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Bone Marrow Biopsy in Cats
What is Bone Marrow Biopsy?
The bone marrow is responsible for producing cell lines vital to life including red blood cells, white cells, and platelets. Conditions resulting in severe anemia (lack of red blood cells), or abnormal white cell or platelet readings may need a bone marrow biopsy in order to identify the root cause. Biopsy is a diagnostic tool which enables the clinician to reach a diagnosis and start appropriate treatment.
Bone marrow biopsy may be undertaken in first opinion practice, when the clinician feels confident to do so, or at a referral center. The procedure can often be undertaken under sedation and local anesthetic, with the patient feeling no more than a momentary discomfort.
Bone Marrow Biopsy Procedure in Cats
The patient will already have had diagnostic tests such as blood samples and an analysis of fresh blood smears. It is entirely appropriate to first screen the cat for problems outside of the bone marrow which can affect cell line production. Thus ultrasound or radiographic imaging of the chest and abdomen may have already been performed and found normal.
There are three locations to choose from to harvest the sample. The cat is sedated and the fur clipped over one of the collection sites:
- The wing of the ilium on the pelvis
- The greater trochanter of the femur (thigh bone)
- The proximal humerus
Local anesthetic is injected into the skin and the membrane (periosteum) overlying the bone. A scalpel is used to make a small stab incision in the skin. A bone marrow biopsy needle is placed on a bony landmark and, with a twisting pushing motion, pushed through the bone into the marrow.
Different techniques are used depending on the type of biopsy needle used. One method involves collecting a 'plug' of marrow in the needle, which is then withdrawn and the plug spread over a microscope slide. Alternatively, a small volume of fluid is injected into the marrow cavity and the resulting mix sucked back into a syringe, and then smeared on a slide.
The biopsy tool is removed from the site and a single suture placed over the stab incision. The slides are sent to a laboratory where a histologist examines the types of cells present.
Efficacy of Bone Marrow Biopsy in Cats
Bone marrow biopsy is a diagnostic tool used to identify the nature of the underlying bone marrow problem. It is not a treatment in itself, but a means to give the clinician the information necessary to decide on a course of treatment.
The information gained by examining the bone marrow cannot be obtained in other ways. In those cases where a bone marrow biopsy is indicated, the only options are to either perform a bone marrow biopsy or go without the information it would give.
It should be said that bone marrow biopsy is a targeted test, which is only performed when the results of other investigations point strongly to bone marrow disease.
Bone Marrow Biopsy Recovery in Cats
The collection of bone marrow is considered a minor procedure and in good natured cats is often performed under sedation and local anesthetic. This means there is relatively little for the cat to recover from, except to fully wake from the sedation. The single suture placed in the skin is usually removed after 10 to 14 days.
Once harvested, the sample is sent away and the results may not be known for several days. This means that targeted treatment may not start immediately, but is held pending the histology results.
Cost of Bone Marrow Biopsy in Cats
The typical cost of a bone marrow biopsy or aspirate, including sedation, taking the sample, and submitting it to a histologist is around $500.
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Cat Bone Marrow Biopsy Considerations
Bone marrow biopsy is a relatively low risk procedure. It is not usually associated with a high degree of hemorrhage, so unless the patient is known to have a bleeding disorder, then it is considered relatively complication free.
The biggest factor to consider is that diagnostic samples are not always obtained. This can be down to the nature of the bone marrow disease or the sampling technique. For example, some types of bone marrow fibrosis (where active marrow is replaced by inactive scar tissue) exfoliates cells poorly, which means that cells do not yield up to the sampling. Alternatively hemodilution can occur, where blood accidentally contaminates the sample and makes it harder to interpret.
The chances of using a negative sample can be reduced by staining the slide in-house, and checking for good cellularity before submitting it to the histologist. This then offers the opportunity to take a second sample should the first one be inadequate.
Bone Marrow Biopsy Prevention in Cats
With the exception of bone marrow suppression as a result of exogenous estrogen administration, the majority of causes of bone marrow suppression are not predictable or preventable.
Bone Marrow Biopsy Questions and Advice from Veterinary Professionals
Domestic long hair
Fifteen Months
3 found this helpful
3 found this helpful
My pet has the following symptoms:
Lethargy
My kitten was lethargic so took him to vet and all vitals came back normal. Cbc came back with red blood cells at 14 so he was transferred to specialty vet. A couple hours later his red blood cells fell to 9 so he had a blood transfusion. After the transfusion we put him on doxycycline and prednisone and his red blood cells were at 21. A cbc the following week showed them at 23. The week after, at 20. The diagnosis is nonregenerative anemia and further blood tests show no parasitic infection. specialty vet is recommending bone marrow aspiration and cytology-is cancer only thing it will find?
Aug. 20, 2020
Answered by Dr. Sara O. DVM
3 Recommendations
Hello, Cancer is one of the main things that a bone marrow aspirate is used for but there are other issues that may be causing these issues. Did you vet check for FELV and FIV? This is a very easy blood test that may be the cause of his non-regenerative anemia. Good Luck with your kitten. I hope he starts to feel better soon.
Aug. 22, 2020
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Domestic long hair
Fifteen Months
1 found this helpful
1 found this helpful
My pet has the following symptoms:
Lethargy
My kitten was lethargic so took him to vet and all vitals came back normal. Cbc came back with red blood cells at 14 so he was transferred to specialty vet. A couple hours later his red blood cells fell to 9 so he had a blood transfusion. After the transfusion we put him on doxycycline and prednisone and his red blood cells were at 21. A cbc the following week showed them at 23. The week after, at 20. The diagnosis is nonregenerative anemia and further blood tests show no parasitic infection. specialty vet is recommending bone marrow aspiration and cytology-is cancer only thing it will find?
Aug. 20, 2020
Answered by Dr. Sara O. DVM
1 Recommendations
Hello, Cancer is one of the main things that a bone marrow aspirate is used for but there are other issues that may be causing these issues. Did you vet check for FELV and FIV? This is a very easy blood test that may be the cause of his non-regenerative anemia. Good Luck with your kitten. I hope he starts to feel better soon.
Aug. 22, 2020
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Domestic -part Siamese, part Ragdoll
Morphs
4 Years
2 found this helpful
2 found this helpful
My pet has the following symptoms:
Lethargy
Very Low Red Blood Cell Count
Non-Regenerative Anaemia
Haematuria
Bacterial Uti
Morphs, a healthy up to now cat, was showing peeing out of the litter box behavior and at some point showed started losing significant amounts of blood in his urine. He was checked for urinary crystals and was found negative, he was taking some soft antibiotics. Then he got tachypnea, lethargy (coming and going, according to the RBC "loss") and a 6% drop in HCT within a week, as he was undergoing various tests for infectious diseases. His HCT stabilized for 5 days at 10%, a point where he got a blood transfusion (+3%). The blood in the pee has continued all this time, his urine culture showed a nasty bacterial infection resistant to a lot of antibiotics, so he started being treated for that and he also gets cortisone. Because he showed kidney damage/inflammation (which could have been chronic), he was also erythropoietin injected, showing very little response to that so far. His HCT after 6 days of blood transfusion fell back to 10%. Would all that be a strong indication towards a bone marrow biopsy?
Aug. 21, 2018
Answered by Dr. Michele K. DVM
2 Recommendations
If Morphs truly has a non-regenerative anemia supported by a reticulocyte count, then a bone marrow biopsy would be the next logical test, yes. I hope that all goes well for him!
Aug. 21, 2018
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tabby
Orion
6 Years
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Hair Loss
Increased Appetite
Urinating Outside Litterbox
Excessive Drinking
Bald Spots
Open Sores
Weight Loss,
Constant Howling And Screaming
Excessive Urine Output
I am trying to determine possible diagnoses for my cat, he lost a bunch of weight and muscle mass after i moved last year, he is still food obsessed and drinks A LOT of water but has started peeing outside the litter box. He pees excessively now. He pees all over the floor or in any food dish i give him. He already had skin and allergy issues causing him to lick bald spots but now he has more than ever. He had a seizure when he was a kitten and was oxygen deprived and has had cognitive issues since then. He yells and meows ALL THE TIME. He steals food, including eating an entire unopened stick of butter than he then practically inhaled. The vet thought it was a viral infection or bone cancer based on his blood work a few months ago but after taking the medicine for a viral infection he hasn't gotten any better. I have him on some steroids for potential bone cancer but he has gotten a lot worse, lost more weight and now has more open sores between his mouth and nose.
June 11, 2018
0 Recommendations
There are many possible causes for the symptoms presented with which may include infection, hormonal conditions, cancer, autoimmune diseases, kidney failure (would have been easily flagged on blood tests) among other causes; it can be difficult to narrow in on a diagnosis, I cannot think of a specific cause based on the information presented in the question. If your Veterinarian is able to narrow in on a specific cause, it may be worth visiting a Specialist. Regards Dr Callum Turner DVM
June 12, 2018
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