red in the face: dr. kim smyth talks about bloody noses in pets

Posted by Dr. Kim Smyth on Feb 26 2014

Last week, while pursuing the seating chart for the upcoming Monster Jam monster truck show (my son is obsessed!), I mentioned something about the “nosebleed section,” to which my son responded in horror. I assured him that the seats would not, in fact, give him a nose bleed, and I think he even half believed me. Seats that are super high up in stadiums and arenas are called the “nosebleed seats” because of the occurrence of real nose bleeds at truly high altitudes. The conversation got me thinking about nose bleeds in dogs.

Epistaxis is the medical term for blood coming from the nose, and it can occur from one nostril or from both. In most cases, epistaxis in dogs that occurs suddenly usually occurs because of trauma, and a close second would be epistaxis due to an upper respiratory infection. While nose bleeds are quite dramatic to witness (and not to mention very messy!) when they occur for these reasons, generally it’s not a huge deal. As long as the trauma that caused the bloody nose didn’t wreak too much other havoc, your dog will likely be just fine as soon as the bleeding stops.

However, epistaxis can also be a sign that something more sinister is occurring. If trauma is not suspected, the first thing that comes to mind when a dog comes in with a bloody nose is a blood clotting disorder. We’ve talked about these kinds of diseases before—when blood can’t clot, any wound or bump can be life threatening. Clotting issues known for causing epistaxis include:

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  • Ingestion of rodenticide (rat poison)
  • Von Willebrand disease
  • Hemophilia
  • Disseminated Intravascular Coagulation (DIC)
  • Immune Mediated Thrombocytopenia (IMTP)
  • Liver failure

Sometimes systemic disease is to blame. The tick-borne diseases Ehrlichia and Rocky Mountain Spotted Fever can both cause epistaxis. And other times, local disease is the cause, as is the case when nasal tumors or nasal fungal disease is present.

Of course, epistaxis is easy to diagnose, but the underlying cause often isn’t. If trauma or respiratory infection isn’t to blame, your vet will go on a hunt for the cause of your dog’s bloody nose. Routine blood work, like a CBC and chemical profile, will account for the health of the liver and the presence of adequate platelets and red blood cells. Other clotting tests may be recommended to ensure your dog’s blood can adequately clot, and tests for tick borne disease will be run. Because occasionally high blood pressure is to blame for epistaxis, your veterinarian will likely want to check your dog’s blood pressure, too.

Treatment will depend on the underlying cause when epistaxis is secondary to some other condition.

If your pet has a sudden onset bloody nose, try to remain calm. But more importantly, try to keep your pet calm to keep his blood pressure normal. Feel free to try a cold pack on your dog’s muzzle to staunch the flow of blood, making sure to leave the nasal passages free so that your dog can breathe. Usually, the bloody nose will resolve, and if it’s a one-off thing, you may not even need to visit the vet. But epistaxis that doesn’t stop or recurring epistaxis should be brought to your vet’s attention, as it could signal serious disease.

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