Nosebleed in dogs

Nosebleeds can be caused by a variety of reasons. If your dog was involved in a fight or accident, it may have sustained injuries to the nose. This is a clear cut cause of a bleeding nose.

Blood clotting disorders or infections that affect the platelets cause majority of nosebleeds. Here is a list of some of these underlying causes:

1. Hemophilia: This disorder impairs the function of blood to clot.
2. Nasal tumours: Usually found in older dogs (more than years of age), nasal tumours cause irritation along the nasal cavity and can cause nose bleeds.
3. Rat poison: If your dog has killed a rat that has consumed rat poison or directly consumed rat poison, there is a chance that its nose will bleed. This is because rat poison works by not allowing the blood to clot.
4. Certain medications: NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin cause the blood to thin and can lead to nosebleeds.
5. Idiopathic rhinitis (unknown causes): Often the cause of a nosebleed cannot be deduced. An inflammation of the nasal cavity causes a bleed but it is not known why.
6. Liver failure: One of the symptoms of liver failure is bleeding from the nose. This is a very serious indication and may suggest that the dog is going into shock.
7. Von Willebrand’s disease: An inherited condition which prevents the blood from clotting properly.
8. Thrombocytopenia: This is either immune-mediated or caused by tick-borne infections. It means that the levels of platelets in the body are low.
9. Bone marrow disease: The bone marrow produces platelets so if there is a disorder there will not be able to clot properly.
10. Cancer: These include various blood cancers, lymphatic cancers and myelomas. 
11. Tick-borne diseases such as rocky mountain spotted disease and babesia: These infections also cause Thrombocytopenia by lowering the number of platelets in the blood.
12. Foreign bodies: Shards of wood, foxtail, blades of grass can get lodged in the nasal cavity and lead to a bleed.
13. Fungal infections: Aspergillus fumigatus is the most common fungi that causes nasal infections in dogs. Inflammation caused by the fungi can lead to nosebleeds.

 Dental issues: Tooth abscesses can drain into the nasal cavity and emerge as bleeds.

Apart from the bloody nasal discharge, your dog may also show some accompanying symptoms depending on what is causing the issue.

• Clawing at the nose, or around the face if there is a foreign body lodged in the nasal cavity 
• Frequent sneezing or snorting 
• Swelling around the nose or the mouth 
• Reluctance to eat
• Weight loss 
• Dark coloured stool
• Halitosis (bad breath)
• Bleeding from the gums
• Odour from the nose

If the gums look pale and the teeth have specks of blood you must take your dog to the vet right away - these can be signs of shock.

If your dog has been taking NSAIDs, or if you suspect it has consumed rat poison, or is on any medication at all, you should tell your vet. This may explain the symptoms. 

• Your vet will start by containing the bleeding by applying a cold compress on the nose. 
• Blood work will need to be conducted to ascertain whether there are issues with coagulation. To this end, a platelet count, PT (prothrombin time) and PTT (partial thromboplastin time) test will be conducted. 
• The vet may also conduct a buccal-mucosal test which involves taking a sample from the cheeks. 
• To eliminate a fungi pathway, a blood test to check for A. fumigatus will be conducted. This test is not the most accurate, however, and nasal tumours make the body more susceptible to the fungi.
• The blood pressure of the dog will also be checked to investigate whether it is contributing to the issue. 
• To check for a tick infestation, a tick panel may be conducted as well.
• Imaging tests may be ordered if nothing turns up in the blood work. Full body scans will reveal if there are masses (tumours) present anywhere in the body which would suggest that there is likely a lesion in the nasal cavity as well. 
• Since abscesses can also cause nosebleeds, your vet will want to conduct a physical exam of the area. This may have to be done under sedation since it is a sensitive area to investigate. 
• Radiograph tests will be conducted to examine the area around the nasal cavity if nothing shows up in the other tests. 
• A biopsy may be collected if there are no other conclusive findings.

Treatment will be based upon the findings. 

• If it is a case of trauma, the vet will patch up the injury. If it is a severe accident, surgical correction may be required. 
• For fungal, tick based infections, appropriate medication will be prescribed. If this is the cause then treatment usually works well and dogs react to it positively. 
• Platelet transfusions will be required for those dogs suffering from clotting disorders. 
• For those dogs that present with metastasized tumours treatment will focus on management and palliative care. Metastasized tumours, especially in older dogs, are unfortunately difficult to deal with.

Nosebleeds are considered serious issues. Unless a foreign body or trauma have caused the problem, diagnosis usually takes some time and a more serious underlying issue is identified. 

For dogs with cancerous tumours, while treatment can aid pain and maintain quality of life, there is not much else that can be done. 

The severity of the clotting issues will define prognosis for the remainder of the cases. If the dog responds well to transfusions and there is a reliable lab around you, then a full recovery is possible.