Epistaxis is a common condition in horses that refers to bleeding from the nostrils. Nosebleeds can range in severity and may result from trauma, underlying health conditions or exercise. [1]

The majority of nosebleeds in horses are caused by minor trauma or irritation and resolve within 10 to 15 minutes. However, recurrent nosebleeds or severe bleeding can indicate an underlying condition that requires veterinary attention.

Treatment of epistaxis in horses largely depends on the identified cause of the bleeding. Horses may need rest, medication, or other interventions to diagnose and address the bleeding.

To minimize nosebleeds in your horse, it is important to maintain a clean and well-ventilated barn environment and manage dust and exposure to respiratory irritants. Training and exercise should be increased gradually, and stalls and turnout areas should be checked regularly for objects that could cause injury. [2]

While it can be alarming to see blood in your horse’s nostrils, understanding the causes of this condition and knowing how to respond is essential for horse owners and caregivers.

Epistaxis (Nosebleed) in Horses

A one-off nosebleed in your horse might not be a significant concern, but some horses experience recurrent or prolonged nosebleeds that need to be evaluated by a veterinarian.

The most obvious sign of a nosebleed is the presence of blood in one or both nostrils. Depending on its origin, this could manifest as a few droplets, a light stream, or a more substantial amount of blood. [3] Bright red or dark blood indicates a fresh bleed, while blood that is brown or black signifies an older hemorrhage.

Some horses, particularly racehorses, may have recurrent nosebleeds linked to intense physical activity due to Exercise-Induced Pulmonary Hemorrhage (EIPH). In such cases, blood is observed dripping from the nostrils after strenuous exercise.

If recurrent bleeding episodes are not connected to exercise or are accompanied by other symptoms, this could be a sign of an underlying condition. Other conditions that can cause epistaxis in horses include bleeding disorders, respiratory issues, infections, tumors or major traumas. [1]

Clinical Signs

Other clinical signs that may accompany recurrent or severe nosebleeds in horses include:

  • Headshaking and rubbing of the nose
  • Coughing
  • Poor performance
  • Lethargy
  • Anxiety
  • Difficulty breathing
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Causes of Nosebleeds in Horses

Some causes of nosebleeds are minor and self-resolving, but others can indicate a more serious underlying condition. Common causes of epistaxis in horses include:

  1. Exercise-Induced Pulmonary Hemorrhage: Often seen in racehorses and other speed-event horses after intense exercise
  2. Trauma: Injuries to the head or nasal passages
  3. Foreign Bodies: Objects lodged in the nostril that cause tissue damage [1]
  4. Sinus Irritation or Infection: Inflammat