Epistaxis (Nose bleed)

A nose bleed occurs when any part of the nasal passages (which are richly supplied with blood vessels), throat, lower airways or lungs are injured to such a degree that blood vessels are damaged and blood leaks out.

Serious causes of nose bleeds include Guttural pouch mycosis, Exercise-induced pulmonary haemorrhage and Progressive ethmoid haematoma. Occasionally tumours somewhere in the respiratory tract or inflammation of the sinuses (sinusitis) will produce a trickle of blood from the nose.

A moderate nosebleed, if accompanied by coughing, suggests a foreign body wedged in the nose or throat. Less serious causes of nose bleeds include a knock to the head and as a result of a stomach tube being removed from the nostril.

Can Equissage help?

Yes it can.

However before taking any action:- if blood is coming from both nostrils and continues to do so after 15 minutes, then consult your vet immediately as this could mean the horse is bleeding from its lungs. If just one nostril is involved but the rate of flow is a "run" more than a "trickle" then this suggests a knock to the head which should also receive veterinary intervention.

Exercise Induced Pulmonary Haemorrhage is very common in racehorses and although there is still a degree of uncertainty with regard to what actually causes this, Equissage is proven to be very effective in helping to manage, if not cure, epistaxis and is one of the reasons why so many racehorse trainers have Equissage in their yard. Regular use helps to keep the airways open (i.e. reduces airway restriction during exercise which in turn helps to protect the lungs from injury/damage) and the cycloidal massage tones the muscles of the respiratory tract and the diaphragm - the diaphragm being the muscular partition between the chest and abdomen. Contraction and relaxation of the diaphragm, in association with the muscles between the ribs, allows the chest cavity to expand allowing air into the lungs and then contract - pushing the air back out again.

A minor bleed (a trickle) from one nostril, can be relatively common in some horses and often, despite the most thorough of examinations including skull x-rays, the cause is not found. However feedback is that with these horses, using Equissage has also eliminated or drastically reduced the occurrence of a nosebleed.


For horses that are known "bleeders" due to EIPH use the Pad as part of the horse's daily management routine. Ideally the Pad should be used prior to exercise as a warm-up - 20 minutes is all that is required on firstly No.4/No.5 for a few minutes, then turn up to No.7/No.8 if the horse is to undergo particularly strenuous exercise (such a cross country, a gallop - as in racehorse training, etc).

If a guttural pouch mycosis proves to be the cause of the nosebleeds, then, DO NOT use Equissage until your vet has given the all-clear following post-surgery checks as you do not want to risk compromising the carotid artery. Obviously once the vet is happy then Equissage can be used to help restore the full health - promoting circulation and lymphatic drainage (particularly of benefit following the necessary drugs the horse will have been on and preventing filled legs), toning muscles, etc.

For horses which have minor nosebleeds with no known cause then using Equissage as part of its daily management routine can help significantly for the reasons as above. Use the Pad on a medium setting for 20 minutes a day, preferably before exercise.