Anemia 2

Question 1

Case 1: 4yr GSP
Lethargy and inappetence
UTD vaccine and preventative
PE: Increase HR and RR
Icteric gums and sclera, bounding pulse
CBC:
PCV 18%
TS 7.2%
Icertis Serum
Lactate increased
All cell lines decreased
Polychromasia, anisocytosis, Heinz body, ghost, spherocyte

What kind of anemia? What additional tests could you perform to help confirm?

Agglutination Positive

What the diagnosis?

Answer 1

Hemolytic

Agglutination Test

IMHA

Question 2

What are some common signs of IMHA?

Answer 2

Immune mediated hemolytic anemia (regenerative)
Spherocyte or agglutination
Strongly suspicious - inflammatory leukogram and hyperbilirubinemia

Primary vs secondary (idiopathic) I(infection, neoplasia, drug induced)

Question 3

What additional diagnostics could be run to rule out secondary IMHA?

Answer 3

Infectious disease testing (regional, species specific, babesia, FeLV, Mycoplasma
Cancer screening - thoracic and abdominal

Question 4

What is the treatment for IMHA?

Answer 4

Treat the underlying disease
Immunosuppression
-Prednisone (months)
Antithrombosis - clopidorgel, asprin
Anticoagnulant - unfractionated heparin, low molecular weight heparin, oral anti-Xa
Blood transfusion as needed

Remission can decrease dose by 25 percent then reassess after 2 weeks

Question 5

Case 2: Hippo
4yr DSH
Lethargy and inappetance, neck pain, hypothermic, bradycardic, tachypnic, weak pulse

PCV 36 (Normal)
TS 5.6 (Decreased)

What kind of anemia?

Answer 5

Loss

Question 6

Additional test for hippo reveals
Prothrobin >120 sec
Partial throboplastin >120 sec

Answer 6

Loss - anticoagulatory disease (rodenticide)

Question 7

What treatments?

Answer 7

Fluid bolus
plasma
Reassess HR, Temp, Mentation
Give vitamin K1
Oral vitamin K1

Question 8

Case 3: Daisy
10yr chow chow
Acute lethargy
inappetence
Assessment:
QAR, white MM, no CRT, murmur

What kind of anemia?

Answer 8

Decease production
Chronic external blood loss
(microcytic, hypochromic)

Question 9

What additional diagnostics do you recommend?

Answer 9

Ultrasound

Cancer

Question 10

Case 4: Margaret
1.5yr female spayed DLH
Lethargy and inappetence sudden
Many cat at home
White mm, no crt, strong pulse, mumur

Anemia?

Answer 10

Lack production
Non-regenerative

Question 11

What diagnostics?

Answer 11

FeLV/FIV
Bone marrow aspirate