What you see. The starting point for addressing any equine health related issue is your observation.


Bleeding from Nostrils or Nose


Bleeding from the nostril or nostrils can be a sign of many conditions, originating anywhere from the external nostril to deep in the lungs. The most common cause of nasal bleeding is ethmoid hematoma, a slow-growing mass in the nasal passage or sinus. Less common but more severe problems include hemorrhage from the guttural pouch or a fracture into the guttural pouch or sinus.

In very dry conditions, minor bleeding from the nasal passages can occur. Usually, blood comes from the nasal passages and not the external nostril. Horses can also traumatize the thin mucous membranes of the inside of the nostril, but this is relatively rare.

Racehorses that are bleeding after a race are bleeding from the lungs (Exercise Induced Pulmonary Hemorrhage), unless proven otherwise.

Horses with clotting disorders can bleed from the nostrils, but usually show other symptoms of disease.

  • Code Red

    Call Your Vet Immediately, Even Outside Business Hours
    • If this problem seems severe and has come on suddenly.
    • If the results of the Whole Horse Exam (WHE) in the resting horse indicate fever (Temp >101F/38.3C) or heart rate greater than 48 BPM.
  • Code Orange

    Call Your Vet at Their First Available Office Hours
    • If this seems mild or occasional and the horse seems normal otherwise.
    • If the results of the Whole Horse Exam (WHE) suggest the horse is otherwise normal.
You also might be observing
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your role


What To Do

Assess your horse's general health using the Whole Horse Exam (WHE), paying particular attention to whether blood is coming from one or both nostrils. Consider attitude and appetite, and whether there is any other evidence of head trauma. Share your findings and concerns with your vet.

What Not To Do

Do not insert or attempt to pack the horse's nose with anything to stop the bleeding.

your vet's role

Your vet uses physical examination, endoscopy and, in some cases, radiography to help determine the source of the bleeding.
Questions Your Vet Might Ask:
  • Does the blood appear to be coming from one or both nostrils?
  • How is your horse's attitude and appetite?
  • When did you first notice this problem?
  • What is the horse's age, sex, breed and history?
  • How much bleeding is there?
  • What are the results of the Whole Horse Exam (WHE)?
  • Does the horse have a history of having been on the race track?

Diagnoses Your Vet May Consider

The cause of the problem. These are conditions or ailments that are the cause of the observations you make.

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Treatments Your Vet May Recommend

A way to resolve the condition or diagnosis. Resolving the underlying cause or treating the signs of disease (symptomatic treatment)

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Author: Doug Thal DVM Dipl. ABVP