Anemia

Question 1

CS for animals with anemia

Answer 1

↑ RR/ effort and HR
Lethargy
Blood in the stool (melena, hematochezia)
Bleeding from nose or other location
Pale or yellow mm

Question 2

Red blood cells

Answer 2

Lifespan: dogs 110-120 dys and 65-76 dys in cats
Carry O2 to the tissues
Dog: central pallor

Question 3

Erythropoiesis

Answer 3

Erythropoietin hormone released from kidney with low blood O2 → to blood stream to BM → makes RBCS →↑ O2 carrying capacity

Question 4

_____________ and ___________ is an indicator of regeneration

Answer 4

Anisocytosis and Pokilocytosis

Question 5

Blood loss anemia

Answer 5

Trauma, sx, hemorrhage
low PCV and total proteins

Question 6

Anemia secondary to destruction

Answer 6

Intravascular hemolysis (immune mediated, RBC destroyed in BV)
Extravascular hemolysis (spleen)

Question 7

Anemia secondary due to decreased production

Answer 7

BM disorder (neoplasia, toxin)

Question 8

Mechanisms of anemia

Answer 8

Regenerative (reticulocytes) → hemolysis or hemorrhage
Noniregenerative → ↓ production
Pre-regenerative → 3-5 days to mount a regen response

Question 9

CBC for anemia

Answer 9

Hematocrit (HCT)
PCV
RBC count

Question 10

Abnormal or normal CBC values in different animals

Answer 10

Greyhounds (normal HCT is high)
Puppies/ pregnancy (Normal HCT is low)

Question 11

What are the RBC indicies

Answer 11

MCHC: differences in the amount of Hb in RBCs (hyper,hypo or normochromic)
MCV: size of RBCs (macro, micro or normocytic)

Question 12

Dx for anemia

Answer 12

Chemistry (electrolytes)
Urinalysis
Dx imaging (fluid in heart or lungs, mass)
Infectious dx testing
Coomb’s testing (Immune mediated)
BM aspiriate

Question 13

External hemorrhage

Answer 13

Low RBC, total protein, and albumin
Evidence of loss

Question 14

Internal hemorrhage

Answer 14

Low RBC, normal total protein and albumin
GI, urinary and 3rd space

Question 15

Extravascular hemolysis

Answer 15

RBCs destroyed in the spleen or BM
Hb released and converts to BR
Yellow/ jaundice mm

Question 16

Intravascular hemolysis

Answer 16

Direct RBC in circulation

Question 17

Disease that cause hemolysis

Answer 17

Intoxicants (snake and insect bites)
Oxidative injury (tylenol, onion, zinc)
Blood parasites (babesia, cytauzoon, mycoplasma)
Fragmentation of RBCs (neoplasia)
Low Phosphorus (diabetes)

Question 18

Mild non-regenerative anemias

Answer 18

Anemia of chronic disease/ inflamm
Kidney disease
Liver disease
Endocrine disease
GI/ pancreatitis

Question 19

Moderate to severe non-regenerative anemias

Answer 19

Infection (FeLV, FIV, tick borne)
Medications (chemo, phenobarb, ACEi)
Toxins (AL, alfatoxin)
Nutrient deficiencies
Aplasia, neoplasia of pure red cell aplasia in BM

Question 20

Transfusions

Answer 20

Lifesaving for low HCT/ PCV <15
Tx CS of tachycardia, tachypnea, lethargy, mental dullness

Question 21

Type and crossmatch

Answer 21

Possibly done before 1st transfusion in dogs
Always 2nd or later in dogs
ALWAYS type in cats

Question 22

Hemantics

Answer 22

Produces more RBCs
Cobalamin (B12)- RBC maturation in animals with GI disease
Folate (B9)- DNA and RNA synthesis in malabsorptive disease (chr. blood loss)
Iron

Question 23

Erythropoietin stimulation agents

Answer 23

Darbepoetin
Epoetin alfa

Question 24

Hookworms

Answer 24

LivIngestion and live in the SI
Dx: fecal flotation
Tx: fenben, moxidectin, pyrantel

Question 25

Hookworms producing anemia

Answer 25

Anemia secondary to blood sucking and bleeding ulcers Low PCV and total proteins

Question 26

If total protein is low, what is the next step?

Answer 26

Blood transfusion

Question 27

Hemangiosarcoma

Answer 27

Tumor from vascular endothelial cells ↑ RR, collapse, lethargy, vomit, anorexia

Question 28

Dx of hemangiosarcoma

Answer 28

Schistocytes (blood cell fragements) Regenerative or non regen anemia (hypoproteinemia) Rads, US and sx biopsy*

Question 29

Tx of hemangiosarcoma

Answer 29

Cutaneous: sx removal Cardiac: pericardiocentesis Splenic: sx, chemo

Question 30

Immune-mediated hemolytic anemia

Answer 30

Lethargy and RBCs from complement or Igs (ruptured = intravascular) ↑ destruction of RBCs (CBC all ↓)

Question 31

IMHA dx

Answer 31

Slide agglutination test ( drop of blood, saline on slide, clumping means Abs around RBCs)

Question 32

What's seen in IMHA CBC?

Answer 32

Anemia, spherocytes and leukocytosis

Question 33

IMHA tx

Answer 33

Transfusions Immunosuppressive meds: steroids, cyclosporine, mycophenolate

Question 33

Important indicator of anemia secondary to oxidative damage

Answer 33

HBs: irreversible denatured Hb on the outside of RBCs (cats more susceptible)

Question 33

Anemia from chr. renal dz

Answer 33

Anemia (non-regen), ↓ erythropoietin and GI bleeding

Question 33

What causes oxidative damage of RBCs

Answer 33

Onion, garlic, zinc, Acetaminophen