Ask the Vet: Preventative Care

Question: I am just in the process of building a barn for my horses. We have well water that feeds our olive grove and now I need to find out if this well water is suitable for drinking water for the horses as it is now. I already have a well water test report with the results on various parameters. Would you be able to help me to find out who could take a look at those results? or, is there a website that I could consult? I live in Glen Ellen, Sonoma County in California.

Answer: Since your water has already been tested, I would consult your county cooperative extension office. Extension agents are trained in pasture management for horses and other livestock and are often an underutilized resource! Most extension offices can help you with soil testing, hay/forage analysis and will even make site visits to search for toxic plants. Lisa Kivett, DVM, Southern Pines, NC

Question: What are the causes of a bloody nose in horses? My 21-year-old Appendix mare had a right side sinus flap procedure to remove an abcessed tooth 4 years ago. At that time, a sinus cyst was discovered and also removed. The mare has had several short one nostril nose bleeds in the last year, bright red blood, from the left and right nostrils (never both nostrils at the same time).

Answer: We typically divide the cause of bloody noses (“epistaxis” in veterinary terminology) into two categories: unilateral (one nostril) and bilateral (two nostrils). Your horse is interesting, since you notice bleeding from both nostrils, but not at the same time! Structures in and around the nasal cavities (like the nasal passages and sinuses) are usually responsible for one-sided bleeding. Structures in the lower respiratory tract (like the lungs) and elsewhere in the body tend to be responsible for simultaneous bleeding from both nostrils.

Causes for bleeding from both nostrils simultaneously include: pneumonia and other lung diseases, exercise-induced pulmonary hemorrhage (“bleeder” race horses), clotting disorders and a few other systemic diseases. Causes for bleeding from one nostril include sinus problems (like the cyst you mentioned), diseases of the guttural pouch, ethmoid hematoma, nasal polyps and other problems of the nasal cavity. Horses with guttural pouch problems may bleed from either one nostril or both.

With your horse’s history, I would probably recommend upper airway endoscopy first. This involves the use of an endoscope, which is a long, flexible camera. With the endoscope, your horse’s nasal passages, throat and guttural pouches could be evaluated for any problems. If nothing significant is found, x-rays of the head can show problems with the sinus cavities and tooth roots.  It’s also never the “wrong” idea to have some bloodwork run! If nothing shows up on any of the tests, I might wonder whether the history of sinus surgery is a clue- perhaps she has some residual sensitive scar tissue in this area? Again, I would only make this assumption if all the tests results are clean. Lisa Kivett, DVM, Southern Pines, NC

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