Flashcards in Equine Neonatal Dz Deck (54)
Causes of haematuria?
- urethral rent (male)
Causes of chronic regenerative blood loss?
- granulomatous enteritis
- infectious (EIA, piroplasmosis)
- toxic (redd maple leaf tox USA)
Causes of NON-regenerative chronic blood loss?
> Fe deficiency
- chronic haemorrhage
- nutritional deficiency (rare)
- chronic dz
> BM failure
- myeloproliferative dz
- toxins (phenylbutazone, chloramphenicol)
- idiopathic pancytopaenia
- rhEPO (less common now)
- chronic hepatic/renal dz
> stabilisation (anaemia itself may not need to be treated)
- guided by cliical and lab findings (HR, RR, lactate, PvO2) NOT PCV
- control blood loss if source found
- IVFT if severe blood loss
Presenting complaint and clinical signs of haemabdomen?
- abdo pain
- hypovolaemia (^HR, slwo capillary and jugular refill time, ^ lactate)
- Dx: ultrasonongraphy
Px of haemabdomen?
depdns on underlying cause, survival ~ 50%
What is periparturient haemorrhage and when is it commonly seen?
- haemorrhge from uterine vessels after more commonly than before parturition
- important cause pp colic and death
- delivery often uneventful!!
> mares may be prone to repeated bleeds in future pregnancy
What 2 forms of pp haemorrhage may occour?
- into broad ligament
- into abdomen (can be rapidly fatal)
Tx pp haemorrhage?
2 forms of IMHA?
- uncommon: ABs directed against patients RBC ag
- Ab formation precipitated by 1* dz, rug administration, neoplasia, immune mediated dz
> coombs test can be attempted
- presence of anti-RBC Ab directly (surface of RBC) or indierctly (serum)
- false +/- possible
> flow cytometry to demonstrate Abs on RBC
Tx haemolytic anaemia?
- tx 1* dz process
- stop lal meds
- transfusion IF signs of inadequate oxygen delivery
- immunosuppressioin (steroids, azathioprine and cyclophosphamide (latter 2 rarely in horse)
What is EIA?
- equine infectious anaemia
- transmitted via insects, blood contaminated equipment
- not present UK, risk from imports
- persistnet infection - infected horse remains lifelong carrrier
3 syndromes of EIA? What is the associated anaemia associated with?
- acute, chronic and inapparent
- anaemia caused by intra and extravascular haemolysis, BM suppression -> thrombocytopenia also common
Coggins test (AGID) or ELISA
Px/management of EIA cases?
- euthanasia/lifelng quarantine if horse + as danger to other horses
What is seen with haemolytic anaemia d/t oxidatic injury to RBC? WHen may this also be seen?
> Heinz Body Formation
- oxidative damage to Hbg precipitates on RBC membrane
- RBC less deformable and rapidly cleared from circulation
- drugs (phenothiazine, methylene blue)
- plants (onions, Brassica spp. red maple)
Pathogenesis of red maple leaf toxicity (not UK)
- wilted leaves
- methaemoglobin results from oxidative change of Hbg Fe to a non usable state for O2 transport
Causes of anaemia d/t inadequate erythropoesis?
> most common d/t chronic dz
- chronic inflam or infection/ neoplasia
- sequestration of iron
- shortened RBC lifespan
- defective erythropoeitin response
> Iron deficiency
- can develop with chronic blood loss
- tx Fe supplmentation
- neoplastic process
- +- chronic renal failure
- after adminsitration og hrEPO (cross reacts against endogenous EPO)
Type of anaemia caused by chronic dz?
- mild - mod
- normocytic, normochromic
- not associated with clinical signs (will not present for this)
Tx anaemia d/t chronic dz?
- tx 1* disease not anaemia itself
Why is anaemia important?
- 98% O2 transported by hbg
- CaO2 determined by Hbg
> CaO2 = (1.34xHbxSaO2) + (0.003xPaO2)
What is CaO2 and what should this be in a normal horse? How does this differ in the anaemic and hypoxaemic horse?
> oxygen content of blood
- CaO2 = 1.34ml/g*15g/dl*0.99+0.003*100mmHg
> Anaemic PCV 10%
- CaO2 = 1.34*[[3.3g/dl]]*0.99+0.003*100mmHg
= 4.7ml/dl (79% decrease)
- CaO2 = 1.34*15*[[0.8]]+0.003*[[45mmHg]]
= 16.2ml/dl (20% decrease)