Anaemia Flashcards
What 3 things can anaemia be define by?
–PCV
–Red blood cell count
–Haemoglobin
Name 2 normal occassions there would be a raised PCV (3)
Greyhounds and other sight hounds often naturally have a higher PCV (>50)
Stress/ excitement causes splenic contraction e.g. going to vets
Anabolic steroids
Name 2 normal occassions there is a decreased PCV (3)
Age – puppies and kittens< 6-12 months have a lower normal range
- Puppies 25-34% vs adult 37-55%;
- Kittens 24-34% vs adult 24-45%
- Always say the age!!! They have a different reference range at the lab
ACP (relaxes splenic capsule so more RBCs in storage) – keep this in might if you use ACP to image the spleen
Reproductive status (late pregnancy)
Name 2 causes of regenerative anaemia
- Blood loss
- Haemolysis
Name the cause of non regenerative anaemia
Supression o erythropoiesis whether it is intra or extra marrow
Where and how can you get regenerative anaemia?
Where?
- External blood loss
- Blood loss into body cavity (haemothorax, haemabdomen)
How?
- Trauma e.g. RTA
- Coagulopathy
- What should normally be okay is being dramatic
- Endo or ectoparasites
- GI blood loss (tumours, ulcers
What is haemolysis?
•Erythrocytes removed prematurely from circulation by macrophages in spleen, liver or bone marrow (extravascular haemolysis)
–Phagocytic system getting rid of them
•Destruction of erythrocytes within the vascular space
Name causes of haemolysis (5)
- Immune mediated haemolytic anaemia (IMHA)
- Neonatal isoerythrolysis (NI)
- Infection (Babesia spp, Mycoplasma haemofelis)
- Oxidative damage
- (Heavy metals, onions, paracetamol toxicities)
- Also oxidative damage from drugs eg paracetamol in cats.
- Rare genetic disorders
- Hereditary non-spherocytic haemolytic anaemia
- Pyruvate kinase deficiency
- Phosphofructokinase deficiency
- Feline porphyria
- Haemolysis in Abyssinian & Somali cats
Name 2 haemolytic infections
Mycoplasma haemofelis
Babesia ssp
(protozoon)
(bacterium)
What is the epidemiology of Babesia sp.?
Endemic in cattle in some areas in UK
Emerging infectious diseases in dogs (pet travel, climate change)
How can oxidants induce haemolysis?
–Oxidation of haem iron to form methaemoglobin (no longer carrying Oxygen)
–Oxidation of haemoglobin to form Heinz bodies
Name 2 things which cause oxidative damage causing haemolysis (4)
- Heavy metals (Zinc, Copper)
- Onion digestions, garlic (usually dogs)
- Rape, kale and cabbages
- Drugs
- Paracetamol
Name 3 primary disorders of erythropoiesis (intra-marrow) (5)
- Iron deficiency
- Aplastic anaemia (damage to haemopoietic stem cells)
–Ehrlichia canis, canine and feline parvovirus, idiopathic
–Drugs including chemotherapeutics (often white cell lines affected too)
•Pure red cell aplasia – RBC just not produced
–Immune-mediated, FeLV C
•Myelofibrosis
–Scarring in bone marrow
•Myelodysplastic syndromes (MDS)
–Stem cells not forming properly usually a neoplasia
Name 3 secondary disorders of erythropoiesis
(extra-marrow) (5)
- Anaemia of chronic disease
- Anaemia of chronic renal failure
–Not more hormone production signalling
- Secondary to endocrine disorders
- Oestrogen-induced bone-marrow suppression
–Or a prolonged oestrous
•FeLV (additionally to specific disease of FeLV-C)
Name clinical signs of anaemia
- Often absent adaptation to chronic anaemia
- Inadequate perfusion/ oxygenation
- Pale mucous membranes
- Lethargy, exercise intolerance
- Compensatory mechanisms
- Tachypnoea
- Tachycardia
- (making up for lack of)
- Other signs
- Poor pulse quality
- Flow murmur
- Pica – eating weird things. Mineral based are common
- Signs related to underlying pathology
- Splenomegaly, lymphadenopathy, pain, icterus, melaena (due to bleeding into GI tract
What is different about cat mucous membranes?
The are naturally paler
What is different about clinical signs of chornic anaemia?
May not show signs as they are used to it
Name clinical signs associated with an increase in haemoglobin catabolism
Haemoglobinemia
Haemoglobinuria
icterus (jaundice)
What is this and when is it seen?
Icteric serum when serum bilirubin levels >20mmol/L
When do you see icteric tissues?
When seerum bilirubin levels >50 micro mol/L
How long might regenerative anaemia lag for?
2-4 days