Dogs having a nose bleed or epistaxis can be alarming. It may be having a nose bleed due to trauma, an upper respiratory tract infection, fungal infections, or blood protein levels. Some of these causes require more emergent veterinary attention than others. It's important to know what to do in the situation and what to expect at the vet visit. Learn more about the causes and preventative measures you can take.
Causes of Epistaxis in Dogs
The most common cause of an acute nose bleed in a dog will be either trauma or an infection in their upper respiratory tract. If your dog is accident-prone or he has a lot of inflammation in his nasal passages from a chronic infection you may see some bleeding from (usually) one nostril. In rarer instances, a foreign object (i.e. grass, foxtails, etc.) that becomes lodged in your dog’s nasal passages or ingestion of rodenticide can also cause your dog’s nose to bleed.
Young dogs that like to investigate things around the house may be at more risk for toxicity-induced epistaxis whereas middle-aged to older dogs would be at more risk for an autoimmune disease that can cause epistaxis. Dogs that are allowed to roam unsupervised are more at risk for trauma-caused epistaxis regardless of age.
Other, more chronic, causes of epistaxis can include things like hypertension, dental disease and infections, growths or tumors within the nasal passages, coagulation disorders, fungal infections, problems with blood protein levels, or certain tick-borne diseases.
Typically, unilateral bleeding, that is bleeding from only one nostril, is indicative of a tooth infection, a growth associated with the bleeding side, or a foreign object in the bleeding side. Bilateral bleeding, or bleeding from both nostrils, is typically seen with clotting disorders, upper respiratory and/or fungal infections, or trauma.
Doberman Pinschers, German Shepherds, Golden Retrievers, Miniature Schnauzers, Pembroke Welsh Corgis, Shetland Sheepdogs, Basset Hounds, Scottish Terriers, Standard Poodles, and Standard Manchester Terriers are the most likely dog breeds to suffer from a congenital clotting disorder called Von Willebrand’s disease. This disease is inherited, though, so prospective owners of this breed should ask the breeder about the incidence of this disease in their breeding line if purchasing from a breeder.
Help! My Dog’s Nose Is Actively Bleeding!
If your dog is actively suffering from a nose bleed, try to keep them as calm as possible. Any extra excitement will elevate your dog’s blood pressure and cause an increase in bleeding. If your dog will allow it, place an ice pack wrapped in a dish towel or several paper towels over the bridge of your dog’s nose. If your dog has a short snout (i.e. pugs, bulldogs, boxers, etc.) take care not to completely cover the nostrils that your dog may be able to breathe around the ice pack. The cold of the ice will work to constrict the blood vessels in the nasal passages and may work to stem the flow of blood.
Once the bleeding has stopped, call and make an appointment to have your vet check your dog over. If you feel there is a chance your dog could have gotten into any medications, such as human NSAIDs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve), or if your fear they may have gotten into rat poison, take them to the vet immediately. Even if you don’t think they could have gotten into rat poison directly, if they got to an animal that passed from rat poison ingestion, your dog will still be at risk for toxicity from the poison.
What to Expect at the Vet
Your vet will want a thorough history when you come in, so write down any and all medications they have ingested recently (within the past several weeks), including those that were accidents. Your vet will also want to know of any potential pesticide ingestion as well as any abnormal stools. During your dog’s physical exam, your vet will take a thorough look around your dog’s nose and gums as well as their eyes. They will be looking for any signs of pain, swelling, redness, or any other abnormalities in those areas.
Once your vet has completed the physical examination, they may want to check your dog’s CBC (complete blood count) to check the percentage of red blood cells in circulation to see if your dog is anemic or not as well as to check your dog’s platelet levels. If your dog is extremely anemic, they may want to do an abdominal radiograph to check for any free fluid (that could be blood) in the abdomen. You vet may also take swabs of your dog’s nasal passages and check them under the microscope for any bacteria or fungi that could be causing an infection.
Treatment for Epistaxis
The treatment for a nose bleed will depend on the underlying cause. Fungal infections will require anti-fungal medications and bacterial infections will require antibiotics. Foreign objects will need to be removed, which may require your dog to be sedated. Dental infections that cause a nose bleed will require a dental procedure so that the offending tooth can be removed. Growths, cancers, tick-borne diseases, coagulopathies, hypertension, and blood protein disorders may require more extensive, ongoing treatment.
Generally, epistaxis that is caused by a dental, bacterial, or fungal infection has a good prognosis. If caught in time, and with treatment, toxicity from rodenticide or NSAID ingestion can be good but if treatment isn’t sought out quickly, the prognosis can change to guarded or even grave. Chronic and/or underlying diseases that cause epistaxis may have a more difficult, or at the very least more drawn-out treatment. Growths or tumors that are within the nasal passages, whether they are benign or not, may progress to a size where symptomatic treatment and medical management may no longer be possible.
Epistaxis can be the result of something as minute as bumping into a coffee table all the way to something as serious as rat poison toxicity. If your dog starts to suffer from a nose bleed, remain calm, try to get the bleeding under control, and seek out veterinary care as soon as possible.