Severe nasal hemorrhage in an anesthetized horse

An 8-year-old Thoroughbred gelding with colic was anesthetized for surgical correction of right dorsal displacement of the ascending colon. Removal of the nasogastric tube at the end of surgery resulted in hemorrhage from the nares and loss of 24 L of blood. Treatment included administration of acetated Ringer's solution, hypertonic saline solution, and dobutamine. A blood transfusion was started after hemorrhage was controlled, and arterial pressure was restored to the prehemorrhage value, but was stopped after infusion of 2.7 L of blood because of a suspected adverse reaction. This case indicates that infusion of balanced electrolyte solution, hypertonic saline solution, and dobutamine may maintain adequate arterial pressure after severe blood loss, and also supports the suggestion that administration of hypertonic saline solution potentiates blood loss in the absence of hemostasis.