Anemic Patient Flashcards
What is a common finding with destructive anemia?
Icterus along with anemia
What are some signs that can lead to a diagnosis of IMHA?
Regenerative anemia and spherocytes OR agglutination or both.
What sign on a CBC would lead to a strong suspicion of IMHA?
Inflammatory leukogram (often profound). Hyperbilirubinemia. ;
What are some diagnostics needed to rule out secondary IMHA?
Infectious disease testing (consider Babesia, FeLV, Mycoplasma).
Cancer screening- thoracic radiographs, abdominal imagining (radiographs and/or ultrasound)
What is the treatment for IMHA?
Treat underlying disease if possible.
Immunosuppression- prednisone (prednisolone)
Consider adding a second agent to wean off prednisone later (Azopriothrine which takes a month to start working)
What are some secondary treatments for IMHA that might be needed?
Antithrombosis to try to prevent thrombotic complications while they are on prednisone. Oxygen carrying capacity will be diminished so blood transfusions might be needed.
What treatment do you recommend a patient who comes in Shocky with high PT/PTT, acute CS and suspected anemia due to loss?
fluid bolus, give blood transfusion of Fresh frozen plasma or fresh whole blood, given Vitamin K1 parenterally to allow the liver to make correct clotting factors.
What does a RBC count on the CBC look like for a chronically anemic patient?
The anemia will usually be relatively severe with few CS. Reticulocytes should be high if its chronic unless it is no regenerative.
What does a chronic external blood loss appear as.
The patient will be iron deficient. If blood loss was internal the body would recycle the iron and would be normochromic.
What is the most common site of chronic external blood loss?
GI tract due to parasitism, ulceration or neoplasia.
Why would a chronic iron deficiency anemia be microcytic hypochromic with no retics?
RBC loss continues too long and eventually the bone marrow cant keep up so its regeneration becomes weak to absent even though it used to be regenerative.
What does Lack of production look like on a CBC?
Severe anemia while BAR is usually normocytic, hypochromic with no reticulocyte.
What are some causes of non-regenerative anemia?
primary bone marrow disease, renal failure, chronic disease
What are some additional diagnostics for a non regenerative anemia in a cat?
FeLV/FIV
bone marrow aspirate and biospy
