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Discussion on Aural Abscess or Hematoma

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nwalken
Member
Username: nwalken

Post Number: 24
Registered: 9-2002
Posted on Thursday, Aug 7, 2008 - 12:55 am:   Edit PostPrint Post

8 days ago I discovered my 27yo Arabian gelding in the evening with the entire ear swollen and dripping a serous liquid out the base of the ear. He did not object to my touching the ear as a horse would that had ticks, but of course when I manipulated it enough to investigate what was going on he was resistant. I was able to clip the hair out of the way, and discovered an area of extreme swelling on the lower third portion of the ear on the inside (concave portion) of the pinnae. I discovered the source of the drainage to be a large sinus tract of some sort near the base of the swelling. There was also a fairly large piece of white tissue that had the appearance of a severed blood vessel coming out of the sinus tract. The ear was so swollen it was difficult to separate the folds to really see what was going on. I spoke with my vet, who is 2 hours away, and we elected to treat him with banamine and antibiotics and re-evaluate in the morning. He suggested that he may have caused a hematoma to form by rubbing his ear, something I had not observed him doing prior to this. He is also not a head shaker. By morning the swelling of the entire ear was down by 50%, so I elected to continue treating him with bute for swelling and tucoprim for the abscess/hematoma. At this point the drainage has basically stopped, most of the swelling is gone, and he is using the ear normally instead of hanging it to the side. But, as you can see in the picture, there is an area of swelling on the inside of the ear with what appears to be a large sinus tract along one side of the swollen area. The tissue that I earlier identified as possibly being a blood vessel is no longer visible. My question is should I continue the tucoprim and bute as it is improving, or should this thing have resolved by now and it is time to seek more help? I hate to haul him 2 hours in this heat at his age. Swelling with apparent sinus tract
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 21169
Registered: 1-1997
Posted on Thursday, Aug 7, 2008 - 6:57 am:   Edit PostPrint Post

Hello nwalken,
This is not a sinus tract nor is the history and appearance consistent with hematoma or abscess, this is a wound. Your horse injured his ear and had a full skin thickness open wound and probable seroma caused the swelling. Most of the seroma has resolved and now the skin needs to finish healing.

I do not see any indication in your post or the image that the wound is not healing well and it would be too much to expect a full skin thickness wounds to heal by eight days. I think you still have about 10 - 14 days before this wound closes and swelling in normal around an open wound. Swelling may persist longer if there is soft tissue damage we cannot see.

We cannot advise you whether you need to see the vet with this but we have guidelines that wounds are not healing well and you will find them at Diseases of Horses » Skin Diseases, Wounds, and Swellings » Wounds / Burns » Long Term Deep Wound Care.
DrO
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nwalken
Member
Username: nwalken

Post Number: 25
Registered: 9-2002
Posted on Thursday, Aug 7, 2008 - 9:39 am:   Edit PostPrint Post

Thanks Dr. O - I guess a picture is worth a thousand words! When I first found him I thought it could be a wound but you could not even see it without prying his swollen ear apart because of the swelling, and all you could really see was a hole. I cannot for the life of me figure out how he did it because he is in his own paddock with vinyl fence. Just out of curiosity, when I was looking for information on the possibility of a hematoma, I was able to find references for that in dogs and cats, but not horses. Does head shaking cause hematomas in horses? I had never heard of that.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 21182
Registered: 1-1997
Posted on Friday, Aug 8, 2008 - 6:49 am:   Edit PostPrint Post

Though I guess such trauma would be possible in a horse I have never seen or heard of a case.
DrO
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