Anemia Flashcards
What is anemia?
The decreased oxygen-carrying capacity of the blood
What is anemia is caused by?
Decreased red blood cell production
Increased loss from bleeding
Destruction from hemolysis
What is anemia measured by?
The decrease in the hemoglobin value
The decrease in the PCV
The red blood cell count below normal
How can anemia be revealed based on the stained smear?
The shape, size, and color of red blood cells
Is anemia a disease?
No, it is a symptom of a disease process
How do you classify anemia?
Morphology
Etiology
Regenerative or non-regenerative
Classification of anemia by Morphology
Based on red blood cell size (MCV) and hemoglobin concentration (MCHC)
What is normocytic, normochromic anemia?
The cells are normal in size and color
Macrocytic anemia
Large red blood cells
Transitory increase in response to regenerative anemia
What is the most common type of anemia?
Microcytic, Hypochromic anemia
Hypochromic
Reduced hemoglobin concentration
Pale hemoglobin
Iron deficiency
Is Hyperchromic possible?
No, because red blood cells have a fixed capacity for hemoglobin
What are the causes of normocytic and normochromic anemia?
Trauma with sufficient hemorrhage
Depression of bone marrow resulting in too slow production of cells
What is the primary cause of microcytic, hypochromic anemia?
The continuous, gradual loss of iron from the circulatory system, faster than it can be replaced
What are other causes of microcytic, hypochromic anemia?
Blood-sucking parasites
Dietary iron deficiency may occur in baby pigs
Can be caused by anything that causes red blood cell loss
Etiologic Classification of anemia
Classified according to the cause Hemolytic Hemorrhagic Iron deficiency Production disorders
What is Hemolytic Anemia?
Due to red blood cells rupturing within the vasculature
Affects the liver and the kidney
Usually regenerative
Why does hemolytic anemia have an excess amount of bilirubin?
Because of the breakdown of hemoglobin
What are the causes of hemolytic anemia?
Bacteria and viruses
Blood parasites
Toxins and chemicals
IMHA
Etiologic classification: Hemorrhagic or Blood loss
Acute blood loss due to traumatic injuries
Young animals heavily infected with blood-sucking parasites
Can normocytic normochromic anemia change to microcytic hypochromic anemia?
Yes it can due to gradual blood loss
Etiologic classification: What is iron deficiency?
Continual loss of red blood cells
Caused by a deficiency of necessary chemicals for complete maturation
Microcytic, hypochromic anemia
Iron deficiency may be caused by improper dietary amounts of:
B-12, folic, nicotinic, pyridoxine, protein, copper, cobalt, nickel
What does an acute condition of bone marrow suppression look like? Is there treatment?
Appear as normocytic, normochromic at first
no treatment
Erythropoiesis is reduced or defective
Metabolic inhibition of bone marrow is caused by:
Chronic renal or liver disease
Severe infection
Malignancy
Endocrine disturbances-hyperthyroid, hypoadrenocorticism
What does the CBC of a bone marrow depressed patient look like?
Pancytopenia
Nucleated Red Blood cells
Metarubricytes
Not found in healthy blood, especially in high numbers
If you see more than 5 nucleated red blood cells what must you do?
Perform a Corrected White Blood cell count
What information do you need to perform a corrected white blood cell count?
Total WBC count (from CBC machine)
Total # nucleated red blood cells
What is the formula for corrected white blood cell count?
Total WBC x 100/100 + #nRBC
Why must you perform the corrected white blood cell count?
The CBC machine may have counted nucleated red blood cells as white blood cells, this corrected number gives you the number of WBCs
What is Non-regenerative anemia?
Bone marrow is unable to respond to blood loss
Reticulocytes are absent in blood
Decreased PCV, hemoglobin, and red blood cell
What is regenerative anemia
Appropriate bone marrow response with the release of increased numbers of normal immature red cells
What laboratory tests can you run to determine if it is regenerative anemia?
Reticulocyte count
Erythrocyte indices
RBC morphology
Plasma color, turbidity, total plasma protein concentration
Serum blood iron measurement, bilirubin measurement, and bone marrow evaluation
What are the common causes of non-regenerative anemia?
Iron deficiency Ehrlichiosis Drug toxicity Histoplasmosis Hypothyroidism Renal insufficiency
What is the best clinical index that an animal is responding to anemia?
Reticulocyte count A measurable (quantifiable) method for looking at new red blood cells
What are reticulocytes?
Immature erythrocytes with no nucleus but with retained ribosomal material
What is the difference between polychromatophils and reticulocytes?
Staining
They are the same stage of maturation
Polychromatophil staining
Romanowsky stains (Diff Quick) You can not see remnant ribosomes
Reticulocyte staining
Supravital stain–> New methylene blue
You can see remnant ribosomes
Reticulocyte Staining: Method 1
Place a drop of new methylene blue onto a coverslip and invert it onto the monolayer of a smear
Reticulocyte Staining: Method 2
Better method Mix equal parts of new methylene blue and blood Allow to stand for 10-15 minutes Mix the sample and make a smear Can stain with Romanowsky stain
What are the two forms of reticulocytes that cats have?
Aggregate and Punctate
Aggregate
Large clumps of reticulum
Punctate
Unique to cats
2 to 8 small singular basophilic granules
What is normal aggregate and punctate for cats?
Aggregate: 0.4%
Punctate: 1.5% to 10%
What is a reticulocyte count?
Expression of the percentage of red blood cells that are reticulocytes
Percentage per 1000 red blood cells on oil-immersion
What anemic animal should a reticulocyte count not be performed on?
Horses
They do not release reticulocytes, you have to look at a bone marrow sample
What is a reticulocyte count useful in determining?
Bone marrow response
What can reticulocytes be confused with?
Basophilic Stippling
Basophilic stippling
Also retained organelles
found commonly in lead poisoning
How can you tell the difference between reticulocytes and basophilic stippling?
Stain
Reticulocytes need New Methylene Blue
Basophilic Stippling stains easily with Diff Quick
How many days usually pass before an animal shows signs of anemia?
4 to 7 days from the cause of anemia
What is an adequate response to regenerative anemia?
The percentage of reticulocytes is greater than or equal to the expected percentage for the corresponding PCV
What are the normal reticulocyte ranges for dogs?
0-1.5%
What is the normal aggregate range of reticulocytes in cats?
0-0.4%
What is the normal punctate range of reticulocytes in cats?
1.5-10%
What are other signs of immaturity?
Howell Jolly Bodies
Polychromasia
Nucleated Red blood cells
