What a Hematoma is in Horses

Something that happens quite regularly with horses is that they get hematomas. A hematoma is simply a pocket of fluid, mostly blood, and is most commonly just referred to as a blood blister. In most cases, there is nothing to do and from anywhere from a week to 3 months the hematoma would be reabsorbed by the body and that’s that. Once in a while though it has to be drained and treated for possible infection. Here is a search on youtube that shows what that would look like. While there are lots of videos out there, it’s not the normal end result of a hematoma and generally would only happen if the horse just doesn’t get the fluid reabsorbed naturally.

We recently had a horse get a hematoma from simply losing his footing and falling on his side. I know that because I was watching at the time. He got back up and walked it off and then continued to play around. The next day he had this:


Then the following day it looked this:


Then next day was this:


The consistency of the lump in the beginning was very watery, like a water balloon. The next day it started to become more stiff and thicker like pudding and the next day and from that forward it has stayed about the same with it moving up the chest a bit. All of this is normal and in many cases it would get bigger as time goes on and the body continue to try to heal itself.

Hematomas happen all the time with horses as they either fall down, get kicked or bump up against something hard that bruises them. In more unusual cases they may even tear something or break/dislocate a bone. In each of these instances a hematoma is very likely as the body sends a bunch of fluid to help heal things up and protect. Once that isn’t needed anymore then the body should reabsorb it and that will be the end of that. If after a couple of months or less than that if you notice your horse is having trouble walking or moving, then obviously the vet has to come out to make an incision to “lance” the hematoma to drain it out. This isn’t something that should be done if it can be helped as you can risk infection and make everything worse. Ask your vet if in doubt though.

Overall, the treatment of hematomas can range from cold or warm water rinsing, regular walking and movement to rest depending on who you talk to. The cold water would be to reduce inflammation if it’s hot, the warm would be to encourage blood flow to reduce pressure and encourage reabsorbing and walking and movement does the same. Riding is encouraged if the horse is not bothered by the pressure or point of where the hematoma is. In some cases it may be in a very bothersome location and get very large. For this it’s recommended to regularly exercise the horse but not force it and possibly not ride. Again, your vet or somebody that can assess the horse properly is your best bet to know what will work for the horse.

With time most hematomas go away on their own so it’s not something to get too concerned about. Assess your horse for any other side effects or direct effects of the injury it attained while out and about. If it’s a kick, look for injuries, a fall down can dislocate bones or tear muscles and general bumps and crashes into things can primarily just bruise the horse. Assess movement by flexing the horse left and right. Going forward and back and side passing if your horse does that too. Stretch all four legs in both the front and backward directions and up towards their body. Check for pain through palpation and see how the horse does at a walk, trot and possibly canter. Each of these things will give you clues as to the condition of the horse and whether there is cause for concern or not. Again though always check with your vet anyways just in case, even if it’s just about sending a picture.

As a follow up, the hematoma in this horse proceeded to get bigger, spread a bit outwards and then in about 3 weeks started to reduce in size. One week of that has left it the size of a golf ball and it was completely gone a week later.