Page 2706 - Cote clinical veterinary advisor dogs and cats 4th

1403.e2 Bleeding Patient: Initial Approach

Bleeding Patient: Initial Approach
VetBooks.ir Bleeding dog or cat

• Obtain (at minimum) PCV + TS
• Provide volume support or
transfusion if needed

Has there been trauma or is there evidence of local
No Yes
disease at the site of bleeding (e.g., abdominal
mass in association with hemoabdomen)?
Assess and address Inspect site:
abnormalities: • Visual Consider lack of Consider
• Hemostasis • Ultrasound vascular integrity hyperfibrinolysis
Platelet count • Radiograph

BMBT • Aspirate cavity (if suspected or

confirmed,
von Willebrand

aminocaproic acid
• PT or tranexamic acid
• PTT (or ACT for indicated)
rapid evaluation)
• TEG
Apply pressure No response Explore site and
if indicated ligate as needed
ACT, Activated clotting time; BMBT, buccal mucosal bleeding time; FDP, fibrin(ogen) degradation products;
PCV, packed cell volume; PT, prothrombin time; PTT, partial thromboplastin time; TEG, thromboelastography; TS, total solids.
(Modified from Slatter DH: Textbook of small animal surgery, ed 3, St. Louis, 2003, Saunders.)

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