Small Animal Anaemia

Question 1

What are the clinical signs of anaemia?

Answer 1

None if mild
Lethargy
Anorexia
Collapse
Pale mm
Increased HR
Increased RR
Heart murmur
Hyperdynamic pulse

Question 2

What are the causes of pale mms?

Answer 2

Anaemia

Poor peripheral perfusion

Question 3

How can you differentiate anaemia from poor peripheral perfusion being the cause of pale mms?

Answer 3

CRT <2s => anaemia
>2s => poor perfusion

Strong pulses => anaemia
Weak pulses => hypovolaemia

Question 4

What needs to be asked in a anaemic patient history?

Answer 4

Lifestyle
Stable or deteriorating signs
Site of bleed identified
Drugs/toxins
Travel history

Question 5

What should be examined on PE of an anaemic patient?

Answer 5

Stable
HR, RR, demeanour
Icterus
Concurrent disease
Pleural and peritoneal spaces
Masses/pain
Rectal (melena)

Question 6

What does a concurrent decrease in total protein and RBC indicate?

Answer 6

Haemorrhage

Question 7

What does a concurrent increase in total protein/nitrates indicate?

Answer 7

Haemolysis

Non-regenerative anaemia

Question 8

How is regenerative and non-regenerative anaemia diagnosed?

Answer 8

Reticulocyte count

Blood smear evaluation

Question 9

What are causes of regenerative anaemia?

Answer 9

Haemorrhage

Haemolysis

Question 10

Give 4 examples of internal haemorrhages that cause regenerative anaemia…

Answer 10

Spleen haemorrhage
Thoracic haemorrhage
Trauma
Amyloidosis

Question 11

Give 4 examples of external haemorrhages that cause regenerative anaemia…

Answer 11

Epistaxis
GIT bleeding
Severe parasitic infection
Urinary tract bleeding

Question 12

What further diagnostics should be considered after diagnosing haemorrhage?

Answer 12

Coagulation profile
Platelet count
Faecal lungworm
ACTH stim test
Search of body cavities

Question 13

How is haemolysis differentiated from haemorrhage?

Answer 13

Normal TP

Evidence of underlying cause on blood smear

Question 14

Which Ig are mainly responsible for intra and extravascular haemolysis?

Answer 14

Intravascular - IgM

Extravascular - IgG

Question 15

How is haemolysis diagnosed?

Answer 15

Autoagglutination test
Coomb’s test
Haemoglobinuria
Bilirubinuria

Question 16

What can cause haemolytic anaemia?

Answer 16

Immune mediated
Inherited
Infectious
Miscellaneous

Question 17

Give two examples of inherited haemolytic anaemias…

Answer 17

Pyruvatkinase (PK) deficiency

Phosphofructokinase (PFK) deficiency

Question 18

What breeds are predisposed to IMHA?

Answer 18

Cocker and springer spaniels

Question 19

How is IMHA diagnosed?

Answer 19

Regenerative anaemia with no haemorrhage
Signs of haemolysis - icterus, autoagglutation, spherocytes, ghost cells
Underlying disease

Question 20

How is IMHA treated in dogs?

Answer 20

IVFT, blood transfusion
Immunosuppressive therapy
Aspirin, clopidogrel
Gastroprotectants
Nursing care

Question 21

Give 4 examples of immunsuppresive drugs used to treat IMHA in dogs…

Answer 21

Prednisolone
Azathioprine
Cyclosporine
Chlorambucil

Question 22

Which immunosuppressive drug is never used in cats?

Answer 22

Azathioprine

Question 23

What is the prognosis of IMHA in dogs?

Answer 23

Guarded

Question 24

Give 2 examples of infectious causes of haemolysis..

Answer 24

Babesia canis

Mycoplasma spp.

Question 25

Why can any infection cause secondary IMHA?

Answer 25

Any kind of infectious will trigger the immune system and could end up triggering IMHA

Question 26

Give 3 miscellaneous causes of haemolysis...

Answer 26

Oxidative damage - onions, paracetamol Hypophosphatamia, DKA Shear injury

Question 27

What causes schistocytes?

Answer 27

Shear injury

Question 28

What are the causes of non-regenerative anaemia?

Answer 28

``` Chronic disease Renal disease FeLV Miscellaneous Bone marrow disease ```

Question 29

What is the most common cause of mild-moderate anaemia?

Answer 29

Chronic disease

Question 30

How does chronic disease cause anaemia?

Answer 30

Poor iron storage Shortened RBC survival Impaired RBC production

Question 31

How does renal disease cause anaemia?

Answer 31

Inadequate EPO production Decreased RBC life span Decreased marrow response to EPO Haemorrhage from ureamic ulcers

Question 32

What diagnostic test should always be carried out on anaemic cats?

Answer 32

FeLV

Question 33

Give 3 examples of miscellaneous causes of non-regenerative anaemia...

Answer 33

Nutrient deficiency e.g. Fe, Cu Endocrine disease Liver disease

Question 34

Give 5 types of bone marrow disease that can cause non-regenerative anaemia...

Answer 34

``` Pure RBC aplasia Aplastic anaemia Neoplasia Myelodysplasia Myelofibrosis ```

Question 35

Where can bone marrow be sampled from?

Answer 35

Iliac crest Humerus Femur in cats

Question 36

How is a bone marrow sample taken?

Answer 36

1. Sedation, LA or GA 2. Clip and aseptically prepare the area 3. Take aspirate and make smear or take core and place in formalin

Question 37

How is bone marrow disease treated?

Answer 37

Immunosuppressive drugs Treat neoplastic condition Supportive treatment - blood transfusions