Epistaxis is a medical term used to describe bleeding from the nose. Bleeding can be sudden (acute, occurs without warning) or chronic (lasting for long periods of time). This can be a result of a rupture of blood vessels, wounds, injuries or could be caused by infections, illnesses and other known systemic diseases.
Bleeding from the nose can be causes by numerous factors. These include:
› Trauma, Physical injury, accidents, scarring of the tissues inside and surrounding the nose
› Foreign body stuck in the nose
› Blood clotting disorders such as Hemophilia, Von Willebrand’s Disease
› Hyperviscosity syndrome
› Tick borne diseases such as Ehrlichiosis, Rocky Mountain Spotted Fever (RMSF)
› Poisoning and Toxicity caused from accidental ingestion of insecticides, rodenticides, disinfectants, chemicals
› Reactions to known drugs and medications
› Food allergy
› Environmental causes such as smoke, pollen, dust, sand, twigs
› Household materials such as Detergents, disinfectants, cleansing materials, chemicals, soap
› Bacterial Infections
› Fungal Infections such as Aspergillosis, Cryptococcosis, Phaeohyphomycosis, Rhinosporidiosis
› Parasitic Infections such as Babesiosis, Linguatulosis
› Genetic disorders
› Tumors on / inside the nasal cavity, lesions
› Dental conditions such as fractured tooth, root abscess, chronic swelling in the mouth
› Structural deformities of the nose
› Thrombocytopenia, platelet dysfunction
› Vitamin K deficiency
› Cancers such as Adenocarcinoma, Chondrosarcoma, Fibrosarcoma, Osteosarcoma and Squamous Cell Carcinoma
› Lymphoma (cancer of lymphoid tissue and lymphocytes)
› Canine Herpes Virus (CHV)
Clinical Sign & Symptoms
Common symptoms include:
› Melena (Blood in stool)
› Swelling on the nose
› Respiratory Noise (noise while breathing)
› Anorexia (Loss of Appetite)
› Tooth fracture
› Swelling inside the mouth
› Difficulty breathing
› Foul odor from the nose
› Foul odor from the mouth
› Bloody discharge from the nose
› Bloody discharge from the mouth (rare)
Veterinarians will require a complete history of your dog which includes medical history, vaccination records, existing health concerns, current and previous medications, onset of symptoms, diet and exercise routine and any information which can help in establishing a correct diagnosis. Diagnosis is done with a combination of tests. These include routine lab examinations and special tests will be conducted to known the underlying cause.
› Physical Examination including an oronasal (oral and nasal) examination, generally performed under anesthesia
› Complete Blood Count (CBC)
› Biochemical Profile
› Serum Biochemical Tests
› Radiographs (X-Rays) of the nasal cavity
› Serology Test
› Computerized Tomography (CT) Scan
› Magnetic Resonance Imaging (MRI) Scan
› Tissue Biopsy – taken from the nasal area
› Rhinoscopy Test
› Coagulation Tests to check for blood clotting abnormalities
Treatment aims at eliminating the causes of bleeding from the nose, reduce pain, maintain blood pressure and minimizing stress.
› Removing any and all foreign body stuck in the nose (under general anesthesia).
› Surgery in-case of structural abnormalities of the nose, removing Tumors
› Medications for treatment of any physical injury, trauma, scarring, facial swellings
› Cold packs, compresses to reduce blood flow and promote clot formation
› Medications for treating and allergic reactions
› Anti-inflammatory medications and Painkillers
› Antibiotic medications
› Anti-fungal medications
Some veterinarians may suggest use of Elizabethan collar to avoid rubbing and scratching of the nose.
Epistaxis is a symptom arising from other known diseases and conditions. Early detection and treatment of underlying causes will reduce stress, discomfort, the chances of problems arising from nose bleeds.
Treatment depends on the underlying cause. Most cases resolve within a week. You have to administer and monitor all prescribed medicines as directed by your veterinarian. If you observe any behavioral changes or if the condition does not improve, please contact your veterinarian immediately.
› Routine and regular checkups to access the condition, further tests may be advised to check for infections.
› It is mandatory to provide a stress-free environment for your pet. Keep water and food bowls within reach, avoid exercise and physical activity, keep away from noise and any kind of commotion. Do not travel with pets.
› Practice hygiene, sanitation, remove any discharges using a damp cloth or tissue. DO NOT ATTEMPT to remove dried blood strains, this can cause generalized swelling, increase sensitivity and tenderness of the surrounding areas of the nose.
› Post surgery, keeping your pet indoors is strongly advised.
› Do not allow your pet to roam freely. Do not allow your pet to go through garbage bins, water sources, fecal infected areas. This avoids the risk of exposure to disease causing agents.
› Always keep sharp objects covered and fragile objects away from pets to avoid the risk of injury and accidents.