In dogs with aural haematoma does draining and injecting corticosteroids versus drainage alone reduce the risk of recurrence?



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PICO question

In dogs with aural haematomas does draining and injecting corticosteroids versus drainage alone reduce the risk of recurrence?


Clinical bottom line

Category of research question


The number and type of study designs reviewed

Three papers were critically reviewed, a retrospective multi-centre cohort study, a randomised case control trial and an observational survey

Strength of evidence


Outcomes reported

Drainage alone at daily or weekly frequency consistently resulted in aural haematoma (AH) recurrence and lack of resolution. Corticosteroid instillation alongside drainage reduced the risk of rapid recurrence for AHs, across both the cohort and the case control studies, provided drainage was frequent


The strength of evidence for local steroid instillation was weak given the type of studies reviewed, alongside small sample sizes and variations in treatment protocol. However, consistently drainage alone appears an insufficient means of addressing AHs in dogs.

In cases where frequent drainage was the chosen treatment option, the addition of local corticosteroid application appeared to improve the outcome compared to drainage alone.

However, as systemic treatment was often employed alongside local corticosteroid instillation, success cannot necessarily be attributed solely to local treatment. Larger, randomised control trials would be required to assess the effect of each individual intervention providing clearer evidence for the most effective medical protocol for treating aural haematomas in dogs


How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.


Open Access Peer Reviewed


Ahirwar, V., Chandrapuria, V. P., Bhargava, M. K., Swamy Madhu, Shahi Apra & Jawre Shobha. (2007). A comparative study on the surgical management of canine aural haematoma. Indian Journal of Veterinary Surgery. 28(2), 98–100.

Hall, J., Weir, S. & Ladlow, J. (2016). Treatment of canine aural haematoma by UK veterinarians. Journal of Small Animal Practice. 57(7), 360–364. DOI:

Joyce, J. A. (1994). Treatment of canine aural haematoma using an indwelling drain and corticosteroids. Journal of Small Animal Practice. 35(7), 341–344. DOI:

Joyce, J. A. & Day, M. J. (1997). Immunopathogenesis of canine aural haematoma. Journal of Small Animal Practice. 38(4), 152–158. DOI:

Kuwahara, J. (1986a). Canine and feline aural haematoma: clinical, experimental, and clinicopathologic observations. American Journal of Veterinary Research. 47(10), 2300–2308.

Kuwahara, J. (1986b). Canine and feline aural hematomas: results of treatment with corticosteroids. Journal of the American Animal Hospital Association. 22(5), 641–647.

Lahiani, J. & Niebauer, G. W. (2020). On the nature of canine aural haematoma and its treatment with continuous vacuum drainage. Journal of Small Animal Practice. 61(3), 195–201. DOI:

MacPhail, C. (2016). Current Treatment Options for Auricular Haematomas. Veterinary Clinics of North America: Small Animal Practice. 46(4), 635–41. DOI:

Mikawa, K., Ito, T., Ishikawa, K., Kushima, K. & Shii, H. (2005). Treatment and prognosis of 59 canine ear hematomas. Veterinary Anesthesia Surgery Magazine. 36(4), 93–96. DOI:

Seibert, R. & Tobias, K. M. (2013). Surgical Treatment for Aural Haematoma. North American Veterinary Conference Clinicians Brief. 3, 29–32.

Swaim, S. F. & Bradley, D. M. (1996). Evaluation of closed-suction drainage for treating auricular haematomas. Journal of the American Animal Hospital Association. 32(1), 36–43. DOI:

Vol. 7 No. 1 (2022): The first issue of 2022

Section: Knowledge Summaries

Categories :  Small Animal  /  Dogs  /  Cats  /  Rabbits  /  Production Animal  /  Cattle  /  Sheep  /  Pig  /  Equine  / 

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