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Differential diagnosis of epistaxis in the horse

EPISTAXIS – bleeding from the nostrils – is a relatively common condition in the horse. Haemorrhage may originate from a number of locations, including the nasal cavity, paranasal sinuses, ethmoid labyrinth, guttural pouches or lungs. There are a number of potential causes of the condition, some of which are mild and self-limiting, and others, such as guttural pouch mycosis, which are potentially life threatening and require surgical intervention. This article discusses how to distinguish emergency from non-emergency cases, and describes a range of investigations that will help in establishing a diagnosis. It goes on to discuss treatment approaches for the most important causes of epistaxis.

Debra Archer graduated from Glasgow in 1996 and worked in mixed and equine practice for three years before completing a residency in equine surgery at the University of Liverpool. She is now a senior lecturer in equine surgery at Liverpool. She holds the RCVS certificate in equine soft tissue surgery, the European diploma in equine surgery, and a PhD for studies on the epidemiology of colic.