External bleeding:

  1. For wounds involving extensive bleeding or spurting of blood, apply pressure as above and seek immediate veterinary attention.
  2. If haemorrhage follows surgery, contact your veterinarian immediately for advice.
  3. For small wounds, using a clean swab, bandage or towel place firm pressure on the wound for five to ten minutes. This should stop the bleeding in a healthy animal with normal clotting factors. Some wounds will require topical treatment or antibiotics – contact your veterinarian for advice.
  4. Do not apply a tourniquet to limbs as this can cut off the blood supply and lead to tissue death. Do not apply a tight bandage around the chest or abdomen as this can restrict breathing.

Internal bleeding:

  1. Where an animal has pale gums/mucous membranes, is weak or lethargic, has a low body temperature and/or has extensive bruising, seek veterinary attention immediately.

WHAT IS IT?

Haemorrhage refers to bleeding, which can be broadly categorised as external or internal. Any of the body’s blood vessels – arteries, veins or capillaries, can bleed. Involvement of larger blood vessels or a greater number of blood vessels results in loss of a greater volume of blood.

Haemorrhage is most commonly associated with trauma, however it can occur due to conditions that affect blood clotting, which leads to an increased risk of haemorrhage or spontaneous bleeding in the body.

CLINICAL SIGNS

  • Obvious bleeding from external wounds
  • Arteries tend to produce spurts of blood, whereas veins tend to ooze blood.
  • Pale gums/mucous membranes
  • Increased respiratory rate
  • Coughing (in the case of haemorrhage into the lungs)
  • Blood in urine or stool
  • Low body temperature (seen with severe haemorrhage/shock)
  • Cold extremities
  • Bruising
  • Lethargy
  • Collapse
  • Death

CAUSES

  • Trauma (cuts, over-clipping nail, lacerations, grazes, penetrating wounds, blunt trauma)
  • Surgery
  • Blood clotting disorder (inability to clot blood)
  • Ingestion of anticoagulants such as rat bait, warfarin or other blood-thinners
  • Some forms of cancer

TREATMENT

Your vet will conduct a physical examination on your pet and assess the extent of its wounds. Where the bleeding does not stop after application of pressure, surgical ligation or electrocautery of the vessel can be done as there are often other branching blood vessels supplying blood to the area affected and it will not lose its blood supply. However, this depends on the vessel involved and is not always possible.

Your pet will need to be sedated or anesthetised for this and for the wound to be thoroughly cleaned and explored. If there is any suspicion that the tissue is not viable, it can be debrided under general anesthesia as well. Depending on the severity and extent of the wound, drains may be placed. A sterile dressing can be placed and bandaged on and some antibiotics or cream may be dispensed. Your pet will also be put on intravenous fluid therapy to maintain blood pressure and in severe cases of blood loss, a blood transfusion can be done.

If internal bleeding is suspected, further diagnostic tests, including a clotting profile, will be required. Medication or exploratory surgery may be required to stop bleeding. Management will depend on the underlying cause of the bleed.

REFERENCES

Wingfield WE (2001) Arterial bleeding. In: Veterinary Emergency Medicine Secrets 2nd Edn. Wingfield WE (ed). Philadelphia, USA: Hanley & Belfus Inc.