Ear bleeding in dogs

Bleeding from the ears in dogs happens due to a number of factors:

• Accidents: The most proximate cause is blunt trauma to the ear or surrounding areas. Your dog may be involved in a dogfight or may get injured during play. A sharp object can penetrate the flap and cause a bleed. Dogs’ ears are densely populated with vessels, so even a small cut will mean a lot of blood. 
• Moisture: Moisture is the chief reason behind the fact that dogs are more likely to suffer from ear infections. If your dog is often in water or is bathed, ensure that the ears are relatively dry afterwards.
• Yeast Otitis: Yeast is the most common culprit behind external ear infections (otitis externa). Malassezia pachydermatis is the yeast that usually causes problems. It is naturally present on the ear flap but an inflammation causes it to proliferate and leave a sticky, greyish-brown paste on the ear. This is uncomfortable for the dog and it may start pawing at its ear and vigorously shaking its head. Self-induced trauma may occur and result in aural hematoma.
• Ear mites: Mite infestations are particularly common in pups or younger dogs. Mites feed on wax and debris in the ear and can block the ear canal if not treated. Again, there is a chance of hematoma if the dog scratches the area vigorously.
• Autoimmune issues: Warts can grow on the body if the immune system is weakened. They are caused by canine papillomavirus-1 (CPV-1) and may need medical attention if there is a sudden proliferation or if there is a noticeable change in colour and shape. They may be harmless or may need to be excised.
• If the wart is in the flap of the ear and causing distress to the dog, he may scratch it and cause it to bleed. Warts on the inside of the ear flap need to be monitored. If they fall off and there is an open wound in the ear, it can become infested with maggots. 
• Hypothyroidism: Persistent ear infections, inflammation and redness despite medication could signify hypothyroidism. This condition causes a host of issues which include ear infections.
• Allergies: Food allergies may also cause ear infections. Usually this is attributed to a protein reaction. Your vet will conduct blood tests to ascertain whether this is the case.

Bleeding ears are themselves symptoms of underlying issues but there are signs you can look out for that are precursors to the incident:

• Rubbing of the ears against surfaces or constant scratching 
• Unpleasant odour on scratching or when the ear is lifted
• Inflamed, malodorous ear flap with sticky discharge 
• Crusting of ear skin 
• Neurological signs if the disease has progressed to the inner ear 
• Facial paralysis, drooling, reluctance to open the mouth 

Ear infections can be extremely painful for your dog, so it is essential that you are on the lookout for these tell-tale signs.

Since there are a variety of reasons behind ear bleeds, a veterinary visit can lead down many paths: 

• If it is an external ear infection with not much debris, the vet may choose to professionally clean the ear with antibiotics or insecticides depending on the source. The debris may be collected and sent to the lab to ascertain what kind of microbes are at play. 
• For more chronic ear infections, a complete blood work and imaging tests may be requested to ascertain the degree and type of issue.
• Warts and hematomas can be diagnosed after conducting a physical exam and inquiring about the clinical history of the pet.

Treatment will depend on the underlying cause that has presented in the diagnosis:

• Ear infections: Ear infections can be caused by yeast or bacteria or a mixture of both. Mites may be responsible as well. If the infection hasn’t progressed deeper into the ear, the vet will flush the ear with antiseptic and clean the ridges of the pinna. You may be given a saline solution to take home to flush your dog’s ears for a while. Antibiotics may also be prescribed if required.
  If the infection runs deeper, stronger antibiotics may be required. If the infection can’t be contained using medicines then surgery may be required. TECA (Total Ear Canal Ablation) includes excising the canal that is infected to prevent the infection from returning.
• Hematoma: Hematomas often require surgical intervention. The surgeon will drain the fluid and suture up the wound such that the affected area does not fill up again. This is done under anaesthesia and involves a longer recovery period. The intention of the procedure is to allow the wound to scab so that it can repair damaged tissue. The ear will be immobilized following the procedure to aid this process.
• Allergies: Appropriate drug therapy will be prescribed once the allergen is identified.
• Warts: Warts can either be surgically excised, or if the vet and owner prefer, certain tumour-reducing medications be applied topically to gradually drain and kill off the wart.
• Hypothyroidism is a chronic issue and treatment is given for life. Broadly, it includes giving oral replacement hormone to make up for the shortage in the body.

If your dog’s ears are bleeding, there are certain steps you can take before going to the vet: 

• Take a piece of gauze or cotton dipped in antiseptic. 
• Hold it on the wound and apply gentle pressure.
• Hold the ear flat against the face and hold down the gauze with tape that goes around the dog’s face
• Make sure you are not impeding breathing and your dog is calm.

Doing this will keep the gauze in place and prevent infection until you get to the vet.

Most ear infections, if caught early, will pass within a couple of weeks. Your vet will prescribe appropriate medication that can be applied topically and ask you to make sure the dog’s ears are kept relatively dry and clean.

For more complicated situations, the prognosis varies. In the case of TECA, recovery time increases to at least a few weeks.