Nosebleed (Epistaxis) in Dogs

The nasal passages are heavily vascular, meaning there are many small blood vessels lining them. Minor injuries or irritation to the nose or face can result in temporary nosebleeds.

Nosebleeds are also associated with blood clotting disorders. In healthy dogs, if a blood vessel is damaged and leaking, the blood will eventually thicken at the site of the damage. This thickening stops blood from continuing to flow out of the leaking vessel. In cases of blood clotting disorders, this process is interrupted and blood does not thicken appropriately which can lead to ongoing blood loss from the damaged vessel.

Mild, self-limiting cases of epistaxis that have a clear underlying cause, such as injury, carry a good prognosis whereas unexplained, intermittent or persistent epistaxis require prompt, or emergency veterinary attention. Dogs with severe epistaxis or dogs that also have unexplained bruising, red spots on their skin and gums, or very pale gums, require emergency attention.

Some cases involve damage to the blood vessels of the nasal cavity, such as nasal tumors or fungal infections. These conditions will clot eventually but are often recurrent and usually progress in severity.

Epistaxis is either due to injury of the blood vessels in the nasal passage, abnormal blood clotting, or both.

Epistaxis is an uncommon symptom in dogs which usually requires veterinary attention. The severity of epistaxis varies significantly; some cases are low grade and resolve spontaneously while other cases involve intermittent bleeding. Some cases present with severe, sudden onset bleeding that requires emergency treatment.

The severity of epistaxis varies significantly. Mild cases are usually associated with trauma where the clotting ability is unimpaired, whereas severe cases often involve an inability to clot due to a clotting disorder or low platelet count.

Investigation of epistaxis involves:

• Physical examination
• Blood work including clotting profiles
• Testing for genetic clotting disorders
• Urinalysis
• Blood pressure analysis
• Testing for infectious disease
• Biopsies
• Diagnostic imaging

Treatment options involve first aid to control the bleeding which includes:

• Packing of the nasal cavity
• Placing an icepack on the nose
• Sedation if the dog becomes agitated
• Intranasal medication to reduce bleeding
• Blood transfusion in severe cases

Following stabilization, treatment depends on the underlying disease process and may involve:

• Antibiotics
• Antifungal agents
• Steroids
• Pain relief
• Blood pressure medication
• Treatment of liver failure or other underlying medical conditions
• Surgery
• Chemotherapy
• Radiation therapy

Bleeding can sometimes be from a source other than the nasal cavity. Dogs with tongue lacerations often appear to have epistaxis due to licking their nose while the tongue is bleeding.

Multiple other symptoms are observed alongside epistaxis which varies depending on the cause and severity.