## Overview Epistaxis is bleeding from the nostrils. Common causes in horses include exercise-induced pulmonary hemorrhage (EIPH), guttural pouch mycosis, ethmoid hematoma, and trauma. The pattern (during exercise versus at rest, unilateral versus bilateral) helps narrow the source. ## Causes EIPH from pulmonary capillary rupture during intense exercise; fungal erosion of vessels in guttural pouch mycosis; progressive ethmoid hematoma; or trauma. ## Diagnosis History and endoscopy. EIPH is confirmed by post-exercise airway examination. Guttural pouch mycosis and ethmoid hematoma are seen on endoscopy at rest. ## Treatment Depends on cause: furosemide and management for EIPH; antifungal and vascular occlusion for guttural pouch mycosis; surgical or laser treatment for ethmoid hematoma. ## Recovery and Prognosis Variable by cause. EIPH is manageable; guttural pouch mycosis can be fatal if untreated. ## Prevention For EIPH, management of racing intensity and medication. No prevention for other causes.
blood from one or both nostrils; may occur during/after exercise (EIPH) or at rest (guttural pouch mycosis, ethmoid hematoma); possible dysphagia with mycosis
## Overview Epistaxis is bleeding from the nostrils. Common causes in horses include exercise-induced pulmonary hemorrhage (EIPH), guttural pouch mycosis, ethmoid hematoma, and trauma. The pattern (during exercise versus at rest, unilateral versus bilateral) helps narrow the source. ## Causes EIPH from pulmonary capillary rupture during intense exercise; fungal erosion of vessels in guttural pouch mycosis; progressive ethmoid hematoma; or trauma. ## Diagnosis History and endoscopy. EIPH is confirmed by post-exercise airway examination. Guttural pouch mycosis and ethmoid hematoma are seen on endoscopy at rest. ## Treatment Depends on cause: furosemide and management for EIPH; antifungal and vascular occlusion for guttural pouch mycosis; surgical or laser treatment for ethmoid hematoma. ## Recovery and Prognosis Variable by cause. EIPH is manageable; guttural pouch mycosis can be fatal if untreated. ## Prevention For EIPH, management of racing intensity and medication. No prevention for other causes.
blood from one or both nostrils; may occur during/after exercise (EIPH) or at rest (guttural pouch mycosis, ethmoid hematoma); possible dysphagia with mycosis