IMHA/ITP Flashcards
If you get an epistaxis or bleeding patient, and you seen petechie when you open the mouth, what does it tell you?
That the dog has lack of 1º hemostasis
Most commonly due to severe ↓ platelets in dogs
Most common cause of Petechiae in mouth in dogs is due to _____
Severely ↓ platelets
Lack of 1º hemostasis
In dogs, the most common cause of SEVERELY ↓ platelets is _______
ITB !!!!
Immune mediated process
Diagnostics which should be considered in any pet with IMHA/ITP? - - - - -
CBC/Chem UA Clotting times CXR & AUS Tick titers or Tick PCR
ITP/IMHA can further be 1º or 2º . Please elaborate?
1º - usually idiopathic(we can’t find trigger)
2º - Drug reaction , infection, Cancer
Author recommends getting urine via cystocentesis in these cases. T/F
F
Not via cysto
Why does author strongly recommend Urinalysis?
UTI can trigger immune response
Tick PCR is based on disease prevalence in area. T/F
T
Most common cause of death in ITP/IMHA over long run.
Thrombo-embolism
Animals almost never die of anemia
-
-
- pet will not get better in 24 hr
- 50-70% can be discharged from hospital but that one year mortality can reach 70%
Survival is poorer for dogs with melena vs those without. T/F
T
Median hospitalization time for dogs with ITP is ____ days
4 days
Keeping HCT high increases ability to clot even if we donot give platelets. T/F
T
3 main differentials for IMHA?
- Zinc toxicity
- Heinz body anemia from oxidant damage
- PK and other RBC enzyme deficiencies
ZINC toxicity can be caused due to ______ and ______ mainly
Pennies
Desitin type diaper cream
Onion and garlic cause heinz body anemia from oxidant damage. T/F
T
Diagnostics recommendations for IMHA is same as ITP. T/F
T
Why are XRAY recommended in cases of suspected IMHA?
R/o Cancer and Heavy metals in stomach
Mainstay therapy in ITP/IMHA is ________
Corticosteroids
Options for corticosteroids for IMHA?
Prednisone 2 mg/kg PO BID to start
If pet does not tolerate oral medication, then DEX XP 0.3 mg/kg IV
What about using a second immunosuppresive agent ?
Controversial
Other options are Aza-thio-prine , Myco-phenolate , cyclosporine
2 most common causes of mortality in cases of IMHA?
Venous thrombus
PTE
Thromboembolism !!!!
Best option currently for Thrombo-embolism prevention?
Clopidogrel(Plavix)
Other option is aspirin but it does not work in all dogs at the recommended dose
Heparin of any type if not the best option for Thromboembolism prevention .T/F
T
Best option currently if Plavix/Clopidogrel
