Nose Bleed in detail

Foreign body

Material such as twigs can get stuck in the respiratory tract causing a variety of signs, often dependant on where the object is positioned, these include respiratory noise, coughing, increased respiratory rate, difficulty swallowing and a nasal discharge (sometimes containing blood). Treatment is to remove the object.

Masses and cysts

Masses and cysts can develop anywhere in the respiratory tract to cause respiratory noise, coughing, increased respiratory rate and a nasal discharge (sometimes containing blood). The common types are cysts, granulomas (caused by bacterial or viral infection) and tumours (lymphosarcoma and squamous cell carcinoma).Endoscopy is required for diagnosis. Treatment is surgical removal.

Ethmoid haematoma

An ethmoid haematoma is mass of blood within the nasal passages that can lead to a persistent nose bleed.

Treatment

Surgical removal.

Exercise induced pulmonary haemorrhage

This condition results in a nose bleed, usually from both nostrils, due to bursting of blood vessels within the lung and allthough many theories exist an exact cause is not fully known. Affected horses, most commonly racehorses, will have a nose bleed or be seen swallowing after exercise and some may have a reduced performance, however, studies in racehorses have shown no link between exercise-induced pulmonary haemorrhage and finishing place.

Diagnosis

Endoscopy, radiographs and occasionally collection of a sample of fluid from the lungs are required to get a clear diagnosis.

Treatment

Treatment is aimed at prevention as all relevant drugs are banned for use in racehorses. This is a combination of training modifications and providing a dust free environment.

Guttural pouch mycosis

In this condition fungal plaques form around the artery in the guttural pouch eroding it and subsequently causing a severe, life-threatening nose bleed.

This is an emergency and once it has been confirmed that the blood is coming from the guttural pouch, surgery must be performed to tie off the damaged blood vessel.