Rottweiler with severe bilateral epistaxis

History of Present Illness

A 3-year-old male Rottweiler dog was brought to the clinic by his owner for further evaluation of recent severe epistaxis. He had two severe nasal bleeds and was given whole blood transfusions by the referring DVM. Approximately 6 months ago, the patient had episodes of excessive sneezing that resolved with treatment of corticosteroids and antibiotics. Recently, the sneezing returned, and occasionally blood has sprayed out of the nose during a sneeze.