Anemia Flashcards
T/F: Cold blooded horses have higher PCVs than warm blooded ones
False
Anemic CS depend on what 2 factors?
Rate and severity
CS for acute anemia
Poor performance - obv ex intolerance Tachycardia Tachypnea Pale MM Can be more severe
CS for chronic anemia
Less severe since they have time to acclimate
T/F in order to figure out if horse in regenerating, we can just look @ peripheral blood smear
False - horse’s don’t have reticulocytes
How can we tell horse regeneration?
High RDW+anemia = regenerating
normal RDW = 19
What is the difference between rouleaux and IMHA? How do we sort them out?
Rouleaux is normal equine RBC pattern
IMHA is clumping of RBC
Drop 1:4 saline, rouleaux will come apart
What is the GOLD STANDARD was of evaluating anemia responses in horses?
Bone marrow aspirates
indicated by M:E <0.5
Where can we take bone marrow aspirates?
Sternum and ribs are best places
What are thee mechanisms for anemia?
- Decreased production
- Destruction
- Blood loss
What 3 things can cause decreased red cell production?
- Deficiencies in RBC essentials
- Chronic disease
- Bone marrow damage
T/F: Dietary deficiencies in iron are extremely rare in horses
True!
What is the difference between TRUE/FUNCTIONAL iron deficiency anemia?
True = chronic blood loss(parasites, bleeding GI)/diet
Functional = anemia of inflammatory dz where iron is sequestered
What is true iron deficiency defined by?
Microcytic hypochromic anemia
What is the PCV of functional iron deficiency horses like?
Usually never less than PCV 18-19%
What is the most common cause of anemia in horses?
Inflammatory dz
Please indicate the TIBC/serum ferritin/serum iron/marrow iron differences between anemia of chronic dz and iron deficiency:
Anemia chronic dz: TIBC - decreased Serum Ferritin - increased Serum iron - decreased Marrow iron - increased
Iron deficiency TIBC - increased Serum ferritin - decreased Serum iron - decreased Marrow iron - decreased
What is the treatment for TRUE iron def?
Supplement it with iron cacodylate - parenterally
What is the treatment for anemia of chronic dz?
Treat underlying cause
NO fe supplementation
T/F: we supplement iron in anemia 2ry to organ dysfunction:
False - just treat the underlying cause
*it occurs independent from iron alterations in inflammatory dz
What happens with commercial EPO use?
Development of ab = life-threatening anemia
What 2 major things cause red cell destruction?
Piroplasmosis and EIA
What are the two causative agents of Piroplasmosis?
- Babesia caballi: lg, extravascular
- Theleria equi: small, intravascular, more severe dz, Maltese cross
Both come from tick vectors
T/F: T. Equi can spontaneously clear
False.
B. Caballi can spontaneously clear b/c less severe dz
T. Equi is more severe dz
T/F: CS are worse in young/old animals in endemic areas
True.
Which agent has intravascular hemolysis?
T. Equi
B. Caballi extravasc
T/F: Hemoglobinuria is common B. Caballi.
False!
B. Caballi is extravascular!
What are some piroplasmosis diagnostic options?
- direct visualization of babesia
- serology = ab detectable within 14 days on infection
- CS
- necropsy :(
How does Piroplasmosis tx differ in endemic vs non-endemic regions?
Endemic = tx symptomatically to alleviate signs
Non-endemic = completely eradicate
What can we use in non-endemic areas to eliminate?
Imidocarb
- needs FDA approval
What are some side-effects to Imidocarb?
Causes cholinesterase inhibition
pre-tx with atropine
Do we remove carrier state in non-endemic areas?
YES
do not remove carrier state in endemic areas
What is another name for EIA?
Swamp fever
not to be confused with swamp cancer = pithiosis
T/F: EIA is reportable
TRUE
T/F: EIA is lentivirus or rhabdovirus family
False.
Lentivirus of RETROvirus family
T/F: EIA infects RBCs
False!
EIA infects macrophages and RBCs are indirectly destroyed
How is EIA transmitted?
Biting Arthropods like deer/horse fly who’s feeding is interrupted
sometimes can be transmitted via mosquitoes if there are a ton
(May also be iatrogenic or via semen/milk but that is rare)
Ab-Ag complexes in EIA induce what 3 things?
Hemolysis
Vasculitis
Glomerulitis
What are the 3 CS types:
Acute = no anemia; thrombocytopenia; death 1st few days
Subacute/chronic intermittent = classic; fever/depression/anemia/icterus
Chronic inapparent = “poor doers”, few CS
How can we diagnose EIA? Which is gold standard?
- Coggins test = GOLD STANDARD (can take 45 days)
2. ELISA = detected earlier than 45 days BUT can have false positives
What is the treatment for EIA?
No specific tx.
Isolate for life, euthanize, or send out to research facility
What are the EIA isolation protocols?
- Double screening as insect control
- keep 200 yards from closest horse with double fencing
- disinfect everything used on these horses
Causes of blood loss in equines?
Lots of things:
Resp - ethmoid hematoma, etc. GI - ulcers, parasites, etc. coagulopathies Iatrogenic Etc...
T/F: CS for blood loss are due to hypovolemia, diminished O2 carrying capacity, or both
True!
but it’s mostly hypovolemia since O2 carrying capacity is not usually diminished enough to compromise horse @ rest
What does the blood volume have to recuse by in order to see shock?
Shock occurs when blood vol. is reduced by 30%
What are some compensatory mechanisms for blood loss?
HR
Vasoconstriction
ADH release
Plasma vol. increase = absorption of fluid from 3rd space, increase glucose
In acute hemorrhage, how long does it take to see PCV/TP changes?
TP can decrease within 4-6h
PCV can decrease around 12-24h - b/c of splenocontraction
When does PCV “bottom out”? What does this mean?
Bottoming out = when PCV reaches true lowest level after hemorrhage
Happens after 48h
T/F: It takes about 3-4 days after hemorrhage for bone marrow to respond and increase PCV
True!
How long does it take for PCV to go back to normal values?
4-6 weeks!
How do you treat blood loss?
- treat cause/stop the bleeding
- minimize stress
- replace depending on what happened (may need fluids, blood, O2)
What are some fluid replacement guidelines?
Crystalloids
Replace 4x volume lost
Hypertonic saline
What are the guidelines fro blood transfusion in acute vs chronic anemia?
Transfuse if:
Acute and PCV under 12%
Chronic and PCV under 10%
