Anemia Flashcards
Animal w/ a severe anemia walking into your clinic demonstrates that the anemia has been chronic How?
Animal w/ a severe anemia walking into your clinic demonstrates that the anemia has been chronic- they have compensated over time.
What do you assume when you see a decrease in all three cell lines?
You have bone marrow issue.
What can you see if you have platelets about 10-15000 or less?
You can have spontaneous bleeding
If you have elevated ALT what can you assume in an anemic animal?
Can potentially have liver dz but could be b/c the liver is hypoxic
and releasing its enzymes. hepatocellular damage due to hypoxi
What can you put on your ddx w/ a st kitts dog w/ a zero reticulocyte count (bone marrow failure) and high globulin?
Animal may have erlichiosis- can have the thrombocytopenia and neutropenia. Antibody destruction of stem cells Is the theory you may have this issue.
Other ddx?–> leukemia involving plasma cells (multiple myeloma)
What are clinical signs of anemia?
Pale mucous membrane, lethargy, reduced exercise tolerance, increase respiratory rate, dyspnea, increased heart rate, murmurs
If you have greater than 50% blasts in a lymph node aspirate- what can you assume?
Lymphoma.
What are some clinical signs associated w/ blood destruction?
Splenomegaly, icterus, hemoglobinuria
Which is more sever slow or rapid onset of anemia?
Rapid onset.
If you see a high mean cell volume in a cat w/ no increase in reticulocyte count what will you think of?
Myeloid dysplasia due to FeLV
What are causes of regenerative anemia?
Blood loos (acute/chronic ) or blood destruction
What occurs during acute blood loss?
Protein decrease along w/ PCV- usually returns to normal w/in one week if blood loss is not ongoing. RBC morphology is usually normal (except w/ hemangiosarcoma in dogs ! acanthocytes and shistocytes
What is common to see in a hemoabdomen dog?
Mesothelial cells (have a glycocalyx brush boarder to distinguish! don’t confuse w/ a neoplastic cell
What are examples of acute blood loss?
Trauma surgery, coagulation disorders, bleeding tumors, thrombocytopenia (blood loss does not cause thrombocytopenia.
Examples of chronic blood loss?
GI ulcer, blooding GI tumor, blood consuming parasites.
o Blood loss form the intestine more common route (90%)
Causes of iron deficiency anemia?
- Nursing animals (inadequate nutrition)
* In adults- almost always due to chronic blood loss
What are lab findings associated w/ iron efficiency anemia?
• Microcytosis, reticulocytes w/ decreased MCV
• RDW usually increased (anisocytosis), normal MCHC, blood film
exam- often show increase in central pallor, keratocyte formation,
• Anemia usually regenerative, unless concurrent anemia of
inflammatory dz. Thrombocytosis common (EPO increase platelets)
• Decrease serum iron concentration, decreased transferrin
saturation, decreased storage iron (ferritin concentration o r hemosiderin in bone marrow, total iron boding capacity usually normal in dogs/cats)
If supplementing iron to neonate- how would you give it?
• Do not give PO!can be hepatotoxic- give IV.
• Oral iron for deficient adults- not very valuable- only have so much
capacity to absorb iron in your gi.
If you see microcytosis what could be a ddx?
• Porto systemic shunt causing microcytosis.
• Breed disposition
• Anemia of inflammatory dz (decreased MCV w/ Autoimmmune dz
common in humans, rare in dogs. (measure storage iron – w/
chronic dz- there is a higher storage iron (blow serum iron)
• Normocytic in dogs- can differentiate b/c anemia of inflame dz will
have increased storage iron.
If you see different bacteria in the GI at same time what can you assume is happening?
• Probably a perforation in the GI.
what are general signs associated w/ blood destruction?
• splenomegaly, hyperbilirubinemia, icterus, hemoglobinemia, hemoglobinuria, total protein normal.
What drugs can cause IMHA?
• Penicillin, cephalosporins, trimethoprim sulfamethoxzaole,
levaminosole
o Horses! penicillin, clostridia infections, and neoplasia
• Cats- associated w/ mycoplasma hamofelis, FeLV, neoplasia
Lab findings w/ IMHA?
thrombocytopenia can be present, leukgraom always inflammatory, may be azotemic.
DDx for spherocteytes?
mismatched blood transfusion, rattlesnake evenomation, Heinz
body anemia in horse can look like spherocyte, zinc toxicosis, bee
stings ba
What are common dog breeds associated with IMHA?
Cocker spaniels, poodles, collies. (slightly higher in females, middle age to old but also young)
What are the disadvantages of the coombs test?
False positives, and false negs
What causes band 3 clustering?
• Heinz body anemia in horses, bee venom (contains mellitin), zinc
toxicosis
o Band 3! exchanges bicarb ion for chloride in RBC
What is the most common cause of anemia by immune mediated mechanism?
RBC parasite
Will you have regeneration anemia in cats w/ M. haemofelis?
- Yes unless FeLV or severe inflammatory dz.
* CATS REMAIN CARRIERS OF m. haemofeils
What is specific about m. haemocanis infections?
M. wenyonii
• Opportunistic, usually only in splenectomized or severely immunosuppressed dogs.
• Only if splenectomized cattle or immunosuppressed – LIMB EDEMA
Issue w/ anaplasmosis?
Immune mediated destruction.
What will you not assume w/ a ruminant w/ regen. Anemia and basophilic stippling like you would in small animals?
lead poisoning.
What does Theileria parva cause?
East coast fever. Hemolytic anemia in ruminants.
What do hemi chromes have to do with heinz body formation?
Hemichrome formation due to oxidative damage. Irreversible hemichromes aggregate into bits of denatured hemoglobin. Sulfhydral groups susceptible to oxidative damage (cats have 8- reason why seen more in cats vs. dogs that have 4. Hemi chrome form complexes w/ protein band 3! cluster of protein band 3 which creates recognition site for autoantibodies.
What is the issue with methemoglobinemia?
Iron is in ferric state- incapable of carrying 02. Blood can look
muddy/ chocolate brown when 30% of hemoglobin is
methmeoglobin. = death when concentration is >90%
What species is susceptible more to copper toxicosis?
Accumulates in liver of sheep! hemolytic anemia, hemoglobinemia, hemoglobinuria, Heinz body formation.
What can cause low phosphrous which leads to decreased glycolysis which an lead to hemolsysis?
Pospartuient hemogloinuria in cattle, diabetes mellitus in cats, enteral alimentation in cats may cause hypophosphatemia> hemolysis
What toxin does clostridum perfinigins type A species produce?
Lecinthinase (alpha toxin! causes hemolytic anemia in lambs and
calves! yellow lamb dz.
What does clostridium haemolyticum cause?
In cattle- bacillary hemoglobinuria- or red water dz. Associated w/ fluke migration.
What is water intoxication in cattle?
Usually in calves- no access to water for a period of time following
unlimited access! decreased osmolality of plasma leads to
hemolysis- can be more sever in animals w/ low iron.
What virus causes hemolysis in horses?
Equine infectious anemia- swamp fever.
What hemolytic anemia’s are due to enzyme deficiencies?
white terrier, cairn terrier)! marked anemia, reticulocytes! meylofobirosis, sclerosis and death by 4
• Pyruvate kinase deficiency in cat! Abyssinian, Somali, DSH- no ultimate osteosclerosis, can live to old age.
o Due to impaired energy metabolism- decrease glucose and ATP formation! increase RBC destruction
• Phosphofructokinase deficiency- English springer spaniel dog, autosomal recessive. PCV normal, hemolytic crisis when alkalemic.
• Porphyria “pink tooth” cattle deficiency of uroporphyrinogen 3 co synthetase! inability to synthesize hemoglobin. Accumulate in teeth. Decrease RBC survival. In pigs! no photosensitization, autosomal dominant. Cats- autosomal dominant- no anemia.
