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RUSVM LAM1 > Anemia > Flashcards

Anemia Flashcards

1
Q

What can account for normal variation in PCV in horses?

A

Splenocontraction (reserve of up to 30% of the RBC mass).

Breed and age

More athletic animals have a higher resting PCV

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2
Q

How many blood groups are there in the horse?

A

8

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3
Q

T/F: Aa blood type is the universal donor in the horse

A

False

There is NO TRUE universal donor in the horse
For all intensive purposes, Aa, Qa, and Ca are considered universal donors

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4
Q

T/F: donkey blood cannot be used for transfusions in horses

A

True

Due to the donkey factor

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5
Q

The development of clinical signs associated with anemia in the horse is mostly dependent on?

A

Rate and severity of RBC decrease

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6
Q

What are the clinical signs associated with acute anemia?

A

Poor performance and exercise intolerance (subtle cases)

Tachycardia, tachypnea, pale MM, lack of episcleral blood vessels 
Lethargy and depression 
Systolic murmur
Icterus (+/-)
Shock, collapse, and death
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7
Q

T/F: regenerative anemias can be assessed by a peripheral blood smear

A

False

—> horses do not release immature and nucelated RBC

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8
Q

Which value on a CBC might indicate a regenerative anemia in the horse?

A

RDW (red cell distribution width) —> increased width shows increased size variability and likely younger populations of cells

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9
Q

What causes heinz bodies in horses?

A

Phenothiazines, onion, red maple leaves

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10
Q

How can you determine rouleaux formation vs aggregation of RBC in the horse?

A

Diluted blood 1:4 in saline

Rouleaux will disperse
Aggregation will stay aggregated

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11
Q

Hemoglobinemia is associated with what condition?

A

Intravascular hemolysis

—> pink discolouration to serum
—> hemoglobinuria

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12
Q

What are Howell jolly bodies and what do they indicate in the horse?

A

RBC with nuclear remnants

1-2% seen in normal horses, therefore not necessarily indicative of increased erythropoiesis

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13
Q

What is the best way to evaluate if an anemia is regenerative in the horse?

A

Bone marrow

M:E ratio < 0.5
Greater than 5% reticulocytes in the bone marrow

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14
Q

What are the three pathophysiologic mechanisms that lead to an anemia?

A

Inadequate erythrocytes production
Increased erythrocytes destruction
Blood loss

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15
Q

The most common cause of anemia in large animals is due to what pathophysiologic mechanism?

A

Decreased RBC production (usually anemia of chronic disease)

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16
Q

A TRUE iron deficiency usually results from what in the horse??

A

Chronic blood loss

  • parasitism
  • bleeding GIT lesions
  • hemostatic defects

Nutritional deficiency (rare)

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17
Q

A FUNCTIONAL iron deficiency is causes by what?

A

Pathophysiology of anemia of inflammatory disease
-> alterations in normal iron metabolism and results in depressed marrow production

Normal response to inflammation
Iron sequestered form circulation into storage forms
Mechanism to delay bacteria

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18
Q

Horses with a functional iron deficiency usually dont have a PCV below??

A

18-19%

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19
Q 
TIBC : N to decreased 
Serum ferritin: N to increased 
%sat transferrin: N to decreased 
Serum iron: N to decreased 
Marrow iron: N to increased

Type of anemia?

A

Anemia of chronic disease (functional iron deficiency)

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20
Q 
TIBC : N to increased
Serum ferritin: N to decreased 
%sat transferrin: N to decreased 
Serum iron: N to decreased 
Marrow iron: N to increased

Type of anemia?

A

Iron deficiency anemia (true - due to blood loss)

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21
Q

How would you treat a True iron deficiency anemia?

A

Iron supplementation —> iron cacodylate is only safe parenteral prep for the horse

22
Q

How would you treat a functional iron deficiency?

A

DO NOT iron supplement

Treat inciting cause/underlying dz

23
Q

How does anemia result secondary to organ dysfunction ?

A

Chronic organ disease —> marrow suppression

  • decreased erythropoiesis
  • toxic compounds (eg endotoxin)
  • interference of normal EPO action and production
24
Q

How does EPO used as performance enhancer result in anemia?

A

Development of antibodies against human recombinant EPO —> cross reacts with he horses own EPO —> life threatening anemia

(Requires blood transfusions and immunosuppression)

25
Q

Clinical signs

Anemia with icterus
Pale mucous membranes, tachypnea, and tachycardia
Fatigue, depression, and exercise intolerance

What type of anemia is this due to?

A

Increased red cell destruction —> extravasular hemolysis

26
Q

What are the causes of increased red cell destruction?

A

Oxidative damage -> heinz bodies (maple, onion, phenothiazines, and monensin)

Infectious disease —> EIA, piroplasmosis, clostridial infection, equine erlichiosis

Immune causes—> neonatal isoerythrolysis, IMHA, and incompatible blood transfusion

27
Q

Piroplasmosis is AKA?

A

Equine babesiosis —> intraerythrocytic parasitic disease

28
Q

What are the two causative agents for equine piroplasmosis ?

A

Theileria equi and Babesia caballi

29
Q

RBC with pyriform bodies with pointed ends meeting in acute angles

What is the organism?

A

Babesia caballi

30
Q

RBC with pyriform bodies dividing into groups of 4, forming the Maltese cross

What organism is this?

A

Theileria equi

31
Q

T/F: both T. Equi and B.cabelli are transmitted transstadially (horizontally) within ticks

A

False

T. Equi = transstadially (horizontally)
B. Cabelli = transovarially (vertically)

32
Q

What tick sp transmits T. Equi and B.cabelli?

A

Dermacentor and Rhipicephalus

33
Q

In endemic areas, what clinical signs do horses usually have with piroplasmosis?

A

Trick question
In endemic areas, horses are usually infected without clinical signs
Recovered horses are often asymptomatic carriers

34
Q

How do we diagnose babesiosis infection?

A

Parasites on blood smear (difficult in carriers or low parasitemeia) —> Giemsa-stain

Serology —> AB detectable in 14days of exposure (IFA or competitive ELISA)

Clinical signs —> hemoglobinuria

35
Q

Horse with

Fever
Hemolytic anemia
Icterus and hemoglobinuria

Depression, weakness, anorexia, incoordination, lacrimation, mucous nasal discharge, and swelling of eyelids?

DDX?

A

Piroplasmosis (Babesia)
Equine granulocytic ehrlichiosis (anaplasma)
Equine infectious anemia (lentivirus)
Liver failure with hemolytic anemia

36
Q

What is the treatment goal of babesiosis in endemic areas?

A

Treat to alleviate clinical signs

Minimize severity of clinical disease

Presence of organisms required to maintain immunity —- DO NOT clear

37
Q

What is the treatment goal for babesiosis in non endemic areas?

A

Complete eradication of organism

Clear and treat serology for reversion to negative status

38
Q

What drug can be used to eliminate the carrier state of babesiosis?

A

Imidocarb diproprionate (cholinesterase inhibitor)

This only clears B.cabelli, T.equi is more resistant —> buparviaquone

39
Q

What are side effects seen with imidocarb? How can this be prevented?

A

Colic and diarrhea

Can half the dose with 1hr interval between doses
OR
Pretreat with glycopyrrolate > atropine

40
Q

Equine infectious anemia is AKA?

A

Swamp fever

41
Q

What is the causative agent for equine infectious anemia?

A

Lentivirus of the retrovirus family

  • > non-oncogenic retrovirus
  • > RNA directed DNA polymerase
  • > infects macrophages - integrates into the host genome
42
Q

What is the main vector for EIA?

A

Deer and horse fly

Biting insects with interrupted feeding (will go feed on another horse and transmit the virus)

43
Q

What is the pathophysiology of EIA?

A 
Infects macrophages (cellular and humoral response) 
-> ag-ab complexes induce hemolysis, vasculitis, and glomerulitis

Anemia

  • > immune mediated hemolysis
  • > decreased intravascular erythrocytes survival time
  • > decreased bone marrow erythrocytes production

Thrombocytopenia

44
Q

Acute EIA causes an (intravascular/extravascular) hemolytic anemia?

A

Extravascular

45
Q

What is the acute form of EIA?

A

Thrombocytopenia

Fever, depression, and petechial hemorrhage
Anemia not typically seen at this stage

46
Q

What is the subacute/chronic intermittent form of EIA?

A

Recurrent episodes of fever, depression, anemia, and icterus (associated with antigenic drift)

Lymphadenopathy, petechial hemorrhage
Edema
Weight loss

47
Q

What is the chronic imapparent form of EIA?

A

Chronic “poor doer”

Periodic anemic crisis

48
Q

What is the only accepted EIA for state and international trade ?

A

Coggins test

-> can take up to 45days to produce detectable level of antibodies

49
Q

What test can be used in earlier cases (<45days) to determine EIA infection?

A

ELISA

50
Q

What is the treatment for EIA? And regulations for postives cases?

A

None

REPORTABLE disease
—> cull

If not culled, required permanent quarantine
—> barn with double screening
—> minimum 200yards from closest horse (double fenced pasture)
—> disinfection of all instruments

51
Q

What can lead to the development of IMHA?

A

Virus -EIA
Bacterial - clostridum
Protozoa- equine ehrlichiosis/babesiosis
Neoplasia - lymphosarcoma
Drugs- penicillin, suphas, phenylbutazone
Immune mediated dz- purpura hemorrhagica or SLE

RUSVM LAM1 (17 decks)

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