Epistaxis in Rabbits
Epistaxis, or bleeding from the nose, occurs due to one of three abnormalities: blood clotting disorder, space-occupying tumor, or organ disease. Complications due to nose bleeds can range from relatively minor ones like sneezing to more severe health risks like anemia due to loss of blood, or respiratory, and circulatory system dysfunctions. The digestive system may also be affected if the rabbit swallows large amounts of blood.
Symptoms and Types
- Bleeding from the nose
- Sneezing, nasal discharge, staining of the front paws (with blood)
- Excessive tear production
- Excessive secretion of saliva
- Loss of appetite
- Blood in urine, stools, or in other parts of the body if hemorrhage is present
- Black stools (from digested blood in stools) if swallowing of blood occurs
Rabbits are at higher risk of developing epistaxis if they have a weak immune system or if they are living in unhygienic conditions. The most common underlying causes, meanwhile, include the following:
- Bacterial or fungal infection
- Tooth root abscess
- Foreign body in nose — mostly inhaled vegetable matter (e.g., grass and seeds)
- Injury to teeth — often due to chewing on electric cords
- Space occupying tumor or growths in nasal cavity
- Blood clotting disorders — may be a reaction to anticoagulant chemicals
Your veterinarian will perform a thorough physical exam on your rabbit, taking into account the background history of symptoms and possible incidents that might have led to this condition. There may be several possible causes for this condition, so your veterinarian will most likely use differential diagnosis to find the underlying disorder.
This process is guided by deeper inspection of the apparent outward symptoms, ruling out each of the more common causes until the correct disorder is settled upon and can be treated appropriately. A complete blood profile will be conducted, including a chemical blood profile and a complete blood count. The blood analysis may show a low blood cell count with anemia. The coagulation time of the blood will be assessed to find if the blood has the necessary clotting factors that are responsible for bringing about the cessation of bleeding. A lack of clotting factors in the blood can be directly responsible for excessive bleeding and hemorrhage.
Visual diagnostics will include X-rays of the skull and cheekbones to examine for tumors, growths or injuries, and X-rays of the chest to detect signs of respiratory system involvement and spread of tumors (if cancer is suspected). Depending on what has been found, computed tomography (CT) and magnetic resonance imaging (MRI) may also be performed on your rabbit. If growths or lesions are discovered, your veterinarian may need to perform a biopsy of the nasal tissues, or take samples for bone marrow studies. Blood and fluid samples will also be analyzed for bacterial and fungal infections.
Your veterinarian will want to treat the symptoms first; this means stopping the bleeding before your rabbit's health becomes further complicated. Drugs will be given to control bleeding and promote clotting. If an infection is identified, antibiotics will be prescribed. Otherwise, treatment will be dependent on the final diagnosis.
Living and Management
Follow-up care for your rabbit will include re-examination of the blood clotting time in order to avoid or quickly control recurrences. At home, you will need to monitor your rabbit for any clinical signs and symptoms, and make the environment in which your rabbit lives as safe as possible from injury, to prevent excessive bleeding from occurring. If your rabbit has been found to have a clotting disorder, you will need to be especially vigilant about preventing accidents, even minor ones.
Though rare, life-threatening anemia and collapse may occur if the epistaxis is not treated promptly and appropriately.