Spontaneous Nosebleeds in Dogs

In 61 dogs with spontaneous epistaxis, there was no difference in age or sex when their records were retrospectively analyzed, but German shepherds were overrepresented. Eighty-five percent of cases were acute, having occurred in the 2 weeks before presentation. In 56 dogs, epistaxis was found to be secondary to a systemic disease: leishmaniasis, ehrlichiosis, rodenticide toxicity, immune-mediated thrombocytopenia, suspected estrogen toxicity, and systemic hypertension. In 5 dogs, the hemorrhage was due to intranasal disease from transmissible venereal tumor, nasal aspergillosis, or nasal adenocarcinoma. The most common causes were leishmaniasis and ehrlichiosis, alone or combined. Nasal disease was associated with sneezing, soft palate mass, stertor, hard palate fistula, or submandibular metastatic lymphadenopathy.

COMMENTARY: Geographic differences may make systemic infectious diseases, such as ehrlichiosis and leishmaniasis, a more prevalent cause of epistaxis in dogs than intranasal diseases. With the increase in tick populations in many areas of the United States, our rule-out list for a patient presented for epistaxis may eventually need to rank diseases such as ehrlichiosis higher than we presently do.

A retrospective study of 61 cases of spontaneous canine epistaxis (1998-2001). Mylonakis ME, Saridomichlakis N, Lazaridis V, et al. J SMALL ANIM PRACT 49:191-196, 2008.