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1076 Buccal Mucosal Bleeding Time

to obtain BAL fluid, allow slow anesthesia SUGGESTED READING Reproduced from the third edition in modified
recovery, and oxygenate well until recovered. McKiernan B: Bronchoscopy. In McCarthy TC, form.
VetBooks.ir others, begin evaluation with the less affected editor: Veterinary endoscopy for the small animal AUTHOR: Brendan C. McKiernan, DVM, DACVIM
• When one lung lobe is more affected than
veterinary practitioner, St. Louis, 2005, Saunders,
EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
lobes.
pp 201-227.
Thompson, DVM, DABVP

Buccal Mucosal Bleeding Time

Anticipated Time Postprocedure
Difficulty level: ♦♦
A total of 5-10 minutes After the clot has formed and the test is
Synonyms completed, it may be necessary to apply direct
Bleeding time, buccal mucosal bleeding time Preparation: Important pressure as needed if the clot becomes disrupted
(BMBT) Checkpoints and bleeding resumes.
Evaluate platelet count before evaluating BMBT.
Overview and Goal Alternatives and Their
To quickly and easily assess primary hemostasis Possible Complications and Relative Merits
(i.e., evaluate formation of a platelet plug) Common Errors to Avoid Cuticle (“toenail”) bleeding time; less reliable
• Animal may become agitated; use seda- as a measure of primary hemostasis and more
Indications tion as needed to keep animal still for painful to the animal
Presence of mucosal hemorrhage (petechiae/ entire test.
ecchymoses, gingival bleeding, epistaxis, melena, • Do not manually disrupt clot while assessing Pearls
hematuria) in animals with a normal platelet clotting time. • Avoid the temptation to place blotting
count and may be used for assessing primary material directly on the incision.
hemostasis preoperatively Procedure • High interoperator variability limits the
• Place animal in lateral recumbency. accuracy of this test.
Contraindications • Evert upper lip, and secure in everted position
Thrombocytopenia (BMBT is not necessary with muzzle gauze. This allows exposure of SUGGESTED READING
or helpful if platelet count is markedly low) the buccal mucosa and causes the vessels to Couto G: Hemostasis. In Nelson R, et al, editors:
become slightly engorged. Small animal internal medicine, ed 4, St. Louis,
Equipment, Anesthesia • Remove safety catch from template. 2009, Mosby, pp 1245-1246.
• Anesthesia is generally not required in dogs. • Place template firmly on mucosa, and activate Reproduced from the third edition in
• Sedation or general anesthesia is necessary the blade. unabridged form.
in cats. • Begin timing when the incision is made.
• Template bleeding device (device with a • Hold filter paper beneath the incision to AUTHOR: Erika de Papp, DVM, DACVIM
spring-loaded blade that creates a standard absorb blood. EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
incision in the buccal mucosa; 5 mm long • Continue timing until a clot has formed Thompson, DVM, DABVP
and 1 mm wide) and bleeding has ceased.
• Filter paper or gauze for blotting blood • Normal BMBT is ≈3 minutes in cats and
• Muzzle gauze (or equivalent) up to 4 minutes in dogs.
• Stopwatch

A B C
BUCCAL MUCOSAL BLEEDING TIME A, Template device before activation. B, Template bleeding device placed
against buccal mucosa. C, Blotting blood below the incision.

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