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Equine Med and Surgery II > Lecture 8: Equine Hematology 1 and 2 > Flashcards

Lecture 8: Equine Hematology 1 and 2 Flashcards

1
Q

What is anemia

A

decrease in RBC or hemoglobin (decrease oxygen carrying capacity of blood)

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2
Q

what hormone is essential for RBC production, where is it produced and in response to what

A

erythropoietin, produced in the kidney in response to hypoxemia

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3
Q

what causes anemia (3)

A
  1. Hemorrhage
  2. Destruction
  3. Decreased production
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4
Q

what are some physical exam signs of anemic patients

A

pale MM, tachycardia

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5
Q

what are some RBC parameters in anemic patients

A
  1. Decreased PCV
  2. Erythropoietin
  3. Decreased hemoglobin
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6
Q

horse presents to you with distal limb laceration affecting medial palmar digital artery that occurred about 1 hour ago. What would you expect PCV to be at this time

A

normal- not enough time for PCV to change

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7
Q

Patient anemic due to loss/hemorrhage, what do you expect plasma protein and bilirubin levels to be

A

plasma protein- low
Bilirubin- normal

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8
Q

patient Anemic due to destruction- what would you expect plasma protein, bilirubin and serum to be like

A

plasma protein- normal
Bilirubin- normal to increased
Serum hemolyzed

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9
Q

What are some causes of anemia due to destruction

A

immune mediated, infectious, toxicity

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10
Q

what are some causes of anemia due to decreased production

A

inflammation, toxicity/drugs, neoplasia, iron deficiency, genetic (fell pony syndrome

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11
Q

what is fell pony immunodeficiency syndrome

A

fatal disorder in dale ponies due to mutation in sodium/myo-inositol cotransporter gene (SLC5A3) causing progressive anemia and B cell lymphopenia (repeated infections)

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12
Q

case ex: you are treating a 10yr quarter horse gelding with pleuropneumonia. He has been in your hospital for a month and you have just run some updated blood work. His PCV is 26% (range: 35-52%).

What is your dx and what is your plan

A

Dx: anemia of chronic dz
Tx: treat pneumonia and monitor PCV

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13
Q

what is the relationship between inflammation and anemia

A

iron sequestration

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14
Q

what does the total iron binding capacity measure (TIBC)

A

indirect measure of transferrin concentration in serum

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15
Q

what is TIBC affected by

A

inflammatory state, liver iron stores, nutritional status/ protein intake

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16
Q

TIBC may be increased in horses with ___

A

iron deficiency

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17
Q

what is the formula for TIBC

A

UIBC (unbound) + iron

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18
Q

what is the % saturation for iron

A

percentage of transferrin that is saturated with iron

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19
Q

what is involved in the treatment of anemia

A
  1. Determine if transfusion is required
  2. Identify and treat underlying cause
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20
Q

perform blood transfusion when PCV <__% following acute blood loss

A

20%

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21
Q

perform blood transfusion when PCV <__% following chronic/slow blood loss

A

<12-15%

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22
Q

what is the transfusion procedure

A
  1. Find appropriate donor
    2., determine how much blood is needed
    3,. Perform transfusion
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23
Q

horses have >___blood cell antigens

A

30

24
Q

horses have ___blood types

A

400,000

25
Q

t or f: there is not universal blood donor for horses

A

true

26
Q

what blood types are most antigenic

A

Aa and Qa

27
Q

if you can’t blood type a horse and find a Aa negative or Qa negative what breeds should you choose

A

QH or standardbred gelding or gelding of same breed as patient

28
Q

what is major cross matching

A

donor RBC’s + recipient plasma

29
Q

what is minor cross matching

A

recipient RBCs + donor plasma

30
Q

blood volume of a horse is __% of its body weight in kg

A

8%

31
Q

500kg horse has __L of blood

A

40L

32
Q

average healthy horse can donate __% of its blood volume

A

15-20%

33
Q

What is the formula for determining amount of blood needed for transfusion

A

(PCV desired-PCV recipient) X (body weight in kg X 0.08)/ PCV donor

34
Q

Case ex: perform transfusion on patient with PCV of 12%. Your patient is a 10yr old thoroughbred gelding who weighs 500kg. You would like to stabilize him with PCV of 20%. Cross matching not possible. Which of the following potential donors would you choose assuming they all have PCV of 38%:

A. 12 year old thoroughbred mare- 500kg
B. 6 year old standardbred gelding- 400kg
C. 8 year old QH gelding- 550kg
D. 7yr old Belgian mare- 900kg

How much blood would you take from donor. What is max your donor can give

A

C- 8year old QH gelding- 550kg

From donor: (20-12) (500x0.08)/ 38=8.421 8.4L

Max from donor: 550(0.08)=44, 44(0.20)=8.8L

35
Q

how would you perform a blood transfusion

A
  1. Collect blood aseptically in collection bag with anticoagulant (ex: sodium citrate)
  2. Administer through blood set only
    - 1mL/kg over first 30 mins
    - 10-20ml/kg/hr
36
Q

you give a transfusion and horses respiratory rate increases to 80bpm- what is happening and what do you do

A

transfusion reaction
1. Slow or stop transfusion
2. Diphenhydramine

37
Q

what is the dose for epinephrine during anaphylaxis

A

0.005 to 0.02 ml/kg IV slowly of 1:1000 formulation
2.25-9mL for 450kg horse

38
Q

what are some causes of thrombocytopenia in horses

A
  1. Immune mediated/ drug reactions
  2. DIC
  3. Endotoxemia/ septicemia
  4. EIA
  5. Anaplasma phagocytophila
  6. Lymphoma
  7. Alloimmunity
39
Q

what are some clinical signs of thrombocytopenia

A

petechia, bleeding if below

40
Q

what is treatment for thrombocytopenia

A
  1. Platelet transfusion if needed
  2. Identify and tx underlying cause
41
Q

what drugs can cause immune mediated thrombocytopenia

A

penicillin, trimethoprim sulfamethoxazole

42
Q

what is the tx for immune mediated anemia, thrombocytopenia

A
  1. Dexamethasone
  2. Prednisone
43
Q

equine infectious anemia is a __virus transmitted by ___

A

lentivirus, tabanidae flies

44
Q

what are some signs of equine infectious anemia

A

fever, anemia, thrombocytopenia

45
Q

what is tx for equine infectious anemia

A

no treatment- either euthanasia or isolation at least 200 yards from other horses

46
Q

what test should you perform on all patients with suspicious anemia

A

Coggins test

47
Q

t or f: equine infectious anemia is a reportable dz

A

true

48
Q

where does the organism for anaplasma pahgocytophila live inside the host

A

neutrophils (morulae)

49
Q

what are some clinical signs of anaplasma phagocytophila

A

very high fever, depression, anorexia, weakness, edema

50
Q

what are some bloodwork signs of anaplasma phagocytophila

A

mild, non-regenerative anemia, thrombocytopenia

51
Q

horse presents with high fever, lethargy, and weakness. Perform a blood smear and see this- what is wrong

A

Anaplasma phagocytophila- morula in neutrophil

52
Q

what is tx for Anaplasma phagocytophila

A
  1. Oxytetracycline IV
  2. Followed by doxycycline PO for 7-10 days
  3. NSAIDS if high fever
53
Q

what Protozoa are involved in equine piroplasmosis

A
  1. Babesia caballi
  2. Theileria equi
54
Q

what clinical signs and blood work findings are seen with equine piroplasmosis

A

Intra/extravascular hemolysis, fever, edema, coagulopathies, thrombocytopenia, hemoglobinuria

55
Q

what is tx for equine piroplasmosis

A

imidocarb

56
Q

you administer Oxytetracycline IV too patient to tx Anaplasma phagocytophila and they suddenly collapse- what happened and what do you do

A

giving Oxytetracycline too fast can diminish calcium and cause them to collapse

Administer calcium

Equine Med and Surgery II (8 decks)

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