Help, on going nose bleed

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memeikle

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Right, am beginning to freak out and think horrible thoughts! My horse (6 yr old TB) started having a little nosebleed on the 3rd Jan, only one side, not too worried. However when he was still bleeding the next day, vet came out, endoscoped and said he thought it was a sinus infection, muchos antibiotics and anti inflams, that should sort it out. Still bleeding 2 days later so vet called out again. Whilst waiting for vet, I get booted & carted off to hospital (you may have seen my post!) so vet comes and this time thinks it may be an erupting molar, keep up with antibiotics and bute and see how he goes. All looks good, bleeding stops, huge sighs of relief when i get out of hospital.

Now, finished antibiotics and bute on Sun night, and today, bleeding is back and vet will be tomorrow so as I said, really starting to freak out now! Anyone had any experience with this kind of thing?
 
Yes. Get your vet to check the guttural pouch. This area is notoriously difficult to treat and can be the source of two very nasty infections. Guttural pouch emphyma or guttural pouch mycosis both of which can be very serious if not treated properly and involve corrosion and infection of the main artery that runs through this pouch.

Hopefully though it will be nothing serious.
 
First thing I did was make sure he checked them when he did the endoscope! Once they were clear I thought we were home and dry, apparently not!
 
Ummm if your horse had Guttural puch bleeding he would have been dead by now - they bleed out v severely and can die within minutes so I would have thought it was VERY unlikely!

Could have an ethmoidal haematoma, a small skull fracture from rolling on a stone (I had a horse that was assumed to have had this after ruling other things out - it settled down fine), lung bleeding (kinda like EIPH but i assume this is bleeding without exercise).

How much blood is it (dripping, just a bit smeared on his nostril), what colour is it, is it bleeding all the time or if you wipe it off when does it come back, can you actually see it coming out of his nose, or could he have bitten his lip (my TB intelligently did this and we all assumed nose bleed for ages!), is it coming out of one of both nostrils?

If in doubt, get a 2nd opinion.
 
It's generally a trickle, very visable flow but drops rather than puddles, dark red. when you clean it, it's back straight away. His box looks like the set of a slasher movie! Always been just the one nostril, although I'm no longer finding that remotely comforting.
 
I'd double check with your vet that he had a good look in both guttural pouches when he scoped your horse, as that would be my concern given this history. Its difficult to do without an assistant (it is for me anyway!) so if he was by himself then it's less likely that he was able to. Horses suffering from guttural pouch mycosis usually have a series of minor bleeds over the course of a week or two before having a big bleed. If this is the problem, now is the time to do something about it so that the fungal infection can be treated and the vessels ligated if this is deemed necessary.

Ethmoid haematomas are very vascular growths that bleed easily. If this is the problem then your vet would've been able to see the growth on the ethmoid bones during the scoping, however a similar condition can occur in the sinuses, and this would give symptoms like you've decribed. I'd be suspicious of this if your vet saw blood draining from the sinuses and there is no sign of traumatic injury. Sinus infections and tooth eruption aren't a common cause of haemorrhage; they're more likely to result in a snotty discharge, but Xrays of his head would be useful to investigate these possibilities if the problem persists.

If your vet has definitely ruled guttural pouch mycosis out then it could be a couple of other things which may require treatment but not so urgently so try not to worry. Also horses will sometimes have a series of nosebleeds in a short period of time that resolve by themselves.
 
my friend rode a horse who got nose bleeds when working and the vet said it was stress related and blood vessels were bursting but then he was 16 years old doing hard work incl sj and endurance lenght hackin etc
 
This might not help much but my horse had something very similar, following x-rays showed a small cyst in her sinus. The vet give her a very minor op to clean out the sinus and fitted a cataphter(not sure on the spelling?) and touch wood we haven't had any problems to date and that was back in october. she has been out hunting and jumping since - I know from experience it's hard not to panic but I'm sure everything will be fine x
 
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