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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.

Hematoma Average Cost

From 571 quotes ranging from $1,000 - $5,000

Average Cost

$2,000

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.

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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.

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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.

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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.

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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.

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Hematoma Average Cost

From 571 quotes ranging from $1,000 - $5,000

Average Cost

$2,000

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Hematoma Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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Ask a Vet

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Tango

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Arabian

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15 Years

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Fair severity

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0 found helpful

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Fair severity

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

July 14, 2018

Tango's Owner

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Dr. Michele K. DVM

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1611 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.

July 14, 2018

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Romeo

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Fresian

dog-age-icon

10 Years

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Mild severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Mild severity

Has Symptoms

Bump

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?

June 25, 2018

Romeo's Owner

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recommendation-ribbon

3320 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

June 26, 2018

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Jasper

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Welsh

dog-age-icon

3 Years

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Mild severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Mild severity

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

May 7, 2018

Jasper's Owner


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3320 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

May 7, 2018

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

July 4, 2018

Kate M.

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Lilly

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Quarter

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21 Years

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Moderate severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Pain
Lump

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?

March 10, 2018

Lilly's Owner

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3320 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

March 10, 2018

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Mylee

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Warmblood

dog-age-icon

10 Years

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Fair severity

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Fair severity

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 ?

Feb. 5, 2018

Mylee's Owner


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Dr. Michele K. DVM

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1611 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!

Feb. 5, 2018

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

Feb. 22, 2018

Nicky W.

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Jaz

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British sports horse

dog-age-icon

16 Years

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Moderate severity

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Moderate severity

Has Symptoms

Facial Hematoma

My mare got cast three weeks ago and hit her head. She had a big swelling below her ear towards her cheek. The initial swelling drained down her cheek but she has been left with a firm lump the size of a large egg just under her ear. She is not keen on you touching it and I cannot put her bridle on due to the location. I lunged her recently and she started to shake her head after 15 minutes. She is now just on rest and turn out as I felt that there was a build up of pressure when lunging. Advice welcome. Alison

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birdie

dog-breed-icon

Thoroughbred

dog-age-icon

20 Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Mild severity

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Mild severity

Has Symptoms

Large Heamatoma

My horse has an injury on her kneecap - causing a large heamatoma 3 days ago- has been seen by a vet and there is no infection - the heamatoma appeared to be going down, but has swollen again the size of half a football -- she is walking ok and eating ok -- I have hosed it - but have very limited water (due to drought) - will this re absorb slowly ???

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Mo

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Quarter Horse

dog-age-icon

5 Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Mild severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Mild severity

Has Symptoms

Hematom

My 5yr old gelding has what appears to be a hematoma behind his front leg/ chest possibility caused by cinch being too tight. I have been putting Asorbin on it and sweeping went down but became a pendulum but not it’s back to sweeping on the side now. At times it feels a little warm but doesn’t seem to cause him any pain. My concern is that it started getting better but is now swollen again. What should I do? Thanks

Hematoma Average Cost

From 571 quotes ranging from $1,000 - $5,000

Average Cost

$2,000

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