Anemia in small animal

Question 1

Define anemia

Answer 1

Reduction in the concentration of haemoglobin in the blood which causes reduced oxygen carrying capacity

Question 2

List some causes for non regenerative anemia

Answer 2

1. Primary bone marrow disease
2. Iron deficiency
3. Inflammatory disease
4. Chronic renal failure
5. Endocrine disease e.g. Hypothyroidism
6. Cobalamin deficiency

Question 3

What are the two categories under regenerative anaemia

Answer 3

Haemolytic
Haemorrhage

Question 4

List some causes for Haemolytic anaemia

Answer 4

1. IMHA (Immune mediated Haemolytic anaemia)
2. Infectious
3. Oxidative injury
4. Metabolic disorders

Question 5

List some causes for Haemorrhage anaemia

Answer 5

1. Trauma
2. GI Ulcer
3. Haemostatic disorder
4. Ruptured neoplasm

Question 6

List some conditions that cause primary bone marrow disease

Answer 6

1. Aplastic anemia
2. Myelomafibrosis-scarring of bone marrow
3. Myelodysplastic (Cats-immature blood cells in the bone marrow do not mature or become healthy blood cells)
4. Precursor IMHA (Dogs)

Question 7

List some conditions under that fall under secondary failure of erythropoiesis

Answer 7

1. Anaemia of inflammatory disease
2. Chronic renal failure
3. Endocrine disease
4. Deficiency in building blocks (Fe/Cobalmin)

Question 8

List some distinguishing clinical features of primary bone marrow disease

Answer 8

1. Lethargy/Weakness/Fatigue
2. BAR (because not quick onset of anemia)
3. Other cell lines affected (thrombocytopenia/neutropenia)

Question 9

List causes of secondary failure of erythropoiesis

Answer 9

1. Chronic Kidney Disease: PUPD/Reduced Appt/Weight loss
   2.Hypothyroidism: Dermatological
2. Fe deficiency: Chronic low-grade external blood loss due to parasitism, ulcerative GI, chronic urinary losses
3. Cobalamin deficiency: Chronic GI disease/Unable to absorb vitamin b12

Question 10

What are the two types of IMHA

Answer 10

Primary (non associative) IMHA- Autoimmune
Secondary (associative) IMHA- E.g. Lymphoma can produce antibodies that target RBC

Question 11

Describe IMHA

Answer 11

When the body produces antibodies or complements that targets RBC

Question 12

State the name of the receptor of RBC that the macrophage binds if a patient has IMHA

Answer 12

Fc Receptor

Question 13

State 3 causes of secondary IMHA

Answer 13

1. Infectious
2. Drug induced
3. Neoplasia

Question 14

List examples of infectious diseases that can cause secondary IMHA

Answer 14

Bacterial (Haemoplasma-Cats)
Parasitic (Babesia-Dogs)

Question 15

What is the cause of Feline Infectious Anemia

Answer 15

Mycoplasmas (Bacteria)

Question 16

How does Mycoplasmas cause Feline infectious anemia

Answer 16

Causes haemolysis involving immune mediated and direct erythrocyte damage

Question 17

How is Feline Infecious Anemia diagnosed

Answer 17

Haemoplasmas seen on bloodsmear- Howell Jolly bodies
PCR
Coombs test positive

Question 18

What is the most common infectious disease of anaemia in dogs

Answer 18

Canine babesiosis

Question 19

What is the clinical signs for Canine babesiosis

Answer 19

Pyrexia
Haemolytic anaemia, including IMHA
Thrombocytopenia

Question 20

List some causes for haemolytic anaemia-Oxidative injury- which causes the formation of heinz body

Answer 20

1. Paracetamol toxicity
2. Onion toxicity
3. Benzocaine
4. Zinc toxicity
5. Propofol infusion in cats
6. Diabetes/Hepatic lipidosis in cats

Question 21

List distinct clinical features of haemolysis

Answer 21

1. Jaundice
2. Haemoglobinuria
3. Hepato-splenomegaly
4. Pyrexia
5. Chocolate coloured oral mm as a sign of metHb

Question 22

List distinct clinical features of haemorraging anemia

Answer 22

1. Evidence of bleeding External/Internal
2. Sings of hypovolaemia
3. Evidence of a haemostatic disorder-Petechiaton

Question 23

What are the values of PCV that define mild/moderate/severe anemia

Answer 23

Mild: 30-39%
Moderate: 20-30%
Severe: <20%

Question 24

What does spherocytes on blood smear suggest

Answer 24

IMHA

Question 25

Distinguish between blood smear result from Primary bone marrow disease and Secondary failure of Erythopoiesis

Answer 25

PBMD: Normocytic (Size) /Normochromic anaemia (Concentration of Hb)/ Concurrent bicytopenia/pan-cytopenia SFOE: Microcytic/Hypochromic

Question 26

List distinguishing laboratory features of IMHA

Answer 26

Regenerative anaemia Spherocytosis Leucocytosis due to neutrophillia Evan's syndrome: Concurrent immunemediated thrombocytopenia Evidence of organ damage

Question 27

Thrombocytopenia

Answer 27

Decreased amount of platelets

Question 28

List the 2 confirmation diagnostic test for IMHA

Answer 28

Positive slide agglutination side Positive Coombs test

Question 29

Slide agglutination test

Answer 29

A certain amount of concentrated killed antigen and patients serum are mixed on a plate, slide or card and allowed to react for a specified period, after which the presence of agglutination is determined by naked eye.

Question 30

List distinguishing laboratory features of Haemorrhage Anaemia

Answer 30

Regenerative anaemia Concurrent hypoproteinaemia Presence of RBC fragmentation Haemostatic disorder: Thrombocytopenia/Prolonged coagulation times

Question 31

Management/Treatment of IMHA

Answer 31

Blood transfusion Immunosuppresive drug therapy-Prednisolone

Question 32

Mortality of IMHA

Answer 32

20-70%

Question 33

How to manage thromboembolic disease

Answer 33

Aspirin Heparin Oxygen Symptomatic management