A guide to garden-variety face lumps

A guide to garden-variety face lumps

A facial lump with an ulcerated appearance.

A facial lump with an ulcerated appearance.


It's time to dig back into the day-to-day cases that make up the bread and butter of clinical practice.


Looking back over my last few articles, I think it's time to dig back into the day-to-day cases that make up the bread and butter of clinical practice.

So, what are people seeing in their animals, and why does it happen?

I've always enjoyed getting calls for lumps.

When it comes to a choice between a call for 'sudden death in 14 cows' or 'lump on head', the lump always wins for a generally stress-free visit where you can provide a satisfying solution.

Some days you want to see something interesting and challenging in practice.

And on other days, you want something that you can fix without too much fuss, especially if you've had a morning of frustrating failures which have left you feeling a little bit fragile.

These calls generally go the same way if the patient is well.

You get the cow into the crush, tie her head securely, and examine the offending lump.

You might poke it gingerly with a finger to try and see what it feels like.

There may or may not be an offensive smell. You might rock back on your heels and say 'hmm' while staring critically at the thing.

But ultimately, what you're going to do is grab a very big needle and stick it right into the centre of the lump.

There's no point in being shy about it.

I usually spray the spot I intend to stick with iodine, shave the hair away and give it a bit of a clean-up first; we're university-trained professionals after all, as I'd often tell myself covered in rotten membranes and crap - sorry, faeces - at some ungodly hour of the morning.

Most of the time you get pus.

Sometimes it's thick white chunky pus you need to suction out with a syringe.

Sometimes it's liquid and creamy, like a caramel crème egg.

There might even be a strawberry tinge to it (you can tell I'm writing this around Easter).

Whatever the consistency, you'll know from the smell that it's an abscess.

But what happens if you don't get pus? This is where it gets a little bit more exciting.

On the odd occasion, you find a clear slightly stringy liquid. Cool!

These lumps are known as sialocoeles and they're a bit rarer than your garden variety abscess.

They happen when the salivary gland or ducts are blocked or damaged, causing the saliva to back up.

I've rummaged around the mouths of these cases attempting to find grass seeds lodged in duct openings, but I can't say convincingly that I've ever found anything.

My treatment preference is to wait and see - draining them like abscesses exposes the cow to infection, and often doesn't treat the underlying problem.

Patients generally don't seem too bothered, in any case.

What happens if you get blood from the lump? It's probably a hematoma - the cow has bashed herself against something, damaged the blood vessels in that area, and there's now blood pooling inside. Poor girl!

Time is also the best medicine for these varieties, although maybe ketoprofen wouldn't be amiss.

A much more unpleasant finding is maybe a bit of blood, but also a feeling of thick fibrous tissue or crunchiness when you stick the needle in.

Your heart generally sinks a little.

I check to see if there's distortion of the surrounding bones or facial structure, because I'm thinking cancer.

Has she had a third eyelid removed on the same side as the lump?

It's hard to give a good prognosis for this type of patient, especially if it's getting bigger quickly.

These may also have an unhappy ulcerated appearance (see photo).

Another possibility from a crunchy lump might be lumpy jaw - a very invasive bacterial infection that eats into bone.

Sodide is the treatment but generally, by the time I'd see these, they were usually advanced and unlikely to go well.

Finally, what happens if you get a clear or slightly yellowish watery liquid?

This type of soft swelling is oedema or 'bottle jaw', an accumulation of fluid in the tissues.

These are usually caused by systemic problems like heart failure, liver fluke or - touch wood - Johne's disease.

Something like this often requires a bit of extra diagnostic work, looking for additional problems like heart murmurs, low blood protein or scouring.

These are the more common varieties although I have seen a few very odd cases, like one cow who was storing several kilograms of silage in one cheek like a chipmunk, and a few animals with dangly benign growths.

They're certainly not all abscesses and can't be treated in the same way. If in doubt, I'd recommend calling your local vet out, or at least checking the lump with a clean needle before draining it.

If the cow is unwell this is doubly true, as there are a few secret killers disguised as innocent lumps.

  • Ee Cheng Ooi is a cattle veterinarian undertaking a PhD at Agribio in dairy fertility and genetics. All comments and information discussed in this article are intended to be of a general nature only. Please consult the farm's vet for herd health advice, protocols and/or treatments that are tailored to a herd's particular needs.

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