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Small Animal Med. I > Anemia & Erythrocytosis - Green > Flashcards

Anemia & Erythrocytosis - Green Flashcards

1
Q

Which animals have lower than normal PCV?

Higher than normal PCV?

A
  • Lower than normal
    • Puppies
    • Kittens
  • Higher than normal
    • Sight hounds
    • Dachshunds
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2
Q

What are 2 big questions you should be sure to ask

the owners of patients that present for anemia?

A
  • Current Medications
    • NSAIDs can cause
  • Cat → FeLV/FIV status
    • Macrocytic, non-regenerative anemia
    • Mild to no reticulocytosis
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3
Q

What do petechia, ecchymoses & evidence of deep bleeding suggest?

A

Platelet or clotting disorder

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4
Q

What do icterus, hemoglobinuria & auto agglutination suggest?

A

IMHA or other causes of hemolysis

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5
Q

Can you have a regenerative anemia with a normal MCV or MCHC?

A

YES

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6
Q

How do you calculate the Reticuloctye Index (RI)?

What does it tell you?

A
  • (Patient PCV/45) x Reticulocyte % = RI
  • RI > 2.5 = regenerative anemia
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7
Q

What does the Absolute Reticulocyte # tell you?

A

> 60,000 = regenerative anemia

NB: Most in-house CBC machines don’t give you this value

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8
Q

When will anemia due to blood loss be regenerative?

A

after 48-96 hrs

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9
Q

List broad causes of Blood Loss.

A
  • Hemoabdomen
  • Hemothorax
  • Epistaxis
  • GI bleeding
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10
Q

What type of Hypersensitivity Rxn is IMHA?

What is targeted?

A
  • Type II Hypersensitivity
  • Abs against cell surface or cell receptors
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11
Q

What does AIHA (Autoimmune Hemolytic Anemia) indicate?

A

1° IMHA

(“Idiopathic”)

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12
Q

What does the term IMHA/IHA imply?

(IHA=immune hemolytic anemia)

A

May be either 1° or 2°

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13
Q

What does “Evan’s Syndrome” refer to?

A

IMHA + ITP (usually 1°)

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14
Q

Which form of IMHA is the most common?

A

Primary

(induction of self-directed Abs)

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15
Q

What classifications of IMHA fall under the “Warm” category?

A

Class I - III

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16
Q

Tell me about Class I IMHA

A
  • Autoagglutination
  • IgG mediated
  • Extravascular hemolysis (MPS)
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17
Q

Tell me about Class II IMHA.

A
  • Involves compliment
  • IgM mediated
  • Intravascular hemolysis
18
Q

Tell me about Class III IMHA.

A
  • Spherocytes
  • IgG mediated
  • Extravascular hemolysis

Most common form in dogs

19
Q

Which classifications of IMHA fall under the “Cold” category?

A
  • Class IV
  • Class V
  • Class IV & V together
20
Q

Tell me about Class IV IHMA.

A
  • Cold agglutination
  • Intravascular hemolysis
21
Q

Tell me about Class V IMHA.

A
  • Cold agglutination
  • Extravascular hemolysis
22
Q

What is the most common cause of hemolysis in DOGS?

A

1° IMHA

23
Q

What is the most common cause of hemolysis in CATS?

A

2° IMHA

24
Q

Which dog breeds have a predilection for IMHA?

A
  • American Cocker Spaniel
  • English Springer Spaniel
  • Old English Sheepdog
  • Irish Setter
  • Poodle
  • GSD

NB: Any breed can get this!

25
Q

What is the minimum data base for IMHA?

A
  • CBC
  • Chem panel
  • RBC parasite evaluation ⇒ blood smear
26
Q

What are some specific tests used to DX IMHA?

A
  • Slide agglutination
  • Coomb’s test
    • ONLY if (-) slide agglutination test
  • Tests for possible causes
    • Rads, tick panel, FeLV/FIV
27
Q

What values on a UA will point you towards the orgin of hemolysis?

A
  • Intravascular hemolysis
    • Hemoglobinuria
    • Proteinuria
  • Extravascular hemolysis
    • Bilirubinuria
28
Q

When is BM assessment needed?

A

Only with Non-Regenerative Anemias

29
Q

How do corticosteroids help manage IMHA?

A
  • Suppress MPS (mononuclear phagocytic system) activity
  • Decrease complement & Abs. binding to cells
  • Suppress Ig production

NB: Requires long term therapy, possibly even life long

30
Q

What drugs can you use for TXing Refractory IMHA?

(4)

A
  • Cyclosporine (Atopica®)
  • Azathioprine (Imuran®)
  • Leflunomide
  • Human Immunoglobulin ⇒ but $$$$$
31
Q

What % of IMHA patients require a blood transfer?

A

70-90%

32
Q

Which organs are we concerned about in regards to perfusion and resulting DIC?

A
  • Liver
  • Pancreas
  • Gut
33
Q

What is the most common cause of Non-regenerative anemia in dogs & cats?

A

Anemia of Chronic dz.

34
Q

What is the most common cause of Semiregenerative Anemia?

A

Chronic GI blood loss

35
Q

Tell me about Relative polycythemia.

A
  • High TS
  • High albumin
  • Due to: dehydration, fluid loss, diarrhea, burns
36
Q

Tell me about Absolute polycythemia.

A
  • Normal TS
  • True polycythemia ⇒ not due to hemoconcentration
37
Q

Tell me about 1° Absolute Polycythemia.

A
  • Independent of EPO
  • Polycythemia Rubra Vera → BM problem
38
Q

Tell me about 2° Absolute Polycythemia

A
  • EPO dependent
  • Physiologically appropriate:
    • 2nd to chronic hypoxemia
  • Physiologically inappropriate:
    • NO systemic hypoxemia
39
Q

How should you approach a patient with Absolute Polycythemia?

A
  1. Arterial blood gas & thoracic rads
  2. Search for neoplasia/renal dz
    • Thoracic rads, Abdominal U/S
  3. Measure EPO levels
40
Q

What does Low EPO indicate?

A

Polycythemia rubra vera

(1° polycythemia)

41
Q

How do you TX Polycythemia rubra vera?

A
  • Periodic phlebotomy
  • Hydroxyurea

Small Animal Med. I (18 decks)

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