EIM 15-18 Haem/Endo/Skin Flashcards
The most common cause of thrombocytopenia in hospitalized horses
increased utilization or destruction of platelets secondary to a primary infectious, inflammatory, or neoplastic disease process.
Thrombocytopenia is also common in strangulating/ischemic gastrointestinal disorders.
An association between thrombocytopenia and a poor prognosis has been demonstrated in
hospitalized horses in general and in horses with colon torsion.
Thrombocytopenia occurs in cases of EIA due to ?
combined effect of immune-mediated destruction and decreased platelet production
A foal presents with ulcerative dermatitis, thrombocytopenia and neutropenia. Based on the most likely suspected diagnosis, what treatment would be indicated?
DEXAMETHASONE
Neonatal Alloimmune Thrombocytopenia. Immune-mediated destruction of platelets following ingestion of preformed antiplatelet antibodies with the colostrum has been reported in horse and mule foals and is suspected to be more common in the latter.
responsive to corticosteroid administration, suggesting an immune-mediated component.
The most common clinical sign of Glanzmann’s thrombasthenia is
epistaxis
Glanzmann’s thrombasthenia
Prolonged or recurrent epistaxis appears to be the most common clinical sign whereas the presence of petechiae or ecchymosis is more variable.
Definitive diagnosis: demonstration of reduced CD41/61 expression on the platelet surface using flow cytometry.
Glanzmann’s thrombasthenia is a quantitative deficiency or a qualitative defect of the platelet fibrinogen receptor (also referred to as GP IIb/ IIIa, αIIbβ3 integrin, or CD41/61). It is an autosomal recessive disorder, and the genetic defect has been localized to the gene encoding GP IIb (also referred to as αIIb).
Breeds: QH, TB, SB, WB, Peruvian Paso
NOTE: distinct from ‘Atypical Equine Thrombasthenia’ = Reduced fibrinogen binding, only occurs in TBs, normal number of CD41/61 expression
Von Willebrand’s Disease
Is rare in horses, only congenital
Diagnosis achieved by measuring plasma von Willebrand antigen levels using an ELISA
Hemophilia A in horses
Reported in Thoroughbreds, Standardbreds, Quarter Horses and an Arabian
Typically factor VIII deficiency, but also can occur with factor IX and X and to a lesser degree factor VII and prothrombin (F 2) deficiencies.
Transmitted via an X-linked recessive trait, colts affected
Iron deficiency anemia
is characterized by low serum ferritin concentration, decreased stainable iron stores in the bone marrow, decreased plasma transferrin saturation, normal or increased total iron binding capacity (TIBC), hypochromic erythrocytes (decreased MCHC), and microcytosis (decreased MCV)
hemangiosarcoma
Present as a disseminated malignancy involving the spleen, heart, lung, liver, and soft tissues of the trunk and extremities
hemangioma
Typically benign, solitary, deep, dermal tumors
What are two well documented causes of IMHA in horses?
NI - primary IMHA
penicillin
EIA
Reverse transcriptase and integrase are utilised by the virus to generate and integrate viral DNA into the host cell genome
Replication occurs in monocytes, dendritic cells, tissue macrophages, and endothelial cells
Fever and thrombocytopenia considered to be the most reliable clinical indicators
One of the ELISA kits detects gp45
Time from infection to seroconversion may take up to 180 days
“ELISA is a sensitive gal”
Babesia caballi
Carrier: can be cleared
Invasion site: erythrocyte
Severity: milder
Incubation period following infection by tick: 10-30days
cELISA target: Apical merozoite protein rhoptry (RAP) 1
TX: Imidocarb, quarantine, or euthanasia
Theileria equi
Carrier: lifelong
Invasion site: leukocyte
Severity: severe; colic, resp, neuro signs also possible
Incubation period following infection by tick: 12-19 days
cELISA target: Equi merozoite antigens (EMA) 1 and 2
TX: Imidocarb, quarantine, or euthanasia
Red Maple Leaf toxicity
Wilted/dried leaves of silver and sugar maple also potentially toxic
Signs of haemolysis predominate before mid-September, whereas signs of methaemoglobinaemia predominate after mid-September
Oxidising agents include gallic acid, and pyrogallol (formed from the metabolism of gallic acid and gallotenins by Klebsiella pneumoniae and Enterobacter clocae in the ileum
Factors associated with mortality include lack of pyrexia on admission and corticosteroid administration
Immune Mediated Vasculitis
Deposition of complexes of antigen and immunoglobulins in the walls of the capillaries and other small blood vessels leads to a type III hypersensitivity reaction
Microscopically, lesions are characterised by a leukocytoclastic vasculitis
Secondary complications such as laminitis and thrombophlebitis are not uncommon
Anaplasmosis
Obligate intracellular bacterium infecting neutrophils
Transmitted by Ixodes ticks
Worldwide distribution
Incubation period of ~10 days
Signs vary from subclinical to high fever (100 – 106.9 F)
how can you diagnose IMHA
Coomb’s test
Presence of autoagglutination
Osmotic fragility testing of RBC’s
Reported causes of equine hypothyroidism are
Iodine deficiency
Iodine excess
Neoplasia
Hypothyroidism in adults is rare and usually non life threatening
In equine primary hypothyroidism, what will be increased/decreased?
Horses with primary hypothyroidism have decreased T4 and T3 concentrations and increased TSH concentrations
The major cause of neonatal hypothyroidism in foals is
nutritional, resulting in congenital goiter (thyroid enlargement at birth). Possibly due to Iodine deficiency in utero (inadequate intake by the dam) OR Iodine excess in utero (excessive intake by the dam)
CHD: congenital hypothyroidism and dysmaturity
First recognized 1970s
Prolonged gestation + signs of dysmaturity
-Musculoskeletal abnormalities (weakness, delayed ossification carpal and tarsal bones, OCD, prognathia)
-Thyroid enlargement rare (different to neonatal hypothyroidism)
–Still have thyroid gland hyperplasia on biopsy though
Etiology unknown
-Nitrates? Combo with low iodine forage
Typically disease of western Canada and north-western USA
Usually die a few days after birth, or suffer many complications
CS: Neonatal Hypothyroidism
Enlarged thyroid or normal thyroid size
Stillbirths, prematurity
Weakness, lethargy, depression, weak suckle
Long haircoat, rough hair coat, silky if premature/dysmature
Respiratory insufficiency and distress
Incoordination
Cold intolerance and hypothermia
Physeal dysgenesis, defective ossification
Carpal and tarsal bone collapse, hypoplastic carpal bones
Common digital extensor tendon rupture
Forelimb contracture
Prognathism, delayed incisor eruption
Growth retardation and death
Or born apparently normal but develop skeletal lesions weeks later