Nose Bleed Senior Horse


Jamie Miller
 

Hello. 

Noticed that my horse had a nose bleed at evening feeding.  Vet indicated this could be something as simple as temperature change (Kentucky went from 50 degree weather to low 20 degree weather) or as severe as a guttural hemorrhage (?).  It is dark red.  No pools of blood noticed in stall or paddock. Vet advise watching the bleed for the night and check in tomorrow morning.  I fed him and he ate his cubes and moved between his various buckets to eat.  Just seemed a bit punky and was yawning quite a bit.  He is blanketed during this low temps.  He's about 33-34 years of age.  Cushings and laminitis. Treatment with Prascend and Sigafoos shoes.  He's been doing all right up until this evening.  Eats Triple Crown Balance Cubes and soaked hay. Gets Cocomega, Uckele Vitamin supplement, Herbal Mune, Uckele Vitamin E, and salt.  He wears a blocked muzzle when in pasture for movement, but only for 1-2 hours per day, though he attempts vigorously to grab blades of grass throw the Best Friends muzzle.  It is possible he also was too vigorous in his attempt today.  

I do have an emergency vet service that will come out if warranted. Look for guidance as this is the first time I've had a horse experience this issue and I'm not sure how to determine the urgency or severity of it.   

  


Thank you for your time. 
--
Jamie Miller
Louisville, Kentucky, USA
July 2019
Horse: Hiram Walker
Walker Case History: https://ecir.groups.io/g/CaseHistory/files/Jamie%20and%20Walker
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=93084
Link to Profile for Hiram Walker


 

That must have been alarming, Jamie!  It looks like you might have tried to attach some photos to your post, which isn’t possible but maybe you could put them in your photo album if you have pictures to share.  My only experience with nosebleeds is that my horse probably didn’t have them.  I would occasionally find drips of bright red blood on his bedding, which I had always thought must be nosebleeds for some reason.  When I mentioned it to the vet, after assuring him that the location of these spots meant it had to be his head, he told me that nosebleeds usually involve a lot more blood than what I was noticing.  I think I finally decided it was coming from my horse’s mouth after he’d been diagnosed with EOTRH syndrome.  I’m assuming you witnessed it happening and can verify it was the nose.  Don’t you love it when the vet suggests watching something for the night.
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Jamie Miller
 

Thank you.  I did upload the two photos to the Photo Album (link HERE).  Yes, I confirmed that it was coming from the small opening just inside the left nostril. It was dark red in color and only in one nostril. 
--
Jamie Miller
Louisville, Kentucky, USA
July 2019
Horse: Hiram Walker
Walker Case History: https://ecir.groups.io/g/CaseHistory/files/Jamie%20and%20Walker
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=93084
Link to Profile for Hiram Walker


Sherry Morse
 

Hi Jamie,

Did you send those pictures to your vet?  Did you clean all the blood out and then see if you could find a cut inside his nose?  Did you see if it continued to bleed after cleaning?  Did you look inside his mouth to see if there's anything noticeable going on in there?  See any cuts on his head? 

If the yawning is out of character that could indicate there's something in his mouth or throat bothering him which may or may not be related to the nose bleed.  Generally speaking bright red blood is fresh but darker blood is older or might not be as oxygenated. 

What I see in those pictures would have me checking for injuries inside his nose and mouth but unless there's rapid bleeding happening once it's cleaned off I'd just keep an eye on it and give the vet an update in the morning.


_


Jamie Miller
 

Thank you. Yes, I did send the pictures to my vet and uploaded them to Hiram Walker's ECIR Case File Photo Album. It is darker, mucous like blood. I do not see any injuries inside nostril or mouth. I checked just now 11 pm EST, 4 hours after initial notice and it is still dripping/draining. Link to view below.  I offered him food, he ate and drank water. Stool in stall appears normal. 

I am concerned that the dark blood is still present 4 hours from me first noticing it.  My options of course are to call emergency vet or wait until morning.

Video

https://photos.app.goo.gl/7LV2EsYKQcbj9TbM8

Photo
https://photos.app.goo.gl/frrcRXqm4W1hCpVD7

--
Jamie Miller
Louisville, Kentucky, USA
July 2019
Horse: Hiram Walker
Walker Case History: https://ecir.groups.io/g/CaseHistory/files/Jamie%20and%20Walker
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=93084
Link to Profile for Hiram Walker


 

Hi Jamie,
Hope you got some rest!  I agree with Sherry, both on the nature of the blood you’re seeing as well as cleaning it out.  I’d use a well wrung out cloth with cold water, keeping your eye out for differences in color as you clean different areas.  He doesn’t seem fazed by it while eating.  I did see blood on the hay bag to his left side.  When you’re not in his space, is there a way he can stand that puts his left nostril there or is it draining from both sides?
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Sherry Morse
 

Hi Jamie,

Like Martha I hope you got some sleep last night.  If it's still going this morning I'd want to get a call into the vet as not necessarily an emergency but something to be checked just in case. It could be something as simple as a cut that keeps getting the scab blown off but you do want to be sure, especially given his age.

FWIW I had a horse one time that presented with a cut on his head about an inch long and maybe a 1/4 of an inch wide between his eyes and a slow dripping nosebleed (bight red blood). I did get the emergency vet out because he started acting colicky and while the nosebleed was mildly concerning that plus his depressed attitude plus colic = emergency.

Two things happened - we opened his mouth and found he had a crazy long tooth growing on the bottom because the opposite tooth had been knocked out; but that wasn't the cause of the nose bleed, just something that needed to be taken care of.  The other thing was the vet concluded he had a concussion and that was causing the nosebleed and colic and the cause was related to the cut on his head which most likely came from a hoof.

He recovered within a few days and the bleeding resolved within 24 hours - took longer to clean all the spots off the wall.




Jamie Miller
 

Again, thank you. 

Vet was out this morning.  There was no active bleeding at the time of her arrival.  She did a scope of nasal area and head radiographs.  The scope revealed a suspicious area that would be consistent with an adenoid hematoma (spelling?) in the sinus cavity.  The guttural pouch was clean and did not indicate a rupture, blood, or anything unusual, so she said that is encouraging.  Radiographs are being reviewed by a surgeon for a second opinion and would help guide next steps for the area suspicious of a hematoma.

So, for now we continue to monitor him since this was his first known episode.  If it happens again and we can scope him during the active bleeding she can more accurately identify if the bleed is coming from the suspicious area in his sinus cavity. The surgeon's review will help us determine how aggressively this is treated and how urgent of situation it is for my guy.  By all other counts, he seems ok.  

She also drew blood for a CBC/Chem Panel, ACTH levels, and got a fecal sample to test for worms since worming medications have historically caused laminitis flare up. 
--
Jamie Miller
Louisville, Kentucky, USA
July 2019
Horse: Hiram Walker
Walker Case History: https://ecir.groups.io/g/CaseHistory/files/Jamie%20and%20Walker
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=93084
Link to Profile for Hiram Walker


 

Jamie, was the ACTH blood drawn before the scoping and sedation? If not, your ACTH results may not be reliable. 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Jamie Miller
 

I am not certain at this time, but I would suspect the vet would be knowledgeable in ensuring that all his bloodwork be drawn prior to putting something into his system, such as sedation (which was zilozine/torb combo, I think).  However, you make a good point for me to double check.  Thank you.
--
Jamie Miller
Louisville, Kentucky, USA
July 2019
Horse: Hiram Walker
Walker Case History: https://ecir.groups.io/g/CaseHistory/files/Jamie%20and%20Walker
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=93084
Link to Profile for Hiram Walker


Eleanor Kellon, VMD
 

Jamie,

The radiographs will give your vet more information. I think you meant ethmoid hematoma. Info here https://horsesandpeople.com.au/ethmoide-haematomas/ . The cause is unknown.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


 

Interesting article!  Thank you!
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Jamie Miller
 

Thank you, Dr. Kellon. Yes, ethmoid hematoma.

A surgeon at Rood and Riddle in Lexington, Kentucky reviewed radiographs and scope pictures and is recommending Walker be transported there (1 hour away) for another scope with their state of the art equipment. Dr. Woodie is the surgeon and indicated the results would determine if the ethmoid hematoma should/could be treated, which would most likely consist of repeated trips to their facility for injections of fermeldahyde (spelling?).  Walker is about 33-34 and in fairly good condition considering age, Cushing's and laminitis. 

I am open to personal and professional opinions.  Thank you. 
--
Jamie Miller
Louisville, Kentucky, USA
July 2019
Horse: Hiram Walker
Walker Case History: https://ecir.groups.io/g/CaseHistory/files/Jamie%20and%20Walker
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=93084
Link to Profile for Hiram Walker


Eleanor Kellon, VMD
 

Very close - it's formaldehyde!  That is the treatment of choice and it's no  more invasive than doing the scoping. You're in good hands.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Lorismorgans
 

My horse had this procedure Last Summer he was in and out and  home the same day.
Vet said it was A somewhat common procedure. Made a world of difference for my horse's comfort. 
Hope this helps

--
Lori, Abel, Bodie & Dusty

2016

Redding, CA

https://ecir.groups.io/g/CaseHistory/files/Lori%20and%20Able%20-%20Bodie%20-%20Dusty

 https://ecir.groups.io/g/CaseHistory/album?id=6053&p=Name,,,50,2,0,0 .


Jamie Miller
 

Lori, 

Thank you.  Did your horse have a surgery or the injections of Formalin?  My horse is a senior horse (age 33-34).
--
Jamie Miller
Louisville, Kentucky, USA
July 2019
Horse: Hiram Walker
Walker Case History: https://ecir.groups.io/g/CaseHistory/files/Jamie%20and%20Walker
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=93084
Link to Profile for Hiram Walker


millionairess1989
 

Hi Jamie,

My Arabian Millionairess developed an ethmoid hematoma back in 2017 when she was 28 years old. It started as a chronic nasal discharge with nothing remarkable showing on x-rays. One afternoon I went out and found a nearly 12 inch long mass on the mat where she eats with tissue and blood splattered across the back of the barn and in her water bucket. You can see photos in her album. Luckily the mass was attached via a small stalk and she didn't hemmorrhage to death. It healed without complications and she's now almost 33. 
--
Jennifer in Middle TN  2010
 Mill 32 yrs Arabian-PPID, IR & Pacemaker Dependent
Jack 22 yrs TN Walker- IR & RAO

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Millionairess

https://ecir.groups.io/g/CaseHistory/album?id=831

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Jack-TN%20Walker


Lorismorgans
 

He had the surgery.the scope missed it. xrays finally found it. It was located high in sinuses.
Went through  below eye.
You cannot even tell where he had it. He was 17yrs..
Feel bad. He had small drips and slight bloody discharge for nearly a year. Other vet said it was from itching breaking little veins not to worry. But I know he had headaches, puffy eyes, and ran slight fevers that confounded vets.


--
Lori, Abel, Bodie & Dusty

2016

Redding, CA

https://ecir.groups.io/g/CaseHistory/files/Lori%20and%20Able%20-%20Bodie%20-%20Dusty

 https://ecir.groups.io/g/CaseHistory/album?id=6053&p=Name,,,50,2,0,0 .


Jamie Miller
 

Oh gosh. I'm so sorry. Walker has been anemic for the past 2 years, but vets couldn't find the source. Abdominal and heart US did not show internal bleeding but now, I have to wonder if the ethmoid hematoma could be the cause of slight anemia. 

Tonight he has had the 2nd nosebleed in 5 days. I guess I'll check on him through the night and call the Rood and Riddle surgeon in the morning, who consulted on Walker's scope and radiographs.

Very scared and sad for my horse. 
--
Jamie Miller
Louisville, Kentucky, USA
July 2019
Horse: Hiram Walker
Walker Case History: https://ecir.groups.io/g/CaseHistory/files/Jamie%20and%20Walker
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=93084
Link to Profile for Hiram Walker