Ask The Vet Archives

Aural Hematoma

Aural Hematomas seem to be a ‘common’ ailment nowadays. My 9 yo Labrador has an aural hematoma in his right ear flap. The discharge is not extremely bloody, it is more pinkish like mixed with a watery liquid. His ear flap is a bit red and slightly hot, but not boiling hot. I’ve drained it a few times, used arnica 30C and even 200C, but it just keeps coming back (it’s been a week now). I know this is part of his chronic disease picture and I will have to address that later on. But right now my main concern is to stop the continual refilling of the ear flap. I’ve read about Phos, Hamm, Mill, not sure which way to go as it doesn’t “haemorrhage” as such.
~ Susan.

Are there any remedies for yeast infection in a cats ears or anything that can prevent an occurrence,my cat had ear surgery for a hematoma.
~ Diane

My dog has a large aural hematoma and was wondering what else I can do to help heal it. I am already using arnica 30c and witch hazel compresses on her ear. her ear is painful she is still the same happy dog apart from her seasonal and food allergies causing itching.her ear just causes pain when she shakes her head.
~ Golden

Dr Sara ChapmanDear Susan, Diane, and Golden,

In order to know what treatment is most likely to resolve an aural hematoma, it is helpful to understand how and why they develop. Aural hematomas are caused by the inflammation and rupture of tiny blood vessels in the ear flap. The blood seeps between the ear cartilage and skin. The ear protrudes away from the body, so the animal may easily damage it further by shaking its head or rubbing the hematoma because it feels strange.

Vets used to believe that hematomas always occurred because of trauma: a bite from another animal, ear mites, or an ear infection. The animal then damaged the blood vessels of the ear by scratching or shaking its head. Trauma can certainly cause inflammation of blood vessels (vasculitis) and rupture of these vessels, but more research is pointing to an immune-mediated cause of the vasculitis. This immune-mediated vasculitis can occur when an animal has seasonal or food allergies, has a transfusion reaction, or has an immune reaction (allergic reaction) to any medicine or vaccine. The current conventional medical treatment for aural hematomas now focuses on treating them as part of an overall allergic process.

We can now see the cause of the hematoma problem for Diane and Golden. Both of these animals are having allergic problems which are causing vasculitis. Yeast ear infections are caused by an animal’s excessive response to normal organisms, and seasonal and food allergies are also indicative of an excessive, abnormal immune response. Symptomatic homeopathic remedies may help alleviate symptoms of a hematoma in the short term, but a constitutional approach with a qualified veterinary homeopath will be necessary to get to the root of the problem. Careful homeopathic prescribing should gently resolve all of the signs of illness as the animal responds to the remedy.

Many remedies can be useful in symptomatic treatment of aural hematomas. Susan and Golden mention Arnica, which is certainly the ‘go to’ remedy for trauma and bruising, and it does help many aural hematomas. However, there are a lot of useful remedies, and as symptoms change, the appropriate remedy may change also. You need to study the first aid remedies so that you can use them appropriately.

As an example, my own dog developed bilateral hematomas as part of a blood transfusion reaction. Initial treatment with Arnica did not help, so I changed to Hamamelis; it did not seem to help either. Two remedies which did help considerably were Crotalus-h, a snake venom remedy, followed by Silicea a week later. The biggest improvement, and final resolution, occurred when I determined what my dog’s constitutional remedy was, and treated her with that. During this time, I carefully observed my girl to see which remedy was most appropriate, I never gave more than one remedy at a time, and I waited to see what was going to happen before switching remedies. This is why it is so important to work with a skilled practitioner who knows you and knows your pets.

S.F. Chapman DVM, MRCVS, VetMFHom

Evans Syndrome, Hypothyroidism, Hyperlipidemia & Pancreatitis

Good day Drs,
I own a 9 year old American Cocker Spaniel, Murdoch, who was diagnosed with Evans syndrome 8 years ago. He has suffered a few relapses since then forcing us to resort to high doses of Prednisolone and initially also azathioprine. During the last 4 years his health problems have multiplied and now includes hypothyroidism and hyperlipidemia. Six weeks ago he became seriously ill with pancreatitis and while being hospitalized our vet also picked up high protein in his urine as well as cholelithiasis. The list of drugs have now become longer with Ursotan and Enalipril added. Latest ultrasound that pancreatitis is almost resolved and “”sludge”” in the gallbladder has reduced. However, he now has frequent bouts of diarrhea, but no vomiting, no sign of pain and normal appetite. Triglycerides are 17 and not coming down in spite of being on an intestinal low fat diet. Omega 3 oil (I used Krill oil) reduced triglycerides to 1.6 a few years ago but I have been told not to give him any oils or fats now. I am very concerned that the hyperlipidemia will predispose him to chronic pancreatitis. We have come this far under extremely difficult circumstances and through all of it Murdoch is still a happy boy. I cannot give up on him now! Any suggestions will be much appreciated please.
~ Nesta

Dr Jeff FeinmanHi Nesta-

Murdoch is a very lucky boy to have a friend as dedicated as you!

You’re right, the hyperlipidemia can indeed predispose him to pancreatitis (and vice a versa). One very common cause for the hyperlipidemia is endocrine disorders such as hypothyroidism, Diabetes Mellitus and Cushing’s dis-ease. Cholestasis which can result in cholelithiasis, obesity, high fat diet and drug use, etc. can also play a role, so he has lots of potential causes for his high triglcerides.

You also mention protein in Murdoch’s urine. Albumin is the most common protein found in the urine and can be associated with low albumin in his blood. Low blood albumen and high cholesterol are seen together in yet another metabolic disease (nephrotic “syndrome”). It is very important to look at all of his maladies as interrelated to allow proper treatment. This is an important part of the homeopathic “totality”.

Now is the time to build a veterinary medical team that includes your local vet, a vet internist (specialist) and a homeopathically-trained holistic vet. Your gathering all of his records and writing up a medical timeline will help put all of the pieces of the puzzle together. This will be very helpful to all members of your vet med team. If you’re not already working with a specialist in internal medicine, I’m sure that your local vet can refer you to one. You can also search here. However, the internist is just one part of the health care team that can help provide optimal care for Murdoch. In addition, adding treatment by a veterinary homeopath can help normalize his internal energetic imbalance. By doing so, you will not only help reduce his serum lipids and chances for pancreatitis, but also minimize other immune-mediated dis-eases like his past episodes of hemolytic anemia and thrombocytopenia (low platelets). It is often best to integrate the best of both worlds in a difficult case such as his.

The first issue to address is his weight. If he is at all overweight, he should go on a low calorie as well as low fat diet. Excess dietary dietary carbohydrates are often incriminated and I feel that it is best to not use any kibble. In fact, You mentioned a low fat diet, but if this one of the commercial diets, consider instead using one which is home-prepared. Your local vet may be able to help you formulate an appropriate one which also may help with his recurrent diarrhea. Dr. Strombeck, who is the “father” of veterinary gastroenterology (he literally wrote the book) has some low fat diets in his book about home-cooking. Some of these are too high in carbohydrates for Murdoch’s, but are still worth considering: Click Here. A nutritionally and holistically trained vet will be able to help you further with these very important dietary decisions.

Along with his diet upgrade, try to maximize his activity. Ideally some of this will be outside in the sun. Maximize the many health benefits of exercise with exposure to sunlight. Sunshine has many health benefits including helping to normalize endocrine hormones. Increasing his activity and caloric output will of course also help control his weight. Try to find games that he likes such as fetch, flyable, playing chase with other dogs, etc.

Supplementation is also very helpful in management of hyperlipidemias. The benefits of omega-3 fatty acids derived from fish are well documented in scientific studies. There are many on the market. Ideally, use an encapsulated form since liquid oils quickly become rancid and may upset his stomach. It’s important to use a high quality brand in serious situations like Murdoch’s. Start with only 1 capsule per day so that you can assess his tolerance to it.

Another useful supplement is niacin (vitamin B3). This vitamin is also readily available and should be started at low doses. Others include red yeast rice, probiotics and prebiotics, garlic, Coenzyme Q-10, DGL, SAMe, etc. These are all potentially useful adjuncts in Murdoch’s treatment and health maintenance. As with the other supplements, start gradually and ideally work with vet who can help guide you in their proper use and/or start only one at a time.

I find that maximizing his energetic balance and “vitality” with classical homeopathy is invaluable in this type of problem. All of his physiologic disturbances can be traced back to this imbalance, so normalizing it is critical. I can’t advise any particular homeopathic medicines though, because there are many other factors that need to be considered. This is where working with a well trained veterinary homeopath really comes in handy. You can find one in the directory on this site.

Lastly, be very cautious with using medications and vaccinating Murdoch in the future. Vaccines can worsen the autoimmune component of his dis-ease. Some drugs are also associated with hyperlipidemia. A human study even found enalapril to be implicated in a some of the patients.

So with proper diet, exercise, cautious use of drugs and supplements, you should be able to reduce Murdoch’s hyperlipidemia. With the addition of homeopathic treatment you can help his physiologic problems even further and optimize his internal energetic health and help him live the best possible life.

Good luck.
Dr. Jeff

Allergies, Rabies Vaccine & Chronic Disease

I have a 7 yr. old GSD who developed seasonal allergies last summer shortly after a rabies vaccine. I’ve done everything, cleanses, detoxes, every supplement known to man………to no avail. She had to have Pred in order to not tear herself to pieces’
My question is, do those allergy desensitizing protocols work?
AllerPaw is one near by, they determine the culprit through blood tests then a specially formulated spritzer is supposed to be used to build up a tolerance, hence, no more symptoms.
Not cheap but I will do it so she never has to be on steroids again…………??
~ Lori

Jennifer RamelmeierDear Lori,

Allergies are a sign of deep chronic disease that is affecting the immune system. A big cause of this is linked to the heavy vaccination protocols many conventional veterinarians continue to employ.

So number one action to take is not to give any more vaccines and to make sure you are feeding a raw meat diet. The effect in most of my patients from the desensitization process has been temporary. There is often initial improvement, but I do not see this last and they end up on prednisone in the long run. My recommendation is to seek out a homeopathic Veterinary practitioner, as this is a deep acting system of medicine that can get to the root of the problem. For now try replacing the prednisone with antronex by standard process and spring tonic by animal apawthecary.

Yours in health,
Jennifer Ramelmeier DVM, CVH

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