Hematoma

"Becky" wrote in message
...
Hiya

My siamese cat Fawn developed a hematoma 2 weeks ago.
(I think it was arose due to him scratching/headshaking and worrying at a
small cut on his head)
He has been treated but im still worried about him...if anybody knows more
about this please may i ask your opinion?
The vet told me if it is left untreated, it can disperse on its own but is
likely to recurr and if so, will cause 'complications', cailiflower
ear,pain,possible infection. They immediately recommended surgery which
involved draining the ear, stitching it up with plastic tubes both on the
outside and underside of the ear flap, looked very messy but apparently
the
tubing is to put pressure on the cartilage layers to stop the ear from
filling up again.


Actually, the tube is probably for drainage- although drainage tubes aren't
usually used in cats. The stitches should be placed in such a way to allow
drainage but still hold the cartilage together until scar tissue forms.




Unfortunately, they seemed to have left a gap with no tubes/stitches and


Sloppy job. The incision should gape *slightly* for drainage- but the
stitches should be placed carefully so they don't make any pockets where the
hematoma can reform. Hematomas in cats' ears are caused by the cartilage
splitting- so, the stitches should be placed through both sides of the
cartilage on either side of the hematoma to pull and hold the cartilage
together evenly. Sounds like vet missed a stitch and a pocket formed and
filled with fluid.




another smaller lump developed within 4-5 days after surgery :-(


The stitches may have been too tight. The stitches can cause edema in the
pinna if they're tied to tightly. Also, the stiches should be placed
vertically- and parallel to the artery and its tiny branches- not
horizontally. across them-- those little branches inside the cartilage are
where hematomas come from.

Another possibility is he may have scratched his ear or shook his head- both
can fracture the cartilage or reopened the fracture before it had time to
heal- could take a few weeks to heal.



Took him straight back to the vets and they had to do the operation again,
this time they stitched the whole ear, plastic tubes all over, looks very
messy and very uncomfortable for the Fawn :-(


He really shouldn't need tubes or stents for support- the cartilage stitched
together should provide enough support if the sutures were placed correctly.


This 2nd operation was 3 days ago and im worried as his earflap looks
generally thicker than the other, even underneath those plastic tubes. Im
really worried the hematoma is returning again....is this likely?


Probably not.



Surely it
cant recurr after 2 operations, i dont know what else they can do! I cant
put him through surgery again!
Any advice/opinions/experiences would be greatly appreciated.
Becky


Does he have a bandage or E-collar? You've gotta keep him from scratching
his ear- that alone can cause a hematoma. He also shouldn't shake his head
violently- because that causes sinusoidal waves in the ear that can also
fracture the cartilage. Other than putting their head in a vice- I have no
idea how to stop a cat from shaking his head. ;-)

I'll try to dig up an illustration of a hematoma repair, a little later so
you'll have an idea of what I'm talking about.

Best of luck,

Phil

Thanks so much for your reply Phil, you seem to really know what ya talking
about.
And thanks for your concern cybercat. Fawn is doing well today, he now seems
recovered from the trauma of surgery and being at the vets, though the ear
is very uncomfortable for him, but at least he seems to be sleeping and
resting alot.
Fawn does have an e-collar on ever since the first op 2weeks ago, gods that
was awful for him, took him about a week to get used to it, but hes
absolutely fine with it now, except he cant wash himself! (we wash him with
wet cotton wool and he likes that).
So he cannot scratch the ear at all. However, he does violently headshake
each time he gets up to walk about (how do they shake their head so fast!)
its like an obsessive reaction now, and i cant stop him from doing it, save
by feeding him to distract him or getting him to sleep. I understand that
this may have been what caused the second lump to appear (as well as sloppy
surgery, I think they did miss a stitch). I could send a piccies after each
surgery, tho its very gruesome.
The tubes do seem to run vertically from the base to the tip of the ear flap
and theres more tubes inside the ear than on top. They do seem to be for
drainange also, as theres a lot of clotted blood around them (should I be
cleaning it up?) It makes alot of sense to me to leave an open wound..so the
fluids can drain, then surely it cant build up again. However the vet told
me these ones arent so much for drainage, but more to apply pressure to the
cartilege. He has very big ears being a siamese, perhaps they need more
support.
Thank goodness the ear doesnt seem to have gotton any thicker these last
coupla days, but im worried that as it heals, the stitches seem to get
looser,whats to stop it from filling up again.
I will give the vet a call tommorow, but Im almost reluctant to take him
back, as they have told me the only repair for hematoma is surgery and I
cant do that again(why dont they have a medicinal treatment!)...but your
words have reassured me and hopefully this will fix it, if we can keep him
calm and minimise the headshhaking! Wonder if some form of sedative will
help him through the discomfort, he really is a fussy cat when he has a 'bee
in his bonnet' hes too much of a fighter to lie there and take it!
Thanks v.much for your help.
Becky

"Phil P." wrote in message
...

"Becky" wrote in message
...
Hiya

My siamese cat Fawn developed a hematoma 2 weeks ago.
(I think it was arose due to him scratching/headshaking and worrying at
a
small cut on his head)
He has been treated but im still worried about him...if anybody knows
more
about this please may i ask your opinion?
The vet told me if it is left untreated, it can disperse on its own but
is
likely to recurr and if so, will cause 'complications', cailiflower
ear,pain,possible infection. They immediately recommended surgery which
involved draining the ear, stitching it up with plastic tubes both on
the
outside and underside of the ear flap, looked very messy but apparently
the
tubing is to put pressure on the cartilage layers to stop the ear from
filling up again.


Actually, the tube is probably for drainage- although drainage tubes
aren't
usually used in cats. The stitches should be placed in such a way to
allow
drainage but still hold the cartilage together until scar tissue forms.




Unfortunately, they seemed to have left a gap with no tubes/stitches and


Sloppy job. The incision should gape *slightly* for drainage- but the
stitches should be placed carefully so they don't make any pockets where
the
hematoma can reform. Hematomas in cats' ears are caused by the cartilage
splitting- so, the stitches should be placed through both sides of the
cartilage on either side of the hematoma to pull and hold the cartilage
together evenly. Sounds like vet missed a stitch and a pocket formed and
filled with fluid.




another smaller lump developed within 4-5 days after surgery :-(


The stitches may have been too tight. The stitches can cause edema in the
pinna if they're tied to tightly. Also, the stiches should be placed
vertically- and parallel to the artery and its tiny branches- not
horizontally. across them-- those little branches inside the cartilage are
where hematomas come from.

Another possibility is he may have scratched his ear or shook his head-
both
can fracture the cartilage or reopened the fracture before it had time to
heal- could take a few weeks to heal.



Took him straight back to the vets and they had to do the operation
again,
this time they stitched the whole ear, plastic tubes all over, looks
very
messy and very uncomfortable for the Fawn :-(


He really shouldn't need tubes or stents for support- the cartilage
stitched
together should provide enough support if the sutures were placed
correctly.


This 2nd operation was 3 days ago and im worried as his earflap looks
generally thicker than the other, even underneath those plastic tubes.
Im
really worried the hematoma is returning again....is this likely?


Probably not.



Surely it
cant recurr after 2 operations, i dont know what else they can do! I
cant
put him through surgery again!
Any advice/opinions/experiences would be greatly appreciated.
Becky


Does he have a bandage or E-collar? You've gotta keep him from scratching
his ear- that alone can cause a hematoma. He also shouldn't shake his
head
violently- because that causes sinusoidal waves in the ear that can also
fracture the cartilage. Other than putting their head in a vice- I have
no
idea how to stop a cat from shaking his head. ;-)

I'll try to dig up an illustration of a hematoma repair, a little later so
you'll have an idea of what I'm talking about.

Best of luck,

Phil

On 2005-10-23 11:57:55 -0500, "Becky" said:

calm and minimise the headshhaking!

Since he has an ecollar and can't lick it, isn't there perhaps some
topical treatment to help ease the pain? That would help with
headshaking.

Just an update...

Simon came home from the vet today and he's doing fine. His ear looks
like a little mangled, but I don't know what it will look like when
it's fully healed. Thanks to everyone here who kicked my butt and
told me what to do.

Perry

"Perry Justus" wrote in message
...
Just an update...

Simon came home from the vet today and he's doing fine. His ear looks
like a little mangled, but I don't know what it will look like when
it's fully healed. Thanks to everyone here who kicked my butt and
told me what to do.


Perry, I am so glad Simon is doing well. I knew you would take good
care of him. I appreciate your bringing these hematomas to my
attention, particularly the fact that they are appearing more and more
in cats. I will keep an eye on my furbabies.

"Becky" wrote in message
...
Thanks so much for your reply Phil, you seem to really know what ya
talking
about.


I've had to deal with enough of them. ;-(


And thanks for your concern cybercat. Fawn is doing well today, he now
seems
recovered from the trauma of surgery and being at the vets, though the ear
is very uncomfortable for him, but at least he seems to be sleeping and
resting alot.
Fawn does have an e-collar on ever since the first op 2weeks ago, gods
that
was awful for him, took him about a week to get used to it, but hes
absolutely fine with it now, except he cant wash himself! (we wash him
with
wet cotton wool and he likes that).


Cats adapt well to E-collars after a day or two.


So he cannot scratch the ear at all. However, he does violently headshake
each time he gets up to walk about (how do they shake their head so fast!)
its like an obsessive reaction now, and i cant stop him from doing it,
save
by feeding him to distract him or getting him to sleep. I understand that
this may have been what caused the second lump to appear (as well as
sloppy
surgery, I think they did miss a stitch).

Here's an illustration of what the procedure should look like; with and
without a drainage tube:

http://www.maxshouse.com/Illustratio...oma_repair.jpg


I could send a piccies after each
surgery, tho its very gruesome.
The tubes do seem to run vertically from the base to the tip of the ear
flap
and theres more tubes inside the ear than on top. They do seem to be for
drainange also, as theres a lot of clotted blood around them (should I be
cleaning it up?)

No. The clot forms a seal around the tube that acts like a barrier and keeps
debris out of the wound.


It makes alot of sense to me to leave an open wound..so the
fluids can drain, then surely it cant build up again. However the vet told
me these ones arent so much for drainage, but more to apply pressure to
the
cartilege. He has very big ears being a siamese, perhaps they need more
support.

I've seen hematomas repairs in large dogs that didn't need supports or
stents.


Thank goodness the ear doesnt seem to have gotton any thicker these last
coupla days, but im worried that as it heals, the stitches seem to get
looser,whats to stop it from filling up again.

The cartilage itself as it heals.



I will give the vet a call tommorow, but Im almost reluctant to take him
back, as they have told me the only repair for hematoma is surgery and I
cant do that again(why dont they have a medicinal treatment!)...


If the hematoma is small, sometimes they can be drained via a needle without
the need to make an incision. But if the hematoma is too large to resolve
on its own- its best to clean it out.


but your
words have reassured me and hopefully this will fix it, if we can keep him
calm and minimise the headshhaking! Wonder if some form of sedative will
help him through the discomfort, he really is a fussy cat when he has a
'bee
in his bonnet' hes too much of a fighter to lie there and take it!
Thanks v.much for your help.
Becky

I'm happy he's doing better- Thanks for the update.

Best of luck.

Phil




"Phil P." wrote in message
...

"Becky" wrote in message
...
Hiya

My siamese cat Fawn developed a hematoma 2 weeks ago.
(I think it was arose due to him scratching/headshaking and worrying
at
a
small cut on his head)
He has been treated but im still worried about him...if anybody knows
more
about this please may i ask your opinion?
The vet told me if it is left untreated, it can disperse on its own
but
is
likely to recurr and if so, will cause 'complications', cailiflower
ear,pain,possible infection. They immediately recommended surgery
which
involved draining the ear, stitching it up with plastic tubes both on
the
outside and underside of the ear flap, looked very messy but
apparently
the
tubing is to put pressure on the cartilage layers to stop the ear from
filling up again.


Actually, the tube is probably for drainage- although drainage tubes
aren't
usually used in cats. The stitches should be placed in such a way to
allow
drainage but still hold the cartilage together until scar tissue forms.




Unfortunately, they seemed to have left a gap with no tubes/stitches
and


Sloppy job. The incision should gape *slightly* for drainage- but the
stitches should be placed carefully so they don't make any pockets where
the
hematoma can reform. Hematomas in cats' ears are caused by the
cartilage
splitting- so, the stitches should be placed through both sides of the
cartilage on either side of the hematoma to pull and hold the cartilage
together evenly. Sounds like vet missed a stitch and a pocket formed
and
filled with fluid.




another smaller lump developed within 4-5 days after surgery :-(


The stitches may have been too tight. The stitches can cause edema in
the
pinna if they're tied to tightly. Also, the stiches should be placed
vertically- and parallel to the artery and its tiny branches- not
horizontally. across them-- those little branches inside the cartilage
are
where hematomas come from.

Another possibility is he may have scratched his ear or shook his head-
both
can fracture the cartilage or reopened the fracture before it had time
to
heal- could take a few weeks to heal.



Took him straight back to the vets and they had to do the operation
again,
this time they stitched the whole ear, plastic tubes all over, looks
very
messy and very uncomfortable for the Fawn :-(


He really shouldn't need tubes or stents for support- the cartilage
stitched
together should provide enough support if the sutures were placed
correctly.


This 2nd operation was 3 days ago and im worried as his earflap looks
generally thicker than the other, even underneath those plastic tubes.
Im
really worried the hematoma is returning again....is this likely?


Probably not.



Surely it
cant recurr after 2 operations, i dont know what else they can do! I
cant
put him through surgery again!
Any advice/opinions/experiences would be greatly appreciated.
Becky


Does he have a bandage or E-collar? You've gotta keep him from
scratching
his ear- that alone can cause a hematoma. He also shouldn't shake his
head
violently- because that causes sinusoidal waves in the ear that can also
fracture the cartilage. Other than putting their head in a vice- I have
no
idea how to stop a cat from shaking his head. ;-)

I'll try to dig up an illustration of a hematoma repair, a little later
so
you'll have an idea of what I'm talking about.

Best of luck,

Phil

"Perry Justus" wrote in message
...
Just an update...

Simon came home from the vet today and he's doing fine. His ear looks
like a little mangled, but I don't know what it will look like when
it's fully healed. Thanks to everyone here who kicked my butt and
told me what to do.


I think you already knew what to do- I just wanted to make sure you listened
to yourself.

I'm happy he's doing well, now.

Thanks for the update.

Phil

Hiya
Just an update on my siamese cat Fawn, who developed an aural hematoma 3
weeks ago.
Yesterday we took him back to the vets to have his stitches out, which was
very quick, tho it took 3 ppl to hold the poor cat still! (he's so strong!)
The vet is very pleased with the final outcome and his ear looked fairly
normal (apart from being quite hairless and having lots of little red
'pinpricks' from where the stitches where!) The ear structure is very strong
and perky, I think when his hair grows back, any deformation will be
unnoticeable.
It seems that the thickness I'd noticed last week was a bit of an
illusion...with the tubes and clotted blood, and the nurses had also
indicated when i phoned them last monday, that some swelling was normal.
I can't tell you how much happier the Fawn is! :-D
He spent hours just washing himself last night and he has stopped the
sctratching and headshaking, he seems back to his normal, fine self :-)
Fingers crossed this will have fixed it, the vet seemed pretty confident
that it shouldnt recurr.
Thanks for your help whilst I was going through the worry of surgery.
Becky

"Phil P." wrote in message
...

"Perry Justus" wrote in message
...
Just an update...

Simon came home from the vet today and he's doing fine. His ear looks
like a little mangled, but I don't know what it will look like when
it's fully healed. Thanks to everyone here who kicked my butt and
told me what to do.


I think you already knew what to do- I just wanted to make sure you
listened
to yourself.

I'm happy he's doing well, now.

Thanks for the update.

Phil

Hiya
Just an update on my siamese cat Fawn, who developed an aural hematoma 3
weeks ago.
Yesterday we took him back to the vets to have his stitches out, which was
very quick, tho it took 3 ppl to hold the poor cat still! (he's so strong!)
The vet is very pleased with the final outcome and his ear looked fairly
normal (apart from being quite hairless and having lots of little red
'pinpricks' from where the stitches where!) The ear structure is very strong
and perky, I think when his hair grows back, any deformation will be
unnoticeable.
It seems that the thickness I'd noticed last week was a bit of an
illusion...with the tubes and clotted blood, and the nurses had also
indicated when i phoned them last monday, that some swelling was normal.
I can't tell you how much happier the Fawn is! :-D
He spent hours just washing himself last night and he has stopped the
sctratching and headshaking, he seems back to his normal, fine self :-)
Fingers crossed this will have fixed it, the vet seemed pretty confident
that it shouldnt recurr.
Thanks for your help whilst I was going through the worry of surgery.
Becky

"Phil P." wrote in message
...

"Perry Justus" wrote in message
...
Just an update...

Simon came home from the vet today and he's doing fine. His ear looks
like a little mangled, but I don't know what it will look like when
it's fully healed. Thanks to everyone here who kicked my butt and
told me what to do.


I think you already knew what to do- I just wanted to make sure you
listened
to yourself.

I'm happy he's doing well, now.

Thanks for the update.

Phil

"Becky" wrote in message
...
Hiya
Just an update on my siamese cat Fawn, who developed an aural hematoma 3
weeks ago.
Yesterday we took him back to the vets to have his stitches out, which was
very quick, tho it took 3 ppl to hold the poor cat still! (he's so
strong!)

I didn't realize he was a Siamese. Do you have a photo page, I would love
to see him.


The vet is very pleased with the final outcome and his ear looked fairly
normal (apart from being quite hairless and having lots of little red
'pinpricks' from where the stitches where!) The ear structure is very
strong
and perky, I think when his hair grows back, any deformation will be
unnoticeable.
It seems that the thickness I'd noticed last week was a bit of an
illusion...with the tubes and clotted blood, and the nurses had also
indicated when i phoned them last monday, that some swelling was normal.
I can't tell you how much happier the Fawn is! :-D
He spent hours just washing himself last night and he has stopped the
sctratching and headshaking, he seems back to his normal, fine self :-)

Wonderful news for Fawn and you too! thanks for the update. Now you can
help those who are faced with this problem, so don't be a stranger.