Hematoma Average Cost

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Average Cost

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What is Hematoma?

Horses, by virtue of their loose skin and vascularized epidermal layers, are prone to forming hematomas. A hematoma is a collection of blood under the skin, similar in mechanism to a bruise, but the blood generally pools deeper in the tissues and is confined to one area, causing the swelling. The skin itself is not damaged, but the tissues and blood vessels underlying the skin are damaged, causing minor internal bleeding. Since the blood is confined to one area, it causes that area to swell out of proportion. Although most hematomas in horses will reabsorb back into the system, some require draining. Attempts to puncture and drain the hematoma should be made by a veterinary professional only as infections and complications can occur.

Also known as blood blisters, hematomas in horses can occur either within the muscle itself or between regions of connective tissue and may require draining or removal.

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Symptoms of Hematoma in Horses

The symptoms related to a hematoma are variable, depending both on the placement of the hematoma and its size. The most noticeable symptom is usually a soft lump somewhere on the horse's body which can become quite large. Some hematomas may cause unexplained bleeding, such as the ethmoid hematoma, which causes nosebleeds; other hematomas, like ovarian hematomas, may have no outward symptoms. 

  • Presence of a soft lump
  • The lump may grow in size
  • Asymptomatic is possible

Types 

Aural 

This is a hematoma that arises on the pinna of the ear. Although common in dogs, cats, and pigs, this is an uncommon condition for horses. 

Ethmoid 

This type of respiratory hematoma is unique to horses and is located in the paranasal sinuses. The smaller ethmoid hematomas generally start on the sinus floor, but the larger ones originate in the ethmoid structure itself. 

Ovarian 

Ovarian hematomas occur when an ovarian follicle fills with blood after ovulation. It can be differentiated from an ovarian tumor using ultrasound and only occurs when the mare is cycling.

Uterine artery 

When a hematoma develops from a bleed in the uterine artery it usually forms in the broad ligament. A small hematoma may cause only minor colic, but a larger hematoma could rupture and bleed into the abdominal cavity. The size of hematomas in this area can reach the size of a basketball.

Causes of Hematoma in Horses

More often than not a hematoma is caused by physical trauma to the area such as might occur when a horse experiences kicks, bites, or falls. The bodily harm may occur from fighting or play fighting between animals, but more often than not it is caused by something more mundane, such as bumping into a fence post or the bite of a horsefly on the ear. Although ethmoid hematomas may not reveal a direct cause, they are more common in middle-aged geldings than in other demographics.

Diagnosis of Hematoma in Horses

In most cases, hematomas are relatively distinctive. A collection of blood, sometimes combined with other bodily fluids and tissues, builds up either within the muscle or between regions of connective tissues. This leaves a large, fluid-filled swelling that can usually be both seen and felt on the surface of the skin. The blood in these lumps often separates out into blood clots and serum, and can be differentiated from an abscess that has not yet ruptured by the feel; an abscess will be much more firm to the touch than a hematoma and will generally cause the horse pain when it is palpated. In the case of internal hematomas, such as ovarian or uterine hematomas, diagnosis is usually achieved using ultrasound technology.

Once the hematoma itself is diagnosed, your veterinarian will evaluate the hematoma to determine whether it can be left alone to reabsorb into the body, or if it requires further treatment in the form of draining. Hematomas that may need draining include masses that have gotten overly large and pendulous, those that are interfering with natural movement, and those that are exhibiting signs of infection such as the area being hot to the touch, painful, or oozing pus.

Treatment of Hematoma in Horses

If you discover a new hematoma on your horse, the first step in treatment is to either ice or cold hose the hematoma for 15-20 minutes. It is best to do this as soon as possible so that it can both slow or even halt inflammation as well as constricting the blood vessels. In many cases, hematomas may be left on their own to reabsorb back into the body. This process can take some time, often a month or longer. Some veterinarians may choose to inject formalin directly into the mass to cause the blood clots to dissolve, making it easier for the body to reabsorb.

If the hematoma is overly large, if it appears to be infected, or if it is hindering the patient’s movement, the veterinarian may choose to lance the hematoma and let it drain. Certain types of hematomas, such as the ethmoid type of hematoma, require surgical removal to prevent facial distortion or necrosis of the bones that surround the hematoma.

Recovery of Hematoma in Horses

The prognosis for an equine hematoma depends on the placement and size of the swelling. In the case of ethmoid hematomas and hematomas caused by the uterine artery, the prognosis may be guarded even with veterinary assistance. The hematomas that are most likely to form, however, are on the chest, ribs, flanks, and haunches, and they have a fairly good prognosis. More often than not these lumps and bumps reabsorb back into the body without further intervention. If your horse is prescribed antibiotics because the hematoma has become infected, then it is critical that you complete the course to prevent reoccurrence.

Hematoma Questions and Advice from Veterinary Professionals

Mylee
Warmblood
10 Years
Fair condition
0 found helpful
Fair condition

Has Symptoms

Firm lump

I think my horse has a hematoma from IM penicillin injections in her neck, it’s about the size of a palm , but fairly firm to touch ? Does this mean an abscess ? She’s not bothered with me touching and quiet enjoys it being rubbed and scratched, should I just wait and see if this goes down by itself or should I be worried ?

Dr. Michele King, DVM
Dr. Michele King, DVM
1607 Recommendations
Thank you for your email. WIthout examining Mylee I can't say whether the lump is a local reaction that will resolve, or an abscess from the injection that needs to be treated. It would be best to have your veterinarian examine her and possibly take a needle sample of it to see what the lump might be. They'll be able to recommend any necessary treatment once they have seen it. I hope that everything goes well for her!

My horse ran into a metal post and had one of these in his chest in the middle just handing down at first he couldn’t move but can run but it’s still fairly large he is exercised daily and it will be a week now he has had this I am hoping it goes by itself as he doesn’t look in pain he’s eating fine and walking fine or should I get a vet out

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tiggertime
thourobred
Three Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Hematoma

i have a hematoma on my horses rump. its the size of half a football .had a vet look at it said it would go down.but its not going down and its a bout a month ago.can i give some penicillan would it help.or should i get it lanced which the dont like to do need help

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3317 Recommendations
Antibiotics wouldn’t be effective against a hematoma which is a collection of blood under the skin, also I wouldn’t recommend lancing it as secondary infection would be a risk; generally the body breaks down the hematoma and reabsorbs it but it can take a while to go down. If there has been no improvement over the course of a month, you should call out your Veterinarian to discuss to see if the cause is something else or if there is a recurring bleed. Regards Dr Callum Turner DVM

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Romeo
Fresian
10 Years
Mild condition
0 found helpful
Mild condition

Has Symptoms

Bump

Medication Used

Purbac and finadyn

Hi

My horse spooked in the horse box about 2 months ago and kicked his hind leg quite badly. His shoe cut open the inside of his near hind leg and on the outside it appears there is a hematoma or a splint (I really hope not).
My vet here had a look at it and said it could be either. It is hard but not a round prominent bump like a splint usually is. It's more gradual.
The leg swelling has gone down but this bump hasnt.
Could it be a hematoma? How could I treat it so that it goes away?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3317 Recommendations
A haematoma would would have been broken down by the body and reabsorbed into the bloodstream; without examining Romeo I cannot say whether it is a splint or something else. I would monitor the lump if it isn’t causing any issues and see if there are any changes over time, I cannot ethically tell you any treatment for this without being sure of the underlying cause. Regards Dr Callum Turner DVM

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Jasper
Welsh
3 Years
Mild condition
0 found helpful
Mild condition

Has Symptoms

Swelling

Hi,
My horse has recently developed what I believe to be a hemotoma. He has a swelling a little bigger then my palm on his left shoulder. Looks like it was from a kick. This was a couple of days ago. Today I noticed that his swelling had gone down, not in size but in location. It seams to have moved down his shoulder a couple of centimeters. He is not lame at all and there is only a little heat in the affected area. I have been sponging it down with cold water and applying Tuff Rock. Is there anything else I should be doing?
Thanks

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3317 Recommendations
It is possible that this is a hematoma, however do not try to piece it or break it up with a needle as this is not helpful and may cause numerous complications; the body will breakdown and reabsorb the blood with time. Regards Dr Callum Turner DVM

Hi

If the hematoma causes no pain or lameness can you still work your horse? Is he ok out grazing or should he be stable kept? Thanks Kate

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Lilly
Quarter
21 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Lump
Pain

My horse has a lump on her girth that has been there for some time, possibly several months. It seems like it is getting bigger recently. She is gets very agitated when I tighten her girth, although she doesn't seem to bothered by me touching the lump unless I put a lot of pressure on it. She has had several weeks off without being tacked and it has not healed. In the past she has had a hematoma from being kicked by another horse that had to be lanced. Could this be a hematoma? How can I treat it?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3317 Recommendations
This doesn’t sound like a haematoma as they usually breakdown and get absorbed by the body within a few weeks, if the mass has been their for several months it is unlikely to be a haematoma. You should call out your Veterinarian to take a look at it especially if it is uncomfortable when tightening the girth; your Veterinarian may aspirate the lump to determine its contents. Regards Dr Callum Turner DVM

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Tango
Arabian
15 Years
Fair condition
0 found helpful
Fair condition

Has Symptoms

Stiffness

My arab had a hemotoma injury while back but has some stiffness in his walk on left leg whT supplements or excerise would you recommend i dont want to injure him

Dr. Michele King, DVM
Dr. Michele King, DVM
1607 Recommendations
Without knowing where the hematoma was or how severe it was, I have a hard time commenting on what might help him, unfortunately. Hematoma's don't typically cause stiffness, and it would probably be a good idea to check with your veterinarian to see if there is anything that you can be doing to help him, as they have seen him and know more about his condition.

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