Vet Nosebleeds By Matt Hanks BVSc MRCVS, Central Equine Vets

he technical name for a the respiratory system of a horse. nosebleed is ‘epistaxis’. Samples can be taken from the TThey can be surprisingly windpipe and checked for the common and be quite alarming presence of blood. If trauma is when discovered by the owner. suspected, X-rays may be taken to see if any fractures exist. X-rays Blood that appears at the nostrils can also be used to visualise can originate from anywhere in fluid within sinuses that could the upper or lower respiratory indicate bleeding or pus within tract. That includes the sinuses, those structures. guttural pouches, nasal cavity and lungs. The causes therefore Treatment can be very varied. An accurate diagnosis of the cause of the haemorrhage Trauma is essential for appropriate treatment to be initiated. Simple The most common cause bleeding, following minor of epistaxis in the horse trauma, will resolve with rest and is trauma to the head. Blood that appears at the nostrils can originate from anywhere time. The horse should receive Trauma, such as knocking antibiotics for several days as guttural pouches (pocket-like the head on a stable door illness, unless associated blood is an excellent medium for extensions of the inner ear canal or a kick or fall can cause with or followed by lung bacterial growth and secondary that open into the pharynx). It is bleeding into a sinus, infection (pneumonia). More sinusitis. rare but can cause sudden and which then drains via severe EIPH may result from life-threatening bleeding. The the nose. In severe cases rupture of larger vessels and this Guttural pouch mycosis (fungal fungus damages and erodes a fracture of the nasal or may be painful. Racehorses that infection) requires surgical the wall of the artery (a branch facial bones can cause bleed too many times can be treatment to tie off the damaged of the internal carotid artery) soft tissue swelling that banned from racing. artery and local flushing of the that passes along the wall of infected pouch with appropriate can also lead to bleeding. the pouch, resulting in severe anti-fungal medication. Carotid Bleeding is often mild but bleeding. It has been known for ligation surgery may be risky, can increase when the affected horses to be found dead Abnormal masses as the patient has often lost horse lowers its head as in a ‘pool’ of blood. a large amount of blood, and this encourages drainage of While rare, horses can cases should be referred to an the blood filled sinus. develop various tumours Exercise induced experienced surgical team. which can ulcerate or Ethmoid haematoma cases become fragile and Exercise Induced Pulmonary can also lose large amounts of suddenly bleed. The most Infection Haemorrhage (EIPH) is a blood before and during surgical common is an ethmoid common condition that occurs treatment. These cases usually haematoma which is an Occasionally a sinusitis (infection in performance horses, i.e. need repeated surgical or laser encapsulated mass in the in the sinus) can cause bleeding racehorses or other horses treatment to remove the mass nasal cavity. The cause is where a large blood vessel that are pushed to the limit of and, in spite of treatment, they unknown. They are mostly bursts, but in such cases there their fitness. Exercise Induced often recur. seen in Thoroughbreds is usually some pus seen as well Pulmonary Haemorrhage often but other breeds can get as blood. Abscesses in the lining goes undetected but can result EIPH has no specific treatment them too. of the nostrils, nasal cavities and in epistaxis. Bleeding is caused though there are numerous pharynx can also result in blood by rupture of capillaries (very products on the market ‘claimed’ in one or both nostrils. Strangles small blood vessels) in the lung to help. is a classic example. due to the enormous differences Diagnosis in pressure that occur there If you have any concerns about A more serious infection that during strenuous exercise. In The best way to diagnose your horse suffering from can occur is guttural pouch most cases, the haemorrhage, epistaxis is by using an epistaxis, then simply phone mycosis. This is a fungal infection although adversely affecting endoscope. The scope is small your vet or phone Central Equine that attacks one or both of the athletic performance, causes no enough to explore most areas of Vets on 0131 6645606.

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