Bleeding from the Ears, Nose, or Mouth

Bleeding from the nose also can be considered a veterinary emergency, especially if the hemorrhage is coming from one nostril and is not associated with exercise.
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Editor’s Note: This excerpt is from Understanding Equine First Aid by Michael Ball, DVM. 

As previously mentioned, the presence of blood in the ear canal after trauma can indicate a skull fracture. Additional clinical signs might include severe depression, seizing, and/or holding the head in a tilted manner. These animals should be evaluated by a veterinarian as soon as possible. Bleeding from the nose also can be considered a veterinary emergency, especially if the hemorrhage is coming from one nostril and is not associated with exercise. Bleeding from the nose (usually both nostrils) during strenuous exercise can be a result of exercise-induced pulmonary hemorrhage (EIPH).

Exercise-induced pulmonary hemorrhage is common in racehorses and is actually a bleeding within the lungs, which is manifested as bleeding from the nostril in severe cases. If a horse bleeds as described after exercise, the horse should have this diagnosis confirmed (and other causes ruled out) by a veterinarian using endoscopy.

Another cause of bleeding from the nose (usually one nostril) is called guttural pouch mycosis. The guttural pouch is a structure in the horse’s head (very few other mammals have this structure) that opens/drains into the nasal cavity. A number of very vital structures travel within the guttural pouch, one being the internal carotid artery. Mycosis refers to a fungal infection–guttural pouch mycosis is a fungal infection within the guttural pouch. As the infection advances, it can erode the internal carotid artery and, if left untreated, eventually lead to a severe and typically fatal hemorrhage

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Michael A. Ball, DVM, completed an internship in medicine and surgery and an internship in anesthesia at the University of Georgia in 1994, a residency in internal medicine, and graduate work in pharmacology at Cornell University in 1997, and was on staff at Cornell before starting Early Winter Equine Medicine & Surgery located in Ithaca, New York. He was an FEI veterinarian and worked internationally with the United States Equestrian Team. He died in 2014.

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