Haematopoietic diseases

Question 1

Why is anaemia common in cats?

Answer 1

RBC shorter life span 
Sensitive to oxidative stress
Cats adjust life style to composate not found until late 
Lower RBC mass 
Feline Hb low affinity for oxygen

Question 2

What are the clinical signs associated with anaemia?

Answer 2

Jaundice (haemolytic anemia)
Pallor MM nose and pads
Increased HR
Hyper dynamic pulses 
Increased RR
Increased size lymph nodes and spleen
Pica 
Underlying disease
Excercise intolerance 
Felv FIV FIP clinical signs

Question 3

At what pcv should anaemia be investigated?

Answer 3

Below 24% in cats below 37% in dogs

Question 4

What is regenerative anaemia?

Answer 4

Bone marrow compensates for loss of blood by producing immature RBCs increased MCV presence of anisocytosis polychromasia (high number of immature RBC) nucleated RBC look for aggregate reticulocytes in cats (not present normally)

Question 5

What is non-regenerative anaemia?

Answer 5

Bone marrow does not respond to anaemia

Question 6

How should a reticulocyte count be performed?

Answer 6

Blood smear, new methylene blue stained blood smear by counting the % of RBCs that are aggregate reticulocytes
Decide if the proportion of aggregates present is proportionate to the anemia present

Question 7

What is the reticulocyte equation?

Answer 7

%reticulocyte on smear X RBC count X 10

Question 8

At what number of absolute reticulocytes suggest regenerative anaemia?

Answer 8

50-100

Question 9

What other conditions can cause you to believe that anaemia is non regenerative when in fact it is regenerative?

Answer 9

Duration of anaemia it takes 3-5 days for new RBCs to be released
Chronic blood loss will lead to an iron deficiency which imparts RBC formation
Concurrent disease
FELV, infectious and inflammatory diseases (cat flu) can reduce the bone marrow response

Question 10

What are the two causes of regenerative anaemia?

Answer 10

Blood loss and haemolysis

Question 11

What can cause blood loss anaemia?

Answer 11

Coagulopathies
Amylodiosis (haemorrhage from the liver)
Congenital and inherited clotting defects
Thrombocytopenia
Ulcerated tumour
Flea infestation

Question 12

What can cause haemolytic anaemia

Answer 12

FeLV infection
Feline infectious anaemia 
Immune mediated haemolytic anaemia 
Heinz body anaemia 
Severe hypophosphateamia 
Neonatal isoerthrolysis 
Inherited defects

Question 13

What is feline infectious anaemia caused by?

Answer 13

Caused by mycoplasma haemofelis
Mycoplasma haemominutum
Mycoplasma turicensis
Blood sucking parasites

Question 14

What are the clinical signs associated with feline infectious anaemia?

Answer 14

Pallor
Lethargy
Jaundice
Anorexia 
Weight loss
Pyrex is 
Dehydration

Question 15

How is feline infectious anaemia diagnosed?

Answer 15

Presence of mycoplasma on RBC dried smear

PCR test of choice

Question 16

How is Feline infectious anaemia treated?

Answer 16

Doxycycline antibiotic follow immediately with water or food

Question 17

What is Heinz body anaemia?

Answer 17

Paracetamol/onion poisoning
irreversibly denatured Oxidised haemoglobin
Are present in small number in the cat normally
Lymphoma
Diabetic ketoacidosis
Destroyed via haemolysis

Question 18

What is Neonatal isoerythrolysis anemia

Answer 18

Cats breed with varying blood types two types type A and type B (pedigree)
type B have strong antibodies to type A blood 
if queen (type B) gives birth to type A kittens antibodies against type A blood will pass through to the kitten via the colostrum in first 24 hours 
Haemolysis of the RBC

Question 19

What tyoes of disorders cause non-regenerative anaemia?

Answer 19

Disorders of the bone marrow
Myeloprofilerative (leukemia) and myelodysplastic (abnormal cells)
Marrow failure (stream cell formation)
Toxins (heavy metals)
Suppression of the bone marrow
FeLV FIP, FIV, chronic kidney disease, chronic inflammation

Question 20

Why does chronic kidney disease cause non regenerative anaemia?

Answer 20

Shorter RBC lifespan
Erythropoietin deficiency (produced in response to hypoxia in the kidney)
Blood loss
Impaired iron utilisation

Question 21

What is AID and what does it stand for?

Answer 21

Anaemia of inflammatory disease
Very common
As a result of chronic inflammation and circulating toxins
PCV rarely falls below 18% does not need specific investigations

Question 22

How is anaemia treated?

Answer 22

Blood transfusion PCV above 10% unnecessary
Oxyglobin
Frozen plasma
Erythropoietin therapy
Bone marrow stimulation (anabolic steriods, prednisalone)

Question 23

What is a bleeding disorder?

Answer 23

An abnormal condition which allows blood to escape injured vessels

Question 24

What is primary haemostasis?

Answer 24

Vasoconstriction of local blood vessels and formation of the platelet plug

Question 25

What is secondary haemostasis?

Answer 25

Stabilisation of the platelet plug with fibrin

Question 26

What three pathways are involved in secondary haemostasis

Answer 26

Intrinsic extrinsic common

Question 27

What is involved in the extrinsic pathway?

Answer 27

Tissue factor VII calcium

Question 28

What test is used to assess the intrinsic pathway?

Answer 28

APTT ACT

Question 29

What is involved in the intrinsic pathway?

Answer 29

Calcium factors , XI, XII, IX VIII

Question 30

What is involved in the common pathway

Answer 30

Factor V and X and calcium Convert prothrombin to thrombin Thrombin then converts Fibrinogen to fibrin

Question 31

What test is used to assess the extrinsic pathways

Answer 31

Prothrombin time

Question 32

Where are coagulation factors synthesised? And what vitamin di they require?

Answer 32

In the liver vitamin k

Question 33

What clinical condition can lead to vitamin K deficiency?

Answer 33

Cholestasis -blockage of the bile duct fat malabsorption | Rodenticide toxicity

Question 34

What history apshould be obtaine when a clotting disorder is suspected?

Answer 34

``` Previous reports of prolonged bleeding at surgery Easily bruised Prolonged bleeding after blood samples Less than 6 months of age Haemophilia effects makes Recent exposure to toxins ```

Question 35

Clinical signs associated with a primary haemostasis disorder?

Answer 35

``` Petechaie Multiple bleeding sites Prolonged bleeding. Surface bleeding(mucous membranes) Multiple bleeds and prolonged ```

Question 36

Clinical signs associated with a secondary haemostasis disorder?

Answer 36

``` Haematomas Localised site of bleeding Delayed bleeding rebelling from cuts Deep cavity bleeds joints abdomen thoracic cavity Single large bleeds and rebleeding ```

Question 37

What laboratory tests can be used to test for primary haemostasis disorders?

Answer 37

Buccal mucosal bleeding times | Platelet counts

Question 38

What labrotary tests can be used to test secondary haemostasis disorders?

Answer 38

Activated clotting time | Prothrombin time

Question 39

What re platelet counts used for and how should they be completed?

Answer 39

Quantity of platelets Collect in edta tube send to lab anticoagulant tests Use of dif quick staining Look for platelet clumps this will affect the numbers Number of platelets per high field are counted repeated for 10 fields average obtained Approximately 11-25 per field is normal

Question 40

What is bucxal mucosal bleeding time used for and how it is preformed?

Answer 40

Primary haemostasis disorders of the vessels and platelet function Upper lip folded up and held in place with a gauze A pair of small standardised incisions are made with a spring loaded bleeding time device Time taken for the cessation of bleeding is recorder Less than 3mintues cats less than 3.5 dogs

Question 41

What are activated clotting times used for and how are they preformed?

Answer 41

Secondary haemostasis evaluates intrinsic and common pathways The collection tube activates the intrinsic pathway. 2mls of blood is collected Tube is inverted then left for 40 seconds after this point tube is inverted every 10 seconds and the time for a clot to form, is recorded

Question 42

What is APTT and how is it preformed?

Answer 42

Evaluates the intrinsic and common pathways activated partial thromboplastin time Sample collected into sodium citrate tube assesse by external lab factor xII

Question 43

What is PT and how is it preformed

Answer 43

Prothrombin time assessed the extrinsic and common pathways sodium citrate tube is filled and sent off to the lab. Very sensitive to rodenticide posing and vitamin k deficiency

Question 44

What is a point of care analyser?

Answer 44

Coagulation instrument Determine APTT and PT Small amounts of citrate blood