Nose Bleed in Cats

Nosebleeds, referred to as epistaxis, are a condition in which blood or bloody discharge occurs from the nose. Epistaxis can be a symptom of a serious medical condition like cancer or organ failure. It is also commonly caused by sinus or respiratory infections or injuries to the nose or head. Nosebleeds can affect one or both nostrils, and this distinction can aid in diagnosing the underlying cause of the condition. Epistaxis can occur in cats of any age, breed, or sex, and there are no clear risk factors that increase the chances of your pet experiencing nosebleeds. If your pet is experiencing nosebleeds on a frequent basis or a nosebleed takes more time than normal to stop, seek medical attention immediately. 

The primary symptom of nosebleeds is blood or bloody mucus from one or both nostrils. Cats experiencing nosebleeds may exhibit a variety of symptoms associated with the underlying cause of the epistaxis. It is also possible that a nosebleed is the only symptom the animal experiences. 

Symptoms include:

• Bleeding from the nose
• Snorting
• Sneezing
• Nasal discharge
• Weakness
• Lethargy
• Facial swelling
• Pawing at or rubbing the nose or face
• Bad breath
• Trouble breathing
• Exercise intolerance
• Bleeding gums
• Unexplained bruising
• Dizziness or confusion
• Dark or black feces
• Prolonged bleeding from wounds or injection sites

Nosebleeds are generally a symptom of an infection, disorder, injury, or disease. It may also be caused by poisoning or toxicity. On some occasions, the cause of the nosebleed will be undeterminable, and it may be an isolated incident. Common causes of epistaxis in cats and other companion animals include:

• Nasal trauma or injury
• Head trauma or injury
• Foreign body in nasal or sinus passage
• Bacterial infections
• Viral infections, including feline leukemia and immunodeficiency viruses
• Parasites
• Fungal infections
• Liver or kidney disease
• High blood pressure
• Blood clotting issues, including hemophilia
• Blood platelet issues
• Anemia
• Nasal ulcerations
• Some cancers
• Certain cancer treatments
• Poisons, including rat poison
• Toxins
• Anxiety
• Certain medications
• Von Willebrand’s disease
• Rocky Mountain spotted fever
• Dental abscesses
• Allergens
• Environmental factors

Because of the large number of conditions that can cause nosebleeds, diagnosing the underlying cause of your pet’s condition may require numerous diagnostic methods. Be prepared to discuss your cat’s medical history and behavior, daily routine, and any symptoms you have observed. If your pet has recently been injured, been around toxins, or exhibited any other symptoms, be sure to advise your veterinarian. A full physical examination will be conducted with a special focus on facial, ocular, and nasal abnormalities. Veterinary staff will also take blood and urine samples and perform a nasal swab. 

Blood, urine, and nasal samples will be cultured for bacteria and fungus. Additional laboratory blood testing will include a complete blood cell count, serum biochemistry, electrolyte panel, and clotting test. A urinalysis will also be completed. If the cause is not easily diagnosed using these methods, diagnostic imaging techniques may be used. X-rays or other imaging techniques allow veterinary staff to look at the nasal passages and surrounding structures. Certain cases may require rhinoscopy, which involves examining the nasal cavities with a small tool called an endoscope. A tissue biopsy may also be required. 

The treatment for epistaxis will depend on the underlying cause. Treatments may range from simple measures to stop the bleeding to prescription medications or more invasive measures like surgery or blood transfusions. If your pet experiences nosebleeds at home, do not attempt to provide them with any medication unless advised to do so by a veterinarian, as this could cause serious complications. The following treatment methods are commonly used to treat nosebleeds in cats:

Icing & Pressure 

Ice or a cold compress, applied to the nose and face, may be used to stop bleeding and treat any facial swelling. This is a common practice for nosebleeds caused by injury or inflammation. If icing does not stop the bleeding, the nasal cavity may be packed with gauze to provide pressure and decrease blood flow. 

Antibiotics or Other Medications 

If an infection is the cause of the nosebleeds, medication may be prescribed to clear up the infection. Antibiotics, antifungals, or parasite eliminating medications will be used depending on the source of the infection. Proper dosing is needed to reduce the risk of side effects. 

Intravenous (IV) Fluids 

Fluid therapy is often used for animals experiencing weakness or lethargy. They help maintain proper hydration and can aid in restoring electrolyte balance. This common treatment is considered low-risk. 

Blood Pressure or Anxiety Medications 

Drugs may be used to reduce blood pressure and lower stress levels as these conditions can increase nosebleed risk. This medication may be prescribed for use on a long-term basis if blood pressure or anxiety is determined to be the cause. 

Surgical Intervention

Surgery to remove an object or tumor, to repair damage, or to surgically cauterize blood vessels may be needed. Any surgical procedure carries some risk. Your pet will likely be hospitalized during recovery. 

Blood Transfusion 

If blood disorders are present or anemia is severe, a blood or plasma transfusion may be required. Proper blood typing and adherence to transfusion protocol will help reduce the risks associated with this form of treatment.

Your cat’s prognosis will depend on the underlying condition causing their nosebleeds. In many cases the prognosis is good, and your pet will require minimal treatment and downtime. More severe cases, including cancers, organ failure, and blood disorders, have a guarded to fair prognosis and may require hospitalization or long-term treatment. Be sure to follow all of your veterinarian’s treatments, including proper dosing of any medication and returning for any requested follow-up visits. Seek medical attention if your cat’s symptoms return or worsen. While your pet is recovering, reduce stress and avoid any changes to your cat’s living environment.