Dog's nose bleeds. What Causes Nosebleeds

Nose bleed occurs due to injury or against the background of blood clotting disorders and some other conditions

A bleeding disorder (coagulopathy) develops. with thrombocytopenia and/or thrombopathy. Thrombocytopenia is predominantly immune in nature and can accompany systemic erythematosis, rickettsiosis, Rocky Mountain spotted fever, bone marrow diseases (neoplasia, aplastic anemia), disseminated intravascular coagulation syndrome, reactions to drugs or live vaccines. Thrombopathy can be congenital (von Willebrand disease, thrombasthenia) and acquired (with the use of non-steroidal anti-inflammatory drugs, hyperglobulinemia, rickettsiosis, multiple myeloma, uremia, DIC syndrome).

Coagulopathy can be congenital, hemophilia A and: B, also acquired as a result of poisoning with rodenticides (for example, warfarin), with prolonged jaundice.

Nosebleeds may occur due to vascular injury from a foreign body, trauma, or bacterial or fungal infection (aspergillosis, cryptococcosis, rhinosporidiosis), neoplasia (adenocarcinoma, carcinoma, squamous cell carcinoma, fibro- and chondrosarcomas, sexually transmitted tumors).

Nosebleeds can also be caused by hypertension caused by renal failure, hyperthyroidism, hypercorticism and the consequences of rickettsiosis, multiple myeloma, polycythemia, immune vasculitis.

Coagulopathy immune origin develops more often in young and middle-aged females of small and medium size.

Congenital diseases that cause nosebleeds are observed in dogs: thrombasthenia - in Otterhounds; thrombopathy - in basset hounds; von Willebrand's disease - in Dobermans, Shelties, Airedales, German Shepherds, Scotch Terriers, Chesapeake Bay Retrievers and others, as well as in cats; hemophilia A - in German shepherds, many others, in cats; hemophilia B - in Yurn Terriers, St. Bernards and others, in cats.

Rickettsial disease affects dogs living in areas unfavorable for this disease. Aspergillosis occurs most often in German Shepherd; neoplasms - in dolichocephalic breeds.

Diagnostics

Symptoms include nosebleeds and sneezing. In cases of bleeding disorders, owners report hematuria, bloody or tarry stools, and/or easy small and large hemorrhages.

With severe nosebleeds, a blood test reveals anemia, thrombocytopenia, neutrophilia, and with bone marrow damage - pancytopenia.

Biochemical examination reveals hypoproteinemia and high level urea nitrogen with normal level creatinine upon entry and breakdown of blood in the gastrointestinal tract. Additional studies reveal hyperglobulinemia in multiple sclerosis or ehrlichiosis, elevated nitrogen levels in the blood in nephrogenic hypertension, high ALT, AST in acute hepatitis complicated by coagulopathy.

Urinalysis sometimes reveals hemoglobinuria (with bleeding disorders) and isosthenuria (due to renal failure due to hypertension) or proteinuria (with systemic erythematosis or rickettsiosis).

In patients with a clotting factor defect, blood clotting time increases, but in thrombocytopenia and thrombopathy it is within normal limits.

In systemic lupus erythematosus, antinuclear antibodies can be detected. A study of platelet function (bleeding time, Wuschebrand factor analysis) reveals an increase in blood clotting time with a normal platelet count. For chronic nosebleeds, it is advisable to rule out ehrlichiosis and/or Rocky Mountain spotted fever. Hormone analysis thyroid gland carried out in old cats with coagulation disorders and multiple hemorrhagic lesions.

In animals with a neoplasm, an X-ray examination of the chest organs is performed to exclude metastases. Examination of the nasal and oral cavities and frontal sinus under anesthesia is indicated for animals with local lesions. For neoplasms and mycotic inflammation adnexal cavities destruction of the nose is observed bone tissue. Foreign bodies are usually not detected.

It is important to examine the nasal cavity, rinse it and perform a biopsy. At traumatic injury if foreign bodies are detected, they are removed and nasal fluid is taken for cytological and pathohistological studies, sowing bacterial and fungal cultures and determining their sensitivity to drugs.

Bone marrow biopsy is indicated in cases of pancytopenia. In case of bleeding and hemorrhage, as well as in azotemia, blood pressure is measured.

Treatment

Coagulopathy is usually treated in a hospital setting. Local lesions and diseases vascular system depending on the cause of the disease and its clinical manifestations can also be treated on an outpatient basis. It is necessary to limit the activity of the animal, as it can increase bleeding. It is imperative to inform the owner about the course of the disease and possible complications (weakness, collapse, pallor, blood loss up to 20-30 ml/kg).

Surgical intervention is indicated to remove foreign bodies if attempts to examine and rinse the nose are unsuccessful.

Rhinitis of fungal origin (aspergillosis, rhinosporidiosis) can be treated with daily instillations of a solution of povidone, enilconazole or clotrimazole through tubes. For the treatment of cryptococcosis, itranazole (Sporonox) is given at a dose of 5 mg/kg every 12 hours, and after surgery and for aspergillosis and rhinosporidiosis, radiotherapy is indicated for 2-4 weeks until the animal is completely clinically recovered. For some tumors, chemotherapy is used to treat lymphoma or sexually transmitted tumors. Positive results of treatment with cisplatin have been confirmed by practice, but it should not be used for adenocarcinoma.

If severe anemia develops, a transfusion of blood or red blood cells may be required.

For autoimmune coagulopathy, prednisolone (1.1 mg/kg every 12 hours) is recommended for 4-6 weeks. As alternative medications in cases of complications, azathioprine (Immuran) 2.2 mg/kg every 24 hours for 14 days, and then every 48 hours, danazol (Danocrine) 5 mg/kg every 12 hours are used.

For rickettsiosis, doxycycline 5 mg/kg is prescribed every 12 hours for 2-3 weeks.

No treatment has been developed for thrombopathy and thrombasthenia. In case of acute bleeding caused by von Willebrand disease, plasma or cryoprecipitate is used; in case of decreased thyroid function, thyroidin is used. Bleeding in some dogs with von Willebrand's disease can be controlled with desmopressin acetate (1 mcg/kg or 4 units in 20 ml of isotonic sodium chloride solution administered over 10 minutes). All non-steroidal anti-inflammatory drugs should be discontinued. For hyperglobulinemia, plasmapheresis is indicated.

For hemophilia A and severe bleeding, plasma or cryoprecipitate is used; for hemophilia B-plasma for 2-3 days (on the 1st day after 4 hours, and then after 6 and 12 hours). In case of poisoning with anticoagulant rodenticides, plasma and vitamin K 5 mg/kg every 12 hours for 1-4 weeks are indicated. Plasma gives good results in patients with liver diseases and disseminated intravascular coagulation syndrome.

At bacterial infections After checking the sensitivity of the isolated bacterial cultures, antibiotics are used.

Treatment of diseases of the vascular system depends on the pathogenesis. For hypertension caused by kidney disease, hyperthyroidism, hyper-(adreno)corticism, weight loss and restriction are recommended. table salt aft. At increased viscosity blood plasmapheresis is indicated.

For vasculitis of rickettsial origin, doxycycline is given (5 mg/kg every 12 hours for 3-6 weeks), for vasculitis of immune origin - prednisolone (1.1 mg/kg every 12 hours for 4-6 months). Angiotensin-converting enzyme inhibitors from the enalapril group are also indicated - enacard (0.25-0.5 mg/kg) or benazepril (0.25-0.5 mg/kg) every 12-24 hours; beta blockers - propranolol (0.5-1 mg/kg) every 8 hours or atenolol (2 mg/kg) every 24 hours; calcium channel blockers - diltiazem (0.5-1.5 mg/kg) every 8 hours for dogs and (1.75-2.5 mg/kg) every 8 hours for cats or amlodipine - 0.625 mg/kg for cats every 24 h, diuretics - hydrochlorothiazide (2-4 mg/kg) every 12 hours, furosemide (0.5-2 mg/kg) every 8-12 hours.

The use of the above drugs helps prevent bleeding. Should be avoided use of NSAIDs and heparin. During chemotherapy, it is necessary to carefully monitor the patient's condition, monitoring the number of neutrophils 2 times a week to determine the animal's tolerance to treatment.

During follow-up of the patient, it is necessary to regularly determine the number of red blood cells, hemoglobin and blood clotting time in patients, as well as blood pressure in hypertensive patients. Other symptoms may appear. At proper treatment Cases of anemia or collapse are rare.

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So, epistaxis is nosebleed. As a rule, this occurs due to damage to the vessels of the nasal mucosa, and may also be associated with increased capillary fragility or a tendency to bleeding. Dogs of any breed and gender are susceptible to this. Dolichocephalic dog breeds (dogs with long noses, such as collies) are more prone to nosebleeds (nasal tumors) than other breeds.

Nosebleeds can be acute (sudden) or chronic. Bleeding can be unilateral or bilateral (both nostrils) and this is due to various reasons.

When your dog has a nosebleed and you, not knowing what to do, are looking for advice on this topic on the Internet on forums, we recommend not to self-medicate or experiment on your beloved pet. The fact is that there are many reasons for epistaxis in an animal, and the consequences of your experiment may disappoint you and your family.

Diagnostics

The veterinarian will conduct a thorough physical examination (which will help identify the cause of the bleeding) and order tests:

A thorough examination of the oral and nasal cavities (can be done under general anesthesia).
A complete blood count to look for anemia, inflammation or infection.
Biochemical analysis blood
Urinalysis to assess kidney function.
Blood clotting test, von Willebrand disease test.
Serological analysis for infectious and fungal diseases (histoplasmosis, blastomycosis), tick-borne diseases
X-ray of nose and mouth

Can be assigned additional research if the above tests did not help determine the cause of the nosebleed:

Treatment

Treatment is aimed at stopping bleeding. It may be necessary to use sedatives to reduce anxiety and agitation in your pet. Can be applied:

Cold compresses to reduce bleeding
Adrenaline can be used to stop bleeding
IN severe cases general anesthesia may be required

Care and maintenance

Sometimes the bleeding will stop on its own and a visit to the vet may not be necessary. However, it is worth doing the following manipulations:

Limit stress
Apply cold compresses
If the bleeding does not stop and only intensifies (can be observed in other places), you should immediately contact your veterinarian.

How to call a veterinarian at home?

What questions will need to be answered?
In order to call a veterinarian, you need to:

Call the operator at the numbers specified in the Contacts section;
Tell what happened to the animal;
Provide the address (street, house, front door, floor) where the veterinarian will arrive;
Specify the date and time of the doctor’s arrival

Call a veterinarian at home and he will definitely help you.
At home, as they say, even the walls heal.

FAQ:

What is nosebleed?

Epistaxis is an acute hemorrhage from the nostril, nasal cavity or nasopharynx. It is commonly referred to as a "nosebleed." Nosebleeds in dogs can be extremely distressing for the owner. Most acute or sudden nosebleeds are caused by simple trauma or infections of the upper respiratory tract. Other causes of nosebleeds in dogs may be more serious and require immediate treatment.

What should I do if my dog has a nosebleed at home?

If your dog's nose starts bleeding, you can try these simple first aid steps to try to stop the bleeding:

Calm your dog. High blood pressure is associated with agitation, which increases bleeding.
Place an ice pack on the bridge of your nose. For dogs with small faces, make sure your pet can breathe when an ice pack is placed on the bridge of the nose. Cold constricts blood vessels, which slows down bleeding.
Do not administer medications to your dog unless you have consulted your veterinarian.

If bleeding does not stop after these steps or your pet is having difficulty breathing, contact your veterinarian or emergency clinic immediately.

Remember that a pet with a nosebleed will likely ingest a lot of blood. This may result in black stools (melena) or vomit that contains blood clots (hematemization). Following an episode of epistaxis, these findings are common and do not necessarily indicate gastrointestinal bleeding.

How is it diagnosed?

First, the veterinarian will require you full history diseases. Useful information may be:

Once the medical history has been assessed, the veterinarian will perform a physical examination. Abnormalities the veterinarian will look for:

Deformation or asymmetry of your pet's face
Swelling of the nasal septum
Third eyelid
Prominence or sluggishness of one eye compared to the other.
Redness of the eyes
The appearance of bald skin around the nose
Gums color, bad if they appear pale

What tests may be required?

Based on the test results, your veterinarian may recommend one or more of the following tests:

Complete blood count - to look for anemia (low red blood cell count - indicates blood loss) and to measure platelets (cells needed for proper blood clotting)
Blood chemistry test - a blood test to evaluate organ function, looking for signs of liver or kidney damage from toxins or other diseases that may cause bleeding
Urinalysis - looks for blood in the urine and other abnormalities
Blood clotting tests are a series of tests that evaluate the function of various mechanisms blood clotting.
X-rays – may be done to look for signs of bleeding inside the body or other abnormalities that may lead to nosebleeds – the sternum, skull and mouth are often x-rayed in cases of nosebleeds
Blood pressure – high blood pressure can cause nosebleeds
Nasal swabs - antibiotic sensitivity tests to detect any infectious agents
Fungal culture analysis

More specific tests may be performed based on the initial results and your pet's condition. Examples of additional tests include bone marrow testing, Ehrlichia antibody tests, tick-borne disease, skull X-ray, MRI and rhinoscopy (viewing the nasal cavities using a small endoscope).

What Causes Nosebleeds?

Although there are many causes of nosebleeds in dogs, the most common causes are injuries And infections. Others more serious reasons, which can cause epistaxis:

Reasons why a dog bleeds from one nostril

Unilateral (one nostril only) nosebleeds are most likely caused by:

The presence of a foreign object in the nostril, a sharp blade of grass stuck in the nostril and irritating the nasal passage
An infection, such as a root tooth abscess, can cause nosebleeds
Nasal tumors or nasal polyps

Causes of bilateral nosebleeds (affecting both nostrils)

Other causes of nosebleeds (often affecting both nostrils)

How to treat nosebleeds?

Treatment is aimed at eliminating or stopping the underlying cause. Antibiotics are often used for infections, and surgical cauterization may be used if the condition is chronic and tiny blood vessels are affected. In cases where there is a suspicion of epistaxis, they may be prescribed sedatives, tranquilizers or other behavior-modifying drugs.

What's the forecast?

The prognosis is based on the cause of the nosebleed and the animal's health at the time of diagnosis. The veterinarian will provide you with detailed plans diagnosis and treatment, as well as a prognosis based on your pet's condition.

Nosebleeds in dogs.

Nosebleeds may be a sign serious illnesses.
In dogs, nosebleeds are most often accompanied by the growth of a tumor in the nasal cavity, trauma to the nose, inflammatory processes in the nasal passages, a violation of the blood clotting process, and less often the cause is a tooth abscess.
Nosebleeds are caused by the appearance of drops of blood when you sneeze or a persistent drop or stream of blood from one or both nostrils.
What to do if you suspect or discover a nosebleed in your pet?

First aid
Let's say you're at home and your dog starts bleeding and won't stop.
Try to calm the animal. When dogs are excited, just like people, their blood pressure increases, which leads to increased bleeding.
Do not give your animal any sedatives without consulting your veterinarian.
Ask family members to remain quiet and calm because nervous excitement transmitted from owners to animals. Again, let us recall the chain: excitement - increased blood pressure - nosebleeds.
Place an ice pack on the bridge of your dog's nose. Make sure this does not obstruct breathing. Cold promotes contraction blood vessels which reduces bleeding.
If after taking the measures the bleeding does not stop or the animal has problems breathing, immediately contact veterinary clinic or call an emergency veterinarian.

While waiting for the doctor or on the way to the clinic
be calm, concentrate and remember some details that will have great importance to make a diagnosis.

Make a list of medications you currently give to your dog.
Is there rat poison in your house or apartment, or perhaps your dog might have eaten poisoned rodents?
Carefully examine the animal's face for asymmetry or deformation. You may notice swelling of the bridge of the nose, loss of integrity or discoloration of the skin on the bridge of the nose, a protruding and reddened third eyelid, unequal size of the eyeballs, and watery eyes. Bring this to the doctor's attention.
Remember if the dog played too active games with another animal? Maybe there was a fight?
Has there been contact with plants that have hard awns? For example, in the morning a dog ran across a field where wheat or rye is grown.
Does the animal sneeze? Does he rub his nose with his paws?
Open the animal's mouth as wide as possible, examine the gums and lips. Is there blood in oral cavity? Is pallor of the mucous membranes of the oral cavity and conjunctiva noticeable? Severe pallor may indicate a large loss of blood, and urgent hospitalization may be required. Please bring this to the attention of the clinic reception staff, The doctor must admit such a patient without waiting in line.
Are there signs of bleeding from internal organs? Intestinal bleeding may be accompanied by black stools. Sign stomach bleeding is vomiting blood. Attention! If these signs appear after a nosebleed, it may be a consequence of it, since the dog has swallowed a significant amount of blood.
Are there any hemorrhages on the skin, swelling on the body (there may be subcutaneous bleeding)?
This information must be passed on to the doctor during the examination.

To make a diagnosis, in addition to a general clinical examination, the following diagnostic tests may be required:
Blood and urine tests
Clinical blood tests (with mandatory platelet count) and urine are required to evaluate general condition health and degree of blood loss, biochemical research blood - to assess the functioning of internal organs. A study of the blood coagulation system is carried out (the blood coagulation rate and coagulogram are assessed).
Detected deviations from the norm may indicate a blood clotting disorder:

due to a decrease in the number of platelets in the blood (for example, with autoimmune thrombocytopenia, side effect some drugs for chemotherapy, ehrlichiosis, hemangiosarcoma and other tumors)
because of pathological changes blood coagulation system (for example, in case of hemolytic poisoning, disseminated intravascular coagulation syndrome, liver failure, von Willebrand disease and true hemophilia).

If the results laboratory research is normal, then the problem probably lies in the nasal cavity itself. But before examining the nasal passages, conditions accompanied by pulmonary hemorrhage should be excluded:
lung tumor, pulmonary edema, injury lung tissue. To do this, an X-ray examination of the chest is performed.

If everything is fine with the lungs, they proceed to an X-ray examination of the nose, superficial rhinoscopy and examination of the teeth. All these procedures require general anesthesia.
They start with x-rays, since other methods can injure tissue. Radiography allows you to assess the condition of the roots of the teeth and sinuses. In the case of a nasal tumor, an area of bone destruction may be visible on an x-ray. Such tumors often cause nosebleeds in older dogs.

Superficial rhinoscopy is performed using a special device. With its help, the nasal cavity is examined and, if necessary, foreign objects that cause bleeding are removed from it.

When examining the oral cavity, teeth are cleaned, turning Special attention on the roots, since a tooth root abscess often affects the nasal sinus cavity.

What's next
If using standard methods studies fail to make a diagnosis, conduct deep endoscopic examination nasal passages. During the study, a tissue biopsy is taken, but only if indicated, because there is a risk of increased bleeding. In addition, it is very difficult to obtain an informative tissue sample:

since the growth of nasal tumors is often accompanied by severe inflammation, which masks the oncological process
since in conditions of bleeding it is difficult to select a tissue site for puncture.

Detection of a tumor of the facial part of the skull as a result of x-ray examination is absolute indication to a biopsy, since the prognosis of the disease largely depends on the type of tumor.

Finally
it must be said that sometimes bleeding areas are only accessible for examination surgical method. This procedure is the most traumatic and is accompanied by heavy bleeding, therefore they resort to it only in exceptional cases to remove a hard-to-reach foreign object or take a tissue sample.