Blood loss and anemia

Question 1

When does blood loss occur

Answer 1

The most recognized cause of blood loss is traumatic injury which results in shearing of blood vessels. However, there are many causes of blood loss that owners are unaware of
Inability to clot due to inherited lack/malfunction of platelets, fibrin, clotting factors
Toxins that affect clotting
Certain cancers can damage blood vessels
Iatrogenic loss as a result of surgery or blood collection

Question 2

Immediate response to blood loss

Answer 2

Identify origin of bleeding
Be mindful that you will not see internal bleeding
Apply pressure to where bleeding is originating from
Asses degree of blood loss (conscious, lethargic, pale mm, arrhythmia, weak pulse ← these are signs you need to act fast)
If there is lots of bleeding, place an IV catheter immediately before vessels collapse

Question 3

Clinical signs of blood loss

Answer 3

External blood
Feces with frank blood (hematochezia) or digested blood (melenia)
Vomit with frank blood or “coffee grounds” (hematemesis)
Internal blood loss
Swelling of the abdomen or SQ space
Problems breathing (if pleural or pulmonary bleeding)
Decreasing blood pressure or pulse strength
Pale mucous membranes
Heart murmur

Question 4

Epitaxis

Answer 4

Nose bleed

Question 5

Melena

Answer 5

Digested blood in stool
Usually from the small intestine

Question 6

Hemoptysis

Answer 6

Throwing up blood

Question 7

Hematuria

Answer 7

Blood in urine

Question 8

Hematochezia

Answer 8

Frank blood in stool
Origin is typically the large bowel

Question 9

Anemia

Answer 9

Decrease int he number of RBCs

Question 10

Ischemia

Answer 10

Lack of blood flow to tissues

Question 11

Common causes of anemia

Answer 11

Bone marrow pathology
Iron deficiency
Chronic renal failure
Oxidative injury to RBCs
Infectious anaemia due to parasites or viruses
External and internal blood loss
Immune-mediated

Question 12

What is the function of RBCs

Answer 12

Carry O2 to tissue
Lack of O2→ hypoxia
Remove CO2 from tissues
Build up of CO2→ acidosis

Question 13

Clinical signs of anemai

Answer 13

Pale to white mm
Icterus may be noted if RBCs are being destroyed within the blood vessels
Tachycardia
May be tachypneic
Lethargy, weakness, exercise intolerance

Question 14

Diagnostic test for anemai

Answer 14

Decreased RBCs
Measured as drop in hematocrit (Hct), packed cell volume (PVC)

Question 15

Signs of blood loss seen on diagnostic tests

Answer 15

Decreased RBC
AND decreased platelets, decreased WBCs, decreased serum proteins

Question 16

Treating acute anemia

Answer 16

Acute loss
All of a sudden
Tissue cant adjust
Transfusion if <21%

Question 17

Treating chronic anemia

Answer 17

Chronic loss
Over time
Tissue adapt
Transfusion if PCV <16%
Overall better prognosis

Question 18

Response/treatment to blood loss

Answer 18

Asses for blood loss/anemia
Stop any visible blood loss
Assess degree of blood loss
IV fluids to support BP
Blood transfusion if necessary

Question 19

When to do a blood transfusion

Answer 19

Mild-moderate risk if carried out correctly, potentially lethal if not done correctly
Blood loss
Dramatically improves patients diagnosis
Normal PCV of most species is between 35-50%

Question 20

Blood types are determined by

Answer 20

Determined by proteins on the surface of the animals RBCs
-Blood group antigens
Some antigens stimulate more of an immune response than others
-These are more likely to cause transfusion reactions

Question 21

Alloantibodies care and how to use them for your advantage

Answer 21

Antibodies that an individual is born with that recognize foreign blood group antigens
Cats
Species that don’t have alloantibodies need to be exposed to a blood group antigen to produce antibodies against it

Question 22

Does alloantibodies affect how we do blood transfusions and how

Answer 22

YES!!
Cats- blood type of recipient and donor MUST be determined before a transfusion ALL OF THE TIME
Dogs- can have up to one “free transfusion” in the event of an emergency

Question 23

Blood typing

Answer 23

identifying an animals blood group antigens

Question 24

Matching

Answer 24

ensuring that the recipient and the donor are compatible to one another

Question 25

Major cross-match

Answer 25

ensure that the host will not reject the donors blood

Question 26

Minor cross match

Answer 26

ensures the donors serum does not contain alloantibodies that will damage the hosts RBCs