Small Animal Anaemia Flashcards
What are the presenting signs of anaemia?
Lethargy, pale MM, tachycardia, heart murmur, hyperdynamic pulses, anorexia/reduced appetite, exercise intolerance, weakness/collapse +/- signs of underlying disase
What can clinical signs relate to?
Cause, severity and chronicity of disease
What can pale MM mean?
Either poor peripheral perfusion or anaemia
How do you differentiate between poor peripheral perfusion and anaemia?
Poor perfusion = slow capillary refil and weak pulse
Anaemia = normal CRT and strong pulse except in anaemia due to acute bleeding
Is signalment relevant to cause of anaemia?
Young puppies and kittens more likely to have parasitic infection and have lower PCVs
Older animals more likely to have bleeding tumours
Breed predisposed to specific illness
What questions are important to ask during history taking?
When was patient last normal? Lifestyle (esp cats)? Appearance of urine and faeces? Presenting signs stable or deteriorating? Any site of bleeding identified? History of drug treatment/toxin ingestion? Travel history?
What checks should be performed on clinical exam?
HR, RR + pattern, pulse quality and general demeanour
Look for icterus or concurrent disease
Resp sound dull ventrally/abdominal distension and fluid thrill/abdominal pain/mass lesions
What does degree of regeneration depend on?
Time scale and severity of anaemia
How do you differentiate between haemorrhage and haemolysis if it is regenerative anaemia?
In-saline agglutination test, manual PCV and TP as decrease could indicate external blood loss, spherocytes/ghost cells/icterus, bone marrow response to haemolysis = high WBC, change in bilirubin on biochemistry
What tests should be considered if haemorrhage is suspected?
Platelet count, diagnostic imaging, faecal lungworm, ACTH stimulation test in cases with melena, abdominal/pleural fluid sampling
What tests should be considered if haemolysis is suspected?
Urinalysis for bilirubin or haemoglobinuria, screen for tick borne diseases, imaging, FNAs of LNs or organs, hunt for underlying disease or trigger factor
What tests should be performed if non-regenerative anaemia is diagnosed?
Haematology/biochemistry/urinalysis, faecal analysis, infectious disease tests, rule out endocrine disease, imaging, bone marrow aspirate and core biopsy
What are the categories of regenerative anaemia in dogs and cats?
Blood loss anaemia, Immune-mediated Haemolytic Anaemia (IMHA), Inherited haemolytic anaemia, Infectious causes of haemolytic anaemia, Miscellaneous causes of haemolysis
What are the different categories of IMHA?
Primary or idiopathic with guarded prognosis and relapse common, Secondary to neoplasia/infection/drug treatment/concurrent immune-mediated disease
What are the different causes of inherited haemolytic anaemia?
Pyruvate kinase deficiency
Phosphofructokinase deficiency
Porphoryia
Red cell membrane abnormalities
What are the different infectious causes of haemolytic anaemia?
Babesia spp
Non-specific infections can act as immunological triggers causing antibodies capable of hurting RBC to be made
What are the miscellaneous causes of haemolytic anaemia?
Oxidative damage to RBC
Hypophosphataemia
Shear injuries
What are the categories of non-regenerative anaemia in dogs and cats?
Anaemia of chronic disease/inflammation, Anaemia of chronic renal disease, FeLV infection-induced erythroid hypoplasia, Primary bone marrow disorders Nutrient deficiency, Endocrine disorder, Liver disease/insufficiency
What are the characteristics of anaemia due to chronic disease/inflammation?
Mild-moderate PCV 25-36% dogs, 18-26 cats
Normocytic normochromic
What are the charateristics of FeLV induced erythroid hypoplasia?
Macrocytic/normocytic
What are the different primary bone marrow disorders?
Pure red cell aplasia, Aplastic anaemia, Neoplasia (myelophthisis), Myelodysplasia, Myelofibrosis
What is the pathogenesis of pure red cell aplasia?
Antibody response directed against RBC precursors
What is the pathogenesis of myelophthisis?
Bone marrow is crowded out but neoplastic cells
What is myelodysplasia?
Abnormal maturation or production of cells
