To Bleed or Not to Bleed...
Well, this week we have celebrated Valentine’s Day, and that should remind us of the people and pets we love. So, in honor of one of mine that I loved and lost, I need to talk to you about something that tugs at my heart. If you have read my blogs, you know about my precious standard poodle, Peyton. I lost her 9 years ago to nasal lymphosarcoma, and I still miss her.
People get nosebleeds for lots of reasons. The two most common causes, according to the Mayo Clinic, are dry air and picking your nose. Allergies can cause nosebleeds. Sinus infections, medications (aspirin and blood thinners), deviated septums, and polyps can also cause nosebleeds.
Dogs, on the other hand, DO NOT HAVE NOSEBLEEDS! Any time a dog has a nosebleed, it is for a serious reason. Obviously, a traumatic cause is pretty easy to know the cause. Dogs can get foreign bodies in their noses, and this can make the nose bleed. Systemic hypertension and bleeding disorders are also causes. Systemic hypertension will rarely be seen as a primary problem, and if the hypertension is associated with chronic kidney disease, signs of the primary disease, such an increased water consumption and increased urination, should help us determine the cause for the nosebleed. Bleeding disorders are uncommon, but these usually become apparent when animals are young, as they are first noticed at the time of ovariohysterectomy or neuter.
Unfortunately, the other big cause for nosebleeds is cancer. My precious Peyton jumped off the grooming table, and she had a few drops of blood come out of her nose. I immediately anesthetized her and scoped her nose (this was before I had my CT, or I would have performed that test as well). I could see the glistening white mass in her nose, and the biopsies came back lymphosarcoma. We fought hard for 14 months before losing the battle.
I want to show you what CT images of nasal tumors look like. These first images are from a dog with intermittent nosebleeds for 3 months although the first nosebleed actually occurred one year ago. The septum has been destroyed. The orbit of the eye has been destroyed. The cribriform plate that separates the nose and brain has been destroyed, and tumor can be seen in the brain. If you look at this dog’s face, she had no visible evidence of the tumor.
The next images are from a dog with a one-year history of nosebleeds (Lucky Reid). The left nasal cavity is filled with tumor that has caused loss of the normal turbinate bone structure of the nose.
The last images are from a dog that presented with a history of nasal congestion (talk about an astute owner to notice a problem!). An aggressive right-sided nasal mass is present that has extended across midline into the left nasal cavity (Pilot Bennett).
Hopefully, after seeing some of these images, you can appreciate how sensitive CT is for detecting nasal tumors. I hope none of you have to treat a beloved pet for nasal cancer, but if your dog has a nosebleed, please don’t pass go. It is NOT normal, and it is time to ask for a referral for aggressive diagnostics.