32. Bleeding disorders (coagulopathies, thrombocytopenia and thrombocytopathy) Flashcards

1
Q

General considerations of animals with bleeding

A

Housing conditions
Rodenticides
Is this the first episode
medication and vaccination history

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2
Q

Lab D of bleeding disorders

A

CT
ACT
Bleeding time
Clot retraction
Blood smear
APTT
ACT
PTT
PT
FDP
PLT

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3
Q

What pathway is APTT

A

Intrinsic

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4
Q

Reference for CT test

A

10-20mins in a clean tube

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5
Q

What pathway is ACT

A

Intrinsic &
Common

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6
Q

Reference for ACT test

A

<120seconds in a special tube

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7
Q

Reference for Bleeding time test

A

<5mins on buccal mucosa

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8
Q

Reference for clot retraction test

A

<2hrs in clean tube

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9
Q

What pathway is PTT

A

Extrinsic &
common

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10
Q

What pathway is PT

A

Extrinsic &
common

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11
Q

What is FDP used for

A

DIC diagnosis

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12
Q

What is PLT count an indicator of

A

Thrombocytopaenia

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13
Q

Primary Haemostatic Disorders

A

Thrombocytopaenia
Thrombocytopathy
Vascular disorders

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14
Q

Clinical signs of Primary Haemostatic Disorders

A

Superficial bleeding
Petechiae
Epistaxis
Melena
Ecchymosis
Haematuria

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15
Q

Lab D of Primary Haemostatic Disorders

A

Increased; bleeding time, clot retraction
Decreased ; Platelet count

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16
Q

cause of Thrombocytopaenia

A

decreased platelet count

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17
Q

Congenital Thrombocytopaenia

A

Hereditary macrothrombocytopaenia — king charles
Cyclic haematopoeisis — grey collies

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18
Q

Acquired Thrombocytopaenia

A

Consumptive Thrombocytopaenia (DIC)
Destructive Thrombocytopaenia (immune mediated)
Sequestration Thrombocytopaenia
Decreased thrombocyte production

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19
Q

Predisposed to Immune mediated thrombocytopenia

A

Females > males
Cocker
Old english sheep dogs

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20
Q

Clinical signs of immune mediated thrombocytopenia

A

Petechiae of skin/ gums
spf bleeding
splenomegaly
ecchymosis
melena
epistaxis

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21
Q

Diagnosis of immune mediated thrombocytopenia

A

Decreased platelet count
bone marrow aspiration
exclusion of other factors - tick born disease, DIC, virus

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22
Q

Treatment of immune mediated thrombocytopenia

A

Stop any immediate bleeding
immunosuppression - pred, vincristine
splenectomy in case of recurrent cases

23
Q

cause of Thrombocytopathy in general

A

Decreased platelet function

24
Q

Hereditary thrombocytopathy

A

von willebrand’s disease

25
Q

Acquired thrombocytopathy

A

Viral cause (FeLV)
Neoplasia
Nephropathy
Hepatopathy
Hypothyroidism
Lupus
Myeloproliferative disease
Drug

26
Q

Von Willebrand’s Disease

A

Deficiency of VW factor
Most common bleeding disorder of dog

27
Q

Type I Von Willebrand’s Disease

A

Mild/ moderate clinical signs
most common

28
Q

Type II Von Willebrand’s Disease

A

Moderate / severe clinical signs
Low vWF conc

29
Q

Type III Von Willebrand’s Disease

A

Most severe clinical signs
No vWF at all

30
Q

Clinical signs of Von Willebrand’s Disease

A

same as primary haemostatic disorders
Perinatal mortality
still birth
prolonged surgical bleeding

31
Q

Diagnosis of Von Willebrand’s Disease

A

Lab D
DNA screening

32
Q

Lab D of Von Willebrand’s Disease

A

Increased; BMBT, clot retraction, ACT, APTT

33
Q

Treatment of Von Willebrand’s Disease

A

Fresh plasma transfusion
Desmopressin acetate (for type I)

34
Q

Vascular disorders

A

Vasculitis
Hyperadrenocorticism (cushing’s)

35
Q

Secondary Haemostatic disorders

A

Coagulopathies
Rodenticide poisoning

36
Q

cause of Coagulopathy

A

decreased clotting factors / proteins

37
Q

Clinical signs of Coagulopathy

A

Deep bleeding
Haemoperitoneum
Hemarthrosis
Haemothorax
Haematoma

38
Q

Lab D of Coagulopathy

A

Increased; clotting time, ACT, APTT, PTT

39
Q

Congenital Coagulopathy

A

factor deficiency in an individual
devon rex cat ( vit k dependant factors )
Factor VIII deficiency
Factor IV deficiency

40
Q

Acquired Coagulopathy

A

Usually a combination of defects

41
Q

a decrease in factor production can be due to

A

rodenticide poisoning
hepatopathy
vit k deficiency

42
Q

Vitamin K factors

A

II
VII
IX
X

43
Q

Rodenticide poisoning

A

Dicoumarol is a competitive antagonist of vit k coagulation factors

44
Q

Clinical signs of Rodenticide poisoning

A

Can take up to 24hrs to occur
Acute collapse
Shock
Dyspnoea
Anaemia
Haemothorax
Coughing
Bleeding gums
Epistaxis
Petechiae
Haematoma
Bruising

45
Q

Diagnosis of Rodenticide poisoning

A

History - access to poison, rodents, state of other pets

46
Q

Lab d of Rodenticide poisoning

A

Increased; PTT, APTT, ACT

47
Q

Treatment of Rodenticide poisoning

A

Treat for shock - fluids, plasma
Fresh whole blood
Vit K1
Emetic & stomach rinse & activated charcoal if poison swallowed within 2-3hrs

48
Q

DIC

A

Disseminated intravascular coagulopathy
(coagulopathy & thrombocytopaenia)

49
Q

Pathogenesis of DIC

A

excessive systemic intravascular coagulation

50
Q

Causes of DIC

A

Shock
acidosis
hypoxia
infection
trauma
pancreatitis
haemangiosarcoma
heat stroke
burns

51
Q

Clinical signs of DIC

A

Organ failure
spf/ deep bleeding

52
Q

Diagnosis of DIC

A

History of diseases causing severe inflammation/ infection
thrombocytopaenia
schistocytosis
Increased ; ACT, APTT, PTT, FDP, D-Dimer
Decreased ; finbrinogen

53
Q

Treatment of DIC

A

Treat underlying cause
fresh whole blood
frozen plasma
heparin
crystalloid
oxygen therapy
correction of acidosis