One of the problems that may be seen in veterinary medicine is an animal with epistaxis. There are many diseases that can cause epistaxis, ranging from a space occupying lesion within the nasal cavity, to a systemic coagulopathy. However, the differential list can be narrowed and the inciting cause can be found by taking a thorough history, a good physical exam, and by using the appropriate diagnostic tools. "Marley" McKelvy was a 7 year old, male, intact white German Shepherd dog. He presented to the Cornell University Small Animal Emergency Service on 4/19/05 with the chief complaint of epistaxis and dyspnea. In early February of that year, Marley became inappetant and lethargic, and also began coughing and sneezing. He was brought to his referring veterinarian who took some thoracic radiographs, which were unremarkable. While he was there, a tracheal wash was performed and bacterial and fungal cultures were submitted. The cultures were all negative for bacteria and fungi. A few months later, on 4/16/05, Marley developed unilateral mucohemorrhagic discharge from his right nostril. The next day, a painful lump was found on the bridge of his nose between and slightly below his eyes. After that day, the nasal discharge became thicker and more hemorrhagic. Marley was prescribed Acepromazine to lower his blood pressure and to slow the amount of epistaxis, but no change in the discharge was seen. At this point, he was referred to Cornell for further assessment.