Anemia in small animal Flashcards
Define anemia
Reduction in the concentration of haemoglobin in the blood which causes reduced oxygen carrying capacity
List some causes for non regenerative anemia
- Primary bone marrow disease
- Iron deficiency
- Inflammatory disease
- Chronic renal failure
- Endocrine disease e.g. Hypothyroidism
- Cobalamin deficiency
What are the two categories under regenerative anaemia
Haemolytic
Haemorrhage
List some causes for Haemolytic anaemia
- IMHA (Immune mediated Haemolytic anaemia)
- Infectious
- Oxidative injury
- Metabolic disorders
List some causes for Haemorrhage anaemia
- Trauma
- GI Ulcer
- Haemostatic disorder
- Ruptured neoplasm
List some conditions that cause primary bone marrow disease
- Aplastic anemia
- Myelomafibrosis-scarring of bone marrow
- Myelodysplastic (Cats-immature blood cells in the bone marrow do not mature or become healthy blood cells)
- Precursor IMHA (Dogs)
List some conditions under that fall under secondary failure of erythropoiesis
- Anaemia of inflammatory disease
- Chronic renal failure
- Endocrine disease
- Deficiency in building blocks (Fe/Cobalmin)
List some distinguishing clinical features of primary bone marrow disease
- Lethargy/Weakness/Fatigue
- BAR (because not quick onset of anemia)
- Other cell lines affected (thrombocytopenia/neutropenia)
List causes of secondary failure of erythropoiesis
- Chronic Kidney Disease: PUPD/Reduced Appt/Weight loss
2.Hypothyroidism: Dermatological - Fe deficiency: Chronic low-grade external blood loss due to parasitism, ulcerative GI, chronic urinary losses
- Cobalamin deficiency: Chronic GI disease/Unable to absorb vitamin b12
What are the two types of IMHA
Primary (non associative) IMHA- Autoimmune
Secondary (associative) IMHA- E.g. Lymphoma can produce antibodies that target RBC
Describe IMHA
When the body produces antibodies or complements that targets RBC
State the name of the receptor of RBC that the macrophage binds if a patient has IMHA
Fc Receptor
State 3 causes of secondary IMHA
- Infectious
- Drug induced
- Neoplasia
List examples of infectious diseases that can cause secondary IMHA
Bacterial (Haemoplasma-Cats)
Parasitic (Babesia-Dogs)
What is the cause of Feline Infectious Anemia
Mycoplasmas (Bacteria)
How does Mycoplasmas cause Feline infectious anemia
Causes haemolysis involving immune mediated and direct erythrocyte damage
How is Feline Infecious Anemia diagnosed
Haemoplasmas seen on bloodsmear- Howell Jolly bodies
PCR
Coombs test positive
What is the most common infectious disease of anaemia in dogs
Canine babesiosis
What is the clinical signs for Canine babesiosis
Pyrexia
Haemolytic anaemia, including IMHA
Thrombocytopenia
List some causes for haemolytic anaemia-Oxidative injury- which causes the formation of heinz body
- Paracetamol toxicity
- Onion toxicity
- Benzocaine
- Zinc toxicity
- Propofol infusion in cats
- Diabetes/Hepatic lipidosis in cats
List distinct clinical features of haemolysis
- Jaundice
- Haemoglobinuria
- Hepato-splenomegaly
- Pyrexia
- Chocolate coloured oral mm as a sign of metHb
List distinct clinical features of haemorraging anemia
- Evidence of bleeding External/Internal
- Sings of hypovolaemia
- Evidence of a haemostatic disorder-Petechiaton
What are the values of PCV that define mild/moderate/severe anemia
Mild: 30-39%
Moderate: 20-30%
Severe: <20%
What does spherocytes on blood smear suggest
IMHA
Distinguish between blood smear result from Primary bone marrow disease and Secondary failure of Erythopoiesis
PBMD: Normocytic (Size) /Normochromic anaemia (Concentration of Hb)/ Concurrent bicytopenia/pan-cytopenia
SFOE: Microcytic/Hypochromic
List distinguishing laboratory features of IMHA
Regenerative anaemia
Spherocytosis
Leucocytosis due to neutrophillia
Evan’s syndrome: Concurrent immunemediated thrombocytopenia
Evidence of organ damage
Thrombocytopenia
Decreased amount of platelets
List the 2 confirmation diagnostic test for IMHA
Positive slide agglutination side
Positive Coombs test
Slide agglutination test
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.
List distinguishing laboratory features of Haemorrhage Anaemia
Regenerative anaemia
Concurrent hypoproteinaemia
Presence of RBC fragmentation
Haemostatic disorder: Thrombocytopenia/Prolonged coagulation times
Management/Treatment of IMHA
Blood transfusion
Immunosuppresive drug therapy-Prednisolone
Mortality of IMHA
20-70%
How to manage thromboembolic disease
Aspirin
Heparin
Oxygen
Symptomatic management