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important historical info:

1. prior drug administration
2. exposure to toxic plants or chemicals
3. family or herd occurrence (look for something in common)
4. recent transfusion or colostrum (will pump up PCV and make you think anemia is not as bad as it actually is)
5. age at onset of anemia


physical findings

clinical signs of anemia +
- icterus
- hemoglobinuria (hemoglobin in urine, it will be red. you know its not RBCs bc when you spin it down you wont have any serum)
- hemorrhage
- fever


how do you tell the difference between hemorrhage and hemolysis

your TP
DECREASED for hemorrhage bc you are losing proteins to the outside world
NORMAL for hemolysis bc whether its intravascular or extravascular you are still able to recycle those proteins to use them again


what will confirm a regenerative anemia

increased polychromasia


what is suggestive of a regenerative anemia

a macrocytic hypochromic anemia - big cells and less Hgb. but only polychromatophils can confirm a regenerative anemia


if an animal is on prednisone and you see microcytosis what type of anemia do you think its?

Fe deficiency anemia. slide should be hyperchromic and has been bleeding out of the butt


EXAM Q: what are the 3 diseases that increase heinz bodies

1. diabetes
2. lymphoma
3. hyperthyroidism


mild anemia is typically due to what?

anemia of chronic inflammatory disease


what does macroagglutination indicate?

intravascular hemolysis


how do you determine the difference between intravascular and extravascular hemolysis?

hemoglobinemia differentiates between the two of them
an increased bilirubin concentration can be seen in both


what should be evaluated to create differential diagnoses of anemia

- plasma appearance
- plasma concentration
- reticulocyte count (if its super low, you know its non-regenerative)
- RBC morphology
- bone marrow evaluation
- coombs test (looking for immunoglobulins and complement)
- plasma bilirubin concentration


what are the pathophysiologic mechanisms that classify anemia?

- hemorrhage
- accelerated RBC destruction (hemolysis)
- reduced or defective erythropoiesis
- hemodilution


hemodilution "anemia"

its not really anemia, its usually something that creates a temporary mild anemia.
- pregnancy (increased extravascular space causes "anemia")
- postnatal growth: growing so fast
- splenic sequestration (splenomegaly, anesthesia, heparin tx in horses)


what will cause young animals to frequently have a physiologic anemia (hemodilution)?

- rapid growth rate will cause hemodilution from plasma volume expansion
- dilutional from colostrum
- destruction rate of fetal RBCs (goats have a diff. fetal Hgb)
- decreased production due to low erythropoietin concentrations early in life)


EXAM Q: what is the difference between HCT and PCV?

PCV is spun down in a crit tube, HCT is figured out on analyzer as a calculation. we always go with PCV bc even though numbers are identical, it can't be messed up


EXAM Q: how do you know whether an anemia is regenerative or non-regenerative?how can you confirm a regenerative anemia?

- increased polychromasia
- absolute reticulocytosis


what is regenerative anemia due to? ie what causes a regenerative anemia?

hemorrhage or hemolysis


what will you typically see with regenerative anemia?

- nRBCs
- basophilic stippling
- increased micronuclei (howell-jolly bodies)
- polychromasia <-- confirms regenerative anemia


what will you see with a severe hemolytic anemia?

- stressed retics = huge polychromatophils
- spherocytes
- this combo of big and small RBCs will give you a HIGH RDW and ansiocytosis


what does a very pale (particularly in the center) RBC inidicate?

Fe deficiency anemia


what do stressed retics due to MCV and MCHC?

increase MCV
decrease MCHC


what are signs that you have a hemolytic anemia?

icterus (bilirubin)


what causes increased bilirubin in hemolytic anemia?

you will see bilirubin bc of RBC destruction. bilirubin is a breakdown product of hemoglobin. bilirubin is processed in the liver. when looking for increased bilirubin, it will go to urine first, then blood, then tissues.


what differentiates between intra and extravascular hemolysis?

hemoglobin in urine (hemoglobinuria) and hemoglobinemia


why is it impt to differentiate between roulaeux and agglutination?

bc if its agglutination, animal will be put on immunosuppressive drugs which is the last thing you want to do if its roulaeux bc roulaeux is caused by increase fibrinogen which is a result of inflammation which usually occurs when there is an infection.


what test do you run to differentiate between rouleaux and agglutination?

saline test! if they disperse its rouleux, if they clump together, its agglutation.


is anemia regenerative or non-regenerative with hemolysis?

regenerative, always


what will your plasma protein concentration be with hemorrhage? increased or decreased?



what lab findings will you find with hemolytic anemia?

- increased plasma concentration
- reticulocyte counts will be higher (bc you aren't losing stuff to the world)


what will you find with extravascular hemolysis that you won't see in intravascular?

like being drunk at your friends house (=ok)
- abnormal rapid RBC death but in a normal location like spleen, liver or bone marrow
- can be acute or chronic
- DIC Is possible
- more common