What is Epistaxis ?
Epistaxis means bleeding from the nose and can mean anything from a spot of blood to a full heavy flow pouring from the nostril. It can affect either one nostril or both. At first glance, it may seem to come from nowhere and an external examination may find nothing. If it is a heavy flow, a veterinarian’s assessment is vital as it could be the sign of something very serious. Should the bleeding persist it will need urgent attention for the health of your horse. Causes ranging from fungal infection to sinusitis need to be investigated by an equine veterinarian.
Epistaxis describes a condition where for no apparent reason your horse may suddenly develop a nose bleed with bright red blood pouring from its nostrils.
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Symptoms of Epistaxis in Horses
- Flow can be sporadic or continuous in which case immediate veterinary treatment is advised
- Blood flowing from either nostril
- A brownish red is a sign of an older hemorrhage
- Bright red indicates a new hemorrhage
- Fast exercise can bring epistaxis on
- Flow can be light or very heavy
- Unusual breathing symptoms
- Idiopathic mucosal bleeding occurs from a damaged mucosal receptacle in the nasal area and is often sporadic in nature
- Pneumonia or pulmonary abscess
- Progressive ethmoid hematoma – comes from a growing mass within the nasal area
- Guttural pouch mycosis -this is a critical life-threatening condition
- Upper respiratory tract neoplasia- growths
- Upper airway fungal infections
Causes of Epistaxis in Horses
- A blunt knock or trauma to the head
- Sinusitis which is an infection
- Injury to the nostril from a foreign object such as a twig
- Tumors in the upper regions of the nasal passage
- Fungal infections
- Exercise induced pulmonary haemorrhage (EIPH)
- An injury to the head such as fracture to the skull bone
Diagnosis of Epistaxis in Horses
Observation and quick action for diagnosis and treatment rely on how soon you can get your horse checked so the veterinary specialist can view where the blood is coming from. Using an endoscopy and radiography of the respiratory area are the main methods of diagnosis. If there are any masses within the nasal area, a biopsy of the sample of the mass can determine the cause. Heavy flows can be fatal so immediate action is needed, whereas a one-off light trickle is less urgent and can be monitored to see if it is reoccurring. The sign of a larger blood flow is a signal that something may be critical, and if it is heavy may indicate a serious condition within the respiratory area that needs attention. A bilateral nosebleed originates from a condition that begins on one side of the respiratory tract and grows around and extends into the other nasal passage with blood draining from both nostrils. Any abnormal breathing sounds or head shaking needs to be investigated to prevent further damage or growth.
Treatment of Epistaxis in Horses
Depending on the cause of the bleeding, treatment can vary. Treatment for fungal growths or tumors include laser removal, injections of 10% formalin solution, or surgical removal. After removal, regular checks are advised, usually once or twice a year is sufficient. If the blood is indicating it comes from the guttural pouch which can be critical and life threatening, immediate surgery may be necessary. Treatment of this condition is aimed at preventing further hemorrhage from the damaged artery and dealing with shock that can affect your horse. Stopping the bleeding is vital and your veterinary specialist can use various technique to achieve this, including artery ligation.
With fungal lesions, surgical excision and topical antifungal medications may be necessary. For growths in the upper respiratory area, the uses of radiation therapy have been useful in some cases. For fractures, supportive medical care is advised. The list of treatments comes from the diverse range of conditions that can initiate the epistaxis, so there is no one cure fits all treatment, it is prescribed depending on the condition causing it.
Recovery of Epistaxis in Horses
Depending on the treatment your horse has been given, the recovery and home management will vary. Surgery will require your horse to rest afterwards, with veterinarian checks to ensure all is healing as it should. Your horse may need the nasal area cleaned as the injury heals and this is best left to the specialist as the nasal area is very delicate and can injury easily. Fungal infections may need continued medication at home over a period to clear the fungus. Whatever the treatment, your horse will need a quiet place of rest with soft bedding and fresh water available. Supportive care at home will assist with healing. Depending again on the cause of the bleeding, prognosis is usually good if caught early and acted upon quickly.