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Cyanosis (Blue Coloration) in Dogs

By: Dr. Arnold Plotnick

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Cyanosis is the bluish or purplish discoloration of the mucous membranes or skin due to excessive amounts of desaturated (poorly oxygenated) hemoglobin in the blood stream. Oxygenated blood is red. Poorly oxygenated blood is dark blue. The more deoxygenated hemoglobin in the bloodstream the more bluish coloration will be imparted to the tissues.

There are two general "types" of cyanosis: central and peripheral.

  • Central cyanosis is a result of the entire systemic blood supply being desaturated. Central cyanosis is due to a decrease in oxygenated blood throughout the systemic circulation. All tissues are affected.

  • Peripheral cyanosis is due to desaturated hemoglobin that may be confined to a specific region of the body, for example, if a blood clot has obstructed blood flow to a particular body part or if a tourniquet has been applied. Peripheral cyanosis implies a purplish coloration in the peripheral tissues (oral mucous membranes, vaginal or penile mucous membranes, paw pads or nail beds, etc). All animals with central cyanosis also have peripheral cyanosis, because the entire bloodstream is desaturated. However, it is possible to have peripheral cyanosis without having central cyanosis, if the cause of the decreased oxygenation is localized to a specific region, such as a blood clot that interrupts the blood supply to a specific limb.

    In young animals, the most likely cause is a congenital heart disease where poorly oxygenated blood that is returning to the heart erroneously bypasses the lungs and is sent back out into the systemic circulation without picking up more oxygen. This is called "right-to-left shunting" because poorly oxygenated blood from the right side of the heart is shunted to the left side of the heart where it is pumped out into the general circulation.

    Any age animal can develop cyanosis secondary to severe pulmonary (lung) disease, such as severe pneumonia, or to diseases that prevent the lungs from expanding properly, such as fluid or air in the chest cavity.

    Genetic defects in hemoglobin can alter its ability to carry oxygen, however, these defects are rare in companion animals. Hemoglobin defects are more likely to develop secondary to ingestion of, or exposure to, chemicals and oxidants.

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