lump on jugular

[IPEsq]

I’ve read some past threads about this but didn’t see many resolutions.

2 weeks ago, horse shook his head at a fly or something while getting one of the sedative shots for teeth float. It bled, vet tech held compression, was kind of swollen. Vet also gives Banamine after teeth, so she thought that would help. By the next day, the swelling was hardly noticeable, so I didn’t worry about it. Didn’t get any NSAIDs after that one dose.

This week, I have been noticing it more because now the area where the lump was has hardened, and especially when horse really flexes his neck, it’s quite visible. The lump is up pretty high, towards the head, but I’m guessing that is just where he got the shot (I believe I was off fetching fly spray at this time–yes the irony that he shook at a fly). He’d already gotten one shot and was in the stocks (it was looking like the first sedative wasn’t going to be enough).

If I can massage it, it briefly looks a bit smaller. It feels pretty hard like scarring around an old bruise (duh). He’s been able to exercise just fine. He doesn’t want me to massage it but I don’t think it bothers him…he’d just much rather I scratch the itchy spots.

So, I guess because of some of the hardening, it looks larger than when the initial swelling had subsided. The vein appears to be in ok shape overall. If I compress lower in the neck, I see a nice pulse go through, like you might when testing that you got a catheter in the right place.

Old threads say to use DMSO and similar. Is it too late for that?

I also have a text into the dentist vet about it.

[ThreeFigs]

You’ve done the right thing contacting the dentist. Just what I’d have suggested. I’m interested in what the dentist has to say.

[IPEsq]

I didn’t hear back yet, which is kind of odd for this vet. I put some sweat stuff on it over the weekend, and while horse wasn’t real thrilled about that (kept trying to wipe his neck on his dutch door), it did make the lump softer and less noticeable. I’m keeping an eye on it.

[IPEsq]

For @ThreeFigs who wanted an update, I talked to my regular vet about it. He said not to do anything that could potentially introduce bacteria into the area. So, no more topicals. He said that the firm feeling is probably nothing to worry about so long as it doesn’t grow in size. It’s likely just the clots that need to be reabsorbed, and the change from soft to hard is probably normal. He would be concerned if it all of a sudden got more fluid feeling, bigger, or hot at this point because that could mean an abscess. He thinks that due to the shake, he probably got stuck a couple of times so had a couple of bleeders. Just said not to use that vein for future injections for a while.

[mvp]

You might ask your vet about adding a course of aspirin to this. The idea is to thin the blood a bit so that more gets to the area and starts to move/break down the clot.

I have a mare with a big, long clot in her left jugular vein. I’m not sure how she got it, but I’m guessing that at some point she had a reaction to an injection and that started it forming. No one knew that was happening until other blood vessels around her ear/throatlatch area started getting puffy. It was found by a smart vet with palpation and ultrasound. It means we can’t use that vein for IV injections anymore.

Your clot sounds much smaller and is newer, and so it will most likely cause no problems. But, IMO, you do want to make sure it gets reabsorbed so that it doesn’t become a permanent feature. They can do OK with blocked jugular veins, but it does mean you need to let everyone know not to use that vein again.

[IPEsq]

The thing is, the vein does not appear to be blocked to me. The lump also is kind of round, like quarter sized…and goes from the vein area up towards the neck muscles (so, not centered around the vein, not anywhere near the trachea, etc.). When he flexes, there does appear to be another vessel in the neck kind of perpendicular to the jugular near this area. Perhaps that vessel got nicked as well? He’s kind of a veiny horse, especially in his summer coat. Originally, the hematoma was a bit bigger in diameter and projection and soft. Became nearly flat the next day but you could see somewhat the quarter-ish sized area where the hematoma had been. Took then close to 2 weeks for this area to turn more hard feeling, which by change in texture added some projection back to it.

I can feel a good pulse on that side and I can see a good pulse go through when compressing the vein lower down the neck that looks equal to the other side. I think the clot is more around the area than in the vein. I’ve also seen horses with collapsed/thrombosed/unusable veins, and his doesn’t look like that (yet?).

If the bulk of the clot is from a sub-dermal hematoma that is outside the vein / more up towards the muscle, would aspirin do anything?

[mvp]

If you don’t see swelling or lack of definition above (on the head side) of the clot, I wouldn’t worry about it. And even with my mare’s long clot** ultrasound revealed that the vein is not 100% blocked^^^

In your spot, I’d palpate it and see if I could feel whether the lump was on the outside of the vein, in the vein wall, or in the vein wall on the inside. Of course, it might take some educated fingers to really tell you. And, frankly, whoever has those educated fingers probably also has an ultrasound machine, which would give you guys a definitive answer.

** My mare’s long clot (feels like a finger running just about the length of that vein where you might think about putting in a needled) has become a bit of a show-and-tell thing when she has any kind of appointment at my local vet school. Lots of students feel it because, being so long, it can be easy to confuse that with her normal anatomy. The vet who figured this out said that lots of vets can find a small clot like your horse’s because it’s so obviously “there” and not normal.

^^^ According to this same vet, horses can live with both jugular veins blocked(!). Their heads will look “congested” but they do re-route their blood a bit.

Perhaps more than you wanted to know, but I have never heard of this happening before, nor seen it. And no one else (good trainer or mediocre vet clinic) had asked the right questions to figure it out, either. So I’m trying to share the wisdom gained from my unusual experience.

Best of luck for your horse’s healing! I’d only do aspirin if I knew the clot was inside the vein and my vet thought it might help and/or wouldn’t do any harm.