Bumps and Bruises: Hematomas

"It looks like Ruby has a chesticle..."

I showed up at the barn on April 13th to Ride after being away for 10 days (Dallas, TX for business travel). At first I did not notice anything was wrong with Ruby- until I tacked her up and she made a face as I tightened the girth (which she never does). I hopped on, took her to the ring, Debi looked right at her...and she asked "are her boobs usually that big?"

The lesson went fine and it didn't seem to have bothered her. I do not know when the actual incident happened, but the fist-sized lump was mildly squishy, not warm to the touch, and did not bother Ruby unless I squeezed pretty hard. At this point we decided it was probably a hematoma.

As you can see, there is also some slight swelling on the right (her left) side. This felt like it was all just stretched skin. These pictures were taken after the lesson, so you can see the swelling in relation to where the girth sits.

Typically, you want to hose a hematoma with cold water right when it happens to encourage the bleeding to clot. Most vets recommend not riding until the form has hardened so that you don't inadvertently cause more bleeding/swelling. The interesting thing about hematomas is that they occur post trauma- but the location of the hematoma is not necessarily where the trauma occurred: Ruby could have been kicked higher up somewhere, but the swelling was pulled down (thanks gravity) to where it sits now. Hematomas on the chest and under the armpit are pretty common for this reason.

Since Ruby's lump had already hardened by the time we noticed it, I missed the early treatment phase. Now, we wait. Smaller hematomas usually resolve on their own, but it can take months for the body to reabsorb the mass.

Here is an article about Hematomas.

By April 22nd, there was already some improvement:

All of the swelling/lose skin is gone on her left side, and the main mass has reduced. The hematoma is still hard and it does not bother her when I mess with it.

I will continue to monitor her each time I come out to make sure nothing changes. If you, at any point, notice that there is more swelling/heat/discomfort- call your vet.

Since Ruby's hematoma is pretty small (most vets consider 'tennis ball' sized as small), I will probably not end up doing anything to hers. However, larger hematomas can be lanced to drain them. Although this can speed up the healing process, you do run the risk of introducing infection/bacteria to the wound. Again, if you think lancing is an option in your case, discuss with your vet the risks of doing so.



It is ugly, but hey. I am hoping the judges won't notice in our next show.


Update (May 15th):

MUCH better-the lump is about the size of a small egg; it is hard to see at this angle because it has migrated a little farther back towards her belly. Still no signs of heat or swelling so everything looks good so far. I am hoping that in another couple weeks it will be gone completely. We have been continuing our weekly lessons with a few rides between (I would say about 3 rides per week) and she has been doing fine. Some people told me not to ride while the hematoma was healing, but it has not caused any negative effects and may actually be helping.

I will continue to monitor her 'chesticle' and update on here when it does finally go away.