Anaemia diagnosis and management

Question 1

List the 3 steps to treating anaemia

Answer 1

Triage and emergency treatment , investigation and stabilisation
fluid therapy/ transfusion if needed
treat specific cause

Question 2

Describe the 6 steps you undertake when emergency stabilising a patient with anaemia

Answer 2

oxygen supplementation
temperature management
fluid therapy
analgesia
treat concurrent conditions
emergency surgery where warranted

Question 3

List 2 reasons why temperature management important in emergency anaemia cases

Answer 3

warming up too quickly will cause vasodilation and decrease BP
being cold will worsen shock signs

Question 4

why is fluid therapy required in patients with emergency anaemia

Answer 4

treat hypovolaemia and address poor perfusion

Question 5

describe how haemorrhage treated

Answer 5

diagnose/ treat coagulopathy
physically stop the bleeding if able
address cause
transfuse if necessary

Question 6

what is a high risk in IMHA cases

Answer 6

Thromboembolism

Question 7

Describe how IMHA is treated

Answer 7

immunosuppressive therapy but must be sure there is no untreated infectious cause first- glucocorticoids are first line
adjunct agents may be required if response is not favourable

transfuse as necessary

Question 8

What adjunct agents can be used alongside glucocorticoids in IMHA treatment?

Answer 8

Azathioprine,
Mycophenolate mofetil,
Ciclosporin,
Leflunomide

Question 9

What is a common infectious disease to cause anaemia via haemolysis?

Answer 9

Babesia

Question 10

what does extravascular haemolysis cause

Answer 10

jaundice

Question 11

what does intravascular haemolysis cause

Answer 11

haematuria and pink plasma

Question 12

what is babesia

Answer 12

intracellular protozoa transmitted by ticks

Question 13

What are the clinical signs of babesia

Answer 13

IV and EV haemolysis
Pallor
Jaundice
Pyrexia
Haemoglobinuria
CV compromise
weakness
Inappetence

Question 14

How can babesia be diagnosed

Answer 14

Microscopy (on blood smear)
PCR

Question 15

how is babesia treated

Answer 15

Imidocarb (unlicensed)
Azythromycin
Doxycycline
supportive treatment such as transfusions and liver support

Question 16

list the 2 mechanisms of oxidative damage in RBCs

Answer 16

Oxidation of haem iron to form methaemoglobin,

Oxidation of haemoglobin to form Heinz bodies.

Question 17

List 4 things that can cause oxidative damage to RBCs

Answer 17

Heavy metals
alliums (onions, leek, garlic)
rape, kale and cabbage
paracetamol

Question 18

how to treat paracetamol toxicity in cats and dogs

Answer 18

N-acetylcystiene

Question 19

What is Ehrlichia

Answer 19

Rickettsial bacteria transmitted by ticks,

Found inside macrophages and monocytes

Question 20

List 5 clinical signs of Ehrlichia infection

Answer 20

Grumbling thrombocytopenia,
Hyperglobulinaemia,
Vague depression, fever, weight loss, anorexia,
Enlarged LNs,
Epistaxis, petechiae, ecchymoses.

Question 21

If animals do not recover from acute Ehrlichia infection, what can it progress to?

Answer 21

Chronic monocytic Ehrlichia

Question 22

List 5 clinical signs of chronic monocytic Ehrlichia

Answer 22

Profound monocytopaenia,
Failure of bone marrow,
Emaciation,
Swelling of hind legs and scrotum,
Hyperglobulinaemia

Question 23

describe how you treat Ehrlichia

Answer 23

doxycycline
Imidocarb