Bone Marrow Aspiration

and Evaluation
Kristi S. Lively, DVM, DABVP

Purpose of Procedure
Bone marrow aspiration and biopsy are important diagnostic procedures for investigating the cause of an abnormal complete blood
count (CBC), which can occur with many different diseases. Bone
marrow may be adversely affected by many cancers, infections,
and certain abnormalities of cell growth.
These procedures may be recommended when an abnormality
in blood cells is suspected, because evaluation of the bone marrow yields important information about the production and maturation of different blood cell lines. Bone marrow aspiration may
be performed in animals with unexplained anemias, platelet disorders, unexplained low or high white blood cell counts, or abnormal
blood cells (such as leukemia cells) in the circulation, and for the
detection of certain infectious organisms. It may also be done for
staging of certain malignant cancers, such as lymphoma. Staging
is the term used when a search is undertaken to determine which
tissues of the body may contain cancer cells.

Preparation of Animal
Most bone marrow aspirates can be obtained with use of a local
anesthetic and mild sedation. The position of the patient during
the procedure depends on the site being aspirated or biopsied. The
most commonly used sites are the pelvic bone in front of the hip
(ilium), the rear leg bone below the hip joint (femur), and the front
leg bone near the shoulder joint (humerus). Less commonly, a rib
or the sternum (breast bone) may be aspirated.
Hair is shaved from the site, and the skin is scrubbed as for a
sterile procedure. A local anesthetic, such as lidocaine, is injected
into the area to be aspirated so that the site becomes numb, which
minimizes the patients discomfort.

Description of Technique
Once the site has been clipped and prepared, a small incision is
made in the skin. The biopsy needle is advanced through this
incision, through the outer layer of the bone, and into the hollow
marrow cavity in the center of the bone. A sample of marrow is
aspirated into the syringe attached to the bone marrow needle and
submitted for analysis. If a thicker sample is desired, a core biopsy
needle may be used. Core needles retrieve small clumps of material rather than only fluid. Once a good sample has been obtained,
the needle is removed, and the small incision in the skin is sutured,
glued together, or left to heal by itself.
A CBC is often submitted along with the marrow sample to
provide the pathologist with a more complete picture of the clinical
condition.

Potential Complications
Complications from bone marrow aspiration and biopsy are rare
but include reactions to the sedative used and damage to surrounding tissues from passage of the needle. The sciatic nerve in
the hind leg runs close to the site of entry into the bone; temporary paralysis of this nerve can result from the lidocaine injection
or damage from the needle. Bleeding may occur from laceration of adjacent blood vessels. Rarely, with aspiration from a rib
or the sternum, air may be introduced into the chest, causing a
pneumothorax.

Follow-up Care
Recovery from the sedative usually takes only a few hours. If sutures
were placed, they are typically removed in 10-14 days. Results of
the bone marrow analysis are often available in several days.

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Copyright 2011 by Saunders, an imprint of Elsevier Inc. All rights reserved.