TECHNIQUE

Bone Marrow Aspiration / Biopsy in Rabbits (Disease Investigation & Management - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords
  • Bone marrow collection
Description
Sites 
  • Proximal femur
  • Proximal tibia
  • Proximal humerus
  • Pelvis
  • (B601.2.w2, J213.2.w3, J495.30.w3)
Bone Marrow Aspiration

Bone marrow aspiration is used to collect a sample for cytology. In the following technique, the proximal femur site is used as an example:

  • Restraint:
    • Anaesthetise the animal. (B601.2.w2, J495.30.w3)
  • Preparation:
    • Use aseptic technique. (J213.2.w3, J495.30.w3)
    • Clip the fur over the proximal femur (a minimum area of 5 cm by 5 cm i.e. 2 x 2 inches) and then aseptically prepare the skin with povidone iodine or chlorhexidine. (B601.2.w2, J213.2.w3)
    • Infiltrate 2% lidocaine (lignocaine) into the periosteum and the local tissues. (B601.2.w2, J213.2.w3)
    • Have a suitable sterile needle ready for collecting the bone marrow (e.g. Rosenthal paediatric needle) and a 2.5 or 5.0 ml syringe (ideally the syringe should contain one millilitre of sterile phospate-buffered saline with 0.24% EDTA). (B601.2.w2)
  • Positioning:
    • Femur: Hold the distal femur firmly with one hand and slightly elevate it. With the other hand, position the sterile needle at the trochanteric fossa, between the first and third trochanter. (B601.2.w2, J495.30.w3)
      • Keep the needle at a 45 degree angle to the long axis of the femur. (J495.30.w3)
    • Humerus: grip the humerus with the forefinger on the medial aspect and the distal segment of the bone pushing into the palm. Position the needle over the deltoid tuberosity, as close as possible to the greater tubercle. (J495.30.w3)
  • Technique:
    • Push the needle through the skin. (J495.30.w3)
    • Using a drilling motion, advance the needle into the bone marrow cavity in the direction of the long axis of the bone. Entry into the medullary cavity will be felt by a sudden loss of resistance; there may also be an audible pop. (B601.2.w2, J495.30.w3)
    • Remove the stylet and attach the syringe. (B601.2.w2, J495.30.w3)
    • Partially withdraw the syringe plunger and keep negative pressure until 0.5 ml of bone marrow is collected. (B601.2.w2, J495.30.w3)
      • If no marrow is obtained, try rotating the needle 90 degrees and then re-aspirate. (B601.2.w2, J495.30.w3)
    • Release the negative pressure. (J495.30.w3)
    • Remove the syringe from the needle. (J495.30.w3)
    • Remove the needle from the bone. (J495.30.w3)
      • Take care to maintain the needle's orientation during withdrawal. (J495.30.w3)
    • Depress the syringe plunger, expel the contents onto a microscope slide and "prepare using a crush technique (specific details regarding preferred preparation of samples should be obtained from the laboratory)". (B601.2.w2)
  • Post-procedure:
    • If the rabbit shows signs of pain (e.g. anorexia, favouring the leg, teeth grinding), give appropriate analgesia such as 0.1 - 0.4 mg/kg butorphanol intramuscularly, 0.05 mg/kg buprenorphine intramuscularly or 100 mg/kg aspirin orally. (J213.2.w3)
Bone Marrow Biopsy

Bone marrow biopsy is used to collect a sample for histopathology.

  • Caution: If samples are needed for both cytology and histopathology, obtain the sample for cytology first (via the bone marrow aspiration technique). (B601.2.w2)
  • Restraint / preparation / positioning and technique:
    • as for the bone marrow collection apart from:
      • a 38 millimetre (1.5 inch) 18 gauge needle is used to collect a biopsy rather than the needle and syringe used in bone marrow collection. (B601.2.w2)
      • The biopsy material should be placed in 10% formalin. (B601.2.w2)
Appropriate Use (?)
Indications
  • To identify and stage certain neoplastic diseases. (B601.2.w2)
  • To investigate disorders of the peripheral blood, e.g. anaemia, leucopaenia, thrombocytopaenia, presence of immature or abnormal cells. (B601.2.w2)
  • For culture and sensitivity if infection is suspected.
  • Bone marrow aspirate
    • Used for collecting samples for cytology.
  • Bone marrow biopsy
    • Used for collecting samples for histopathology.
Appropriate restraint
  • Anaesthesia is necessary for this procedure. (B601.2.w2)
Notes
  • Mature noncycling blood cells as well as precursor and mature differentioated myeloid, lymphoid and erythroid cells, and undifferentiated blast cells, will be present in the aspirate. (J495.30.w3)
  • Sterile equipment
    • Needles, syringes etc. must remain sterile during the procedure. 
  • Disposal of used equipment
    • Used disposable equipment needs to be put into the appropriate clinical waste container and needles should be disposed of in a sharps container.
Complications/ Limitations / Risk
  • Failure to obtain a sample during bone marrow aspiration:
    • If no marrow is obtained, try rotating the needle 90 degrees and then re-aspirate. (B601.2.w2)
  • Samples needed for both cytology and histopathology:
    • Obtain the aspirate for cytology first and then take a biopsy sample. (B601.2.w2)
Equipment / Chemicals required and Suppliers
  • Bone marrow aspirate 
    • 2% lidocaine (lignocaine). (B601.2.w2)
    • A suitable sterile needle for collecting the bone marrow (e.g. Rosenthal paediatric needle). (B601.2.w2, J495.30.w3)
    • 18-gauge Rosenthal paediatric biopsy needle suggested. (B461.170.w170)
    • 2.5 or 5.0 mL syringe (ideally the syringe should contain one millilitre of sterile phosphate-buffered saline with 0.24% EDTA as an anticoagulant). (B601.2.w2, J495.30.w3)
      • Locktip syringe. (J495.30.w3)

    • Microscope slides.
  • Bone marrow biopsy
    • A 38 millimetre (1.5 inch) 18 gauge needle is used to collect a biopsy rather than the needle and syringe used in bone marrow collection. (B601.2.w2)
    • Sterile container with 10% formalin for the biopsy. (B601.2.w2)
Expertise level / Ease of Use
  • This procedure should only be carried out by an individual with appropriate clinical training and practical experience.
Cost / Availability
  • Equipment is relatively inexpensive.
  • Cost of equipment for in-house testing
  • Cost of external laboratory fees.
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery." (see: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).
Author Nikki Fox BVSc MRCVS (V.w103)
Referee Debra Bourne MA VetMB PhD MRCVS (V.w5); Frances Harcourt-Brown BVSc FRCVS (V.w140)
References B601.2.w2, J213.2.w3, B461.170.w170, J495.30.w3

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