Anaemia

Question 1

What are the cut offs for anaemia in the dog?

Answer 1

30-36% mild anaemia
18-29% moderate
Less than 18% severe

Question 2

What are the cut off for anaemia in the cat?

Answer 2

20-24% mild
15-19% moderate
Less than 14% severe

Question 3

How can you classify an anaemia based on MCV?

Answer 3

High MCV - macrocytic - regenerative anaemia
Normal MCV - normocytic - normal / anaemia of chronic disease
Low MCV - iron deficiency anaemia, PSS

Question 4

How can you classify anaemia based on MCHC?

Answer 4

Raised MCHC - hyperchromic - rare - artefact
Normal MCHC - normochromic - anaemia of chronic disease
Low MCHC - hypochromic - iron deficiency anaemia

Question 5

How can you assess the regenerative response on a blood smear?

Answer 5

Degree of polychromasia on a blood smear

Absolute reticulocyte count

Question 6

When will you see a regenerative anaemia?

Answer 6

Haemolysis

Haemorrhage

Question 7

When will you see non-regenerative anaemias?

Answer 7

Primary bone disease
- Bone marrow suppression - oestrogen pill ingestion, Sertoli cell tumour
Chronic kidney disease

Question 8

Chronic blood loss anaemia

Answer 8

Regenerative or non-regenerative

Microcytic, microchromic anaemia

Question 9

Anaemia of chronic disease

Answer 9

Non regenerative, normochromic, normocytic anaemia

• CKD
• mild chronic inflammation

Question 10

Anaemia in IMHA

Answer 10

Severe anaemia 
Marked regeneration 
Spherocytes
Cell ghosts 
Agglutination - diagnostic 

Left shift neutrophillia and monocytosis

Question 11

What is a metarubricyte?

Answer 11

Young nucleated RBC that can’t be distinguished from a granulocyte by the analyser

Question 12

What test should you use to confirm a diagnosis of IMHA?

Answer 12

Coombs test

Question 13

How should you treat idiopathic IMHA?

Answer 13

Corticosteroids 
Azathioprine 
Cyclophosphamide 
Ciclosporin
Plasmapheresis 
Splenectomy 

Supportive

• oxygen
• fluids
• clopidogrel / aspirin - reduce the risk of thromboembolism
• blood transfusion

Question 14

Cause of secondary IMHA?

Answer 14

Neoplasia
Intra-erythrocytic parasites / Bacteria
- mycoplasma haemofelis
- anaplasma 
- babesia 
- erhlichia
Feline retroviruses - FeLV

Question 15

What infectious agent causes a non-regenerative, normocytic, normochromic anaemia which is not responsive to erythropoietin?

Answer 15

FeLV

Virus attacks bone marrow causing an aplastic anaemia

Question 16

Which feline retrovirus causes leukopathia and leucocytopaenia?

Answer 16

FIV

Question 17

Mycoplasma Haemofelis

Answer 17

Regenerative or non regenerative anaemia
Causes both intra and extra vascular haemolysis
Severe anaemia

Blood smear examination is insensitive therefore PCR recommended for diagnosis

Tx: doxycycline, prednisolone

Question 18

Schistocytes

Answer 18

Fragmented RBCS

• DIC
• Glomerulonephritis
• Neoplasia
• Vascular anomalies

Question 19

Acanthocytes

Answer 19

Multiple mounded projections on RBCs

• Liver disease
• Splenic haemangiosarcoma
• lymphoma
• Glomerulonephritis

Question 20

Indicators of oxidative damage

Answer 20

Methaemoglobinaemia
Heinz bodies
Eccentrocytes

Question 21

How can you treat oxidative injury to RBCs?

Answer 21

Withdraw cause
Methylene blue
N-acetyl cystine - paracetamol toxicity