, you can make things safer for your wow puppy and possibly prevent injury-caused hematoma.  Just as if you were baby-proofing your home, make things safe for a puppy by putting soft cushions on sharp corners (such as the corners of coffee tables).  If your Poms’s doggie bed is in the corner of a room, be sure to buy a doggie bed that has high edges…and have a baby blanket around it, so that if your Pom puppy plops down into bed, they cannot bang their head on the wall.  And be sure to teach all young children (especially those who may just occasionally visit and may not understand puppy care) how to carefully handle a young puppy so as not to injure them.
 
Final Thoughts

Hematoma is a terrible condition, but in most cases, it CAN be treated and your Pomeranian’s ears will not shrink… Or IF an ear shrivels, with proper treatment it will be minimal and not be very apparent.  Please never think that this will “go away on its own”.  Your Pomeranian trusts you to take care of him or her…And all needed help is detailed here for you. 

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