TL;DR: Sneezing blood, or epistaxis, is a high-priority medical sign that requires prompt veterinary attention to rule out causes ranging from foreign bodies to systemic illness. Seek immediate emergency care if bleeding is continuous or if your cat has pale gums.
What causes a cat to sneeze blood and what does it mean?
Seeing blood when your cat sneezes—a condition known as epistaxis—is naturally alarming and occurs when the sensitive blood vessels within the nasal passages or sinuses rupture. The causes can range from:
- Localized issues like a foreign object (such as a blade of grass) stuck in the nose
- A severe dental abscess
- Systemic problems like high blood pressure
- Fungal infections
- Clotting disorders
Is it an emergency if my cat is sneezing blood?
Yes, any instance of a cat sneezing blood should be treated with a high level of urgency. While it may not always be a sudden life-threatening event, it is a clinical sign that requires a veterinary exam as soon as possible. You should seek immediate emergency care at a 24-hour clinic if:
- The bleeding is continuous
- Your cat is pawing at their face in distress
- Your cat’s gums are pale or white
How does taking a photo of my cat’s sneezing help the veterinarian?
When you arrive at the clinic or call ahead, providing a clear photo of the discharge or the sneezing episode can be incredibly helpful for the veterinary team. A photo allows the vet to see:
- The volume of blood lost
- The color (bright red versus dark)
- Whether the blood is coming from one nostril or both, which helps narrow down potential causes like foreign objects or systemic infections
Clinical Context (Merck Veterinary Manual)
In cats that are sneezing blood, potential causes include oronasal neoplasia, dental disease with oronasal fistula, nasal foreign body, or nasopharyngeal disease such as a foreign body or mass lesion. Diagnostic evaluation should include a complete blood count, serum chemistry profile, and urinalysis to exclude concurrent systemic disease. If epistaxis is present, a one-stage prothrombin time, partial thromboplastin time, and buccal mucosal bleeding time should be considered, along with a platelet count. Imaging of the nasal chambers via nasal or dental radiographs, or preferably CT, should be performed. More invasive procedures such as rhinoscopy, retroflex nasopharyngoscopy, nasal flushing, and nasal biopsy should be delayed until after imaging to avoid iatrogenic changes. Rhinoscopy and nasal flushing are useful diagnostic tools. Advanced imaging and biopsy may identify a specific diagnosis, such as fungal rhinitis, neoplasia, or foreign body.
Chapter: Otorhinolaryngology, Diagnostic Imaging, Clinical Pathology
Source: The Merck Veterinary Manual, 11th Edition (Page 1480)