My eleven-year old dog has been having a recurring nosebleed. It doesn't seem to stop very easily, even when I apply pressure to the nostril. I have noticed that she licks her nose often and afterward blood is on her tongue. Is this something we should be concerned about? She is normally a very healthy dog. Thanks!
Bleeding from the nose, termed epistaxis, is a clinical sign of an underlying disorder. There are several possible causes, including local nasal problems, various systemic diseases, and exposure of the affected dog to toxins.
Local problems include foreign objects lodged in the nose, fungal and bacterial infection of the nasal passages, injury, and benign and cancerous tumors. Generally the affected dog will sneeze a lot, may have had a nasal discharge prior to the recognition of epistaxis, and may have a mucoid or pus-like discharge with the bleeding as well. There may be impaired airflow, snoring or other signs of nasal discomfort, irritation, or obstruction. These signs may accompany bleeding from nasal inflammation or cancer, especially as the disease progresses. The diagnosis of local nasal disorders can be very time consuming and expensive. If platelet count and function (mucosal bleeding time) tests and coagulation test results are normal, then local causes for epistaxis must be considered.
Local inflammatory or infiltrative conditions are relatively common in dogs. Nasal aspergillosis, a fungal infection of the nasal passages, commonly causes bleeding, which may be from one or both nostrils, and may cause erosion around the nasal openings. The prognosis for this disease is good. Most dogs will recover with treatment, but the inflammation does cause permanent changes in the nasal anatomy that predispose to secondary bacterial infections and chronic nasal discharge. Early veterinary care might improve the chances for a better outcome.
Unfortunately, nasal cancer does not offer the same prognosis. Nasal adenocarcinoma is the most common tumor type identified in the sinonasal area. This is a malignancy that is locally invasive and almost impossible to cure. Radiation treatment with external beam or implants has been the most useful treatment but results are unpredictable. Diagnosis requires tissue biopsy or cellular microscopic study for verification. As an adult your dog may be susceptible to nasal cancer, but could have other problems as well.
If there has been no history of sneezing or nasal discharge prior to the recognition of epistaxis, then a generalized bleeding disorder may be the more likely cause of nasal bleeding than a local problem. Isolated nasal bleeding may be the most common manifestation of reduced numbers of platelets, which are blood elements that aid in blood clotting.
If the platelet count is low (a condition called thrombocytopenia), or if platelet function is abnormal, then the first step of blood clotting is delayed or inefficient and spontaneous hemorrhage, especially into mucous membranes, results. Frequently there will be pinpoint or paintbrush hemorrhages on the gums, ears or skin, as well as bleeding from the nose. Infections with tick-borne pathogens such as
Ehrlichia or other rickettsial organisms, or problems with the immune system are common causes of reduced platelets.
Your dog may be experiencing the nosebleeds because of poisoning or intoxication with warfarin-based rodenticides; these alter blood clotting through various mechanisms by reducing levels of vitamin K-dependent clotting factors. Vitamin K1 is indicated as an antidote. There are some specific and general tests that may aid in diagnosis of intoxication, but they are most helpful early in the course of the intoxication, before treatment is initiated.
High blood pressure, which may be associated with renal disease, hyperthyroidism, hyperadrenocorticism (an adrenal gland disorder) and other problems, is an uncommon cause of epistaxis in dogs.
Patients rarely experience life-threatening hemorrhage if the disease is confined to the nose, but bleeding may be consequential if the problem is a generalized one.
If your dog's problems persist, please speak with your veterinarian about them, as they may signal a serious condition. He or she may wish to refer you to a veterinary internist for further diagnostics and/or treatment if the screening tests are all normal. In addition to performing a physical examination, your veterinarian may take radiographs (x-rays) or perform bloodwork, as well as other diagnostic procedures to determine the exact disease that underlies the epistaxis.
Please call your veterinary office as soon as possible.
11/02/00
