Causes, Treatment, and Prevention of Ear Hematomas
by Rita Reimers, Multi Cat Behavior Expert
If your cat suddenly develops a swollen, pillow-like ear (like our Bella did) they may be suffering from an ear hematoma. While it may look alarming, this condition is treatable with proper veterinary care. Let’s break down what an ear hematoma is, why it happens, and what you can do about it.

What is an Ear Hematoma?
We’ve had a few ear hematomas happen in our sanctuary, which made me realize that not a lot of people know what that is, how it happens, and how to treat it.
An ear hematoma, also known as an aural hematoma, occurs when blood collects between the layers of the ear flap (pinna). This happens due to a rupture of small blood vessels inside the ear, leading to a fluid-filled swelling.
The affected ear may appear puffy, warm, and is very uncomfortable for your cat.
Causes of Ear Hematomas

Hematomas are usually caused by excessive head shaking or ear scratching, which can result from:
- Ear infections – One of the most common causes, leading to inflammation and irritation. This is what happened to Bella this year.
- Ear mites – These tiny parasites cause intense itching, making your cat scratch excessively. This was the cause of our hematomas last year, and a few kitties needed surgery.
- Allergies – Skin sensitivities can lead to chronic ear irritation.
- Trauma – Rough play or accidental injuries can contribute.
- Underlying health issues – Conditions that affect blood clotting may increase the risk.

Symptoms to Watch For
- Swollen, soft, or firm lump on the ear flap
- Redness or warmth in the affected area
- Head shaking or ear scratching
- Discomfort or sensitivity when the ear is touched
- Possible tilt of the head due to irritation
These symptoms can be very painful for your cat, and you might notice behavior changes as a result. You may find your cat isolating more or becoming irritable, especially when her head is touched.
Treatment Options

Veterinary intervention is essential for treating an ear hematoma properly. Options include:
- Drainage – A veterinarian may use a needle to remove the fluid, though recurrence is common without further treatment.
- Surgical correction – The preferred long-term solution, which involves draining the hematoma and suturing the ear to prevent reformation.
- Steroid injections – Used to reduce swelling and inflammation.
- Treating the underlying cause – Addressing infections, mites, or allergies to prevent recurrence.


Can You Treat an Ear Hematoma at Home?
While it may be tempting to drain the swelling yourself, this is not recommended. Without proper veterinary care, the hematoma can return, become infected, or cause permanent ear deformities.
Always consult a veterinarian for the best course of action.
Prevention Tips
- Regular ear checks – Monitor for signs of infection, mites, or allergies.
- Routine ear cleaning – Use a vet-approved ear cleaner to keep ears healthy.
- Flea and mite prevention – Keep up with parasite control treatments.
- Address allergies – Work with your vet to manage skin sensitivities.
For more information, see WebMD Article: Aural Hematoma in Cats
Final Thoughts on Ear Hematomas in Cats
An ear hematoma may look dramatic, but with prompt care, your cat can recover comfortably. If you notice any signs of swelling in your cat’s ear, don’t wait—seek veterinary attention to keep their ears healthy and pain-free!
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I have a fiv ,five year old male cat that I love so much. He experienced ear Infection three weeks ago. Now has a small hemotoma on his right ear flap. The vet drained it about two and a half weeks ago. But about five days ago it began filling back up. Now it’s right where it was before. He is scheduled for surgery on Friday three day from today. I’m so worried about him ,one waiting that long ,two the painfulness of the procedure,the damage it may cause and how will he heal and the length of time he will keep stitches is it really not too bad on the kitty I feel like I’m putting him through something horrible. If we drained it a second time would that just come back ? I’m so worried please share if y’all think I’m doing right by my baby 😭
Hi Sonnette,
First, take a deep breath. ❤️ Based on what you’ve described, I do think you’re doing the right thing for your boy.
An aural (ear) hematoma is essentially a pocket of blood that forms between the layers of the ear flap, usually because a cat has been shaking or scratching his ear due to irritation, such as the ear infection he recently had. Simply draining the hematoma often provides temporary relief, but unfortunately many refill, just as your veterinarian warned you might happen.
Surgery is commonly recommended when a hematoma returns because it helps prevent it from continuing to refill while the ear heals. Although the ear may look a little rough during recovery, most cats do remarkably well. They receive pain medication, and once the initial recovery period is over, they’re generally much more comfortable than they were with the swollen ear.
Waiting a few days for the scheduled surgery is usually not a problem unless the ear suddenly becomes much more swollen, starts bleeding, develops a foul odor, or your cat seems significantly more painful or unwell. If any of those things happen, call your veterinarian right away.
I know it’s heartbreaking to think about him having surgery, but you’re not putting him through something horrible. You’re helping him heal and reducing the chance that this keeps happening over and over. ❤️
Please give your sweet boy an extra chin scratch from me, and I wish him a smooth surgery and a speedy recovery. Let me know what happens.
Purrs,
Rita