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Ecchymosis and Petechiation: Clinical Assessment of Bruising in Small Animals
Bruising, clinically categorized as petechiae or ecchymosis, often indicates underlying hematologic dysfunction, vascular disorders, or trauma. This article provides a systematic approach to differentiating between coagulopathies and vasculopathies in veterinary patients.
Clinical summary
- Clinical signs
- Petechiae (pinpoint hemorrhages on mucosa/skin), ecchymosis (larger subcutaneous bruising), epistaxis, hematuria, melena, and lethargy.
- Possible causes
- Primary causes include thrombocytopenia (e.g., IMT), von Willebrand disease, rodenticide toxicosis, disseminated intravascular coagulation (DIC), and vasculitis secondary to infectious agents like Rickettsia rickettsii.
- Diagnostic approach
- Minimum database includes CBC with platelet count, blood smear evaluation for platelet clumping, PT/PTT (coagulation panel), and BMBT (buccal mucosal bleeding time) for suspected vWD.
- Management
- Treatment is etiology-specific. Includes blood product transfusion (plasma/whole blood) for coagulopathies, immunosuppressive therapy for IMT, and targeted antidotes for toxicosis (e.g., Vitamin K1 for anticoagulant rodenticides).
References
- [1]Brooks, M. B.. Coagulation Disorders (2020)
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