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  Discussion on Hematoma
Author Message
New Member:
goliva

Posted on Monday, Aug 9, 2010 - 9:20 pm:

Hi there,

I'm new to the website and I need some guidance. My 6 y.o. TB recently got a hematoma on the outside of his right hind when he fell while out in the field. It got to be the size of watermelon and my vet came out and drained it. After she drained it, she injected atropine, steroids, and antibiotics. She told me that it would probably fill back up, since it was so big, but that wouldn't happen for at least a couple of weeks. Well, that was almost 2 weeks ago, and the hematoma has already swelled to 50% of what it was when my vet drained it. I tried DMSO + cortisone, but my horse could not tolerate it. I've tried epsom salt poultice, arnica gel, lavender oil, and vitamin c plus bioflavonoids - nothing seems to be helping. I called my vet, and she told me she had consulted a surgeon who said we should lance it and place a drain to allow the serum to drain.

My concern is this - in all my years of owning horses, I've never had a horse need a drain. What is entailed in the care? Will he need to be on stall rest? What about infection? The flies are HORRIFIC right not (I live in NJ) and I'm concerned they will contribute to infection. Anyway, any help or experience with this would be much appreciated!
Moderator:
DrO

Posted on Tuesday, Aug 10, 2010 - 1:49 pm:

Welcome Gina,
The surgeon is correct, if you cannot get this to drain through an incision you should install a drain. There is more concern for a undrained pocket of fluid to become infected than one that is draining well. Cleaning it several times a day and applying antibiotic ointment to the outside will usually suffice. As to whether he will need stall rest can best be determined by your veterinarian.
DrO
Member:
gramsey1

Posted on Tuesday, Aug 10, 2010 - 2:43 pm:

Be sure to read the articles here. This happened to our horse and we didn't pay enough attention.
He ended up with a big dent in his muscle because it atrophied. Check the article on fibrotic myopathy. https://www.horseadvice.com/horse/messages/4/5349.html
New Member:
goliva

Posted on Monday, Aug 16, 2010 - 1:24 pm:

So, my vet came out on Thursday, 8/12/10, and opened up the hematoma and put in a penrose drain. Actually, I should say the penrose is tied to keep the drains open. When it was opened, there were quite a few bits of necrotic tissue within the hematoma, which my vet said may have been inhibiting it from healing. My vet gave my horse some IM long-acting antibiotics and said that the drain should be taken out on Tuesday, 8/17/10 (my mom is an OR nurse, so she will be taking it out). However, the drain in continuing to put out quite a bit of serum. He is soaking through, and I mean it could wring out, 2 gauze 4x4's every 2-3 hours. Also, yesterday the hematoma was filling again so my mom opened the drain holes back up with a syringe and milked it to get the fluid out. Again, this morning it was filling again and I opened it the same way to milked all the fluid out.

I guess my question is: how long are drains left in for? Is it "normal" for a hematoma to be putting out so much fluid after 4 days? Is it normal for the hematoma to fill up even with the drain and have the drain holes need to be reopened? How long can drains be left in? My mom was thinking that the whole thing may need to be opened and debrided. Does this happen? I know these are a lot of questions, but any insight and help is much appreciated to ease my anxious mind right now!
Moderator:
DrO

Posted on Tuesday, Aug 17, 2010 - 7:26 am:

Usually a properly placed drain does not require constant work to keep it working. You might try hot packing with antiseptic solution to gently cleanse the drain. There is no "normal" time for a drain it all depends on the amount of damage done. Often 3 days is long enough.

Guy's advice above to check out the article on fibrotic myopathy is "spot on" for this injury.
DrO
Member:
vickiann

Posted on Tuesday, Aug 17, 2010 - 10:31 am:

Thanks so much for pointing out this article, Guy, and thanks also to Dr. O.

I never knew about this condition but it may explain some situations that I have seen over the years with horses, possibly including one of mine.

Gina, I hope that your horse's condition improves and clears up soon.
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