Jugular Hematoma From Blood Draw

[Guest Proudmoore]

I've been a long time lurker, but finally decided to post because I'd like some thoughts on this...

 

Our hound, Jaina, developed a hematoma on Friday after a blood draw for DHPP titer and heartworm tests. This is the first time she has had blood drawn from the jugular to our knowledge. The hematoma was about the size of two golf balls (it was oblong), and had gone down/been resorbed by Saturday morning. However, the entire ventral surface of her neck and the front of her chest were very bruised. We monitored the bruising carefully and brought her back to the vet after noticing that it spread a further 1.5 inches down her chest from Saturday to Sunday. The weekend on-call vet thinks this was just gravity moving the blood from the hematoma, but we are doing a clotting test just in case.

 

Jaina is in excellent spirits, eating, drinking, and playing as usual, and the bruising hasn't spread any further throughout today. Maybe I'm being paranoid, but I can't help but wonder:

 

-Is the hematoma something that "just happens sometimes" as the vet said, or does this mean the tech doing the blood draw made a mistake?

-Does the titer require such a large volume of blood that a jugular draw is required, or can we request a leg in the future so they can easily apply a pressure wrap?

-Would a jugular draw normally be wrapped at all? Ours was not.

 

I know the rules, so I'll make an intro post with pictures when I'm not on a tablet!

[Riverhound]

I apparently never took a pic, but did have a similar experience. Maybe not as bad as yours.

 

Joe's bruise

 

The consensus seemed to be that it does happens, but kinda sucks. If you wanna take a sharpie and outline it, you can be sure that it doesn't get any bigger.

[tbhounds]

It happens--it occurs after a draw from the tech/vet not applying pressure to the venipuncture site long enough. Either they need to improve their technical skills or they need to draw from a limb and apply a pressure wrap post draw. The bruise should dissipate over the next week.

[Guest jetska]

Yup, Barbie had one on her leg from a draw for pre anaesthetic bloods - they hadn't pressure bandaged it. They now pressure wrap every time.

[krissy]

Greyhound clotting is generally abnormal. All the clotting tests are normal, however they have trouble with breaking clots down too soon. Usually this results in some pretty impressive bruising post-op.

 

I always, always, always apply a pressure bandage after drawing blood from anywhere on a greyhound to avoid massive hematomas. I do it for both of my dogs and I also do it for all my greyhound patients that I see. I send them home with instructions to remove it in 20 minutes. Might be something for the next time she has a blood draw... just ask for a pressure bandage. Assuming of course that her blood tests all come back normal and she doesn't actually have any clotting disorders beyond simply being a greyhound.

[hikinghounds]

This has happened to my boy a couple times. They always, and I remind them, to draw from his leg and they use a bandage with cotton ball after. I've wondered if it's because greyhounds have larger hearts so pump their blood with higher pressure. But, it's always cleared up quickly with no problems.

[Guest Proudmoore]

Thanks, all, for the advice and experience. I'll try not to worry so much and just sit tight for test results. We are definitely going to request that they use her leg and remind them to always use a pressure bandage in the future.

 

I'll include a picture of her bruising for reference if anyone else stumbles across this thread with the same issue. She's a very light-skinned girl all around, so anywhere you see the dark red/purple color is bruising:

[Guest Liz_in_PA]

Yowza. I can see why you'd be concerned.

[Rickiesmom]

Holy cow! Jaynie had a hematoma on her neck one time after a blood draw - it looked like a golf ball. I iced it and there was some bruising, but nothing like this!

[Sambuca]

Sometimes they have trouble drawing from a leg and they use the jugular. It's relatively normal and actually tell my vets to do it if they need to as some people are Squamish about. Personally, I'd rather is be a jugular draw than their legs getting poked over and over if the vein is hiding. My boys have never had any blood draw wrapped that I can recall. Mine have never had hematomas from it, but I brought in a Newfoundland once and she ended up with one on her leg. They seem to happen occasionally.

[o_rooly]

That is one spectacular bruise!!
Aston's only had major bruising post-surgery, when he had gangrenous lesion cut out of his butt (long story). He's never had a hematoma pop up after a blood draw, and we've had many, many. Sounds like we've been lucky!

[scullysmum]

Ouch! I live in the UK and have never in over twenty years of owning dogs seen a vet take a blood sample from the jugular, horses yes, but never dogs. Hope your girl is back to normal very soon.

[tbhounds]

I perform jugular blood draws all day long--you, typically obtain a better sample via a jugular draw and it seems better tolerated by most patients. You do have to apply direct pressure to the venipuncture site--esp with ghs. I have seen bruises like this with hounds-it will resolve just need to give it some time.

Edited February 24, 2014 by tbhounds

[scullysmum]

I perform jugular blood draws all day long--you, typically obtain a better sample via a jugular draw and it seems better tolerated by most patients. You do have to apply direct pressure to the venipuncture site--esp with ghs. I have seen bruises like this with hounds-it will resolve just need to give it some time.

No criticism was intended by my remark, it's just not something I have experienced with any of my dogs. I would also be interested to know what you mean by a better sample? As for the poor puppet it probably has the same problem that I do when giving blood, I usually end up black and blue (thank goodness they don't take that from my jugular, I would look like I'd been ravaged by vampires!)

[ZoomDoggy]

For a hematoma that large, I think you're justified in doing a clotting test. Some greyhounds are predisposed to have clotting/bleeding issues. It will be good to know if your pup is among them, so you may take precautions in the future (pre- and post surgical Amicar, for example) if she ever needs surgery or even a dental cleaning with extractions.

[tbhounds]

No criticism was intended by my remark, it's just not something I have experienced with any of my dogs. I would also be interested to know what you mean by a better sample? As for the poor puppet it probably has the same problem that I do when giving blood, I usually end up black and blue (thank goodness they don't take that from my jugular, I would look like I'd been ravaged by vampires!)

 

No worries-didn't see your post as any criticism. By better sample I meant it's easier to draw from a jugular vein-it's a larger vessel and therefore a cleaner sample is easier to obtain-less hemolysis. Honestly most pets seem to tolerate the jug stick better than a limb. We have always been taught to save the legs for further catheter use, therefore we routinely draw jug samples from dogs and cats. If the ops dog wasn't a gh I would be more concerned about a clotting problem but, I have seen some pretty narly bruises from jug sticks (and quite frankly leg draws). Heck, it happened to one of mine while at the e-vet. I had a "talk" with their technicians about gh blood draws stressing the importance of applying direct pressure to the site post draw.

[scullysmum]

No worries-didn't see your post as any criticism. By better sample I meant it's easier to draw from a jugular vein-it's a larger vessel and therefore a cleaner sample is easier to obtain-less hemolysis. Honestly most pets seem to tolerate the jug stick better than a limb. We have always been taught to save the legs for further catheter use, therefore we routinely draw jug samples from dogs and cats. If the ops dog wasn't a gh I would be more concerned about a clotting problem but, I have seen some pretty narly bruises from jug sticks (and quite frankly leg draws). Heck, it happened to one of mine while at the e-vet. I had a "talk" with their technicians about gh blood draws stressing the importance of applying direct pressure to the site post draw.

Thank you, that makes perfect sense, perhaps the nurses who have taken blood from me haven't applied enough pressure either

[Guest mydes1998]

Please help! How long did it take for this to begin to resolve and was it dangling like a little pool of blood before it spread? It just seems like so much blood in the wrong place. I took my girl to the vet yesterday and they performed a jugular draw for a thyroid and heartworm test. Apparently, she put up a fight, so I'm sure the needle was wiggling. They didn't tell me they had any trouble until today when I took her back in because I was terrified about the pool of blood dangling from her neck. The vet said it will reabsorb into her body, but I am hysterical. She is a beagle hound, so she has a lot more excess skin in the neck area than a greyhound, but this is the best forum I have found so far with regard to the issue I'm having. I trust my vet. They are not shady at all. But, I am looking at my dog and I am so afraid.

[hikinghounds]

When this happened, a few times, to my greyhound it did pool and dangle before it spread and resorb. It looks bad, but she should be okay.

[Guest mydes1998]

Wow. Thank you for responding so quickly! I am a wreck. Everything I've read said it should resolve within 24 hours. It's been over 24 hours and it hasn't gone down at all. There looks like 1/2 cup of blood in there. How long did it take to start to go down?

[Moneypenny]

Not a blood draw, but my senior girl had a run in with the corner of the screen door and she had a very bad bruise and a dangling pocket of blood on the bottom of her chest, it reabsorbed on it's own. It looked horrible and I was very concerned, but it resolved itself just fine.

Wow. Thank you for responding so quickly! I am a wreck. Everything I've read said it should resolve within 24 hours. It's been over 24 hours and it hasn't gone down at all. There looks like 1/2 cup of blood in there. How long did it take to start to go down?

 

For Raina, it probably took a good 48-72 hrs for it to look not so "horrible" and maybe 5-6 days to look almost normal.

[hikinghounds]

I think the pool took about 24 - 48 hours to go down and spread. I remember that his skin seemed a little loose in that area for a couple days. I guess if it doesn't start to go down after a day or two you might want to check with the vet again. It did take about a week for most of the bruising to go away.

[Guest mydes1998]

Thank you all so much for responding. I am truly grateful. I feel better now that I know it is a normal "rare incident" and have some kind of expectation of when it will go away. It's unfortunate my vet wasn't able to put me at ease with honest and realistic information, but she's human. I will never allow another blood draw this way. They've always gotten plenty from her leg. I can tell Lucy is just a little more tired than usual, but she's missing a lot of blood from where it should be. Since she's eating, drinking and relieving just fine, I will just keep a close eye for another day. If the pool isn't getting smaller after the 48 hour mark, we'll take another vet trip. Thank you again!

[Brandiandwe]

Thank you all so much for responding. I am truly grateful. I feel better now that I know it is a normal "rare incident" and have some kind of expectation of when it will go away. It's unfortunate my vet wasn't able to put me at ease with honest and realistic information, but she's human. I will never allow another blood draw this way. They've always gotten plenty from her leg. I can tell Lucy is just a little more tired than usual, but she's missing a lot of blood from where it should be. Since she's eating, drinking and relieving just fine, I will just keep a close eye for another day. If the pool isn't getting smaller after the 48 hour mark, we'll take another vet trip. Thank you again!

It's great that this forum helps more than just greys. Could you give Lucy some ice cream from us and let us know how she goes? I'm reading this thread for education, but I'd like to know. And how did things end up with Jaina?

[KristenMichele]

From personal experience and being a registered veterinary technician hematomas happen even when the proper technique is used. Now in my 9 years of working as a technician in the veterinary profession I have never seen a dog or even greyhound bleed like that following a blood draw and I have worked ER and general practice. I would be more concerned about a clotting issue. At least from the photo that was posted.