An article from a qualified vet. Nose bleed in the dog, causes, diagnosis, treatment.
In a normal small animal practice a vet will be presented with a dog with a chronic nose bleed perhaps once each six months. Often the owner thinks that this is a trivial condition which will be resolved easily and their visit to the vet is just a case of being better safe than sorry, sometimes they are right and sometimes it is something quite serious. Anyway today’s topic is nose bleeds in the dog, your vet may refer to this condition as Epistaxis. This condition is very much rarer in cats by the way.
Causes : Nose bleed is not a disease in itself but is a sign of a disease so I will give you my list of possible conditions, such lists may be called a Differential Diagnosis.
1. Bleeding disorders.
2. Nasal infections.
3. Foreign objects such as grass awns lodged in the nasal cavity.
4. Nasal cancers.
6. High blood pressure and other generalised diseases.
7. Rare parasites of the nasal cavity.
Clinical Signs : At first you would think that the clinical signs are obvious but a careful examination will help greatly with the diagnosis. Is the discharge from both nostrils or just one? If the discharge is just from one nostril then it could be a foreign object in the nasal cavity, but if it is from both nostrils then your dog could have generalised disease. Is there bleeding or bruising from elsewhere in the body such as the mouth? this could point to a bleeding disorder, is there a change in shape of the nose? this could point to a nasal cancer. The age of the dog is important as cancer of the nasal cavity is more common in older dogs. Nose bleed as I have said first appears a simple condition but the dog owner would be well advised not to try and work things out for themselves but to seek veterinary advice on this one.
Treatment : The treatment will depend on the diagnosis, I normally treat these animals in a non specific way such as broad acting antibiotics the first time I see them if there is nothing obvious on simple examination. If the bleeding does not quickly resolve then I would have the animal in for a work over. An x-ray of the nasal cavity would reveal nasal cancers and some foreign objects, a nasal swab sent for culture would pick up infections, and a comprehensive blood test would reveal underlying disease and point to clotting disorders. Nasal infections such as aspergillosis may be treated with drugs, foreign objects such as grass awns may be extracted under general anaesthetic and cancer of the nose does have treatment options, you can try such as radiotherapy and surgery. Treatment of generalised disease such as high blood pressure and clotting disorders will depend on the individual condition, there are too many possible options to discus them in depth here.
Prevention : None really possible.
So there we have it, some information on nose bleeds in the dog, why a photo of a Doberman at the top? well Dobermans have an inherited predisposition for a clotting disorder called Von Willebrand’s disease. I guess the worst possibilty in the differential diagnosis list would be nasal cancer which is actually not an uncommon cancer in older dogs. The only good thing I can say about this form of cancer is that it is in my experience a very slow growing type of cancer and affected animals may live many months with this disease and there are treatment options such as radiotherapy. so you can see nose bleeds are not a condition you should ignore, seek veterinary advice as early as possible.
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Could be hemangiosarcoma!!!!
my lovely girl had a nosebleed and vet said lawn allergies. It got worse but he said the same. Then 6 months later, she falls from weakness and is bloated, vet says pinched nerve. Emergency vet suggests an ultrasound and biopsy but regular vet poo-poos it. After third fainting, I took her to UC Davis. hemangiosarcoma. Lethal. One of the symptoms: nosebleed. She has only a small time on this earth. I am noit ready to have her die. I will miss her terribly. Please get an (annual) ultrasound of the abdomen and a biopsy. These small things cannot hurt, and may save you from agony over what you could have done but did not.
Thanks for your comments M MU
I am so sorry to hear about your dog
Haemangiosarcoma is a nasty disease and cannot be foreseen, while nosebleed is a rare symptom of heamangiosarcoma it can occur. Hopefully people will read your post and consider that disease as well as the more normal causes I have listed.
The commonest site for a haemangiosarcoma is on the spleen, as it is a vascular tumour it can cause bleeding into the abdomen.
Good Luck,
Scott
My 14yr old cocker spaniel has frequent heavy nose bleeds from one nasal cavity, He has a swelling on the bridge of his nose. I am loathed to have an x-ray under anasthetic because of his age. Do I assume this is cancer and how long should I let this situation continue?
Thanks for the question Mr Finch.
While I cannot diagnose this over the internet for you the symptoms you describe are highly suggestive of nasal cancer. Chronic nose bleeds combined with any change in the external appearance of the nose would make me almost certain that I was dealing with a nasal cancer. It is quite a common cancer in older dogs.
I do not blame you in the least for not wanting an x-ray in a dog of fourteen because often nothing much can be done for animals with this condition.
How long should you let the situation continue?
Well in my experience this is often a very slow sort of cancer a bit like prostate cancer in the human and it can go on for many months. The main thing here is that your dog is not suffering in any way. As the owner you will have to make a weekly assessment of your dog’s quality of life and weigh up his discomfort against his daily enjoyment of such things as your company, daily walks, and his food.
I often find that a caring owner will intuitively know when the right time has come to let go … In the final stages oral pain relief or steroids may be of benefit.
If I have not covered your question fully enough or you would like to ask more I will be online for the next hour or so and I will be at your disposal.
Scott Nimmo BVMS
My doberman is 11 months old aand has developed a nose bleed out of her right nostril, not both nostrils. This happened at about 8AM in the morning, went to the Vet for a 1045 AM appt. and the vet said she would have to keep her for monitoring the situation. The dog would blow blood out of her nose every time she would breath out of her nose, kinda like sneezing. By the time we left the vet, she was literally dripping out of her nostril. I am not sure if her blood pressure was just up from the vet looking into her nostril or what, but it seemed to have gotten alot worse as time developed. The vet did call us back at 8PM last night to let us now that they have her sedated and finally just got the blood to stop. Not sure what is going on with her, but seems more than just a nose bleed. She is very young to indicate any nose cancer I would think? The vet did mention maybe doing a blood transfusion that would cost around $1000.00, Don’t think I could afford that. Any thoughts?
Hello Mr Sachs.
I agree with you, your dog at eleven months of age would be very young to have cancer of the nasal passages and this diagnosis is therefor almost impossible which is good news. All the dogs I have seen with nasal cancer have been very much older, more like eleven years than eleven months.
Given your dog’s age group and the fact that the bleeding is just from one nostril this is more likely to be a foreign object of some kind up the nose. However you cannot discount bleeding disorders which I would imagine your vet would check for.
The decision whether to transfuse or not would be based on simple blood tests such as a PCV to see how anaemic your dog is. In my own experience I never found a blood test to be necessary in this situation but if there was sufficient blood loss then that would be all you can do.
If I can advise you further please get back in touch …
Scott
I have a Dalmatian who is 14 1/2 years old, good age for the breed, she is a happy dog, I would know if she was in pain, but she has been sneezing a lot and if she is close to a wall or lying down she will wack her nose with such a force against the floor etc, you can hear it from a distance, now she has started bleeding, am I being too head in the sand on this one or could it be as a result of the knocks. She had a massive bleed the other day, I got her to the vets, and she said at her age she did not want to pull her about too much, which I appreciate, so we are not going down the road of Xrays or anything, she’s on tablets after an injection of something and no more bleeding, there are no lumps or cavities on her face or nose, do you think it could be as a result of damage?
Hello Mr Brewer,
In my experience trauma very rarely leads to nose bleeds because the sensitive parts of the nose such as the turbinate bones and nasal mucosa are very well protected by the bony tunnel which forms the nose itself.
I do not think any vet would be able to come to a diagnosis from the information you have supplied but while it is encouraging there are no external signs you cannot discount the reasons listed in my article.
I think if it was my dog in that age group I would take your approach and try not to have the dog pulled about too much with tests etc.
If I can help you further please get back in touch.
Regards,
Scott
My two year old English Bull terrier gave blood at the National Pet blood bank around 4 months ago and they were unable to use his blood because of A-typical Lymphacites. He had another blood test and nothing showed up.Recently he started having nose bleeds. They started as one once every month or so but in the last week he has had 4-5 heavy bleeds. The vet says there is nothing wrong with him and just keep an eye on him. The blood comes from both nostrils. What should we do?
Hello Jess,
Having four of five nose bleeds in one week is not normal for a dog in my experience, it is likely that there is some underlying pathology.
Well the good news is that at two years of age this is unlikely to be something very serious like a cancer of the nasal cavity which is really the focus of my article.
Since both nostrils are affected it is unlikely to be a foreign body lodged somewhere. While I cannot diagnose this over the internet it is suspicious that your dog has had a recent abnormal blood picture and this would make me suspicious of clotting disorders.
The way forward here may be to have your vet runs tests for clotting disorders, this may mean sending samples to an outside lab but it would be worth while ruling this out.
If I have not covered your question fully enough or you would like to ask more please get back in touch.
Scott Nimmo BVMS MRCVS
Hi, we have a 13 year old basenji/shar pei who has started having nosebleeds in the past week. She is in the middle of a significant one this evening. While my husband is trying to keep her calm and applying ice to the bridge of her nose, I am looking for answers.
We took her to the vet 2 weeks ago for breathing difficulty (no bleeds at that time), and was told it was allergies. He prescribed clemestine and also noted an infected tooth, but he also said it wasn’t a big deal and we could take care of it later.
Last Tuesday she had her first nose bleed… it was pretty scary. The vet now says that the nosebleed is probably due to the tooth. I had to urge him to prescribe an antibiotic for her, which he did last week, along with a steroid as her breathing is getting worse.
Could the tooth be causing all of these issues all of a sudden? Or due to her age, are we more likely looking at a nasal cancer?
Thank you in advance.
Hello Anne, thanks for dropping by …
It is possible that that a badly infected tooth may have formed a pocket of infection which has eroded through into the nasal cavity and so produce a nose bleed, I have known this happen.
On the other hand cancer of the nasal cavity is a common cancer in older dogs and an initial symptom is frequently a nose bleed.
I think that guessing is no good in this situation and you will have to precisely diagnose the condition if it appears to be ongoing. I personally think the best way forward would be to have an x-ray of your dog’s nasal cavity. This would be done under anaesthesia so that will give your vet a chance to resolve the tooth issue if that proves to be the source of your dog’s problems.
If I have not covered your question fully enough or you would like to ask more please get back in touch.
Scott Nimmo BVMS MRCVS
Thank you for your time and response. I will talk to the vet about an xray.
That really does make sense, at the end of the day you have to find out exactly what is going on so you can treat your dog properly in the future.
Regards,
Scott
I have now closed comments on this page as it gets a lot of hits and interest because of this I have published a new more comprehensive web site devoted completely to nose bleed in the dog which I hope will become an internet resource on the subject. Please post any comments or questions you may have there, visit it at http://www.vetblog.co.uk/nosebleed
Regards,
Scott