Clotting disorders and other vascular disorders

Question 1

Clotting requires

Answer 1

Platelets
Clotting factors
Fibrin
Vitamin K

Question 2

Failure to clot results in

Answer 2

External blood loss
-Lost into the environment
-More obvious
Internal blood loss
-Usually into 3rd spaces; can be more challenging to diagnose
-Can auto-transfuse

Question 3

Disseminated intravascular coagulation is and signs

Answer 3

Acute and rapidly fatal
DIC
State of hypercoagulability
Microscopic clots form throughout the body
Clotting process uses up fibrin and clotting factors
Animal then becomes unable to clot and will bleed out

Question 4

Causes of DIC

Answer 4

Secondary to another serious primary condition
Severe infections (sepsis, GI perforations)
Severe heat stroke
Burns
Neoplasia

Question 5

DIC treatment and prognosis

Answer 5

Blood or plasma transfusion
Treat the primary problem
Prognosis is VERY poor, death usually occurs due to:
Organ failure due to thrombus formation and ischemia
Massive hemorrhage
Concurrent hemolytic anemia

Question 6

Types of rodenticides

Answer 6

Warfarin
-1st gen
-Shorter half life (<55hr)
-Better prognosis
2nd gen
-Most of the rodenticides that are now available
-Much longer half life (15-21 days)
-Worse prognosis

Question 7

Clinical signs of ingested rodenticides

Answer 7

Hematoma or bleeding that is severe related to the trauma
Large bruise from small bump
Spontaneous hematomas
Spontaneous bleeding into the thoracic or abdominal cavities
Clinical signs appear 1-14 days after ingestion

Question 8

Treatment of ingested rodenticides

Answer 8

Induce vomit if under 2 hours since ingestion
Vit K1- first dose may be given by injection, continue with oral supplementation

Question 9

How to take blood from animals with clotting disorders

Answer 9

How often
-Every 24 hours
Selection of needle
-As small as possible
Where to poke
-Lateral saphenous
Where not to poke
-Jugular

Question 10

Aspirin toxicity does what and how long does it last

Answer 10

Inhibits COX-1 enzyme which is required for platelets to stick to one another
Irreversible
Duration of action is 21 days- new platelets need to form
CATS

Question 11

Types of vascular problems

Answer 11

Abnormal vasodilation or vasoconstriction
Too much or too little clotting
Blockages
Damage to blood vessels
Changes in oncotic and osmotic pressure

Question 12

Vasodilation

Answer 12

the blood vessels dilate causing the blood pressure to decrease

Question 13

Vasoconstriction

Answer 13

the blood vessels constrict causing the blood pressure to increase

Question 14

Normal blood pressure of all species

Answer 14

120/80 (90)
Plus 10 for horses

Question 15

Normal BP of LA

Answer 15

110-160/90-110 (110-120)

Question 16

Normal BP for cats and dogs

Answer 16

110-160/60-90 (85-120)

Question 17

When is BP considered hypertension

Answer 17

Systolic pressure >180mmHg

Question 18

Physiological

Answer 18

activation of sympathetic response

Question 19

Pathological

Answer 19

primary or secondary

Question 20

Pathological hypertension caused by

Answer 20

Usually secondary to another disease process
-Hyperthyroidism
-Heart failure
-Kidney disease
-Excess body water adrenal gland disease

Question 21

Effects of hypertension

Answer 21

Extra strain on heart
Fluid movement out of blood vessels
Lungs and abdominal space most commonly
Pulmonary edema
Pleural effusion
Ascites
Blindness
Especially in cats!

Question 22

Hypotension is seen when BP is

Answer 22

Systolic pressure <90mmHg

Question 23

Causes of hypotension

Answer 23

Not usually a primary condition- can be a secondary problem to a number of other conditions
Heart dysfunction
Lack of blood volume
Vasodilation
Iatrogenic

Question 24

Effects of hypotension

Answer 24

Decreased blood flow to vital organs
Kidneys- damage will occur very quickly
Brain- varying levels of consciousness to death
Muscles- acidosis, weakness, decreased heart function

Question 25

Treatment of hypotension

Answer 25

Based on underlying cause
Potentially fatal condition- body has compensation mechanisms
Decreased heart function→ vasoconstriction
Decreased blood volume→ increased heart rate and vasoconstriction
Vasodilation→ increased heart rate
Osmotic pressure- based on concentration of electrolytes (especially sodium) in the blood vessels compared to the extravascular space
Oncotic pressure- affected by the amount of soluble proteins in the blood vessels, most importantly albumin

Question 26

Thrombus is

Answer 26

Stationary blood clot
Platelets, fibrin, clotting factor from a “clot” that traps RBC
Trigger:
Damage to vascular endothelium
Decreased blood flow
Severity and c/s depend on location, species and underlying cause

Question 27

Embolus is caused by

Answer 27

Cam from somewhere else and now is forming a bloc in the blood vessels
Can be a thrombus that started elsewhere→ dislodged→ reattaches in a new location and grows
Or can be a piece of foreign material
The disease c/s and prognosis depends on where the embolism is obstructing

Question 28

T saddle thrombus in cats is caused by

Answer 28

Complication of hypertrophic cardiomyopathy
Cats with HCM have a high risk of forming clots due to altered blood flow through the small ventricle

Question 29

Pathology of T saddle thrombus in a cat

Answer 29

Disturbances in blood flow increase risk of thrombi forming in the LV→ dislodges→ enters aorta→ lodges in the iliac artery→ blocks blood flow to the iliac and femoral arteries

Question 30

Presenting complaint and treatment for T saddle thrombus in a cat

Answer 30

Cats present with hind end weakness or paralysis; but are (almost always) diagnosed with HCM
Treat with blood thinners
Prognosis is poor- there is a high risk that thromboembolism may also lodge in the coronary arteries or go to the brain
EMERGENCY NEEDS TO BE SEEN RIGHT AWAY