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Progressive Ethmoid Hematoma in Horses - Mad Barn - Vet Talk
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Nosebleeds in horses can be concerning, especially when they happen unexpectedly or without a known trauma to the head or sinuses! One of the differential diagnoses for blood in the nostrils, or epistaxis, in horses, is Progressive Ethmoid Hematoma.

Join Dr. Fran Rowe, DVM, one of Mad Barn’s Veterinary Nutritionists, to learn more about Progressive Ethmoid Hematoma. In this video, Dr. Rowe explains how these masses form, how they’re diagnosed, and treatment options.

Progressive Ethmoid Hematoma (PEH) is a non-cancerous mass that originates from the ethmoid turbinates- a structure in the back of the horse’s nasal cavity. Once these masses form, they can extend into the nasal cavity and/or surrounding sinuses.

The underlying cause of PEH is largely unknown. However, we understand that the hematoma forms from a point of bleeding in the tissue covering the ethmoid turbinates. The tissue forms a capsule and recurrent bleeding causes the tissue to balloon.

The most common clinical sign of PEH is an intermittent trickle of blood or blood staining in the nostrils. Additionally, horse owners may report respiratory noise either at rest or while exercising. Anytime there is blood from the nostrils, your veterinarian will want to investigate the cause.

Most often, they’ll start with a combination of upper airway endoscopy and radiographs to locate the source of the bleeding. PEH is highly suspected if a mass originating from the ethmoid region is identified.

While PEH is generally not a life-threatening condition, it can limit performance and lead to sinus and airway complications if left untreated. The two most common treatment options for PEH include formalin injections via endoscopy and surgical removal. Treatment success is variable, and the hematoma can recur.

To learn more about nosebleeds in horses, check out our blog article 👉 https://madbarn.com/nosebleeds-in-horses/

Have ideas for topics to cover or questions about your horse’s health? We would love to hear from you! Please send any questions or comments to vet@madbarn.com.

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