SURGICAL TREATMENT OF EAR HAEMATOMA IN DOGS Mohsin Abdul Jalil Falih ABSTRACT

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SURGICAL TREATMENT OF EAR HAEMATOMA IN DOGS Mohsin Abdul Jalil Falih Department of Surgery and Obstetric, College of Veterinary Medicine - Basrah University. Basrah - Iraq (Received 3 January 2010, Accepted 24 February 2010 ) Keywords; dogs, haematoma, serum. ABSTRACT The was conducted on 15 dogs of either sex and of different breed presented at my clinic (canine clinic* during a period of sex months. Their ages were ranging between 2-3 years. The dogs showing unilateral or bilateral swollen ear that is Haematoma. The surgical treatment was done by making a longitudinal incision on in entire length of haematoma. After draining the blood or serum, cleaning the debris. Haematoma pocket flushed with saline or week tincture iodine. Horizontal interrupted materess suture placed parallel to the incision, the pinna was dressed with antiseptic then bandaged with compression bandage to keeping the ear in erect position. The suture removed after 9-10 days post operation. Bandaging will continue to 6 more days till the operated ear return to its normal condition. INTRODUCTION Aural haematoma in dogs is a common problem particularly in a dogs with floopy pendulous ear like labrador, cookel spanil and basset hound, it was also reported in erect ear dogs like German Shipherd and some breed of Spits (1). Ear haematoma is an accumulation of blood in between skin and cartillage of the ear, it usually appear as fluid filled swelling on the concave surface of Pinna. However the external ear consist of skin covered cartilage, the ocular cartilage and annular cartilage. The ocular cartilage is a single- sheet of elastic cartilage which is thin and pliable at the apex. The skin on the concave (inner) surface of pinna is tightly adherent to the cartlage whereas that on the convex (outer) surface relatively mobile the cranical the caudal border of auricular cartilage is relatively straight whereas the caudal border is curved. The helix is the free margin and adjacent part it is serrated and perforated by numerous foramina which are also found through out the auricular carting. Branches of cranial auricular and the great auricular artery form the blod supply to the pinna. They encircle the margin of the aurical cartilage and pass through the foramina supplying the lateral surface. The venious drainage of the ear broadly fallows the arterial supply (1,2). 65

Aural haematoma may occur uniulateraly with occasional subsequent development of haematoma in the contralateral ear, less commonly present bilaterally (3, 4) it is genearally occur on a conave surface or the pinna (5) the predisposing factor to haematoma include trauma to pinna, a history of violent head shaking and acute or chronic otitis external (6). The other factor may be ear mites, fly bites dermatological diseases (7, 8). Dogs with long and heavy droopy ear are prone to bacterial infection as the droopy ear prevent natural airing and drying of ear canal and it block light and maintaining dark, moist and warm environment suitable for yeast and bacteria growth in addition a foreign body paeasies and neopaltic growth may became a source irritant cause ear scratching and make the dog shake it's head vigorously to get rid of itch. Thus blood vessels in earflap may rapture and bleed in to the tissue of the pinna forming a pocket, but continuous head shaking will cause the pocket to enlarge until it became very noticeable (1,9,10). For treatment of aural haematoma, there are three approaches, medical (9) surgical (10) and corbon dioxid laser approach (11). The aim of this study was to evaluate the surgical treatment approach to treat aural haematomia in dogs. MATERIALS AND METHODS During a period of six months (between) September to March } 15 dogs of different sex and breed were presented to a private clinic, All the dogs were suffering from swelling on concave surface of uni or bilateral ear. the diagnosing was depending the history, clinical symptoms and physical examination For surgical treatment the dog was premeditated with 0.02mg/kg BW atropine sulphate I/M{12 }. Fifteen minute later general anesthesia was induced by administration of Xylazine Hydrochloride {interchemo Holand} at dose rate15mg/kg BW I/M and Ketamine HCl {Holdn} at dosage rate of 15mg/Kg BW I/M {13}. And when the dog attend surgical stage of anesthesia kept on lateral recompense with affected ear upward ear canal was packed with cotton, After clipping and shaving the hair, the pinna cleaned and disinfectant with surgical spirit {70% alcohol} longitudinal incision on the skin of ventral surface of the pinna was made to include entire length of haematoma, the incision was made under complete a septic technique. Then drainage of the accumulated blood or serum. The debris was removed and the cavity flushed with normal saline)and followed by placing of several rows of horizontal interrupted mattress suture parallel to the incision line and on both sides to cover entire pinna giving the knots on concave surface. However while tidings the knot a uniform pressure were maintained on the suture with help of thumb in order to make the suture 66

sufficiently tied and the skin at this point straight with no wrinkle formation. Then after the operated ear cleaned and dressed with antiseptic{spirit} and was Bandaged, For bandaging the operated ear two piece of card board were prepared in the shape and size of pinna. The inner one was lesser by 1-2cm. from the ear edge. The cards board pieces were first warbled with cotton and cotton bandage and were placed one piece on each side of operated ear pinna now the operated ear in between the pieces were warbled together with the comparative cotton bandage taking the support of opposite ear.then layers of adhesive tape was placed in order to keep the ear in erected position as in [figure 1). The bandage was changes whenever it is necessary and suture were removed on 9-10 days post operation as in (figure 2). After that bandaging continued for -6 more days until the ear return to its normal condition. 1 RESULTS AND DISCUSSION Surgical treatment of ear haematoma was proved more successful and all the operated ear were rapidly healed and return to there normal condition within 2 weeks as in figure (2) and completely recovered with normal hair after 6 weeks as in figure (3). There were no incidence of of hamatoma recurrence noticed and all the ear well erected comparing with untreated cases which mentioned by (1) as said that untreated cases was associated with scaring bluish and deformity. In addition to that other worker like 1,2, 4 and 10 a said that the large untreated haematoma needed longer time for healing. However by placing several rows of horizontal materess suture parallel to the incision and on both side to cover enteric pinna could help in reducing the pocket and to bring of the two separated layer of pinna together. While the competitive bandage along with card board Pisces could prevent re accumulation of serum and blood. In haematoma pocket, in addition it also acted as a guard to protect the ear from scratching with clews which may cause farther damage, adhesive tape could help in keeping ear erected and facilitate proper drainage and to prevent head shaking which may disrupt suture line(1) there for healing take place. The thickening of ear pinna post operatively could be reduced by applying and applying an anti- inflammatory ointment that is inflamine which reduce irritant and inflammatory swellen However with this procedure of treatment the prognosis is good and rapid this finding coincide with (1-10) as they said that surgical treatment of Aral haematoma was rapid and usually require 2-3 weeks 1 *Canine clinic (private clinic) robra complex narmada road M.P. India. **Inflamine an arvadaic ointment /Indian herbs 67

Figure (1 ): this shows operated ear bandaging with cotton bandage and adhesive tape immediately after operation Figure (2 ): This figure shows the operated ear after 2 weeks 68

Figure (3): shows the operative ear after 6 week العالجات الجراحية لورم األذن الدموي في الكالب يذس ػثذ انجه م فانخ فرع انطة انثاط انجرادح انر ن ذ كه ح انطة انث طر جايؼح انثصرج انثصرج انؼراق. الخالصة خالل فررج سرح اش ر اػرثارا ي آرار إن أ ه ل ادضر خ سح ػشر كهثا ي كال انج س ي فصائم يخرهفح إن )ػ ادج انكالب انسر ر ح( كا د تأػ ار يخرهفح ذررا ح يا ت 3-2 س اخ ج غ انكالب كا د ذؼا ي رو إر دي إيا أداد أ ث ائ. ػ ه جد ج ؼ ا ت اسطح ػ م جرح ط ن ػه انجهذ ان غط نه ريح انذي ح تؼذ سذة انذو يصم انثالزيا ان رج غ ذ ظ ف انخثر ذى ذ ظ ف ان كا يثاشرج ت ذه ل يهذ ا يذه ل ضؼ ف ي صثغح اال دا ضؼد ػذج صف ف ي انخ اطح ان رقطؼح ت ازاج انجرح ان ؼ ل نكال جا ث انجرح نرغط ص ا اإلر تأك ه تؼذ ضغ ان را ان ضادج نالنر اتاخ ض ذ انجرح ت ساػذج قطغ ي انكارذ ان ق ان ؼ نح تشكم اإلر شذج ت ضغ ان ق ف. از هد انخ ط ف ان و انراسغ انؼاشر ي انؼ ه ح اسر ر انرض ذ إن سرح أ او أخر ن دظ ػ دج اإلر إن دانر ا انطث ؼ ح تؼذ سد أسات غ ي انؼ ه ح 69

REFERENCES 1- Judith, Jayce. (2000). Canine aural Haematoma. Wattnam Focus. Vol 10 No 4 pp 4 9. 2- Joseph ltarari (1996) ear small animal surgery Williams and wilkinsed chep 14 pp 193 195. 3- Gurbutt, Rj surqical treatment of haematoma 1956 of ear the north American veterinarian 37 : 1056 1059. 4- Kagon KG 1983 Treatment of Canine Aural haematoma with on indwelling drain j. Am vet medicin Assoatrn No 1 : 183 (9) 972 4. 5- Juyce j. A, Day M. j (1997 Immunopathoenesis of canine aural haematoma Journal of small animal practice 38 : 152 153. 6- Urs, B.; Olof, H; Richord, G. and Froncoise, R. (2007). Fibrin sealant as a treatment for canine aural Haematoma: Acase history. The veterinary Journal. 173(3): 697-700. 7- Mastousek jl (2004). Diseases of the ear pinna. Veterinary clinic north Am small animae loractice 34(2) 511 40. 8- Griffin C (1994). Pinnal diseases. Vet clin Northarn small animal practcc sep 24 (5) 897 904. 9- Ashock Kumor (2002) therapeutic management of otitis in dog. Intas polyret vol3 No 11, 294 299. 10- Amrsh Kumar (2000). Operation for oral haematoma. Veterinary surgical technique. Vikas publishing house PVT ltd, New Delhi. Pp.: 208-209. 11- Teresa L, Dye, H. Douglas Teague, Donal, A, ostwald, j and steren D, Ferrera (2002). Eraluation of a Technique using the corbon Dioxide laser for the treatment of Aural hematomas, jovonal of the American Animal and hosprtal Association 38: 385 390. 12- Hall L. W. (1974). Wright veterinary anaesthesia and analgesia 7 th ed pp 456. 13- William, V, lvmb and jone E Wynn (1984) Ketaminc and Zylazine. Veterinary anaesthesia. Iled pp 310. 70