* NOSE BLEEDS

We saw an old Maltese Terrier earlier this week called ‘Ellie’. She has been having intermittent nose bleeds (called epistaxis) for the past six months with her most recent bleed being last weekend.

 

There are a number of things that need to be considered when we see a dog with epistaxis. Broadly speaking epistaxis can be caused by either local disease (disease within the nose) or systemic disease (disease elsewhere in the body).

 

The type of systemic diseases we consider are things such as high blood pressure and diseases causing blood clotting disorders. Ellie’s blood pressure was normal. A blood test as well as a full physical exam made other systemic diseases less likely. Her blood was clotting well.

 

Local diseases can include foreign bodies such as grass seeds within the nasal cavity, bacterial infections, fungal infections, chronic allergic disease and tumours.

 

On Monday we admitted Ellie for a number of tests.

 

The first test was to take x-rays of her nasal cavity under anaesthesia. The nasal cavity is made up of hundreds of small bones called nasal turbinates. In normal dogs, x-rays of these bones take on a honeycomb appearance. The xrays of Ellie’s nasal turbinates showed these bones to be eaten away. This can sometimes mean that the disease is nasty and aggressive, but this can also be seen with less nasty chronic problems.

 

The second test was to place a rigid endoscope (a tiny camera at the end of a long thin rod) up both her nostrils and have a good look around. If there was a tumour in her nose, this can often be detected this way. If there was a fungal infection, sometimes fungal plaques can be seen – just like the furry bits you see on old bread. Luckily, we saw neither. In fact all we saw was a bit of blood, mucous and red/inflamed tissue, especially towards the back of the nasal cavity.

 

The third test was to take biopsies of her nose. This was done at the same time as we ‘scoped’ the nose.

 

At the writing of this article, we are yet to have Ellie’s results, but we’ll keep you posted and our fingers crossed.