Pale Mucous Membranes Flashcards
How can we differentiate between Anaemia and poor peripheral perfusion? (2)
Capillary refill time- prolonged in poor peripheral perfusion but normal in Anaemic patients
Pulse quality- weak in hypovolaemic patients, strong in anaemic patients (with the exception of anaemia due to haemorrhage)
How can a urine test help diagnose Extravascular Haemolysis?
Look for Bilirubinuria- good early indicator in Cats
What can cause Haemolytic Anaemia? (3)
Immune mediated- idiopathic or secondary
Inherited haemolytic anaemias such as Pyruvatkinase deficiency or PFK deficiency
Infectious causes
How do we diagnose IMHA?
Usually by process of elimination
Presence of spherocytes or ghost cells in blood suggests haemolysis but not definitive of IMHA
How do we treat Non associative/ Idiopathic IMHA? (2)
Immunosuppressive Therapy- Glucocorticoids, Prednisolone (dexmethasone)
Clopidrogel- Anti thrombotic medication - thromboembolism is the number 1 killer!!
How does Prednisolone work in the treatment of IMHA?
Suppresses Macrophage activity
Suppresses IgG production
What immunosuppressive medication do we give to cats with IMHA?
What do we NEVER give?
Cyclosporine, Chlorambucil
NEVER Azathioprine- the therapeutic window is too narrow to risk giving it to cats
What do we monitor when treating animals with IMHA? (2)
PCV/TP prior to each dose immunosuppressive dose reduction
Biochemistry to monitor immunosuppressive effects of medication
Why can it be more difficult to diagnose IMHA in cats?
Cat RBC’s lack central pallor so all of their RBC’s look like Spherocytes
Why can Diabetes treatment lead to Haemolysis?
Insulin is given which stimulates phosphorous uptake in cells- this phosphorous alters oxygen transport and causes haemolysis
Why can Chronic inflammation cause anaemia?
Inflammatory interleukins IL-1 & IL-6 disrupts Iron recycling and causes mild/moderate anaemia
75% of anaemic cats did have…
FeLV infection prior to the vaccine being created
In severe non regenerative anaemia with unknown aetiologies, what can we sample to help find a cause?
Bone Marrow sampling
Where should we sample bone marrow from?
Iliac Crest or Humerus
