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SPRING 2016 ISSUE
EQUINE MATTERS
4
NOSEBLEEDS
Nosebleeds in horses can be from a number of
different causes, ranging from very minor to
severe and life threatening, so knowing the
difference could save your horse's life!
The answers to these questions can help narrow
down the cause of bleeding.
Profuse, bright red blood from one or both nostrils
is considered an emergency
(figure 1)
. However,
in many cases bleeding is mild
(figure 2)
and
is not witnessed, or will be suspected if blood is
seen around the muzzle or on the front legs; or
will have stopped by the time the vet arrives.
Diagnosing the cause of nosebleeds is usually
quite straightforward, beginning with a thorough
clinical examination and often includes endoscopy.
Endoscopy involves a small flexible camera
being passed into the horse's nostril to visualise
the upper and lower respiratory tract and allows
samples to be taken from the guttural pouches,
trachea and even deeper down in the lung
lobes. This is usually done under sedation or with
the aid of a twitch
(figure 3)
.
If no diagnosis can be drawn from these
examinations, then further techniques that may
be used are: radiography of the head, and less
routinely the chest; blood sampling to assess
clotting function; sinoscopy, where a flexible
camera is placed into the sinuses; computer
tomography (CT) or magnetic resonance
imaging (MRI).
Treatment depends entirely on the cause of the
bleeding. Many of the causes of nosebleeds can
be treated effectively, some with conservative care
and medication, others with minor or major
surgery. Unfortunately a few causes have no
treatment and will eventually prove to be fatal. In
summary, nosebleeds are reasonably common
in horses and mild, recurrent cases often go
unnoticed without problems. However, if you do
notice that your horse has nosebleeds, we would
always recommend consultation with your vet
to ensure prompt diagnosis and appropriate
treatment.
Veterinary surgeon
Jenny Fanning
XLEquine practice
Rosevean Vets Practice
Figure 1. Profuse bleeding from both
nostrils is considered an emergency
If your horse ever has a nosebleed then
there are some important points to note:
●
when did the nosebleed occur
?
●
have there been any previous episodes of
nosebleeds
?
●
was it a trickle or running
?
●
how long did the bleeding last
?
●
was the bleeding from one or both nostrils
?
●
what colour was the blood
?
e.g. bright red,
dark red or black/brown
●
is there any history of trauma to the head
?
●
did the bleeding occur after exercise
?
●
has the horse done any recent travelling,
especially long distance
?
●
has there been any other nasal discharge
?
●
has there been any recent respiratory tract
infection
?
●
is there any coughing
?
Causes of nosebleeds in horses include:
●
head trauma
●
fungal infection of the guttural pouch
(mycosis)
●
ethmoidal haematoma
●
exercise-induced pulmonary haemorrhage
●
neoplasia (tumours)
●
foreign bodies
●
clotting/bleeding disorders
●
pneumonia/lung abscess
●
sinusitis
Figure 2. Trickle of blood from the left
nostril
Nosebleeds in
the horse
Jenny Fanning BVetMed, Cert AVP (EM), MRCVS,
Rosevean Veterinary Practice
Figure 3. A horse being endoscoped. The
image on the monitor is of the mainstem
bronchi