The Evaluation of the Anemic Patient

Question 1

what is anemia?

Answer 1

hematocrit below the normal range for the specific species

Question 2

what is the significance of anemia?

Answer 2

decreased hematocrit results in decreased oxygen delivery to tissues
marker of systemic disease
helpful in guiding diagnostic evaluation

Question 3

what are the causes of anemia?

Answer 3

decreased production
increased loss
hemolysis
combination

Question 4

what can lead to regenerative anemia?

Answer 4

loss
hemolysis

Question 5

what can lead to non-regenerative anemia?

Answer 5

bone marrow disease
acute loss or hemolysis

Question 6

what colors should you check the plasma for in anemia?

Answer 6

icteric
hemolyzed

Question 7

what can be seen with immune-mediated hemolytic anemia on a blood smear?

Answer 7

spherocytes
auto-agglutination

Question 8

why should you consider a bone marrow aspirate with non-regenerative anemia?

Answer 8

etiology
prognosis

Question 9

what are the common causes of blood loss?

Answer 9

wounds
gastrointestinal
cavity

Question 10

with what type of bleeding might you have high BUN?

Answer 10

gastrointestinal bleeding

Question 11

what can be found on examination of an animal with hemolysis?

Answer 11

signalment
icterus
hepatosplenomegaly
fever
bounding pulses

Question 12

what can be seen on laboratory tests with decreased production?

Answer 12

non-regenerative anemia
leukopenia
thrombocytopenia
chemistry profile/urinalysis normal

Question 13

what are the common causes of decreased production?

Answer 13

anemia of chronic disease
bone marrow failure
feline leukemia
Ehrlichia canis

Question 14

what are the specific therapies for anemia?

Answer 14

surgery
gastrointestinal protectants
vitamin K
immunosuppressive
doxycycline

Question 15

what makes an anemia regenerative?

Answer 15

reticulocytes
>60,000/ul

Question 16

what should you look at on a blood smear of an anemic patient?

Answer 16

abnormal cells
platelet numbers
cell morphology
regeneration

Question 17

what is feline leukemia a common cause of?

Answer 17

non-regenerative anemia
Mycoplasma hemofelis

Question 18

how can you tell anemia is from blood loss?

Answer 18

low to low normal platelets
maybe regeneration
low total proteins
elevated BUN if gastrointestina

Question 19

what can cause gastrointestinal bleeding?

Answer 19

ulcer
thrombocytopenia

Question 20

what are the common causes of hemolysis?

Answer 20

idiopathic
drug/vaccine
zinc
onions
neoplasia

Question 21

what can cause bone marrow failure?

Answer 21

toxins
immune-mediated
idiopathic

Question 22

what are the supportive therapies for anemia?

Answer 22

oxygen
transfusion: red blood cells, plasma, other

Question 23

what does all bleeding result from?

Answer 23

damage to vessel/organ
coagulopathy

Question 24

what are the major interventions for bleeding?

Answer 24

surgical
transfusion: plasma, platelet, fresh whole blood?, packed red blood cells
supportive for underlying disease

Question 25

what can waiting to fix surgical bleeding lead to?

Answer 25

loss of factors/platelets
possibly accelerated fibrinolysis

Question 26

what are the common coagulopathies?

Answer 26

thrombocytopenia
von willebrand’s disease
anticoagulant rodenticide
DIC

Question 27

how can you treat ITP?

Answer 27

immunosuppressives
vincristine
whole blood or packed red blood cell transfusions

Question 28

when can you taper drugs for ITP if there is no specific underlying cause?

Answer 28

9-12 months

Question 29

should you give a platelet transfusion for ITP?

Answer 29

probably no

Question 30

what is fibrinolysis for?

Answer 30

normal clot breakdown after healing is complete

Question 31

what is premature fibrinolysis associated with?

Answer 31

bleeding

Question 32

which animals have accelerated fibrinolysis?

Answer 32

greyhounds
dogs with severe bleeding

Question 33

what are some causes of anemia in cats?

Answer 33

pure red cell aplasia
FELV
urinary bleeding
IMHA and trauma far less commonly