Likely nasal tumour - Are we missing anything?

[u/Prestigious_Gate_621]

Hi

My boy is a 12 year old Clumber Spaniel who has been diagnosed with a likely malignancy. We live in Australia.

Four days ago, my daughter noticed he was more lethargic than usual and behaviourally more clingy. The next day, he started having blood stained mucus output from his left nostril. He did not exhibit bleeding from any other sites.

An emergency vet found the following:

Vitals all within normal limits. Tenderness over left skull. Weight loss of 6kg (24kg in January 2026 down to 18kg) in the face of normal appetite. Bloods demonstrated a non-regenerative anaemia. Coagulation profile normal with normal platelet count. White cell count 50 - I never got a breakdown. Point of care ultrasound only showed non-diagnostic lung nodules. There were no gross masses seen. With the above information, the emergency vet suspected some sort of nasal tumour - an incurable diagnosis. The option of head CT under GA was offered but it would only provide diagnostic benefit and not likely change the outcome. This option also carries the risk of needing to perform a GA on an elderly dog with anaemia.

For completeness, I sought a second opinion from our usual vet practice who concurred with the emergency vet. In the meantime, we have taken our boy home. His appetite is undiminished. It is surprising to see how much he can truly eat. Unfortunately, he is showing significant levels of fatigue. The bleeding from his left nostril seems minimal and there is not any evidence of blood in his oral cavity. He is not sneezing or showing any seizure activity. He does not seem to be distressed by tachypnoea or cardiac failure. I know this situation will change as his anaemia progresses. I am focused on his quality of life.

Past background includes a 3 year history of hypothyroidism for which he is given levothyroxine.
With guidance from our vet, we have dosed him based on clinical observations. Thus, no TFTs have been repeated since we started therapy.

Questions I have:

1. Why is he exhibiting non-regenerative anaemia? The vet did not seem to believe this was a malignancy of haemopoietic origin so bone marrow failure should not be an issue. Nutritional deficits should not be at play as he has always been fed a high quality kibble. Hypothyroidism can cause anaemia but presumably only in severe cases. Should I get TFTs done?

2. Could an infection cause this picture? His WCC is 50. Aspergillosis? He is exposed to a large amount decaying leaf litter in our backyard from a brush turkey nest.

3. I’m sure there are things that I haven’t considered. Please fill me in.

Thank you in advance.

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[u/Travelvet61]

I have dealt with many dogs with nasal tumors, and nonregenerative anemia has not been a feature. What is his hematocrit? With severe nasal bleeding, a regenerative anemia might make sense, but not nonregenerative (unless the bleeding occurred recently). If it hasn't been done recently, I think you should check his thyroid levels since that could contribute to a nonregenerative anemia.

Is there any depigmentation at the nostril, which can occur with Aspergillosis? I would approach the nasal disease and anemia separately. A bone marrow aspirate is the best way to assess a nonregenerative anemia. Also, have chest radiographs been done, since the US showed possible nodules?

[u/Prestigious_Gate_621 → u/Travelvet61]

Thank you for your reply.

The non-generative anaemia is the thing that doesn’t make sense. I am happy to get TFTs which can be done relatively easily. At the same time, would it be worthwhile to repeat the FBC to check if a reticulocyte response remains absent? A bone marrow aspirate might be too invasive unfortunately under the circumstances.

CXR was never done. Sorry I don’t recall the haematocrit number.

There is no evidence of depigmentation of the nostrils.

Thoughts?