Diagnosis and Treatment of Hematoma in Horses

April 10, 2022

Does your horse have a large lump on his back? It’s about the size of a softball? What’s going on? It was not there yesterday?

If you have recognized all such symptoms, there are chances that you are dealing with ‘Hematoma’. Due to the loose skin and vascularized epidermal layers, horses are more prone to forming a hematoma. Hematoma treatment in horses may require draining or removal.

What is Hematoma?

Hematoma is a collection of blood under the skin which is similar to bruise, but the blood in this condition generally pools deeper in the tissues. This condition is confined to one particular area and causes swelling. Typically, this condition is formed due to trauma, such as a kick. This kind of lump is slightly squishy and has the same temperature as the surrounding skin. This skin itself is not damaged, but the tissues and blood vessels underlying the skin are damaged. This further causes internal bleeding and causes the area to get swelled.

Although, most of the hematomas may get firmer and smaller with time while some others require draining. However, complications may develop in some cases. If the casual trauma broke the skin, even with a tiny puncture that you can’t see, then there are chances that bacteria have entered the hematoma space. This may cause infection. In such cases, your horse may feel painful and have a fever. In such cases, you need to contact to your veterinarian.

Hematomas are also known as blood blisters and may occur within the muscles itself, or between the regions of connective tissues.

Different types of hematomas

1.      Aural: This condition arises on the pinna of the ear. This is an uncommon condition in horses.

2.      Ethmoid:  This type of hematoma is unique to horses and is located on the sinuses.

3.      Ovarian: These hematomas occur when the ovarian follicle fills with blood. It can be differentiated from ovarian cancer after an ultrasound.

4.       Uterine artery: When the hematoma develops due to bleeding in the uterine artery, it forms in the broad ligament. The small hematoma may cause minor colic while the larger one could rupture and bleed into the abdomen. The size of the hematoma in this condition may reach the size of a basketball.


The symptoms related to Hematoma may vary, depending on the size and its placement. Usually, the most noticeable symptom is the soft lump which can become large. There are some hematomas that may cause unexplained bleeding that causes nosebleeds. Such types of hematomas are called ethmoid hematoma.  For the treatment of hematoma in horses, draining is advisable.

Common symptoms that may occur during hematoma:

·        Pain around hematoma

·        Skin discoloration

·        Redness, swelling, or warmth

Causes of hematoma

Most hematomas are caused due to physical trauma to that particular area. This trauma may occur due to kick, falls, or bites. Additionally, bodily harm may also occur due to fighting or play fighting between the animals. It may also cause by something else like bumping into a fence post or due to the bite of a horsefly into the ear.

Common causes:

·        Blood draw procedure

·        Coagulation disorders

·        Chronic diseases

·        Trauma or injury

·        Platelet deficiency


Hematomas are relatively unique and distinctive in most cases. Generally, in this condition, there is a collection of blood combined with other tissues and bodily fluids which build up within muscles or between the regions of connective tissues.

This further leaves a large and the fluid-filled swelling which can be seen or felt on the surface of the skin. In case of ovarian or uterine hematomas, the ultrasound of the skin is required to diagnose.

Once the condition is diagnosed, your veterinarian will determine whether it can be left alone to dissolve into the body, or if it requires further treatment through draining. The hematomas which need draining are overly large and pendulous.


 If you have revealed a new hematoma in your horse, then you may first consider home-care including:

·        Elastic wraps to limit swelling

·        Ice packs several times

·        Elevate the area to reduce swelling

·        Warm compresses after two days of applying ice packs

Some of the hematomas are harmless and will resolve on their own. Your veterinarian, after complete diagnosis, will provide the necessary hematoma or bruise horse treatment. Aside from the above, medical treatment for the larger hematomas varies depending on their causes and symptoms.

If the hematoma is larger in size and it seems to be infected, then your vet may choose to cut it and let it drain. Certain types of hematomas require surgical removal to prevent the distortion. Natural resource Vitamin E may also help horses recover from injuries.

Hematoma recovery

The prognosis of the hematoma usually depends on its size and place of the swelling in horse. In case of the hematomas caused due to the uterine artery, the diagnosis requires assistance from the veterinarian.  The hematomas which are more likely to form are generally on the chest, flanks, haunches, and ribs. More often these lumps may reabsorb back in the body. If the horse is prescribed antibiotics then there are chances that the hematoma is infected and it is critical for you to complete the course to prevent its occurrence. 

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