Anemia 1 and 2 Flashcards
define anemia
reduced oxygen carrying capacity from insufficient hemoglobin and red blood cell mass within the vasculature
what hx implies anemia?
weakness, lethargy, collapse, pallor, pale gums, jaundice, icterus, yellow gums, sclera, skin, recent trauma, melena, hematochezia, obvious blood loss, breathing changes and a distended abdomen
what physical exam findings imply anemia?
pale pink or white gums from vasoconstriction, tachycardia, heart murmur, bounding or weak pulses, dullness, weakness, collapse, icterus, bruising, petechiae, pleural or abdominal effusion
T/F: rapid moderate drops in hemoglobin/RBC’s would show more severe clinical signs that slow severe reductions
T, the body adjusts to the anemia in chronic cases
what tests should be used to confirm anemia?
PCV, TS, CBC (hematocrit, blood smear, reticulocyte count)
3 categories of anemia
- loss
- destruction
- lack of production
PCV/TS with blood loss anemia
Early -> normal PCV with slightly increased or normal TS
Later -> low PCV, low TS
PCV/TS with destruction anemia
Low PCV, normal or increased TS
PCV/TS with lack of production anemia
Low PCV, normal or increased TS
CBC with blood loss anemia
Early (less than 3 days of bleeding): pre-regenerative -> low or normal reticulocytes, normocytic, normochromic
Later (more than 3 days): regenerative, reticulocytosis, macrocytosis, hypochromic, polychromasia, maybe some nucleated RBCs
CBC with destruction anemia
This is usually and inflammatory leukogram, reticulocytosis, spherocytosis, macrocytic, hypochromic
CBC with lack of production anemia
Low reticulocytes (non regenerative), Normocytic, hypochromic or normochromic
broad categories that may cause acute blood loss anemia
trauma, coagulopathy, cancer
broad categories that may cause chronic blood loss
parasites, ulcers, cancer
Hemolytic Anemia
This is commonly immune mediated but sometimes infectious or oxidative damage. Rarely its a result of inherited RBC abnormalities. The hemolysis can be intravascular or extravascular
Hypoplastic anemia
This includes your refractory anemia such as renal failure, anemia of chronic disease, and iron deficiency along with bone marrow disorders. If you have a hypoplastic anemia and suspect a bone marrow disorder, sample the bone marrow .
what do bounding pulses indicate?
a difference between systolic and diastolic pressure
key features of zinc toxicity
young dog that is vomiting and has a moderate to severe regenerative anemia, hyperbilirubinemia, and an inflammatory leukogram. Around 20% of cases will have mild spherocytosis. The prognosis is good to excellant.
a patient presents with yellow mucous membranes, what type of anemia are you MOST concerned about?
destruction
Describe blood work findings that would make you suspect IMHA.
- Regenerative anemia - spherocytes
- agglutination
- inflammatory leukogram
- hyperbilirubinemia
secondary causes of IMHA
infections, neoplasia, drug induced
Treatment for IMHA
Immunosuppression with prednisone is the first line of treatment and will be reassessed when the patient is clinically normal. Once they are considered in remission by clinical signs and CBC, wait 2 weeks and start to wean the dose. IT important to warn clients that this may take months or in some cases be permanent. Alternatives to prednisone are cyclosporine or azothioprine. The patient should also be started on an anti platelet drug, clopidogrel, and blood transfusions as needed.
If PCV/TS are moving down together what type of anemia is it?
blood loss
treatments for vitamin K antagonist rodenticides
- Fluid bolus with LRS
- thaw fresh frozen plasma
- reassess HR, temp, mentation after fluid bolus
- give vitamin K parenterally
- start oral vitamin K1 as soon as reasonable (preferably with fatty meal)
- depending on what you having/how they react you may need to give whole blood
why do we give vitamin K to rodenticide cases?
Rodenticide are vitamin K antagonists that make clotting factors 2, 7, 9 and 10 nonfunctional prolonging the PT and PTT. Therefore you need to administer vitamin K so the liver can make functional cofactors.
Describe the CBC of iron deficient anemia
- microcytic
- hypochromic,
- regenerative or non regenerative anemia
- poikilocytes (rbc’s w/abnormal shapes)
if a patient has iron deficient anemia, where should you go looking for a lesion?
GI tract-> neoplasia, parasitism, ulcers
looking for chronic external blood loss
