Hemorrhage from the nostril(s) with multiple potential sources. EIPH (Exercise-Induced Pulmonary Hemorrhage) is the most common cause in performance horses; occurs in up to 75% of racehorses and results from extreme pulmonary capillary pressure during intense exercise. Guttural pouch mycosis (Aspergillus fumigatus fungal infection eroding the internal carotid artery) causes potentially fatal hemorrhage. Ethmoid hematoma is a progressive, encapsulated mass of hemorrhagic tissue in the ethmoid labyrinth. Other causes: trauma, sinus disease, coagulopathy, and exercise-induced nasal congestion.
EIPH: bilateral epistaxis during or after intense exercise; blood may only be seen on endoscopy; poor performance. Guttural pouch mycosis: spontaneous unilateral epistaxis at rest (may be fatal); dysphagia; cranial nerve deficits (VII, IX, X, XI, XII). Ethmoid hematoma: progressive, intermittent, unilateral epistaxis; may see serosanguinous discharge; obstruction of nasal passage visible on endoscopy. Trauma: acute onset after injury, usually resolves
Hemorrhage from the nostril(s) with multiple potential sources. EIPH (Exercise-Induced Pulmonary Hemorrhage) is the most common cause in performance horses; occurs in up to 75% of racehorses and results from extreme pulmonary capillary pressure during intense exercise. Guttural pouch mycosis (Aspergillus fumigatus fungal infection eroding the internal carotid artery) causes potentially fatal hemorrhage. Ethmoid hematoma is a progressive, encapsulated mass of hemorrhagic tissue in the ethmoid labyrinth. Other causes: trauma, sinus disease, coagulopathy, and exercise-induced nasal congestion.
EIPH: bilateral epistaxis during or after intense exercise; blood may only be seen on endoscopy; poor performance. Guttural pouch mycosis: spontaneous unilateral epistaxis at rest (may be fatal); dysphagia; cranial nerve deficits (VII, IX, X, XI, XII). Ethmoid hematoma: progressive, intermittent, unilateral epistaxis; may see serosanguinous discharge; obstruction of nasal passage visible on endoscopy. Trauma: acute onset after injury, usually resolves