# Persistent Hematoma



## tippykayak (Oct 27, 2008)

I was wondering if anybody had experienced this and might have some advice.

My sister's family has Jax's brother, Ojo, and he's a similarly driven, high-energy dog. A few months ago he threw his head up while he was under a table and cracked himself on that bump of bone they have on the top of their heads (I think it's called the occipital protuberance or something similar). He got a knot of a bruise there. He kept whacking it into stuff, including the top of his crate, now and then. He's very excitable and has an extraordinary pain tolerance, so if he jumps up in his crate and smacks it, he doesn't really learn not to do it again.

Over the last few months, it's become a large, persistent hematoma that just isn't going away. Of course, since it's so big (around the diameter of a half-dolar and a good 3/4" raised), it's easier for him to whack it.

The vet has seen it several times and has said it's harmless and should be reabsorbed eventually.

Still, it's huge, looks painful, and keeps getting reinjured. Has anybody had experience with something like this or know any tips for getting it to be reabsorbed faster or otherwise improving it?


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## Oaklys Dad (Dec 28, 2005)

Foam padding on the top of his crate and under the tables? Crash helmet? Sharlin posted a picture of a dog in a crash helmet just tonight.


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## Swampcollie (Sep 6, 2007)

Smaller crate, so he can't bounce and bang his head on the top. We had a lab in for training a few years ago that we affectionately called "Lumpy". He kept banging his head on the top of the kennel run causing a hematoma. We finally had to resort to a small crate to sufficiently confine him to prevent the bouncing.


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## moverking (Feb 26, 2007)

Awww, he's trying to make his 'smart bump' bigger....well, may be that's a stretch :curtain:

What about a soft e-collar for a few days, could provide some padding or at very least, subdue him a bit. 

Not stylish at all, huh...:no:









I'd be a bit worried about repeated trauma, too. And the _way_ outside chance there's a clotting disorder.


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## tippykayak (Oct 27, 2008)

I think a smaller crate might be smart. The one he has is pretty big, I think.

Just getting him not to injure it for a few days won't do the trick. They've been able to get him not to injure it for days and days and it doesn't really get smaller very quickly.

They did replace their coffee table, since he got himself a number of times on that. They got a big padded ottoman thing instead.

I think the crate is the only place he's hitting himself anymore, so maybe if they can get a smaller one or otherwise pad it, that'll help.


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## moverking (Feb 26, 2007)

Maybe the vet should aspirate and drain it one time? I know there's a risk of infection but damage from the pressure of the build-up to nerves and tissue and possible scarring leaving a permanent bump could be an issue too. Poor pupper


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## tippykayak (Oct 27, 2008)

moverking said:


> Maybe the vet should aspirate and drain it one time? I know there's a risk of infection but damage from the pressure of the build-up to nerves and tissue and possible scarring leaving a permanent bump could be an issue too. Poor pupper


Yeah - I wish there was something to do to start moving it in the right direction. They've been again and again to the vet with it, but they keep saying that mucking around with it won't help and that it'll take care of itself now that there's a new coffee table.


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## GoldenJoyx'stwo (Feb 25, 2007)

My Mom had more than one hematoma. She'd get them if she bumped herself. It took time before they went down.


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## Abbydabbydo (Jan 31, 2007)

Oh, poor Ojo! I might call in a specialist because that does not sound right. Even when Abby ran into the wall and knocked herself out, she did not come up with a hematoma. And Finn, for goodness sake hit his head on the kitchen table a million times trying to do a stealth attack for food.

Blood tests?


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## tippykayak (Oct 27, 2008)

Abbydabbydo said:


> Oh, poor Ojo! I might call in a specialist because that does not sound right. Even when Abby ran into the wall and knocked herself out, she did not come up with a hematoma. And Finn, for goodness sake hit his head on the kitchen table a million times trying to do a stealth attack for food.
> 
> Blood tests?


Apparently this is a common thing when a single site is injured over and over. It's a spot where the bone is right there and the swelling has nowhere to go. There are no concerns at all that it's anything but a nasty blood-filled mass.


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## fostermom (Sep 6, 2007)

Abbydabbydo said:


> Oh, poor Ojo! I might call in a specialist because that does not sound right. Even when Abby ran into the wall and knocked herself out, she did not come up with a hematoma. And Finn, for goodness sake hit his head on the kitchen table a million times trying to do a stealth attack for food.
> 
> Blood tests?


Yeah well, Finn's a lab. They have the hardest skulls on earth! LOL


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## Abbydabbydo (Jan 31, 2007)

fostermom said:


> Yeah well, Finn's a lab. They have the hardest skulls on earth! LOL



Good point. And the highest pain tolerance of any living being


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## tippykayak (Oct 27, 2008)

So, here's an update.

We've had Ojo with us for the last few weeks since I'm on vacation and have lots of time to devote to hiking and training. We're basically running dog camp for the three pups. Ojo _still_ has the lump, even though they replaced the coffee table and even replaced the top of his crate with bungee cords so there's nothing for him to hit his head on. It's gradually gotten smaller over the last six months, and now it's about the diameter of a quarter and raised about 3/4 of an inch.

He's been swimming about three times a week while he's been with us, and it seems to have gotten a bit smaller. Today while we were at a class, it started spontaneously releasing its contents in two places on the lump. 

(WARNING: SOMETHING SUPER GROSS COMING UP)

What came out was sort of a beige paste. I applied gentle pressure, and tons of the stuff came out. The entire lump was made pretty much of this beige paste. Even weirder, one of the two holes that leaked the stuff has a clump of hair coming out of it. It's possible that the clump of hair was curled up in the lump the whole time and straightened itself out when the junk came out. The rest of the lump doesn't grow fur (though the fur around it lies over it and you can't see a bald spot normally). I think there may have been a cyst around the hair that was created when the original injury happened.

I figured the vet would gently push out as much foreign matter as possible and then carefully clean it, so that's what I did. I didn't think she'd want to cut it open on the spot or lance it, so I didn't bother taking him in when I could clear it and clean it myself. Obviously, we'll carefully monitor it, and at the first sign of infection or complication, we'll head right in.

It's dramatically smaller now. Instead of being rounded and protruding, there's just a little swelling in the skin.

So here's one of my questions: what's the beige stuff? The vets initially told my sister that the lump was full of congealed blood and that it would slowly be reabsorbed. This beige stuff doesn't look like congealed blood. It looks like what you'd get if you soaked a piece of kibble in water. I guess it could be decomposed blood, or perhaps it could be that exudate that forms around a foreign object.

It's definitely not pus or serous fluid, but it could be some horrible mix of sebum, exudate, and congealed blood. I have high hopes that now that most of it has exited, the cyst/hematoma will be reabsorbed with minimal scarring. There's a chance that the pocket could refill itself with the same garbage, in which case I think it'll have to be surgically opened, cleaned, and sewn up so it can no longer create the pocket for a cyst.

Anybody have experience with something like this or ideas about what to do next? I'm going to keep cleaning the wound daily, and obviously I'm keeping the other dogs from licking it, and I've thought a compress might be helpful if I can keep it on his head for long enough. Any other thoughts?


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## zephyr (Sep 29, 2009)

tippykayak said:


> So, here's an update.
> 
> We've had Ojo with us for the last few weeks since I'm on vacation and have lots of time to devote to hiking and training. We're basically running dog camp for the three pups. Ojo _still_ has the lump, even though they replaced the coffee table and even replaced the top of his crate with bungee cords so there's nothing for him to hit his head on. It's gradually gotten smaller over the last six months, and now it's about the diameter of a quarter and raised about 3/4 of an inch.
> 
> ...


Oh dear, that IS gross, fair warning!! :yuck: : But wow you are a champ for getting it all cleaned out/up!!

I don't know much about this kind of thing, but I googled cyst and from your description, it sounds a little bit like a sebaceous cyst...? Apparently those can happen rather commonly in dogs too. If you do an image search, it does look they can appear as red raised bumps that look sort of blood-filled -- but also have some gross, white-ish, keratinous contents...!

Perhaps it was some combination of the two: a hematoma created an infected hair follicle, or the cyst kept getting bumped and a hematoma formed...??

It sounds like you cleaned it up well; I would think the vet probably would have done the same thing at this point, unless it gets any worse. Maybe they will have some additional tips on how to get it healed if it is some kind of cyst! (And if it is related to some kind of infection that happened in a cyst or wound, maybe he will need some topical antibiotics or other special cleansing solution...?)

Good luck to you, Ojo, & your sister's family!


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## IowaGold (Nov 3, 2009)

Definitely a cyst (probably TMI but I always enjoy a good cyst!). Those thick ones are way less likely to come back once you get all the gunk out than fluid filled cysts, so hopefully your pretty much done with it. But if it does come back, your plan of having the vet removed it is a good one.

FWIW, there *could* have been hair in the cyst but usually it will be all mixed in with the gunk no a discrete clump and if the hair wasn't all wet/greasy looking it probably was from the surface and just got incorporated as you were emptying the cyst.

Just keep it clean. A warm compress for 5-10 minutes a couple of times a day sure wouldn't hurt (but if he doesn't like it, I would really push it).


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## tippykayak (Oct 27, 2008)

IowaGold said:


> Definitely a cyst (probably TMI but I always enjoy a good cyst!). Those thick ones are way less likely to come back once you get all the gunk out than fluid filled cysts, so hopefully your pretty much done with it. But if it does come back, your plan of having the vet removed it is a good one.
> 
> FWIW, there *could* have been hair in the cyst but usually it will be all mixed in with the gunk no a discrete clump and if the hair wasn't all wet/greasy looking it probably was from the surface and just got incorporated as you were emptying the cyst.
> 
> Just keep it clean. A warm compress for 5-10 minutes a couple of times a day sure wouldn't hurt (but if he doesn't like it, I would really push it).


You are the greatest for responding. Guessing what the vet would do is a lot less reassuring than hearing a real vet say it.

As far as that hair clump, it was super dark and greasy, really different in character from the surrounding hair, even the surrounding hair that got gunked. And it all came through in one spot, almost like it was growing from the tissue below the cyst and had punched through the top. Truly bizarre.

It makes tons of sense to me that the original diagnosis of hematoma turned out to be off. Maybe it started as a horrible bruise, but it's pretty clear that what persisted for all these months is a cyst, either based around the hair or around the congealed blood. So, if it refills or if I only got some of it (there's still a lump that doesn't quite feel like straight up swelling), we know that having it removed will be straightforward and put him back to normal.

Glad to know that this type of cyst is fairly likely to resolve now that it emptied itself.

He already looks better! More disinfecting on the schedule for today, and I'll try out a warm washcloth and see if he tolerates it.


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## tippykayak (Oct 27, 2008)

zephyr said:


> Oh dear, that IS gross, fair warning!! :yuck: : But wow you are a champ for getting it all cleaned out/up!!
> 
> I don't know much about this kind of thing, but I googled cyst and from your description, it sounds a little bit like a sebaceous cyst...? Apparently those can happen rather commonly in dogs too. If you do an image search, it does look they can appear as red raised bumps that look sort of blood-filled -- but also have some gross, white-ish, keratinous contents...!
> 
> ...


Thanks! I think you're right. The stuff that came out was definitely sebum-ish. I think it was browner than typical sebum because it was so ancient and might have started out with some congealed blood from the hematoma too. 

Fortunately, it doesn't have any of the characteristics of an actual infection. There was no pus, no smell, no inflammation beyond the minor swelling you'd expect with the injured tissue. I think the foreign matter was sustaining the cyst but that it never got infected, which is great.

Infection is my biggest concern now that it's opened up, and I'm checking it at least twice a day for signs of it. I'm also going to clean it at least daily, maybe twice a day for now.

I'm so hopeful that this is the end of the thing. He's such a handsome little dog, and the cyst makes him look less healthy and vibrant than he really is.

Here's a picture of him from a couple weeks ago. The cyst is right on the top of his head by the occipital bump, slightly off center to his right (our left in the picture). You can't really see it here and when he's looking head on at you with his head up.


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## tippykayak (Oct 27, 2008)

Here's another one of him where you can see it a bit better. It's not as bad as it was since it's been shrinking steadily for months, but it's visible here.


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## IowaGold (Nov 3, 2009)

Maybe he bumped his head hard enough that it severely damaged some of the hair follicles and they started growing down? I've seen a handful of cysts with "stuff" (like hair) in them-it's always a fun surprise.


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## tippykayak (Oct 27, 2008)

IowaGold said:


> Maybe he bumped his head hard enough that it severely damaged some of the hair follicles and they started growing down? I've seen a handful of cysts with "stuff" (like hair) in them-it's always a fun surprise.


Once it got full sized, all kinds of things could have been incorporated. It was quite large at one point. It's had a lot of time and a lot of re-injuries before they were able to buy a new coffee table and adapt their crate.

When it burst, I thought I'd be seeing congealed blood, which is what their vet said it was probably full of. This beige stuff was a real surprise. I have to say, though, it was so strange that I was more curious than grossed out. It also seemed a lot less harmful than other things that can come out, like parasites, infected material, etc. So it was mostly a "wow, I can't believe how much of this weird stuff there is" moment, rather than a real gross out one.


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## esSJay (Apr 13, 2009)

What a handsome guy he is! He's a lucky boy to be spending his summer with you and your boys.

Glad to hear that you've determined what the bump is. Although it sounds thoroughly disgusting, I'm happy that you're taking care of it and keeping an eye on it while it heals. Hopefully it continues to shrink away!


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## GoldenCamper (Dec 21, 2009)

I hope Ojo's cyst heals up and does not refill with that disgusting stuff, been through it twice with Tucker who is 13+yrs. Two of his cysts burst late last year. One healed but formed a small adenoma on top. The other still leaks a little blood and oil mix now and then. I was told by my vet never to squeeze them any harder than you would a tube of toothpaste, and of course to always keep it clean. Good thing it expelled it's contents outwards, sometimes they burst under the skin and have to be removed, which is not an option for my boy. It certainly isn't pretty, the amount of junk that comes out of them is surprising. Welcome to the burst sebaceous cyst club (sarcasm) I think Beaushel & Coppersmom have been through this experience with their dogs too.


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## tippykayak (Oct 27, 2008)

LOL - not the best club ever, but at least the company is good.


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## Ljilly28 (Jan 22, 2008)

How about epsom salts for soaking?


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## LibertyME (Jan 6, 2007)

My dear Lexi is apart of the sebaceous cyst club...must admit it is disgustingly satisfying to empty one of those suckers!


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## Karen519 (Aug 21, 2006)

*Tippykayak*

Tippykayak

You sure got lots of suggestions for Ojo.
How is he doing?


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## tippykayak (Oct 27, 2008)

Ljilly28 said:


> How about epsom salts for soaking?


Good call. I managed to get a warm wet washcloth on it for a solid five minutes this morning, and we'll disinfect it again tonight. Do you think the salts might soften the skin more and draw out garbage better?


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## tippykayak (Oct 27, 2008)

Karen519 said:


> Tippykayak
> 
> You sure got lots of suggestions for Ojo.
> How is he doing?


He's great. The lump is still pretty small, and he let me hold the compress on him for more than five minutes. We've been practices stays anyway, so we worked on that and I held it to his head.

I'll post again later if anything interesting happens when we clean it tonight.


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## Ljilly28 (Jan 22, 2008)

tippykayak said:


> Good call. I managed to get a warm wet washcloth on it for a solid five minutes this morning, and we'll disinfect it again tonight. Do you think the salts might soften the skin more and draw out garbage better?


Well, that is what I learned to do for horses, and I did use it on Acadia once when she had a gross pus-filled cyst because our favorite vet(boohoo) told me to. It worked great as a remedy, but I am unsure what is actually in Ojo's.


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## tippykayak (Oct 27, 2008)

Just in case anybody was curious, the cyst never came back. The skin was slightly thicker there for many months, but nowadays, you have to feel very carefully for a while to even find the original spot. Ojo is doing great in general too as a grown up dog with two kids who love him very much.


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## Dallas Gold (Dec 22, 2007)

tippykayak said:


> Just in case anybody was curious, the cyst never came back. The skin was slightly thicker there for many months, but nowadays, you have to feel very carefully for a while to even find the original spot. Ojo is doing great in general too as a grown up dog with two kids who love him very much.


Funny you just revived this thread tonight- not 10 minutes ago Toby and Yogi were running around and Toby whacked the top of his head on a table top! :doh: Glad Ojo is doing well!


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