Nose bleeds (or epistaxis) can be a common occurrence in horses of all breeds and ages. Some can last from a couple of minutes, and others up to an hour. Although even the slightest bleed can appear very dramatic, common nose bleeds can occur spontaneously, and usually resolve (or clot) by themselves within 15 min.
A few things to determine the significance of a nose bleed can decide whether or not to call the vet out. - Whether the bleed is coming from one or both nostrils. This can help determine if the cause is within the head, or lower down the airways. - Presence of nasal purulent discharge, as well as blood. This could indicate some level of infection. - The amount of blood loss. A 500kg horse can lose up to 5 litres of blood without causing any problem, therefore there is no need to panic at the first sight of blood. -Rate of blood loss. Is it a couple drops, a trickle, or a steady flow? - Previous occurrence, or a one-off. It is definitely worth investigating further if your horse has had repeated nose bleeds. -Recent trauma. If you were able to visualise your horse hitting its head or catching a nostril on something sharp, the nose bleed could be evident. Another common cause of nose bleeds is through passage of a stomach tube by a veterinarian. The lining of the nostril is very sensitive and thin, therefore even the slightest irritation can cause it to bleed. -Recent exercise. If your horse has just been through strenuous exercise or fast-pace work, and you’ve noticed a nose bleed after, it could indicate exercise-induced pulmonary haemorrhage. This condition is usually seen in Thoroughbreds, Standardbreds or eventers, where the blood originates in the lungs.
Other causes of repeated nose bleeds should require veterinary intervention. Even a small foreign body can cause the lining of the nostrils to be damaged and bleed. Inflammation of the sinuses, or occasionally tumours within the head of the horse can also be the origin. Small polyps can also form within the sinuses, named ethmoid haematomas, which can cause recurrent bleeding. Finally, guttural pouch mycosis, a fungal infection within blind sacs of the horse’s head, can also be found. The key in visualising and diagnosing such conditions requires endoscopic examination performed by a veterinarian.
Treatment relates directly to the factors listed above. This can range from no treatment if the bleed resolves itself, or as far as surgery to remove certain conditions from within the nasal cavities, sinuses, or guttural pouches. In any case, the horse should be kept calm and still, until veterinary advice is sought.