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Elizabeth Rozanski, DACVIM (Small Animal) & DACVECC, is associate professor of emergency and critical care medicine at Tufts University. Her area of interest is respiratory disease. A graduate of University of Illinois, Dr. Rozanski completed her internship at University of Minnesota and her residency in emergency and critical care medicine at University of Pennsylvania.
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Evaluation of mucous membranes—including assessment of color, capillary refill time, and degree of moisture—can help provide vital insights when assessing and diagnosing patients. The author most frequently evaluates the oral mucous membranes, although the conjunctiva and the vulva or prepuce may also be evaluated.
In the author’s experience, mucous membrane color may vary among patients, as some canine breeds such as Weimaraners and red Doberman pinschers have naturally pinker membranes. In addition, some drugs (eg, dexmedetomidine) may alter membrane color.1 Cats have much smaller mouths than do dogs, and interpretation of mucous membrane color may be more challenging than with canine patients.
Prompt and markedly delayed capillary refill time are associated with vasodilation (and/or hyperdynamic shock) and vasoconstriction, respectively.2,3 Patients, particularly dogs, may develop vasodilation associated with early shock (eg, sepsis) or heatstroke, which results in mucous membranes appearing brick red in color.3 Conversely, patients in more advanced states of shock will have pale mucous membranes associated with cool extremities that reflect vasoconstriction.3 Critically ill patients may progress from hyperdynamic to hypodynamic shock if illness advances.3 Oral diseases (eg, dental disease) or oral foreign bodies (eg, quills, foxtails) may also result in abnormal oral mucous membrane appearance.3
The following images of mucous membranes in dogs illustrate various diseases and conditions. Match each image with the correct corresponding item.
Which answer best matches the image?
Methemoglobinemia
Ptyalism
Brick red mucous membranes
The correct answer is Ptyalism.
A patient demonstrates excessive salivation, which may have been caused by conditions such as nausea, oral pain or irritation, oral foreign bodies, and/or hepatic encephalopathy.
The correct answer is Ptyalism.
A patient demonstrates excessive salivation, which may have been caused by conditions such as nausea, oral pain or irritation, oral foreign bodies, and/or hepatic encephalopathy.
The correct answer is Ptyalism.
A patient demonstrates excessive salivation, which may have been caused by conditions such as nausea, oral pain or irritation, oral foreign bodies, and/or hepatic encephalopathy.
Which answer best matches the image?
Icteric mucous membranes
Methemoglobinemia
Severe dental disease
The correct answer is icteric mucous membranes.
The mucous membranes are yellow, which is consistent with icterus and supports a suspicion of hyperbilirubinemia. Elevations in bilirubin often indicate hepatic disease, hemolysis, or posthepatic obstruction.
The correct answer is icteric mucous membranes.
The mucous membranes are yellow, which is consistent with icterus and supports a suspicion of hyperbilirubinemia. Elevations in bilirubin often indicate hepatic disease, hemolysis, or posthepatic obstruction.
The correct answer is icteric mucous membranes.
The mucous membranes are yellow, which is consistent with icterus and supports a suspicion of hyperbilirubinemia. Elevations in bilirubin often indicate hepatic disease, hemolysis, or posthepatic obstruction.
Which answer best matches the image?
Methemoglobinemia
Severe dental disease
Icteric mucous membranes
The correct answer is methemoglobinemia.
The mucous membranes demonstrate dusky-blue severe methemoglobinemia, which, in this case, was associated with consumption of a bottle of acetaminophen.
The correct answer is methemoglobinemia.
The mucous membranes demonstrate dusky-blue severe methemoglobinemia, which, in this case, was associated with consumption of a bottle of acetaminophen.
The correct answer is methemoglobinemia.
The mucous membranes demonstrate dusky-blue severe methemoglobinemia, which, in this case, was associated with consumption of a bottle of acetaminophen.
Which answer best matches the image?
Ptyalism
Brick red mucous membranes
Severe dental disease
The correct answer is severe dental disease.
Red and/or injected mucous membranes may occur secondary to local inflammation caused by severe gingivitis. Presence and severity of dental disease should always be considered when evaluating the mucous membranes.
The correct answer is severe dental disease.
Red and/or injected mucous membranes may occur secondary to local inflammation caused by severe gingivitis. Presence and severity of dental disease should always be considered when evaluating the mucous membranes.
The correct answer is severe dental disease.
Red and/or injected mucous membranes may occur secondary to local inflammation caused by severe gingivitis. Presence and severity of dental disease should always be considered when evaluating the mucous membranes.
Which answer best matches the image?
Methemoglobinemia
Pale and icteric mucous membranes
Cyanosis
The correct answer is pale and icteric mucous membranes.
The mucous membranes are pale with an underlying tint of yellow (ie, icterus), which is consistent with hemolysis.
The correct answer is pale and icteric mucous membranes.
The mucous membranes are pale with an underlying tint of yellow (ie, icterus), which is consistent with hemolysis.
The correct answer is pale and icteric mucous membranes.
The mucous membranes are pale with an underlying tint of yellow (ie, icterus), which is consistent with hemolysis.
Which answer best matches the image?
Brick red mucous membranes
Methemoglobinemia
Ptyalism
The correct answer is brick red mucous membranes.
The mucous membranes are consistent with vasodilation during a hyperdynamic phase of shock, which may occur secondary to sepsis or heatstroke.
The correct answer is brick red mucous membranes.
The mucous membranes are consistent with vasodilation during a hyperdynamic phase of shock, which may occur secondary to sepsis or heatstroke.
The correct answer is brick red mucous membranes.
The mucous membranes are consistent with vasodilation during a hyperdynamic phase of shock, which may occur secondary to sepsis or heatstroke.
Which answer best matches the image?
Icteric mucous membranes
Methemoglobinemia
Cyanosis
The correct answer is cyanosis.
A blue discoloration of the mucous membranes supports suspicion of low oxygen levels; however, low oxygen levels can only be detected via mucous membrane evaluation when hypoxia is severe.
The correct answer is cyanosis.
A blue discoloration of the mucous membranes supports suspicion of low oxygen levels; however, low oxygen levels can only be detected via mucous membrane evaluation when hypoxia is severe.
The correct answer is cyanosis.
A blue discoloration of the mucous membranes supports suspicion of low oxygen levels; however, low oxygen levels can only be detected via mucous membrane evaluation when hypoxia is severe.
Which answer best matches the image?
Pigmented mucous membranes
Brick red mucous membranes
Ptyalism
The correct answer is pigmented mucous membranes.
Black mucous membranes may hamper further interpretation of color. Even in patients with primarily pigmented mucous membranes, there is often a spot or area of the mucous membranes that remains pink.
The correct answer is pigmented mucous membranes.
Black mucous membranes may hamper further interpretation of color. Even in patients with primarily pigmented mucous membranes, there is often a spot or area of the mucous membranes that remains pink.
The correct answer is pigmented mucous membranes.
Black mucous membranes may hamper further interpretation of color. Even in patients with primarily pigmented mucous membranes, there is often a spot or area of the mucous membranes that remains pink.
Which answer best matches the image?
Methemoglobinemia
Pale mucous membranes
Icteric mucous membranes
The correct answer is pale mucous membranes.
The mucous membranes are nearly devoid of color. This patient’s hematocrit was 13% (range, 37%-52%).
The correct answer is pale mucous membranes.
The mucous membranes are nearly devoid of color. This patient’s hematocrit was 13% (range, 37%-52%).
The correct answer is pale mucous membranes.
The mucous membranes are nearly devoid of color. This patient’s hematocrit was 13% (range, 37%-52%).
Mucous Membrane Evaluation in Dogs Quiz
Final scoreReferences and Author Information
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