Anemia, Blood Loss, Hemolysis Flashcards
what is anemia?
decrease in circulating red cell mass
how can you recognize anemia due to hemolysis?
low PCV
normal protein
how can you recognize blood loss?
low PCV
low protein
what factors should you consider when a horse presents with anemia?
sex
hydration status
excitement
age
breed
what type of heart murmur might be present with anemia?
usually systolic
what do we evaluate for anemia?
HCT/PCV and total solids
hemoglobin concentration
red blood cell count
blood smear
red blood cell indices
bone marrow (chronic/long term anemia)
what do we look at in horses to see if anemia is regenerative?
increased percentage of macrocytes
not reticulocytes
what is the circulating volume of blood?
approximately 8% of body weight
how much can horses increase their PCV by contracting their spleen?
acutely double their PCV
how long does it take for the PCV and total solids to drop after acute blood loss?
8-24 hours
what are some causes of blood loss that loses blood outside of the body?
trauma
epistaxis
hematuria
gastrointestinal bleeding
what is the positive of bleeding inside the body?
the blood may have a chance of being recovered by the body
increase PCV’s faster
what are the causes of gastrointestinal hemorrhage?
ulcerations
NSAID toxicity
parasites
granulomatous intestinal diseases
neoplasia
coagulopathy
how does hypertonic saline help with restoring blood volume?
high oncotic pressure will cause rapid expansion of blood volume
why might high volumes of crystalloids be a problem with restoring blood volume?
may lead to dilution of clotting factors
is blood the fluid of choice for rapid resuscitation?
no
when should you give a blood transfusion in chronic blood loss?
elevated lactate
persistent hypotension
PCV <12%
how much blood can you safely take from a 450kg donor?
6-8 liters
what horses are ideal donors for nonmatched?
gelding
mare that has never been pregnant
what do antifibrinolytic lysine analogs do?
prevent clot breakdown
how can you recognize intravascular hemolysis?
hemoglobinuria
hemoglobinemia
what infectious diseases can cause hemolysis?
piroplasmosis
equine infectious anemia
what is oxidant induced damage characterized by?
heinz body formation
hemolytic anemia
methemoglobinemia
how can you differentiate intravascular hemolysis from extravascular hemolysis with hemoglobin?
hemoglobin high in intravascular hemolysis
hemoglobin low in extravascular hemolysis
is hemoglobin low or high in lack of production anemia?
low
what is hemoglobin in reference to hematocrit?
1/3 of hematocrit
higher in intravascular hemolysis
what does nonregenerative anemia result from?
abnormal bone marrow erythropoiesis
how much can an animal bleed and still have a chance of survival?
33% of circulating blood volume
where is there the most vasoconstriction in compensatory mechanisms for decreased blood volume?
splanchnic
cutaneous
skeletal tissue beds
why might PCV not be abnormal immediately (up to 8-24 hours) after acute blood loss?
splenic contraction
what are some blood loss causes from inside the body?
trauma
mesenteric vessel rupture
verminous arteritis
uterine artery rupture
abdominal abscess
neoplasia
coagulopathy
what can cause hematuria?
neoplasia
pyelonephritis
urolithiasis
trauma
coagulopathy
what can cause GI hemorrhage?
ulcerations
NSAID toxicity
parasites
granulomatous intestinal diseases
neoplasia
coagulopathy
is it okay to give hypertonic saline if the bleeding is not controlled?
no- deleterious
what is the dose of hypertonic saline?
4-6 ml/kg
what are the natural colloids?
blood
plasma
what are thee advantages of colloids?
plasma volume expanders
increase cardiac output
what does giving blood help with?
restores oxygen-carrying capacity, clotting proteins, and oncotic pressure
what is a major cross match?
donor red blood cells
recipient plasma
what is a minor cross match?
donor plasma
recipient red blood cells
when should you give a blood transfusion for chronic blood loss?
elevated lactate
persistent hypotension
PCV <12%
when should you give a blood transfusion for acute severe hemorrhage?
PCV <20%
what should you collect blood into for a blood transfusion?
acid-citrate-dextrose
how much of the calculated blood loss should you administer?
30-40%
what types of hypersensitivity can be seen with transfusions?
1, 2, 4
what can you give naloxone for?
decrease cardiovascular derangements
what infectious diseases can cause hemolysis?
piroplasmosis
equine infectious anemia
what can cause oxidant induced damage hemolysis?
red maple
onion
phenothiazine
what can be seen on a chem with IMHA?
increased total and indirect bilirubin
why should you monitor the feet of horses with oxidant-induced hemolysis?
laminitis
