Exam 3 - Anemia: Blood Loss & Inadequate Erythropoiesis Flashcards
what are some examples of traumatic & underlying pathology causing blood loss?
traumatic – HBC, animal attack, & abuse
underlying pathology – gi parasites, inflammation/neoplasia in the gut, drug induced (ulcer or diffuse bleeding), or coagulopathy
trauma causing acute gi bleeds likely affect what organs?
spleen, liver, major vessels, & cardiac
what ectoparasite commonly causes anemia in puppies & kittens?
fleas
what gi parasites can be causes of gi bleeding?
whips & hooks
what primary coagulopathy problems can cause acute bleeding? secondary problems?
primary – IMTP or DIC, platelet disorder
secondary – clotting factor problem or DIC, factor disorder
what are the main categories of mechanisms causing acute gi bleeds?
- trauma
- parasites
- ulcers
- coagulopathy
what are the main categories of mechanisms causing chronic gi bleeds?
- addison’s – atypical or typical, cortisol deficiency
- parasites
- ulcers
- coagulopathy – primary or secondary
what primary coagulopathy problems can cause acute bleeding? secondary problems?
primary – slower onset of decreased platelets, thrombocytopathia
secondary – hepatic dysfunction
in primary coagulopathies caused by platelet disorders, what are the 2 general pathologies?
either decreased number of platelets or function of platelets
what 4 mechanisms are usually involved in primary coagulopathies?
- destruction
- consumption – DIC or hemorrhage
- production problem
- sequestration – splenic
what are the 3 most common primary coagulopathies?
- immune-mediated thrombocytopenia
- rickettsial – consider geographic factors
- paraneoplastic
what is the most severe primary coagulopathy? what about mild-moderate?
- immune-mediated – no other etiology will usually decrease platelets below 10,000-20,000
- rickettsial, consumption, & sequestration
what factors are affected in secondary coagulopathies?
II, VII, IX, & X
what is the most common secondary coagulopathy caused by a toxicity?
anticoagulant rodenticides – affects vitamin k dependent factors
what is expected in the clinical presentation of an animal with a primary coagulopathy?
mucosal surfaces affected!!!
skin – petechiae & ecchymoses
gi, urinary, nasal, cns, & lungs (rare)
what is expected in the clinical presentation of an animal with a secondary coagulopathy?
large cavities affected!!!!
peritoneum, hemothorax, pericardium, & mediastinum
what are the key differences between primary & secondary coagulopathy?
primary – platelet disorder
secondary – factor disorder
what medications can be responsible for large bleeds?
NSAIDS, steroids, & new antibiotics (platelet disorders)
what clinical signs are associated with acute blood loss?
collapse, acute lethargy, extreme thirst prior to anemia to restore volume, & tachypnea in an attempt to increase oxygenation
what clinical signs are associated with chronic blood loss?
weight loss with a good appetite, lethargy, melena from gi or nasal/upper airway bleeding from swallowing blood, & pica which is often indicative of iron deficiency
why can a CBC appear normal in an animal with an acute bleed?
can take up to 48-72 hours to manifest on the CBC as fluid will move from the interstitium to replace deficit
what abnormalities may be seen on a CBC of an animal with an acute bleed?
may be normal or decreased
often not regenerative because it’s too early
platelets may be normal to mildly decreased
what abnormalities may be seen on a CBC of an animal with a chronic bleed?
often low HCT/PCV – variable in severity, but the more chronic, the lower it can go without altered perfusion
low or normal total solids, anisocytosis early on
+/- microcytic hypochromic
should be regenerative if chronic & marrow is working
what abnormalities may be seen on a chemistry panel of an animal with an acute bleed?
panhypoproteinemia
increased BUN:Cr ratio
+/- increased bilirubin with cavitary bleeding – reabsorption of blood
