Lymphoreticular amd haemopoietic Flashcards
difference between mammal and avian/reptile RBC
mammals are anucleated, birds/reptiles have nucleases
RBC production sites
mainly bone marrow in adult some from liver and spleen
life span of a erythrocyte
dog = 100 days cat = 70 days horse/cow = 150 days
which is more accurate PCV or haematocrit
PCV, haematocrit is measured by a machine and relies on red cell count and volume
what is the PCV
% of red cells in blood
what does a pink plasma indicate after in has been spun down?
hemolysed
normal dog + cat PCV
dog = 35-57 cat = 30-45
different anaemia classifications
mild(<10% below), moderate (MM pale) and severe (PCV in teens)
regenerative or non-regerative
normocytic, microcytic, macrocytic
normochromic, hypochromic
normochromic and hypochromic anaemia
normochromic = normal levels of haemoglobin in the RBC hypochromic = reduced haemoglobin conc (iron deficiency, LOW MCHC/MCH)
MCV
mean cell volume of red blood cells
Normocytic = normal size = mild non-rengerative anaemia/ acute haemorrhage
Microcytic=small RBC=iron deficiency/hepaticfailure/PSS
Macrocytic = large RBC = FeLV or storage artefact
regenerative or non-regenerative anaemia
increased reticulocytes in regenerative
increased MCV on regenerative normal on non-regenerative
reduced MCH on regenerative and normal on non
causes of regenerative anaemia
haemorrhage: Melena, surgery, UT, epistaxis
haemolysis: intra/extravascular, immune mediated (coombes test), parasite (babesia/ mycoplasma haemofelis), onion ingestion, zinc toxicity
coombe’s test
test for antibodies against RBC
can also use AGGLUTINATION TEST
Ghost cells
RBC that have lost their haemoglobin: intravascular haemolysis
Heinz bodies
denatured haemoglobin: caused by onion ingestion and paracetamol ingestion in cats
acanthocytes
projections from RBC: caused by splenic disease (hemangiosarcoma)
causes of non-regenerative anaemia
inflammatory, chronic renal failure, hypothyroidism, hypoadrencorticism,FeLV
Pale MM
anaemia or poor peripheral perfusion
CFT 2 = PPP
how to differentiate between haemorrhage and haemolysis
Haemolysis has normal TP reduced in haemorrhage
what is a anaemia cocker/springer spaniels are predisposed to
immune mediated haemolytic anaemia
treatment: IV fluid, blood transfusion, immunosuppressive therapy (prednisolone)
spherocytes
sphere shapes RBC cells: auto immune disease.
normal TP
dog: 5.4-7.4
cat: 6.6-8.4
how does blood separate in a centrifuge
plasma: water and protein
buffy coat: leukocytes and platelets
erythrocytes
blood typing dogs/cats
Dogs: not typed just DEA-1 or not
Cats: must be typed
Neonatal isoerythrolysis
found in foals and kittens: blood group different form dam so blood attacked and icterus and anaemia is caused
‘fading kitten syndrome’
when should a foal be ingesting colostrum and how much
1-2 litres in the first 3 hours
causes of failure of passive transfer
Mare: lack of or poor colostrum
Foal: lack of colostrum intake (unable to suckle illness or rejected), lack of abortion (GI disease, ingested too late)
how is failure of passive transfer measured
IgG concentration in blood snap test (8g/L good)
treatment for failure of passive transfer
colostrum( < 12hours) by nasogastric tube, IV plasma (1-2L)
cause of foal, increased RR,HR and Temp, Icterus, weakness, depression, sepsis
Neonatal isoerythrolysis: stop further ingestion of colostrum, transfusion of mares washed RBC , IV fluid
normal PCV and Hb for cow/sheep/pig
cow: PCV 24-46% Hb = 8-15 g/dl
sheep; PCV 27-45% Hb = 9-15 g/dl
Pig: PCV 22-38% Hb = 8-12 g/dl
causes of anaemia in large animals
Haemorrhagic: rupture, fasciolosis, lice, GIT
Haemolytic: Lepto, babesia, chronic copper poisoning, brassica poisoning (rape,kale,cabbage)
Depressed erythrocyte production: cobalt/copper/iron deficiency, bracken poisoning, renal disease
Haematuria
bracken poisoning
cause of blood in faeces, air in abdomen and abdominal pain
abomasal ulcers: caused by sand, DA or stress
jaundice, pallor, haemoglobinuria, sudden death in texel or suffolk sheep?
chronic copper poisoning : black swollen kidneys and swollen yellow liver
treatment: ammonium tetrathiomolybdate (ATM)
NEVER GIVE SHEEP, PIG OR COW FEED!!!!!!!
how much colostrum does a dairy calf need?
3-4 Litres = 20-30 minutes suckling
IN FIRSH 6 HOURS
how is colostrum assessed
Specific gravity (>1.048) or hygrometer
what is a left shift
more immature neutrophils (band and segmented)
degenerative = neutropenia bands>segmented
regenerative = neutrophilia segmented>band
causes of neutropenia
acute bacteria infection, endotoxemia, immune mediated, shock, FIV, FeLV, bone marrow disorders,
causes of neutrophilia
infections , immune mediated, neoplasia, haemolysis, stress or steroids
causes of lymphopenia
protein losing enteropathies, chylo-thorax, steroids, infectious (distemper, parvo, FeLV FIV)
causes of lymphocytosis
persistent antigen stimulation (fungal, protozoa, FeLV) , post vaccination, lymphocytic leukaemia, stage five lymphoma, hypoadrenocorticism (addisons)
stress leukogram
neutrophilia(+), lymphopenia(-), monocytosis(+), eosinopenia(-)
steps of haemostasis
primary: platelet plug
secondary: coagulation cascade, insoluble fibrin produced to stabilize plug
Firinolysis: breakdown of fibrin and platelet plug
what is released from damaged endothelial cells to help platelets aggregate
Von Willbrand’s factor
what is the aim of the coagulation cascade
to produce insoluble fibrin to stabilize the platelet plug
platelet counting
automated is fine apart from cats where a estimate from a blood smear is better (RBC same size as platelets)
normal platelet levels
100<1000x10/L
most common cause of thrombocytopenia
immune-mediated thrombocytopenia
primary: antibodies against platelets
secondary: other immune diseases, drugs, neoplasia or infection
breeds with genetic disorders of platelets
otter hound, great Pyrenees, bassert hound, quaterhorse, simmentals
mucosal bleeding but with no petechiae hemorrhages
Von Willebrand’s disease: common in dogs (Dobermans)
test for Von Willebrand’s disease.
EDTA blood, Elisa for vWF should not be less than 50% (carrier) if less than 35% is clinical.
what is the treatment for Von Willebrands
Transfusion to supply vWF (whole or plasma is anemic)
Desmopressin (causes release of vWF)
what are most coagulation test blood samples collected in
citrated plasma: with minimal trauma and no heparin
blue, purple or green tubes
what is a PTT test on blood
Partial Thromboplastic time: measuring time for a citrated plasma to clot, screen test for coagulopathys
uses of PTT, PT and ACT test
PTT and ACT are used for intrinsic and common factors
PT is used for extrinsic and common factors
what is the latex agglutination test used for
test for fibrin degeneration products: DIC (disseminated intravascular coagulation), hemorrhage and liver disease
Vitamin deficiency causing a coagulophathy
Vit K: rodenticide toxicity, sweet clover ingestion (cattle)
treatment for Vit K deficiency
Emetics/charcoal, whole blood transfusion, oral VitK NOT IV,
DIC and causes
Disseminated intravascular coagulation: secondary to neoplasia, hepatic disease, immune-mediated infections, infectious diseases.
treatment for DIC
Heparin(stop coagulation), whole blood transfusion, aspirin (reduce platelet activation) POOR PROGNOSIS
If both PTT and PT are prolonged what should be considered
Vitamin K deficiency or DIC
if only PT prolonged what should be considered
early Vit K deficiency, liver disease, early DIC
If only PPT prolonged consider
intrinsic: hemophilia A and B
FeLV prevelence in UK
2-3% of cats
How is FeLV spread
oral,nasal secretions, faeces, urine and milk
Clinicial signs of FeLV
many asymptomatic: inappetance, WL, poor coat, fever, Pale MM, gingivitis, diarrhea and skin infections
most common presentation of FeLV
immunosuppression: non-regenerative anemia
disease commonly caused by a FeLV infection
Lymphoma
test for FeLV
PCR, ELISA, Clip Antigen test.
how reliable is a FeLV test
Poor: can be a localized infection so not be picked up on test. However most are picked up on serum ELISA
If negative repeat in 4 weeks
FeLV treatment
Vaccination: nutrition, preventing secondary infections, neuter and confine indoors.
FIV
Feline immunodefficency virus: like HIV, 3-6% prevalence
transmitted primarily by bite wounds, saliva, mating andtransplacental.
5 stages of a FIV infection
Acute: days-weeks mild illness, fever, neutro/lymphoenia
Asymptomatic: up to 10 years, healthy
Persistent generalized lymphadomegaly:
Terminal: AIDS: only a few months, infections
treatment for FIV
Antiviral therapy, antibiotics, NO VACCINATION IN UK
FIP
feline infectious peritonitis: Fatal, caused by feline coronavirus causing increased vascular permeability , oronasal transmission,
CS: V+D, upper respiratory signs,
2 forms of FIP
Effusive: 60-75%cases, ascites, pleural effusin (dyspnoea)
Non-effusive: dry/granulomatous, eye, brain, kidney, liver or GIT
FIP diagnosis
Difficult anti-mortem, Lymphopaeia, Neutrophilia with left shirt, mild non-regenerative anemia, Fluid analysis
Coranavirus test cannot distingusish between FIP or infection
Treatment and prognosis for FIP
Grave, No cure only palliative(antibiotics, fluid,rest, thoracocentisis) VACCINATION
FIA
Feline Infectious Anemia (Mycoplasma Haemofelis)
immune destruction of RBC because pathogen is attached, Transmitted: fleas,blood,oral,in utero
FIA clinical signs
common top young entire males, Low PCV (regenerative anemia), lethargy, fever, anorexia, splenomegaly, icterus
diagnosis of FIA
PCR of blood smear with on EDTA
treatment of FIA
oral Doxycycline (potential GIT damabe + V) Flea control, blood transfusion, Immunosuppression (prednisolone)
attachment of the spleen
Gastrosplenic ligament and short gastric vessels from head onto the greater curvature of the stomach
what must you tie off/ not tie off in a slenectomy
tie: short gastric vessels, left gastroepiploic aplenic artey and vein but caudal to the pancreatic branch
perioperative considerations of a splenectomy
Increased risk of DIC (PT/PTT test and blood type)
increased risk of cardiac arrhythmias (shock therapy)
most common causes of a splenectomy
canine haemangiosarcoma, splenic torsion, splenic trauma, abscess, haematoma, infarction, infection
most common malignant tumor in both cats and dogs
lymphoma
aetiology of lymphoma in cats and dogs
Dogs: breed predisposition(Boxers), spontaneous
Cats: FeLV, Siamese, passive smoking,
site of lymphoma in cats and dogs
Dogs: 85% multicentric LN, 7% GIT. 3% thymic
Cats: 50% GIT, 25% LN, 20% thymic, 5% extranodal
dog with generalized lymphadomegaly, lethargy PU/PD
multicentric lymphoma, disseminated infection, IM disease, neoplasia, skin disease, sterile granulomatous lymphadenitis
main LN effected by lymphoma
sub mandibular, prescapular, axillary, superficial inguinal, popliteal
Hodgkin’s-like lymphoma
effects cats and is lymphoma in only the head and neck LN
most common presentation of a cat with lymphoma
GIT signs: anorexia, diarrhea/ vomiting, weight loss
DDx for cat with GI lymphoma
IBD, other GI tumors, FB or interssusception,
if old cat (hyperthyroid,CKD, diabetes)
lymphoma causing dyspnoea, cough, regurgitation and displaced heart sounds in cats + hypercalcemia in dogs
mediastinal lymphoma
work up of suspected lymphoma
FNA/biopsy of LN, high(large cells) or low grade(small lymphocytes), immunophenotype T or B and clonal assay to find monoclonal population. STAGE Then hematology, biochemistry and urinalysis, FIV + FeLV test before chemo.
How are lymphomas staged
1: single LN
2: multiple regional LN
3: generalized LN involvement
4:Liver/spleen involvement
5:Bone marrow involvement
sub stage a if with systemic signs, b if without
treatment options for lymphoma
systemic chemotherapy(CHOP/COP),Prednisolone for short term remission, radiation therapy (nasal/oral), RARELY surgery
what are the different chemotherapy protocols for lymphoma
COP: Cyclophosphatase, Vincristine, Prednisolone
CHOP: + Doxorubicine (eg Madison-Wisconsin)
LOPP: for high grade canine T cell lymphoma
MONITORING: URINE AND BLOOD WEEKLY
Different types of Leukaemias
Lymphoid: effects lymphoid cell line (T,B,plasma,NKC)
Myeloid: effects myeloid cell line (RBC, mast, neutrophil, eosinophil, macrophage, platelets)
acute or chronic leukaemia
Acute: poorly differentiated cells, immature, POOR
Chronic: well-differentiated cells, REASONABLE
clinical signs of Leukaemia
lethargy, weakness, anorexia, Pyrexia, pallor, petechiae, mild generalized lymphadenophathy, hepatosplenomegaly, hematology
treatment of Leukaemias
Acute: L-asparaginase/prednisolone,cytarabine or CHOP
Chronic: Chlorambucil and prednisolone
How to differentiate between stage 5 Lymphoma and Leukaemias
Stage 5 Lymphoma = CD34 -ve on flow, LN huge,not sick
Leukaemias: CD34 +ve on flow, sick, marked cytopenias
cause of bone pain in older dogs
multiple myeloma: bone plasma cell tumor, increased globulins, radiograph bones
treatment: melphalan and prednisolone
Lymph Node classification under the microscope
Normal: mainly small lymphocytes (1-1.5 RBC)
Hyperplastic/Reactive: more M-L lymphocytes
Lymphadenitis: more inflammatory cells
Lymphoid neoplasia: >50% M-L(immature) lymphocytes
Metastatic neoplasia: Foreign cells present
