Appendix 2. Blood collection sites
Timothy Portas
| Venipuncture site | Comment |
| Short-beaked echidna (Tachyglossus aculeatus)T3 | |
| Venous sinus of the dorsal beak* | In all but the sickest animals, chemical restraint is required; use small-gauge needles and/or butterfly needles to prevent laceration of the skin; maximal blood volume occurs in the sinus bulge located immediately caudal to the nares; the needle is inserted midline in a rostrocaudal direction |
| Jugular vein | Requires dorsal recumbency and access is challenging because of the short neck |
| Cephalic and femoral veins | |
| Platypus (Ornithorhynchus anatinus)4~6 | |
| Venous sinus of the dorsal bill* | Chemical restraint is usually required; use small-gauge needles and/or butterfly needles to prevent laceration of the skin; the sinus runs transversely across the rostral aspect of the bill; the needle is inserted into the rostral edge of the upper bill just off the midline to a depth just beyond the bevel of the needle |
| Jugular vein | Access complicated by loose skin of neck |
| Femoral artery | |
| Macropods3,7,8 | |
| Lateral tail vein* | Located at the base of the tail at the mid-point of the lateral aspect; venipuncture possible in the conscious animal restrained within a bag with tail exposed |
| Recurrent tarsal vein | Large, branched vein that runs caudodorsally across the lateral aspect of the proximal tibia; sedation or anaesthesia required |
| Jugular vein | Sedation or anaesthesia required; short neck can make access challenging in smaller species |
| Cephalic vein | Visible on the dorsal aspect of the antebrachium; sedation or anaesthesia required |
| Femoral vein | Sedation or anaesthesia required |
| Medial saphenous artery | Accessed on the distal dorsomedial tibia; sedation or anaesthesia required |
| Brachiocephalic/subclavian vein | Useful in potoroids if larger blood volumes are required (L Vogelnest pers. comm.) |
| Koala (Phascolarctos cinereus)3 | 9 |
| Cephalic vein* | Visible on the dorsal aspect of the antebrachium; cephalic vein can be used in unrestrained or resting koalas or physically restrained kolas; butterfly needles facilitate collection |
| Tibial vein | Runs vertically down the caudal aspect of the tibia; collection of blood with conscious koala restrained in a bag with the hindlimb exposed is possible |
| Jugular, femoral veins | Sedation or anaesthesia required |
| Wombats3,8,10 | |
| Blood collection usually requires sedation or anaesthesia. Thick skin can make visualisation and palpation of the veins difficult. Veins are most easily accessed after clipping fur and use of digital pressure or tourniquet. | |
| Radial vein* | Located on the medial aspect of the forelimb, less mobile and more medial than the cephalic vein, both of which are often located more medial than in other species |
| Venipuncture site | Comment |
| Femoral vein | Accessed close to inguinal triangle, just caudal to the palpable femoral pulse. Large volumes may be drawn quickly from this site |
| Cephalic, brachial, auricular, medial metatarsal, caudal tibial and jugular veins | |
| Large possums and gliders3,8,11 | |
| Jugular vein* | Place in dorsal recumbency; occlude jugular at the level of the thoracic inlet |
| Lateral tail vein | Application of a tourniquet to tail base helps occlude and distend vein |
| Ventral tail vein | Located in the ventral midline of the tail; the needle is inserted perpendicular to the skin close to the tail base until bone is encountered and withdrawn slowly applying negative pressure |
| Femoral vein | Venipuncture location is identified by palpation of the femoral arterial pulse in the inguinal region; a needle is inserted at a 45° angle immediately caudal to the femoral artery; arterial puncture is common and may result in significant haematoma formation |
| Lateral saphenous vein | Lateral aspect of the tibia just proximal to the tarsal joint |
| Brachiocephalic/subclavian vein | Useful in gliders where larger blood volumes are required (L Vogelnest pers. comm.) |
| Pygmy possums and small gliders3,11,12 | |
| Ventral tail vein* | Located in the ventral midline of the tail; the needle is inserted perpendicular to the skin close to the tail base until bone is encountered and withdrawn slowly applying negative pressure |
| Tibial artery | Located superficially on the medial aspect of the stifle; use insulin syringes with 27-29G needles |
| Lateral tail vein | |
| Dasyurids3,8,13 | |
| Jugular vein* | Blood collection is facilitated by placing the animal in dorsal recumbency with the neck extended; occlude jugular at the level of the thoracic inlet; in larger species access is easy at the thoracic inlet using an almost perpendicular approach |
| Femoral vein* | Venipuncture location is identified by palpation of the femoral arterial pulse in the inguinal region; a needle is inserted at a 45° angle immediately caudal to the femoral artery; arterial puncture is common and may result in significant haematoma formation |
| Median metatarsal vein | Small vein running along the medial aspect of the hindlimb |
| Lateral saphenous vein | Lateral aspect of the tibia just proximal to the tarsal joint |
| Retro-orbital venous sinus (dunnarts [Sminthopsis spp.], antechinus [Antechinus spp.], red-tailed phascogale [Phascogale calura] and kowari [Dasyuroides byrnei]) | Collection via microhaematocrit tube inserted under the globe via the medial canthus; not recommended as may result in haematoma formation and optic nerve damage |
| Numbat (Myrmecobius fasciatus)14 | |
| Even in anaesthetised animals blood collection is difficult because of the thick skin, lack of visible vessels and poor blood flow. | |
| Brachiocephalic vein* | Site for brachiocephalic venipuncture lies at the point where the vein emerges from the thoracic inlet; with the animal in dorsal recumbency, and forearms positioned alongside the body a 23-25G, 16-19-mm needle is introduced perpendicular to the skin, either just cranial or just caudal to the clavicle, into the deep notch palpable at the medial extremity of the clavicle adjacent to the sternum; while applying suction, the needle is advanced slowly until it enters the vein and blood appears in the syringe; if no blood appears, suction should be maintained while slowly withdrawing the needle as the vein can often be entered on withdrawal if it is missed when advancing the needle; the large sternal gland in males, particularly during the breeding season, limits access to landmarks |
| Venipuncture site | Comment |
| Jugular and femoral vein | |
| Bandicoots and greater bilby (Macrotis Iagotis)3'8,15 | |
| Femoral vein* | The skin in the inguinal area of many species allows for visualisation of the femoral vein running parallel and caudal to the femoral artery; arterial puncture is common and may result in significant haematoma formation |
| Jugular vein | Place in dorsal recumbency; occlude jugular at the level of the thoracic inlet |
| Lateral tail vein | Only in species with a substantial tail |
| Cephalic and lateral saphenous vein* | In the greater bilby the lateral saphenous vein is the preferred site for blood collection (L Vogelnest pers. comm.) |
| Dingo (Canis familiaris)16 | |
| Jugular, cephalic, saphenous veins | Approach as for the domestic dog (Canis familiaris) |
| Flying-foxes (Pteropus spp.)17,18 | |
| Propatagial (cephalic) vein* | Located on leading edge of the propatagium; use 25G needles and 1-mL syringes; the flying-fox is positioned in dorsal recumbency and the vein accessed on the medial aspect of the wing; the phlebotomist holds the wing in full extension with the non-dominant hand and holds the needle and syringe in the other; an assistant occludes the vein proximal to the phlebotomy site |
| Medial artery or vein | Located on the medial aspect of the distal humerus; the flying-fox is positioned in dorsal recumbency and the elbow joint is angled at 90° while the biceps is rotated laterally to compress the medial vein |
| Jugular vein | The flying-fox is positioned in dorsal recumbency and the jugular vein occluded at the thoracic inlet |
| Microbats17,18 | |
| Located on leading edge of the propatagium; suitable for vessel puncture and collection of blood droplets into microhaematocrit tubes in small species | |
| Uropatagial (interfemoral) vein | Located medial to the femur in the uropatagium; visible across the posterior aspect of the hindfoot; heat packs can be applied to assist in venous dilation |
| Medial vein | Located on the medial aspect of the humerus |
| Rodents3,19,20 | |
| Femoral vein* | Venipuncture location is identified by palpation of the femoral arterial pulse in the inguinal region; a needle is inserted at a 45° angle immediately caudal to the femoral artery; arterial puncture is common and may result in significant haematoma formation |
| Brachiocephalic/subclavian vein | The site for brachiocephalic/subclavian venipuncture lies at the point where the vein emerges from the thoracic inlet; the animal is positioned in dorsal recumbency, with its forearm positioned alongside the body; a pulse is detected visually at either the left or right thoracic inlet; a 26G, 16-19mm needle is introduced at the site where the pulse is visualised, with the needle directed caudally and at a 45° angle to the skin; while applying suction, the needle is advanced slowly until it enters the vein and blood appears in the syringe; if no blood appears, suction should be maintained while slowly withdrawing the needle, as the vein will often be entered on withdrawal (L Vogelnest pers. comm.) |
| Ventral tail, femoral and lateral saphenous veins | |
| Otariids21,22 | |
| Caudal gluteal vein* | Located deep within gluteal muscles running caudally lateral to the sacrum; the animal is restrained in sternal recumbency with the hind flippers spread; a needle is inserted perpendicularly, approximately one-third of the distance from the femoral trochanter to the base of the tail, just lateral to the sacral vertebrae; a 20-22G, 2.5-cm needle is used in animals <25 kg, an 18-20G, 3.8-cm needle is used in animals 25-100 kg, with longer needles required for larger animals |
| Venipuncture site | Comment |
| Dorsal interdigital veins of hind flippers* | Located parallel to the phalanges on the dorsal surface of the flipper; application of a tourniquet around the base of the hind flipper and warming of the flipper can improve visualisation; a heparinised butterfly catheter can aid blood collection as the veins are small and blood flow is slow |
| Brachial vein | Located on the medial aspect of the fore flipper in the loose tissue on the trailing edge of the flipper between the elbow and carpus; rolling the animal onto its side or back and placing the flipper perpendicular to the body facilitates access |
| Jugular vein | Located in the jugular groove in the mid-cervical region on a line running between the commissures of the lips and the point of the shoulder; requires dorsal recumbency under anaesthesia, ultrasound guidance useful as generally not palpable or visible and the jugular is small compared with other species |
| Dorsal interdigital veins of hind flippers | Located parallel to the phalanges just proximal to the origin of the interdigital webbing on the dorsal surface; more often than not the vessel is not palpable and a blind approach is made |
| Subclavian vein | Not recommended except for emergencies |
| Phocids21-23 | |
| Intervertebral extradural sinus* | Located dorsal to spinal cord within the vertebral canal; the seal is placed in sternal recumbency and an intervertebral space is located by palpating along the dorsal midline of the caudal lumbar vertebrae (L3- L5); a needle is inserted perpendicularly between spinous processes into the intervertebral space until blood is observed in the hub |
| Plantar interdigital veins of hind flippers | Located parallel to the phalanges just proximal to the origin of the interdigital webbing on the dorsal surface; a 20-21G, 2.5-3.8-cm needle is inserted at a 10-20° angle to the skin over the second digit or medial to the fourth digit at the origin of the interdigital webbing |
| Cetaceans22,24-26 | |
| Dorsal and ventral fluke periarterial vascular rete* | Located in grooves parallel to the leading edge of the tail fluke near the midline on the fluke's dorsal and ventral surfaces; use 19-23G, 2-4-cm needles; the needle is inserted perpendicularly or at a slight angle into the vessels; blood may be venous or arterial-venous admixture |
| Dorsal fin periarterial vascular rete | Access challenging in smaller cetaceans; blood may be venous or arterial-venous admixture |
| Superficial caudal peduncle periarterial vascular rete | Located on ventral aspect of terminal vertebral bodies; use 18-21G, 2-4-cm needles; best site for collection of arterial blood samples; ultrasound guidance improves access (see Fig. 45.5) |
| Haemal arch/caudal vascular bundle | Runs along ventral midline of caudal vertebral bodies within an arch formed by chevron bones; 9 cm spinal needles required; transverse approach into the ventral intervertebral space in mid- to caudal peduncle |
| Common brachiocephalic vein | Ultrasound guidance improves access; 14G, 16-cm needles used in dolphins; right lateral recumbency preferred |
| Dugong (Dugong dugon)27 | |
| Tail fluke veins | Neonates only, veins run parallel to leading edge of fluke and located within fibrous connective tissue; using a needle slightly longer than half the maximum thickness of the tail fluke (e.g. 23G, 19-mm winged infusion set) the needle is inserted perpendicular to the skin, slowly advanced to its full length and then withdrawn until blood is seen |
| Pectoral flipper brachial arteriovenous plexus* | Located in the interosseous space between radius and ulna; use 18-21G, 38-mm needles; the pectoral flipper is pulled away from the trunk of the body; using a medial approach the needle is inserted obliquely into the interosseous space between the radius and ulna in the lower one-third of the antebrachium (see Fig. 46.3). |
*Indicates preferred site for blood collection
1Middleton (2008); 2Johnston etal. (2006); 3Clark (2004); 4Holz (2014a); 5Booth (1994); 6Booth and Connolly (2008); 7Vogelnest and Portas (2008); 8Holz (2014b); 9Blanshard and Bodley (2008); 10Bryant and Reiss (2008); 11Johnson and Hemsley (2008); 12Booth (1999); 13Holz (2008); 14Vitali and Monaghan (2008); 15Lynch (2008); 16Hulst (2008); 17Heard (2014a); 18Olsson and Woods (2008); 19Breed and Eden (2008); 20Heard (2014b); 21Barnes etal.
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