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Thread: Hematoma on ribcage? or ?

  1. #1
    Senior Member Erin Lynes's Avatar
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    Default Hematoma on ribcage? or ?

    I have a 3 year old bitch who has developed a mass on her lower ribcage, in the region of a mammary gland. I first noticed subconsciously a few days ago but didn't think anything of it, maybe because I was expecting some mammary swelling as she is nearing the end of her heat cycle. Anyway, yesterday I really 'noticed' it and had a moment of panic, took her into the vet asap thinking of all sorts of horrid possibilities. Vet's first thought was mammary tumor or broken rib. She palpated it, aspirated it, and x-rayed it from 2 angles. Palpation suggested that it is not involved with the mammary gland and the gland is not active. Aspiration revealed a kind of gooey fluid (she said it reminded her of what you'd find in a salivary gland) - red blood cells and neutrophils but no white blood cells, no tumor cells. X ray showed ribs are in good condition, all visible organs looked normal, lump did not show up that well but did not see any evidence of calcification or foreign bodies. Her conclusion was that it might be a dry abcess or more likely a hematoma, but she didn't seem very confident on that and I'm not entirely convinced either. She sent us home with cephalexin in case there was some undetected infection, and said to provide hot compresses to the area twice a day in hopes of softening it up for drainage. The mass is about 4x4 inches in area and rises about 1/2 -3/4 of an inch outwards from her ribcage, sprang up pretty suddenly and hasn't noticeably changed since I first saw it. The vet remarked that it felt 'crunchy' when she aspirated, but it is smooth and hard, not lumpy feeling. It is painful to the touch although this dog is pretty stoic and isn't being overly dramatic with her reaction, she is wincing a little. There is nothing on the exterior that is suspicious- hair is all healthy, skin in good condition, no wounds, etc.

    In addition to the obvious mass, a 'symptom' which may or may not be related is that Shelby has been restricting her movement for about the last month. Not limping, but choosing not to run most of the time and hesitating on jumps/stairs. She is a VERY high drive dog and her favorite activity is blasting around at warp speed so it is pretty unusual that she isn't wanting to run. The reduced mobility started at an agility trial where she wasn't jumping correctly and seemed to be unable to extend her left front (lump is also on the left side but wasn't visible at that time). I pulled her from the trial and she was rested for about 2.5 weeks, started training again for a few days, then I was away, and when I came home she is sore again and with this mass.

    So.... any thoughts on what this could be (does hematoma even seem like a likely hypothesis?) If a hematoma could result from her smashing into something, that seems possible as she is a 'full body contact' kind of dog, although if it related to her intial soreness it seems to have taken a long time to appear! However, I am worried that it is something more serious and don't want to wait too long before taking action if that's the case .... The plan is to continue with the compresses/antibiotic and if there is no change by next week, to go for an ultrasound to try to get a better look at it and for possible drainage. If there are any suggestions as to what things we should be ruling out at the u/s appointment, or if there are any suspicious alternate diagnosis based on what I have described, please share. I'll post a picture of it tomorrow if that helps.
    Erin Lynes
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  2. #2
    Senior Member JusticeDog's Avatar
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    I would Be very worried about this scenario. I would be trying to find a good internal medicine vet for a second opinion. I don't like what you describe as being aspirated. You want somebody with a lot of experience reading that ultrasound. Otherwise there is no point in doing it. I hope your dog is okay.
    Last edited by JusticeDog; 10-14-2013 at 10:43 AM.
    Susan

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    A hematoma is blood-tinged fluid, not a gooey fluid. Agree with Susan that you need to get to a specialist because of the factors mentioned--slowing down, showing pain, etc.

    Meredith

  4. #4
    Senior Member pupaloo's Avatar
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    Could it be a grass awn? Sounds similar to what happened with my dog when an awn he inhaled stopped traveling and started to form an abscess.
    Marlana Smith
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  5. #5
    Senior Member JepDog's Avatar
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    Did they rule out a foreign body like a foxtail? Shave down the area and look for any point of entry? Infection can make the area sore and restrict movement in addition to rapid swelling of that size.
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  6. #6
    Senior Member Erin Lynes's Avatar
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    The fluid inside was blood tinged, but kind of thick. The consistency of saliva (slimy, compared to water or fresh blood kind of thing). When I feel the area it doesn't feel like an abcess (doesn't feel like fluid under pressure), but I don't know. It's not something I've seen before.

    She did not shave the area.... I guess a seed or awn would not show up on x-ray? Vet did not think it was a foreign body (I think the reason was there was no infection showing on the aspiration) but my interpretation may not be correct on that. I think I will try to get the ultrasound done asap. The good news is that the swelling, after several days of no change, does seem to be down by about a third this morning...

    Thanks everyone for your input. I am worried but will definitely ensure a foreign body is ruled out.
    Erin Lynes
    Eromit Labrador Retrievers

    Home of:
    Twig AGDC, Ruger JH ADC SGDC MGDC MSDC MSCDC CRNCL, Winchester SGDC CRNCL, Shelby SGDC CRNCL, Spider, Kimber, Verona, Missie, Jackie,
    Victor CRNCL, Jet, Glitzy CRNMCL SGDC, Harvey & Viper
    ..........gone but never forgotten, the gal who started it all: Spider's Sunshine MSDC MSCDC AADC AGDC NAC NGC NJC (Nestle) ...........

  7. #7
    Senior Member Erin Lynes's Avatar
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    Update:
    The day after I posted, the lump was down in size a bit- I shaved it to see if I could see any puncture or anything and did not find anything noticeable. By the next morning after that, the lump was completely gone and so was any sign of soreness. The little maniac was back at full speed running around - so I guess I was right about her weird gait being associated with the lump . We went for an ultrasound anyway just to make sure, and didn't see anything suspicious, by then everything looked normal and no trace of any foreign bodies or anything else unusual. She is still has a few more days of antibiotics so will finish that up but I am much relieved and thought I should post the good news. Thanks for all the input.
    Erin Lynes
    Eromit Labrador Retrievers

    Home of:
    Twig AGDC, Ruger JH ADC SGDC MGDC MSDC MSCDC CRNCL, Winchester SGDC CRNCL, Shelby SGDC CRNCL, Spider, Kimber, Verona, Missie, Jackie,
    Victor CRNCL, Jet, Glitzy CRNMCL SGDC, Harvey & Viper
    ..........gone but never forgotten, the gal who started it all: Spider's Sunshine MSDC MSCDC AADC AGDC NAC NGC NJC (Nestle) ...........

  8. #8
    Senior Member Labs R Us's Avatar
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    Glad to hear the lump is now gone and that it was not serious.
    Becky
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