Disorders of Hemostasis Flashcards
What are the most common disorders leading to spontaneous bleeding in dogs?
(Immune mediated) thrombocytopenia
DIC
Rodenticide ingestion
What are the most common disorders leading to spontaneous bleeding in cats?
Liver disease
FIP
Neoplasia
Retrovirus induced bone marrow disorders
What is the importance of fibrinolysis?
Prevents excessive clot formation
What is the first part of a smear examination in the bleeding patient?
Low power scanning for platelet clumps
What part of the smear is examined with an oil immersion lens?
Monolayer- where 50% of the RBC touch eachother
How is a platelet count estimated?
Each platelet represents 12,000-15,000 per micro litre
What is the second cage side test for coagulation?
aPTT or OSPT
What does a prolonged buccal mucosal bleeding time indicate?
Thrombocytopenia,
or thrombocyte dysfunction from vWB or NSAIDs
What is the common cause of primary hemostatic defects?
Thrombocytopenia
How are primary hemostatic defects characterised?
Superficial and mucosal bleeding
Bleeding immediately after venepuncture
What is the less common cause of primary hemostatic defects?
Platelet dysfunction-
von Willebrand Disease
In what breeds is von Willebrand disease common?
Doberman pinscher German shepherd Poodle Golden retriever Shetland sheepdog
When does a dog with vWD bleed and how is it treated?
During or after surgery (not spontaneous)
DDAVP
Approach to thrombocytopenia in 4 steps
1️⃣Drug associated until proven otherwise (2-6 days)
2️⃣FeLV/FIV test cats
3️⃣ Bone marrow aspiration (if no response to pred)
4️⃣ Rule out vector borne disease
What dogs are commonly affected with IMT?
Cocker spaniels
Old English sheepdogs
How is IMT treated and how long before a response is seen?
Prednisolone
GI Protectants
Response within 24-96 hours
How does a secondary haemostatic defect present? (4)
Collapse,
exercise intolerance and dyspnoea,
Abdominal distension,
Hemoarthrosis
What are the two most common causes of secondary hemostatic defects?
Rodenticide poisoning
Liver disease leading to vit K deficiency
What is the cause of a mixed hemostatic defect?
Disseminated Intravascular Coagulation
What disorders are associated with DIC in dogs? (6)
Hemangiosarcoma Sepsis Pancreatitis Haemolytic anaemia GDV Liver disease
What disorders are associated with DIC in cats? (3)
Hepatic lipidosis
Lymphoma
FIP
What clinical feature suggests DIC rather than other haemostatic disorder?
Combined primary (mucosal bleeding) and secondary (blood in body cavities) bleeding
How is DIC diagnosed?
RBC fragments/schistocytes
Anaemia
Thrombocytopenia
Coag abnormalities
What are the 5 interventions required to manage DIC?
Halt coagulation- heparin/blood products Aggressive fluid therapy Oxygen Correct acid/base balance Antiarrhythmics
