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my dog bled from his mouth and nostrils yesterday.. is it internal bleeding? what shud i do?

Posted by sumeet

my dog bled from his mouth and nostrils yesterday night. He bleeds from his nostrils once or twice every year in summers due to the heat.. we usually give him the prescribed blood coagulation tablet and it stops. but this time he bled through his mouth too. Also, his stools have been dark black in color today. He bled yesterday night, hasn't happened again but i am very tensed. is it internal bleeding ? what should i do?
Answers (23)
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It sounds like your dog is either getting into something seasonally that acts like an anticoagulant or has an internal clotting problem that's getting worse as he gets older. I don't normally associate bleeding with heat, although here in New England we don't experience the kind or duration of heat experienced in other parts of the country or world. However, because your dog's problem is getting worse, I'd recommending  finding out exactly what's causing it and treating that rather than just the symptoms.
thanks so much for the reply.... our place usually goes upto 45 degrees n sometimes higher in summers and my dog is a pomeranian (age 10-11 yrs)... he bled again today from his mouth for a very brief period of time..  last time we had noticed the blood when he had already stopped bleeding and the blood was on the floor and some of it clotted in his mouth. but this time we saw it running and it seems his gums are bleeding and that the blood hadn't come out from the inside... any suggestions on this???   
he bled again and this time was the worst... now we can see it is definitely from some place near the gums on one side of his mouth only... please advice as to what the CORE PROBLEM COULD BE. he has had a tendency for excessive bleeding from his nose every summer as i have told you. we have consulted various vets but we are in a relatively remote place - Kutch (Gujarat), India. The vet suggests a course of "THREE IV HAEMOSTATIC INJECTIONS IN THREE DAYS" but that is just curing the symptom of bleeding not the actual cause right?. And those injections can have side effects too right?? pl advise on the possible causes of this and what should we do now...

It sounds like a clotting problem and unfortunately clotting is a highly complex process, a problem in any part of which could produce bleeding. Even more unfortunately, identifying which factor is the cause may require sophisticated testing that's beyond the range of the average veterinary practitioner. I live in a rural part of the US and would send all such cases to a veterinary hematologist at the nearest veterinary college to work up and treat because I knew I couldn't do so myself.

I have never used haemonstatic injections and can't say anything meaningful about their effects or side-effects. Your veterinarian should be able to provide this information, if you can't get your dog to someone with more specialized knowledge. It goes without saying that your pet  should be kept cool and only exercised during the coolest part of the day. If he's overweight and/or on a diet that could elevate his blood pressure (such as eating people food or treats with a lot of salt), that could also be a factor

cant thank u enough for ur quick replies... my dog hasn't bled since yest -We have an appointment today with a vet today. i will ask him to get tests done for clotting problems. even i dunno whether he will be able to do those tests at his hospital or if he can arrange for the blood samPles to be sent to some other place for sophisticated testing. can u name some tests that i should get done??

p.s.: additional info ::

last night when he bled LIKE HELL FOR ALMOST AN HOUR OR SO FROM HIS GUMS, he obviously kept on swallowing the blood that dripped into his mouth . after the dreadful hour and after bleeding had stopped finally , he then threw up (probably bcoz he'd had dinner n then so much of his own blood). he threw up all his food but everything was based in red liquid- blood of course. now i dunno if that blood was due to internal bleeding or it was the blood that he swallowed from his gums. also, as i'd told u, whenever his gums bleed, his stool is also black in color.

also, today, half an hour ago, while i gave him an anti-biotic syrup as per our vet's prescription, he, as usual, tried to throw it out of his mouth, but this time, he salivated pretty badly in his attempt to reject the syrup. his foam-like-salivation stopped in a minute though.


PL SUGGEST THE TESTS WE NEED TO GET DONE TO FIND OUT THE CORE PROBLEM. I HAVE SEARCHED A LOT OF INFO ON THE NET N IT TURNS OUT - he could have anything from dental problems like periodontitis to blood clotting problems (as u said). 




A good two weeks back, we found my dog's penis leaking blood ... that is, blood dripped from his urethra... but very slowly.. a drop in a minute or so.... we gave him the anti-biotic medicine that the vet prescribed to cure this particular "infection"(as he quoted it) and the occasional dripping stopped. (the dripping actually occured only twice or thrice before the dose of the medicine was completely given over a few days time and it leaked hardly some drops of blood every time) 

First of all and something I should have thought about sooner but it's not an issue in this area, could your dog have gotten into any rodenticides (rat or mouse killers)? If so, some of these contain an anticoagulant called warfarin and your vet should be able to look up how to treat this if he/she isn't familiar with it. Other drugs may also cause the problem so your vet should consider these, too.  For example, if your dog was put on a drug every summer for some condition, that might have caused the problem.

If your veterinarian hasn't done so already, a routine CBC and platelet count should be done as should a complete panel for thyroid gland function. The latter should be sent to a lab that has or has access to breed-specific data.  A bone marrow biopsy could be done to help pin down the cause, but should be done with someone familiar with the technique. What you don't want to do is put your dog through a lot just to do something and not gain anything of value from it.

And finally, I suspect that your veterinarian can call or email a member of the hematology department of the nearest veterinary college or of the one from which he or she graduated and find someone willing to provide assistance in this matter. That's what a lot of vets here in the US do when they get into trouble.  Also, if your vet doesn't know this already, the entire Merck Veterinary Manual is available on line. I'd give you the URL but I'm stuck with a dial-up connection and don't want to risk losing this post by looking it up.

I'm sorry I can't be of more help to you. My field is veterinary ethology--the interaction of animal health, behavior, and the bond--and it's been a while since I've dealt with a clotting problem.  Within the bond context, though, do try to stay calm. There are plenty of studies to prove that our pets are capable of picking up on our most subtle body language. At such a time, you want yours to communicate your utmost confidence in yourself and your dog to make it through this.

thanks so much.... i'l try to get the tests done today iself and will get back to u with the results... thank u!

hey.... i got some tests done n the results are far 4m normal... now i'd told u my dog had lost a lot of blood these past few days and the result shows it :

haemoglobin level - 3.1 whereas normal level- 12

RBC - 1.76 while normal = 5.5

platelets = 1 lac while normal = 2 lac

there are some high-lows in his urea count and some other things pertaining to the liver n kidney functions

but his behaviour has been in complete contrast to the results... he's regained his activity and seems rather normal n active... we gave him the IV HAEMOSTATIC INJECTIONS to nullify any chances of internal bleeding. as it is, his RBC r low...



These test results tell us he's definitely anemic from all the blood he's lost, but they don't tell us why.  Unfortunately, blood transfusions aren't as easy in dogs as they are in people because they're are many more blood types and sometimes canine blood banks are few and far between even in large metropolitan areas.

At this stage and given your dog's age and good response to the injections, I'd repeat the blood work in a week and see if it's improving. If it is, and you've gone through your home and yard to eliminate any possible toxins that might be causing this, then I'd continue with this treatment as needed. Collecting blood  is a relatively benign process, but because of his current anemia and clotting problem, I wouldn't stress him with any further tests at this time unless absolutely necessary.

Also, it goes without saying that he should be on a good quality diet, staying away from garlic which can cause anemia.

thank u so much ...

well ... all the vets we consulted say that the deficiency in rbc and haemoglobin would have been definitely caused by the blood loss during the bleeding. Also, the injections were to stop any more bleeding (we werent sure if there was any internal bleeding coz his stools were black). now he's showing signs of normal activity and no bleeding.

also, the vet said his activiy levels say the haemoglobin levels appearing in the report might be lower than the actual level coz of his blood loss just hours before the test. The vet says he doesnt look like he's got such low blood counts. He's given us some tonics that shud help build up his blood counts gradually.. do u advise anything in the diet that might help the process ?

Ideally if you can find a diet formulated for older dogs, that would be the best.

thanks so much 4 ur responses.. they've helped me a lot in the process of figuring out what really is wrong with my li'l kid - sammy...

hey i know this is probably due to his low RBC n haemoglobin count but i wanna know how serious this is ::

i noticed today - he faints for just half a second and loses his balance for that fraction of a sec , not long enough to fall off his 4 legs... just a slip off his back legs.

First he suddenly started looking blank n looked down, his legs trembling just a bit before he lost the balance off his back legs but before he could fall, he regained his composure and he never lost his front legs balance. all this happened within a couple of seconds...and then he was completely normal and energetic.

other than this "fainting" happening twice, his behaviour and activity level is completely normal during the whole day.... No bleeding has occurred again.

how serious is this doc?? my vet is ignoring this, saying his haemoglobin level and RBC count suggested this cud happen. i wanna prevent this from becoming any more serious.. i am giving him the tonics- that th vet gave- for building his haemoglobin... does he require blood transfusion ??? 

Again, I wouldn't be thinking transfusions at this time because it's a complex process in dogs and could wind up creating more problems than it solves. Anemia can cause weakness in animals just as it does in humans. And if the animal over-exerts him/herself or gets too excited, they may lack the red blood cells to carry sufficient oxygen to the brain support that activity. If that occurs, the body's protective response is fainting, i.e. cause the individual to lie down. It sounds like Sammy may be coming close to this point, but then recovers before he actually falls.

If Sammy is one of those dogs who gets excited when you or others come home or when you have company, practice ignoring him when you leave and return until he quiets down to relieve him of this stress. Similarly, if you know he's coming over to jump up on you, calmly turn and walk away as if you didn't see him and then stoop down and call him to you so there's no need for him to jump up. The more excited he gets, the more his blood pressure goes up and the more pressure that puts on his cardiovscular system as it tries to keep up. If being a very attention-seeking  reactive dog has been his norm in the past, you may have to create a new, calmer one for him.

Re: how serious it is, unfortunately that's impossible to say because the cause of the problem is unknown.

hey doc.. thnx for all the info on the bleedin problem.. sammy recovered v well by the dose of the medicines n suplements tht the doc prescribed.. he hasnt bled - thts also bcoz the summer heat is no more takin a toll....

i'd earlier tol u abt some blood leak from his urinary tract rite? it happnd yest- a couple of drops .. bt wats worryin is - today he's gone down completely.. he's vomiting, v weak AND IS HAVING SOME STRANGE ABDOMINAL CONTRACTIONS THT LOOK V PAINFUL TO ME. the blood test had earlier shown he had some urinary infection n v'd given him the anti-biotics dose tht the doc had prescribed.. but today al of a sudden (until yest, he was the ever playful- all-energetic sammy), he's nt even able to walk properly.. of course the vomitin n al might hav made him weak, bt then wats wit the abdominal contractions (every 30 seconds or so).. he cant sleep bcoz of em, hes nt eating! my vet says its bcoz of a urinal tract infection n has prescribed anti-biotics again 4 10 days... wat do u think??

pl reply... i cant see my li'l kiddo in so much pain ..

also, he's havin a li'l fever.. i'm afraid my vet is again tryin to cure the symptoms of this infection.. i wanna know wat exactly is the root problem.. cn u suggest any tests? or nythin else tht i shud do??
The question is what's the causing the abodominal contractions? When the lining of the stomach is highly irritated, this may cause increased motility and vomiting. Although this is a protective reflex, it may continue long after the irritant is gone, or if the dog has eaten a forgeign body he can't digest or has a mass somewhere. I wouldn't expect this to be related to the bleeding from his penis, unless the problem is a cancer that has spread, although a chronic bleeding problem could have the same effect.  I'd recommend abdominal x-rays to see what's going on, paying particular attention to his stomach and intestinal tract, bladder and prostate gland. If these have been done before, I'd compare the two sets to see if any changes have occurred. Ultrasound or other sepcialized tests would be another way to go if available.  One problem with such diagnostic tests is whether anesthesia would be necessary to do them. In a dog of his age with his problems, doing so could be life-threatening. This one reason why vets may opt for palliative/symptomatic treatment in older animals or those with serious problems, just as is done in humans. You don't want to lose your dog in the process of getting an answer that supported treating him exactly the way the animal was being treated.

hey.. thnx a lot 4 the prompt reply.. the abdominal contractions stopped within half a day.. the vet said it was a symptom of the urinary tract infection he had.. also, v got blood tests done to c his progress since the last blood test- he's done well since then- all his levels except one have moved significantly towards the normal...

the one problem that has INCREASED is his SERUM CREATININE levels in the kidney... current level :: 3.31 mg/dl normal range :: 1.2 to 1.9

Any idea if this is the problem for all of it??

symptoms currently ::

1) he was throwin up some sticky fluid(saliva-like) in the morn today- the vet said it was bcoz of his infection n fever... since sammy has grown v v weak in a matter of 24 hrs, the vet gave him a drip (glucose)... after that, the throwin up has stopped completely.

2) he's too weak to even stand up since yest evening (bfore that he was as active as ever) ...

3) He cant let go of his urine himself... the urine's been comin involuntarily while he's lying down at times...

3) no blood has leaked from his urinary tract again

any idea if the CREATININE levels are the problem behind it all...? wat can v do nw?? 

I suspect the elevated creatinine levels are a result rather than a cause. If his BUN is also elevated, then the probability is high that he has kidney problems. In order to treat them you need to know the cause. These are often divided into three categories: prerenal, renal, and post-renal. That is, something somewhere else is demanding kidney function that he can't keep up with such as a heart problem or systemic infection. Renal problems are those arising within the kidney itself, such as stones, masses, etc. Post-renal include bladder or other problems that cause a back up of urine or bladder infections that then spread to the kidneys. Unless the cause is known, treatment will be symtomatic. If he strains to urinate and nothing comes out, but urine flows out of him when he's lying down, I have to think of some sort of physical obstruction--such as a stone or tumor in his bladder near the sphincter or somewhere in the urethra that goes from the bladder through his prostate and penis.
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