Bruising and Bleeding in Cats
Dr. Bari Spielman
Complete medical history (including travel history, toxin exposure, housing and environment) and thorough physical examination
There are many tests that may be recommended for the patient with abnormal bruising or bleeding. The following is a list of the tests that are often performed initially:
A complete blood count (CBC) to evaluate for the presence of systemic infection or inflammation. This test may reveal anemia secondary to bleeding, and may show changes in other cell lines such as the white blood count that might be indicative of other or concurrent disorders.
Platelet count to accurately count the number of circulating platelets
A biochemical profile to evaluate kidney and liver function, electrolytes (such as potassium and calcium), total protein, and blood sugar. The biochemistry profile is very helpful in identifying potential underlying causes of the bruising and bleeding.
A urinalysis to evaluate the kidneys, hydration status of the patient, and confirm the presence of blood
Thoracic (chest) and abdominal radiographs (x-rays). Although they may be within normal limits, x-rays may reveal evidence of lymphadenopathy (enlarged lymph nodes), liver and/or splenic enlargement, bleeding into the chest and abdomen, etc. In addition, x-rays are helpful to rule out other diseases that cause similar clinical signs (such as weakness, pallor, lethargy, difficulty breathing, abdominal distention, etc.).
Fecal tests for blood and parasites
Coagulation (clotting) studies to measure the time in which it takes blood to clot. A number of tests are available to assess blood clotting and 2 – 3 tests are often run at the same time.
Serologic tests to detect infectious diseases that can affect clotting, especially tick titers in dogs
Abdominal ultrasonography to evaluate the abdominal organs, including the liver, kidneys, lymph nodes and spleen
A blood pressure test to detect hypertension
A bone marrow aspirate in the patient with unexplained thrombocytopenia, alterations in white blood cells, or persistent anemia.
Von Willebrand's factor assay to measure the amount of this factor in the blood
Measurement of other clotting factors in the blood
Depending upon the animal's clinical signs and the results of the above tests, your veterinarian may recommend additional tests to insure optimal medical care. These ancillary tests are selected on a case-by-case basis, and include the following:
Endocrine testing and assays of certain hormones
Protein electrophoresis for animals with abnormally high circulating protein levels
Platelet function tests, which must often be sent to very specialized laboratories
Cytologic examination of any abnormal body fluids
Bacterial culture of abnormal body fluids, blood, or bone marrow for some suspected bacterial infections
Biopsy of any abnormal tissues, organs, or masses
As a diagnostic work-up is progressing treatment of serious bleeding and clinical signs may be needed. Supportive care of seriously ill animals usually requires hospitalization and may involve the following:
Intravenous fluids and treatment of shock if present
Transfusions with blood or other blood products
Confinement in a small, soft-padded area to minimize movement and trauma
Protective/adsorbant medications to coat and protect the lining of the gastrointestinal tract
Antibiotics for fevers or suspected infections
Supportive and nonspecific therapies are not a substitute for definitive treatment of the underlying disease responsible for your pet's condition. It is important to determine any underlying or contributing causes and to address those specifically. For example:
Discontinue any medications that may cause bleeding or bruising.
Begin corticosteroids for immune-mediated diseases.
Institute Vitamin K therapy for clotting disorders associated with rodenticide toxicity and severe liver disease.
Begin antibiotics for any rickettsial diseases or known bacterial infections.
Remove or treat any contributing cancers or tumors.
Return hormone levels to normal.
Start specific treatments for heartworm disease, kidney disease, liver disease and any identified blood parasites.
Begin treatment for DIC if it is diagnosed.