Anemia Flashcards
CS for animals with anemia
↑ RR/ effort and HR
Lethargy
Blood in the stool (melena, hematochezia)
Bleeding from nose or other location
Pale or yellow mm
Red blood cells
Lifespan: dogs 110-120 dys and 65-76 dys in cats
Carry O2 to the tissues
Dog: central pallor
Erythropoiesis
Erythropoietin hormone released from kidney with low blood O2 → to blood stream to BM → makes RBCS →↑ O2 carrying capacity
_____________ and ___________ is an indicator of regeneration
Anisocytosis and Pokilocytosis
Blood loss anemia
Trauma, sx, hemorrhage
low PCV and total proteins
Anemia secondary to destruction
Intravascular hemolysis (immune mediated, RBC destroyed in BV)
Extravascular hemolysis (spleen)
Anemia secondary due to decreased production
BM disorder (neoplasia, toxin)
Mechanisms of anemia
Regenerative (reticulocytes) → hemolysis or hemorrhage
Noniregenerative → ↓ production
Pre-regenerative → 3-5 days to mount a regen response
CBC for anemia
Hematocrit (HCT)
PCV
RBC count
Abnormal or normal CBC values in different animals
Greyhounds (normal HCT is high)
Puppies/ pregnancy (Normal HCT is low)
What are the RBC indicies
MCHC: differences in the amount of Hb in RBCs (hyper,hypo or normochromic)
MCV: size of RBCs (macro, micro or normocytic)
Dx for anemia
Chemistry (electrolytes)
Urinalysis
Dx imaging (fluid in heart or lungs, mass)
Infectious dx testing
Coomb’s testing (Immune mediated)
BM aspiriate
External hemorrhage
Low RBC, total protein, and albumin
Evidence of loss
Internal hemorrhage
Low RBC, normal total protein and albumin
GI, urinary and 3rd space
Extravascular hemolysis
RBCs destroyed in the spleen or BM
Hb released and converts to BR
Yellow/ jaundice mm
Intravascular hemolysis
Direct RBC in circulation
Disease that cause hemolysis
Intoxicants (snake and insect bites)
Oxidative injury (tylenol, onion, zinc)
Blood parasites (babesia, cytauzoon, mycoplasma)
Fragmentation of RBCs (neoplasia)
Low Phosphorus (diabetes)
Mild non-regenerative anemias
Anemia of chronic disease/ inflamm
Kidney disease
Liver disease
Endocrine disease
GI/ pancreatitis
Moderate to severe non-regenerative anemias
Infection (FeLV, FIV, tick borne)
Medications (chemo, phenobarb, ACEi)
Toxins (AL, alfatoxin)
Nutrient deficiencies
Aplasia, neoplasia of pure red cell aplasia in BM
Transfusions
Lifesaving for low HCT/ PCV <15
Tx CS of tachycardia, tachypnea, lethargy, mental dullness
Type and crossmatch
Possibly done before 1st transfusion in dogs
Always 2nd or later in dogs
ALWAYS type in cats
Hemantics
Produces more RBCs
Cobalamin (B12)- RBC maturation in animals with GI disease
Folate (B9)- DNA and RNA synthesis in malabsorptive disease (chr. blood loss)
Iron
Erythropoietin stimulation agents
Darbepoetin
Epoetin alfa
Hookworms
LivIngestion and live in the SI
Dx: fecal flotation
Tx: fenben, moxidectin, pyrantel
Hookworms producing anemia
Anemia secondary to blood sucking and bleeding ulcers
Low PCV and total proteins
If total protein is low, what is the next step?
Blood transfusion
Hemangiosarcoma
Tumor from vascular endothelial cells
↑ RR, collapse, lethargy, vomit, anorexia
Dx of hemangiosarcoma
Schistocytes (blood cell fragements)
Regenerative or non regen anemia (hypoproteinemia)
Rads, US and sx biopsy*
Tx of hemangiosarcoma
Cutaneous: sx removal
Cardiac: pericardiocentesis
Splenic: sx, chemo
Immune-mediated hemolytic anemia
Lethargy and RBCs from complement or Igs (ruptured = intravascular)
↑ destruction of RBCs (CBC all ↓)
IMHA dx
Slide agglutination test ( drop of blood, saline on slide, clumping means Abs around RBCs)
What’s seen in IMHA CBC?
Anemia, spherocytes and leukocytosis
IMHA tx
Transfusions
Immunosuppressive meds: steroids, cyclosporine, mycophenolate
Important indicator of anemia secondary to oxidative damage
HBs: irreversible denatured Hb on the outside of RBCs (cats more susceptible)
Anemia from chr. renal dz
Anemia (non-regen), ↓ erythropoietin and GI bleeding
What causes oxidative damage of RBCs
Onion, garlic, zinc, Acetaminophen
