Medically known as epistaxis, nosebleeds are a relatively uncommon problem in cats. While some causes are harmless (such as a minor knock), there are several potentially serious causes of nosebleeds in cats, therefore it is important you seek veterinary attention as soon as possible.
There are several possible causes of nosebleeds in cats, the most common being trauma to the nose, other causes include:
- Blood clotting disorders such as haemophilia or thrombocytopenia (low blood platelets).
- Ingestion of poisons (rat poison, aspirin). It is possible for cats to either directly consume rat poison or to indirectly become poisoned by killing and/or eating a rodent who has ingested rat poison itself. Rat poison stops the blood clotting as it should.
- Foreign body (such as grass seed).
- Trauma (running into something, hit by car etc).
- Cancer (osteosarcoma, lymphoma)
- Dental abscess.
- Infections (bacterial, viral) which can cause ulceration.
- Fungal infection such as cryptococcosis.
- Liver failure - The liver is responsible for the production of clotting factors which assist with the normal clotting of blood. As the liver fails, the blood is not able to clot as it should.
- Kidney failure.
- High blood pressure.
Obviously, the presence of blood coming from one or both of the nostrils, however, there may be accompanying symptoms depending on the underlying cause.
These may include:
- Swelling around the nose, mouth, cheeks or eye(s). I had a cat with bone cancer and the first symptom we observed was blood and a slight protrusion from one nostril.
- Pus or nasal secretions (snot) also coming from the nose.
- Eye discharge.
- Bad breath.
- Pawing at the nose.
- Pale gums.
- Weight loss.
- Black stool (melena), this is caused by your cat swallowing blood.
- Bleeding from other parts of the body including the anus, eyes, gums etc.
- Loss of appetite due to pain, or being unable to smell the food.
Place an ice pack on the bridge of the nose, this will help to reduce the flow of blood and assist in clotting.
Your veterinarian will perform a physical examination of your cat, including a medical history, he will want to know how long the bleeding has been present and if there were any previous episodes. Other questions relating to your cat's general health, including appetite and activity levels, exposure to possible toxins and/or medications. The nose will be examined for foreign objects, the mouth for signs of dental disease or abscess. He will wish to perform some diagnostic tests, including:
- Complete blood count - To check for anemia and platelets as blood loss can be heavy enough to cause a notable drop in red blood cells and platelets.
- Biochemical profile - To determine the overall health status of your cat and evaluate the kidneys and liver.
- Urinalysis - To check the kidney function, and for possible infection.
- Radiographs of the nasal passages may be required if a tumour is suspected.
- CT scan - This is a much more detailed type of x-ray which will need to be performed in a specialist veterinary centre (our cat had her CT scan in a human hospital).
- Nasal flush - This may be the first line of diagnosis after baseline tests to try and obtain a sample from the nasal passage which will be examined under a microscope.
- Biopsy - A small sample of nasal tissue will be taken and sent off for microscopic evaluation.
- Endoscopy - The insertion of a thin, flexible tube to check the nasal passages. This may need to be performed at a specialist veterinary practice.
Treatment depends on the cause of the nosebleed. If it is due to trauma, ice may be all that is required. In severe cases, the cat may have his nasal passages packed to control the blood loss.
- Infections will be treated with appropriate medications. Antibiotics for bacterial infections, antifungals for fungal infections. Most viral infections can not be treated with medication and supportive care is required while your cat fights off the infection.
- Removal of any foreign bodies, this may need to be performed under anesthetic.
- Surgery and or chemotherapy will be required for cancers.
- Kidney failure is managed by feeding a good quality, low protein diet, phosphorous binders as well as supportive care as needed.
- Liver disease should be managed by treating the underlying cause which may include surgery, antibiotics, nutritional support as well as supportive care such as anti-nausea medications, vitamin K to help with clotting, fluid therapy and if necessary plasma transfusions.
- High blood pressure should be treated by finding the underlying cause as well as medications to reduce blood pressure and a low sodium diet.
- Activated charcoal may be administered to a cat who has consumed rat poison along with intravenous fluids and if necessary a blood transfusion. Vitamin K may also be administered.
- Surgery to drain an abscess along with antibiotics.
- Blood clotting disorders are treated with blood plasma and blood transfusions in an emergency, home treatment includes vitamin K.
Last updated 2nd March 2017.