Vet Guide 2025: Bloody Nose (Epistaxis) in Dogs and Cats – Steps, Causes & Diagnosis

I'm Dr. Duncan Houston. Seeing your dog or cat bleed from the nose can be alarming. This comprehensive guide explains how to manage it at home, common causes, initial diagnostics, and when to head straight to emergency care.

🆘 First Aid at Home

If your pet’s nose starts bleeding, here’s what to do before seeing your vet:

• Stay calm—your anxiety raises their blood pressure and worsens bleeding.
• Apply a cold compress (e.g., ice pack wrapped in cloth) to the nose bridge.
• Do *not* insert cotton or swabs; sneezing worsens bleeding.
• A single spray of oxymetazoline (e.g., Afrin) may help constrict blood vessels.
• Ask your vet about the herbal supplement Yunnan Baiyo for recurrent bleeding.

If bleeding won't stop or breathing becomes difficult, take your pet to the veterinarian immediately—time is critical.

📋 What Your Vet Will Ask & Examine

Answering these questions helps streamline diagnosis:

• Any medications? NSAIDs or aspirin can impair clotting.
• Has your pet ingested rat poison or dead rodents?
• Any facial trauma, swelling, foxtail exposure, or recent sneezing?
• Is bleeding from one or both nostrils?
• Look inside the mouth—are gums pale? Is there blood or bruising?
• Have you noticed bruising or bleeding elsewhere (e.g., black/tarry stool)?
• Is this the first episode? Are there any other concerning signs?

🧪 Initial Diagnostic Testing (Non-invasive)

1. Blood panel + urinalysis: Confirms blood loss and assesses clotting (platelets, PT/PTT, ACT, buccal bleeding time).
2. Fungal tests: Cryptococcus (cats), Aspergillus or Blastomyces (dogs) if regional risk exists.
3. Blood thickness / hyperviscosity: High protein from conditions like multiple myeloma may burst nasal vessels.
4. Blood pressure check: Hypertension can rupture vessels—evaluate retina and eyes.
5. Tick disease panel: Ehrlichia, Babesia, etc., can cause thrombocytopenia and nose bleeds.

🌬 When Additional Imaging Is Needed

If blood work is normal and bleeding persists, further tests under anesthesia may be required:

• Chest X‑rays: Detects cancer spread or systemic fungal infections.
• Oral exam: Look for dental abscesses that may bleed into nasal passage.
• Nasal X‑rays: Reveal bone loss from nasal tumors.
• Rhinoscopy/endoscopy: Direct visualization and possible biopsy of nasal passages.
• Nasal biopsy: Helps diagnose tumors, infection or severe inflammation—but risks more bleeding.
• Advanced imaging (CT/MRI): Referral required for deep structural lesions or tumor evaluation.

🚨 Emergency & Surgical Intervention

Surgery may be the last step—for example, to remove deep foreign bodies or obtain a biopsy. Referral to a specialist is crucial when previous diagnostics fail to find the issue.

📊 Common Causes — Percentages from a 2007 Study

Nasal fungal infections were not seen in this cohort but can be regionally important in dogs.

📚 Further Data on Untreated Nasal Carcinoma

A 2006 JAVMA study of 139 dogs with untreated nasal cancer (all alive ≥7 days post-diagnosis) found:

• 77 % had nosebleeds.
• Median survival was 88 days in dogs with bleeding, vs. 224 days without — supportive care improves outcomes.

🏁 The Bottom Line

• Epistaxis can range from benign to life-threatening. Bleeding > 5 minutes or with airway compromise requires immediate vet attention.
• Early diagnostics start with blood work and blood pressure and proceed in phases to pinpoint the cause.
• Many causes can be ruled out with non-invasive tests.
• Serious conditions—like tumors, clotting disorders, hypertension—warrant imaging, biopsies, or surgery.
• Early intervention and supportive care significantly improve outcomes, especially in cancer or severe bleeding situations.

If you see blood from your pet's nose, keep cool, apply cold pressure, and consult your vet quickly—early evaluation can be critical.

Dr. Duncan Houston, BVSc