Dorsal Hematoma

A 5 yo QH mare flipped on her back after after it was decided to try to take her off the trailer forcefully.

A fluid filled pocked was felt on the dorsal part of the lumbar region. The fluid filled pocket kept getting bigger throughout the next two weeks, according to the owner.

On palpation there was movement of fluid inside. aspiration of bloody fluid was obtained, what seamed to be whole blood.

The hematoma was surgically opened and drained, a penrose drain was left in. The pocket was flushed with antibiotics and saline. After a 3 days the drain was taken out.

The opening closed nicely. DMSO and Cortisone were applied daily to reduce the thickness of the capsula that formed from the hematoma.

I highly doubt that the swelling gradually got bigger, in my personal opinion the swelling was big through day one, they just decided to play it through and see what happens if they don’t call the vet right away, bad choice.

Sometime I will not open these hematomas, they can bleed the horse to death. The main problem is that they can gradually lose all their coagulation elements and then the bleeding persists. In this case they need a blood transfusion. I told the owner to keep an eye on the bleeding, if it persists we would need to do coagulation tests to ensure that the coagulation time is still within normal limits. I decided to open it because it is in such a problematic place, where the saddle fits, and that is like this for two weeks already. The likelihood of her bleeding from there after 2 weeks are slim.