32. Bleeding disorders (coagulopathies, thrombocytopenia and thrombocytopathy)

Question 1

General considerations of animals with bleeding

Answer 1

Housing conditions
Rodenticides
Is this the first episode
medication and vaccination history

Question 2

Lab D of bleeding disorders

Answer 2

CT
ACT
Bleeding time
Clot retraction
Blood smear
APTT
ACT
PTT
PT
FDP
PLT

Question 3

What pathway is APTT

Answer 3

Intrinsic

Question 4

Reference for CT test

Answer 4

10-20mins in a clean tube

Question 5

What pathway is ACT

Answer 5

Intrinsic &
Common

Question 6

Reference for ACT test

Answer 6

<120seconds in a special tube

Question 7

Reference for Bleeding time test

Answer 7

<5mins on buccal mucosa

Question 8

Reference for clot retraction test

Answer 8

<2hrs in clean tube

Question 9

What pathway is PTT

Answer 9

Extrinsic &
common

Question 10

What pathway is PT

Answer 10

Extrinsic &
common

Question 11

What is FDP used for

Answer 11

DIC diagnosis

Question 12

What is PLT count an indicator of

Answer 12

Thrombocytopaenia

Question 13

Primary Haemostatic Disorders

Answer 13

Thrombocytopaenia
Thrombocytopathy
Vascular disorders

Question 14

Clinical signs of Primary Haemostatic Disorders

Answer 14

Superficial bleeding
Petechiae
Epistaxis
Melena
Ecchymosis
Haematuria

Question 15

Lab D of Primary Haemostatic Disorders

Answer 15

Increased; bleeding time, clot retraction
Decreased ; Platelet count

Question 16

cause of Thrombocytopaenia

Answer 16

decreased platelet count

Question 17

Congenital Thrombocytopaenia

Answer 17

Hereditary macrothrombocytopaenia — king charles
Cyclic haematopoeisis — grey collies

Question 18

Acquired Thrombocytopaenia

Answer 18

Consumptive Thrombocytopaenia (DIC)
Destructive Thrombocytopaenia (immune mediated)
Sequestration Thrombocytopaenia
Decreased thrombocyte production

Question 19

Predisposed to Immune mediated thrombocytopenia

Answer 19

Females > males
Cocker
Old english sheep dogs

Question 20

Clinical signs of immune mediated thrombocytopenia

Answer 20

Petechiae of skin/ gums
spf bleeding
splenomegaly
ecchymosis
melena
epistaxis

Question 21

Diagnosis of immune mediated thrombocytopenia

Answer 21

Decreased platelet count
bone marrow aspiration
exclusion of other factors - tick born disease, DIC, virus

Question 22

Treatment of immune mediated thrombocytopenia

Answer 22

Stop any immediate bleeding
immunosuppression - pred, vincristine
splenectomy in case of recurrent cases

Question 23

cause of Thrombocytopathy in general

Answer 23

Decreased platelet function

Question 24

Hereditary thrombocytopathy

Answer 24

von willebrand’s disease

Question 25

Acquired thrombocytopathy

Answer 25

Viral cause (FeLV) Neoplasia Nephropathy Hepatopathy Hypothyroidism Lupus Myeloproliferative disease Drug

Question 26

Von Willebrand's Disease

Answer 26

Deficiency of VW factor Most common bleeding disorder of dog

Question 27

Type I Von Willebrand's Disease

Answer 27

Mild/ moderate clinical signs most common

Question 28

Type II Von Willebrand's Disease

Answer 28

Moderate / severe clinical signs Low vWF conc

Question 29

Type III Von Willebrand's Disease

Answer 29

Most severe clinical signs No vWF at all

Question 30

Clinical signs of Von Willebrand's Disease

Answer 30

same as primary haemostatic disorders Perinatal mortality still birth prolonged surgical bleeding

Question 31

Diagnosis of Von Willebrand's Disease

Answer 31

Lab D DNA screening

Question 32

Lab D of Von Willebrand's Disease

Answer 32

Increased; BMBT, clot retraction, ACT, APTT

Question 33

Treatment of Von Willebrand's Disease

Answer 33

Fresh plasma transfusion Desmopressin acetate (for type I)

Question 34

Vascular disorders

Answer 34

Vasculitis Hyperadrenocorticism (cushing's)

Question 35

Secondary Haemostatic disorders

Answer 35

Coagulopathies Rodenticide poisoning

Question 36

cause of Coagulopathy

Answer 36

decreased clotting factors / proteins

Question 37

Clinical signs of Coagulopathy

Answer 37

Deep bleeding Haemoperitoneum Hemarthrosis Haemothorax Haematoma

Question 38

Lab D of Coagulopathy

Answer 38

Increased; clotting time, ACT, APTT, PTT

Question 39

Congenital Coagulopathy

Answer 39

factor deficiency in an individual devon rex cat ( vit k dependant factors ) Factor VIII deficiency Factor IV deficiency

Question 40

Acquired Coagulopathy

Answer 40

Usually a combination of defects

Question 41

a decrease in factor production can be due to

Answer 41

rodenticide poisoning hepatopathy vit k deficiency

Question 42

Vitamin K factors

Answer 42

II VII IX X

Question 43

Rodenticide poisoning

Answer 43

Dicoumarol is a competitive antagonist of vit k coagulation factors

Question 44

Clinical signs of Rodenticide poisoning

Answer 44

Can take up to 24hrs to occur Acute collapse Shock Dyspnoea Anaemia Haemothorax Coughing Bleeding gums Epistaxis Petechiae Haematoma Bruising

Question 45

Diagnosis of Rodenticide poisoning

Answer 45

History - access to poison, rodents, state of other pets

Question 46

Lab d of Rodenticide poisoning

Answer 46

Increased; PTT, APTT, ACT

Question 47

Treatment of Rodenticide poisoning

Answer 47

Treat for shock - fluids, plasma Fresh whole blood Vit K1 Emetic & stomach rinse & activated charcoal if poison swallowed within 2-3hrs

Question 48

DIC

Answer 48

Disseminated intravascular coagulopathy (coagulopathy & thrombocytopaenia)

Question 49

Pathogenesis of DIC

Answer 49

excessive systemic intravascular coagulation

Question 50

Causes of DIC

Answer 50

Shock acidosis hypoxia infection trauma pancreatitis haemangiosarcoma heat stroke burns

Question 51

Clinical signs of DIC

Answer 51

Organ failure spf/ deep bleeding

Question 52

Diagnosis of DIC

Answer 52

History of diseases causing severe inflammation/ infection thrombocytopaenia schistocytosis Increased ; ACT, APTT, PTT, FDP, D-Dimer Decreased ; finbrinogen

Question 53

Treatment of DIC

Answer 53

Treat underlying cause fresh whole blood frozen plasma heparin crystalloid oxygen therapy correction of acidosis