Non Regenerative Anaemia Flashcards
What are the 2 questions that must be asked when approaching a symptomatic non-regenerative anaemia with acute onset?
Could this patient have chronic anaemia but is now symptomatic due to intercurrent disease?
Has the patient had acute blood loss or haemolytic anaemia but less than 48-96 hours have elapsed?
What does the absence of regeneration imply?
A primary or secondary bone marrow abnormality
How is anaemia of chronic disease characterised?
Excluded in dogs with severe and cats with moderate-severe anaemia
Sustained inflammation or neoplastic process reduces iron availability
To differentiate IDA from ACD bone marrow staining with Prussian blue may be required
What are the two types of bone marrow disease?
All bone marrow cell lines- aplastic cytopenia
The red cell precursor- pure red cell aplasia
What testing should be considered with bone marrow disorders?
Cats- FeLV FIV (if positive, transfusion is only option)
Coombs- PRCA of immune origin is common- tx is immune suppression
Diagnosis made on bone marrow cytology
How is bone marrow disease treated?
4mg dexamethasone per cat every 1-2 weeks
2-4mg/kg pred and Azathioprine 50mg/m2
Takes 2-3 months, may require blood transfusions as supportive tx
How and why does ARD present?
Mild to moderate anaemia uncovered when dehydration is corrected
Kidney produces EPO, RBC lifespan reduced, sub clinical GI bleed is common, PTH suppresses erythropoesis
What is the typical tetrad of haematological abnormalities in iron deficiency anaemia?
Microcytosis (high RDW)
Hypochromasia
Mild regeneration 1-5%
Thrombocytosis
What are the common causes of IDA in dogs?
Chronic blood loss-
GI bleed from neoplasia, ulceration, endoparasites
Urogenital bleeding
Heavy flea infestation
In what cases does iron deficiency anaemia occur in cats?
Weanling kittens- just need to supplement
Chronic blood loss in GI lymphoma
