Sneezing is a natural reflex to expel unwanted particles from the nose or throat. In dogs, it is generally harmless and can be due to anything from a dusty environment to playful snuffling in the grass. However, if your dog starts to sneeze blood (or gets a bloody nose), it may be a sign of a more serious health issue. While sneezing blood isn’t something that we see every day in clinical practice, pet parents should nonetheless be educated about this potentially concerning clinical signs and what to do if it occurs.
Possible causes of dog sneezing blood
A dog sneezing blood, also known as epistaxis (nosebleed), can be quite frightening for an owner to witness. While many cases are due to trauma or respiratory infection, others can be due to more serious medical issues requiring prompt care.
Foreign bodies in the nose
Objects like grass seeds, small toys, or sticks can end up in your dog’s nasal passages, especially if they are prone to sniffing and exploring. These can cause irritation, inflammation, and subsequent bleeding. It’s not uncommon for dogs to sneeze in an attempt to remove the object, often leading to blood being expelled too. In this case, blood is usually seen only from the affected nostril.
Dental problems
Some dental problems, such as a severe tooth infection or periodontal disease, can lead to bloody nasal discharge. As the tooth roots are in close proximity to the nasal passages, this can cause inflammation and bleeding, noticeable when the dog sneezes. Other signs of significant dental disease include bad breath, tartar buildup on the teeth, red or inflamed gums, loose or missing teeth, mouth pain, bleeding from the gums, and in some cases, swelling on the side of the face indicative of a tooth root abscess.
Trauma
Just like us, physical injury to a dog’s face or nose can result in bleeding. This might be from a fall, a fight with another animal, or a road accident. Depending on the severity of the injury, vet evaluation is recommended.
Infection: bacterial, fungal, upper respiratory, and tick-borne diseases
Certain bacterial, viral, fungal, and tick-borne infections can cause sneezing, inflammation, and bleeding in a dog’s nasal passages. This may be a result of a simple upper respiratory infection causing inflammation and irritation, or a more significant fungal infection in the nasal passages. Depending on the type of infection, clinical signs may include discharge from the eyes or nose, cough, decreased appetite, lethargy, limping, or fever.
Blood clotting disorders
Some diseases and medications can affect a dog’s ability to form blood clots. These disorders can lead to prolonged or spontaneous bleeding. If your dog has a clotting disorder, they may sneeze blood due to minor nasal irritation that would otherwise not result in noticeable bleeding. Conditions such as Von Willebrand’s disease, immune-mediated disease, Disseminated Intravascular Coagulation, rodenticide ingestion, and liver disease can cause clotting disorders in dogs. Other clinical signs may vary depending on the underlying cause. Bleeding will often occur from both nostrils.
Tumors
A bloody nose or sneezing blood can also be a sign of a nasal tumor or other cancer. This will require professional veterinary attention for diagnosis and treatment, often involving imaging tests to identify the size and location of the tumor. Bleeding may occur from one or both nostrils.
How to Respond When Your Dog Sneezes Blood
Seeing your dog sneeze blood can be a scary experience for many pet parents. Here is what I recommend:
- Remain calm and do your best to keep your dog calm (anxiety will increase blood pressure and could make the bleeding worse).
- You may place an ice pack on top of the muzzle to help constrict blood vessels and stop bleeding, but be sure that it doesn’t cover their nostrils.
- Try to see if there is an obvious foreign body in the nose, but do not attempt to remove it unless it is very easily accessible.
- If the bleeding continues, it is essential to contact a veterinarian as soon as possible. If your dog is showing other signs of distress, discomfort, or illness, emergent evaluation is also indicated. Be prepared to provide details about the sneezing and any additional symptoms or changes in behavior.
- If sneezing blood was a one-time event and the bleeding has stopped, it is still important to have your dog seen within the next couple of weeks.
- Do not be alarmed if you notice black stool or bloody vomit after the episode, this may be a sign that your dog ingested a significant amount of blood.
What to expect at the vet
Diagnostics
Your vet will start by getting a thorough history from you. They will want to know about the presence of other clinical signs, whether this was the first nosebleed or if it is a recurring issue, and if the blood is coming from one or both nostrils. Next up is a physical examination, paying special attention to your dog’s nose, throat, eyes, and mouth. Further diagnostics may include:
- Blood tests – to evaluate your dog’s overall systemic health and major organ function, as well as specific tests to check blood clotting ability.
- X-rays – to look for other evidence of bleeding in the body or as a first step in evaluating the skull and nasal cavity.
- Nasal swabs – to examine cells under the microscope or submit for culture to grow organisms causing an infection.
- Referral – for advanced imaging such as MRI, CT, rhinoscopy (visualizing the nasal passages with a small camera), and biopsy of any abnormal areas or tumors.
Treatment options
Treatment for a dog sneezing blood will depend on the underlying cause. Removal of foreign bodies, if present, will be the initial step. For allergies or infections, appropriate medication will be prescribed, which may include antibiotics, antifungals, and anti-inflammatories. In cases of tumors or dental problems, surgery will likely be necessary. Trauma or blood clotting disorders may need supportive care and, potentially, hospitalization.
Cost
Due to the wide range of underlying issues that can cause a dog to sneeze blood, the cost of treatment will vary greatly. An office visit and medication for an upper respiratory infection may cost around $100-300. If your dog needs a dental exam and cleaning under anesthesia it can range from $800-$1300, with additional cost for extraction of diseased or damaged teeth. Referral for an MRI can cost up to $6000.
Preventing Dog Sneezing Blood
Prevention primarily involves routine veterinary care and check-ups, which can detect potential issues early. Regular dental hygiene is also important, as dental issues can sometimes lead to nasal problems. Furthermore, try to keep the home environment free from allergens and supervise playtime to prevent trauma.
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