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Equine Med & Surgery > Hematology > Flashcards

Hematology Flashcards

(58 cards)

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1
Q

What type of clinical presentation do animals with acute, severe hemorrhage show?

A
  • SHOCK
    • low BP, tachycardia, tachypnea
    • pale MM & prolonged CT
    • poor peripheral pulses & cool extremities
    • trembling, weakness, depression
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2
Q

With acute blood loss, how long does it take for anemia to become clinically important?

A

12-24 hours

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3
Q

What clinical signs are associated with anemia?

A
  • pale MM
  • tachycardia/tachypnea
  • weakness/exercise intolerance
  • anorexia/depression
  • physiological heart murmur
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4
Q

What is a good indicator of regeneration in the horse?

A

MCV > 60 fl

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5
Q

Common causes of hemorrhage in the horse

A
  • uterine rupture (pregnant mares, late gestation)
  • NSAID toxicity
    • renal medullary necrosis
    • GI bleeding
  • exercise-induced pulmonary hemorrhage
  • guttural pouch mycosis (internal carotid rupture)
  • trauma (internal or external hemorrhage)
  • coagulopathy
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6
Q

When do TP & PCV changes occur after an acute blood loss event?

A
  • TP-4-6 hours after
    *may not drop significantly if internal bleeding
  • PCV-12-18 hours after
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7
Q

What bloodwork findings are evidence of acute blood loss anemia?

A

regenerative anemia & hypoproteinemia without evidence of hemolysis

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8
Q

Appropriate diagnostic steps if hemorrhage suspected but not evident externally

A
  • peritoneal or abdominocentesis
  • thoracic or abdominal US
  • rectal examination
  • endoscopy
  • fecal occult blood
  • urinalysis
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9
Q

Hemorrhage is what kind of fluid loss?

A

isotonic

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10
Q

Why should acepromazine be avoided in horses with acute blood loss?

A

Don’t use in hypotensive animals because it reduces peripheral vasoconstrictive response

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11
Q

What is one potential reason to avoid colloids in a hemorrhage situation?

A

colloids can inhibit coagulation, so be careful using unless positive that bleeding is controlled

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12
Q

Fluid support for horse that suffered hemorrhage and is in shock

A
  • Hypertonic fluids first (5% NaCl)
  • follow with isotonic fluids (LRS)
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13
Q

When is a blood transfusion warranted in hemorrhage situations?

A
  • PCV<15 if acute
  • PCV<8-10 if chronic
  • HR>90 een after circulatory support
  • PCV decreases to <20% in 12 hours
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14
Q

Describe the ideal universal blood donor

A
  • non-thoroughbred
  • gelding
  • Aa, Qa, and Ca-negative
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15
Q

What is the lifespan of transfused RBCs?

A

2-5 days

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16
Q

After treating an acute hemorrage, horses should rest until PCV is ______

A

>20%

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17
Q

What causes clinical signs seen with chronic hemorrhage?

A

poor oxygen delivery

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18
Q

What findings provide evidence of iron deficiency?

A
  • non-regenerative anemia
  • LOW serum iron concentration
  • LOW serum transferrin saturation
  • HIGH iron-binding capacity ‘
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19
Q

What is the pathophysiology of chronic hemorrhage?

A
  • bone marrow suppression d/t underlying disease
  • bone marrow failure
  • iron deficiency anemia may be factor
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20
Q

What is the focus of treatment for chronic hemorrhage?

A

treat the underlying cause

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21
Q

What is the dominant clinical picture of chronic hemorrhage?

A

Anemia

  • pale MM
  • tachycardia/tachypnea
  • weakness/exercise intolerance
  • anorexia/depression
  • physiological heart murmur
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22
Q

Differentials for chronic anemia

A
  • chronic blood loss (iron deficiency)
  • underlying disease (anemia of chronic disease or inflammation)
  • EPO administration
  • aplastic anemia
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23
Q

Oral iron should not be given to what age horses?

A

neonates (2-3 weeks)-Hepatotoxic

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24
Q

What findings are used to diagnose hemolytic diseases?

Study These Flashcards
A
  • anemia with normal plasma protein, hyperbilirubinemia, hemoglobinemia, and/or hemoglobinuria
  • altered RBC morphology (spherocytes, eccentrocytes, Heinze bodies, etc.)
25
What are other rule-outs for hemolytic diseases?
* liver disease * anorexia
26
What are some main differences between EV and IV hemolysis?
MCHC * **Normal** w/ **extravascular hemolysis** * **High** w/ **intravascular hemolysis** Hemoglobinemia & hemoglobinuria-**intravascular** Splenomegaly-**extravascular**
27
Infectious causes of hemolytic disease in horses
* *Anaplasma phagocytophila* * EIA * Babesiosis/Piroplasmosis
28
Possible immune-mediated causes for hemolytic disease
* Drugs (**Penicillin)** * Infection (**S. equi)** * Neoplasia * Neonatal isoerythrolysis
29
Toxic causes of hemolytic diseases
* Red maple * onions * phenothiazine * rattlesnake venom
30
What type of virus is EIA?
Retrovirus
31
How is EIA transmitted?
hematophagous arthropods or contaminated instruments
32
What is the mechanism of anemia with EIA?
likely from BM suppresion AND hemolysis
33
Typical lab findings with EIA
* PCV 10-20% * normal TP (to possibly marginally high) * possible thrombocytopenia * hyperbilirubinemia
34
Acute EIA clinical signs
* icterus * depression * fever * edema * petechia
35
Chronic EIA clinical signs
* intermittent fever * icterus * weight loss * lethargy * pale MM \*episodic
36
What is the vector for *Anaplasma phagocytophila*?
*Ixodes* spp.
37
What cells does *A. phagocytophila* infect?
neutrophils
38
Anemia due to *A. phagocytophila* is probably by what mechanism?
immune-mediated
39
What pathologies result from *A. phagocytophila?*
* systemic inflammation * reduced granulocyte & platelet production/increased clearance * vasculitis
40
What clinical signs are seen first with *A. phagocytophila* infection?
fever & depression
41
*A. phagocytophila* causes what clinical signs?
* fever (104-105) & depression first * after 2-3 days: * icterus * petechia * edema * ataxia * reluctance to move
42
Lab findings associated with *A. phagocytophila*
* anemia * thrombocytopenia * neutropenia with left shift * hyperbilirubinemia
43
Treatment for *A. phagocytophila*
* Oxytetracycline IV SID slowly for 7 days * Doxycycline PO BID for 2 weeks * Supportive care * Anti-inflammatory (flunixin meglumine IV 3 d)
44
*A. phagocytophila* diagnostic tests
* neutrophil inclusions on peripheral blood smear (during first few days of disease then become harder to find) * serology (not helpful acutely) * PCR-buffy coat-very sensitive
45
What type of hemolysis is most common with IMHA?
extravascular
46
Pathophysiology of IMHA
* immune-complex mediated RBC destruction * direct (IV) or phagocyte-mediated(EV) * tissue hypoxia * organ dysfunction * systemic inflammation/shock
47
Clinical signs of IMHA
* fever * icterus * lethargy * tachycardia & tachypnea if anemia severe * pale MM * splenomegaly * may also develop thrombocytopenia or DIC * rarely hemoglbinemia or hemoglobinuria-if IV
48
IMHA diagnostics
* autoagglutination maybe evident (dilute whole blood in saline) * Coombs-direct or indirect * higher red cell fragility than normal * flow cytomoetery for RBC bound IgG
49
What are some therapies for IMHA?
Dexamethasone Prednisolone Cyclophosphamide (if refractory) Plasmapheresis (if refractory)
50
What is the purpose of using diuretics as part of treatment for IMHA?
help reduce the nephrotoxicity from pigmenturia-especially important with methemoglobin
51
Major components of Red Maple pathophysiology
* oxidative damage to hemoglobin causing methemoglobinemia * oxidative damage to RBC membranes -\> hemolysis * systemic inflammation
52
Clinical signs of red maple toxicity
* icterus * weakness, ataxia * yellow-brown membranes * brown urine * brown serum * tachypnea/tachycardia * colic (especially prone; painful colic) * oliguria or anuria * DIC/acute death
53
Treatment for Red Maple toxicity
* remove source-activated charcoal via NGT * fluids for circulatory support & diuresis * blood transfusions-based on clinical signs since PCV/Hb may be inaccurate * diuretics (furosemide) * dopamine CRI if remain oliguric * anti-oxidants-Vitamin C (?) - can't hurt, not sure if works
54
What drugs should be avoided in animals with Red Maple toxicity?
corticosteroids
55
Causes of relative polycythemia
* hemoconcentration * dehydration, endotoxemia * splenic contraction * excitement, shock * drug-induced
56
Clinical signs of polycythemia
* bright red, congested membrane color-relative * muddy red membrane color-absolute * CS of dehydration/endotoxemia if cause * tissue hypoxia signs if absolute * thrombosis if absolute
57
What organism is sometimes a cause of thrombophlebitis?
*Staphylococcus aureus*
58
Treatment plan for thrombophlebitis
* early aggressive treatment of underlying disease * aspirin for thrombosis * antibiotics if septic * drainage if infected

Equine Med & Surgery (11 decks)

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