Horse Health Issues: Hematomas

Learn how to recognize and treat hematomas in your horse.

From The American Quarter Horse Journal

There are basically three types of swellings: non-infectious, infectious and the hematoma, which is caused by broken blood vessels. Although non-infectious and infectious swellings are forms of cellulitis (a cellular process that causes edema in the tissue), the hematoma is not. The hematoma is a localized collection of blood that is either clotted or unclotted in an area of tissue, an organ or some other body space. It is usually caused by trauma, such as a kick or bite.

Treatment of the hematoma largely depends on how long the enlargement has been present and where it is located on the horse. Hematomas located on the side of the horse are not nearly as large or as difficult to heal as those on the inside of the thigh and underneath the ventral part of the body (abdomen and chest).

According to veterinarian Dr. L.D. “Max” Walker Jr., early treatment of a hematoma includes inactivating the horse so that the bleeding will subside.

“Put the horse in an enclosed area so that he remains inactive and then apply cold water or ice compresses to the hematoma. The cold will aid in shrinking the blood vessels. The horse is left in a stall for about four to five days so that the bleeding stops and the blood clots. Once the bleeding stops, the hematoma will not increase in size. But if the horse is allowed to run around, the bleeding can reoccur,” Dr. Walker says.

Normally, with a hematoma, the skin will not break. However, an extremely enlarged area is often punctured so that fluid is released and healing can begin. “If the fluid is straw-colored, this is blood-colored, then more time is needed before the area is drained so that the blood clots,” he says.

The straw-colored fluid is often removed, but the blood clot is not. Dr. Walker explains that the reason for leaving the blood clot is that removal will cause a defect or indentation in the muscle after the hematoma heals.

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Dr. Walker strongly advises that sterile conditions be used when draining the area. “Use a new needle and clean the skin,” he says. “If you take bacteria inside the hematoma, then you set up an infection. The hematoma will usually abscess, and that’s when you get into problems.”

The horse is also given antibiotics and a tetanus injection during treatment.

After the hematoma is drained, it is usually allowed to heal on its own. But after about 10 days to two weeks, the horse's healing process can be stimulated by applying warm towels on the area, which opens up the blood vessels, and applying DMSO (dimethyl sulfoxide).

Hematomas that are the size of ping-pong or tennis balls usually are not punctured.

“They normally take care of themselves- the swelling will go down and there’s no problem,” Dr. Walker says.

The healing time for a horse's hematoma depends on its size. The smaller ones will usually disappear in about 10 days. The larger ones can take as long as a month to heal.

Whereas a hematoma is caused by bleeding, an infectious type of swelling often develops from a cut or puncture wound. Dr. Walker explains that you look for the following four signs in an inflammatory situation:

    • Heat
    • Pain
    • Swelling
    • Redness of the skin

Treatment includes antibiotics, draining any serum or pus and cleaning the wound.

With the non-infectious swelling, the area will normally not show signs of heat and redness. Sometimes the swelling is a little painful. This kind of swelling will pit when you push your finger against it - you can produce an indentation in the skin.

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“A good example of a non-infectious swelling is the swelling of a mare gets under her belly before she foals, and the horse’s legs stocking up,” Dr. Walker says.

Some swellings are caused by allergic reactions, and these are often displayed as welts or bumps all over the horse’s body. Allergic reactions can be caused by such things as fly sprays, too much protein in the feed, or an insect bite. Dr. Walker says, “These should be treated with an antihistamine, which reduces the swelling. If the swelling continues, it can cause some skin loss.”

Swellings should not be taken lightly. They need to be watched and closely inspected. If the swelling does not improve, or if it worsens, a veterinarian should be contacted.

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