Term
| How do you differentiate blood loss and hemolysis anemia? |
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Definition
-Blood loss: normal-low protein, evidence of bleeding, negative Coomb's test
-Hemolysis: normal-high protein, icterus, hemoglobinemia, spherocytosis, hemosiderinuria, autoagglutination, Direct Coombs test, splenomegaly, RBC changes |
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Term
| What are some acute causes of blood loss anemia? |
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Definition
-hemoabdomen: HSA, rodenticide toxicity
--severe thrombocytopenia: urinary, GI, subcutaneous, epistaxis |
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Term
| What are some chronic causes of blood loss anemia? |
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Definition
-GI hemorrhage: ulcer, neoplaisa
-Intestinal parasites: hookworm
-ectoparasites: severe flea infestation
-Chronic meight have a normal TP |
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Term
What clinical signs are associated with bleeding in the following locations:
a) GI
b) urinary
c) epistaxis
d) hemoabdomen
e) pulmonary/hemothorax |
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Definition
a) GI: melena, hematemesis
b) Urinary: hematuria, stranguria, pollakiuria
c) epistaxis: nose bleed, nasal signs
d) Hemoabdomen: abdominal distention, discomfort
e) pulmonary/hemothorax: tachypnea, resp distress |
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Term
| If you suspect chronic bleeding, what should you make sure to add to your PE? |
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Definition
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Term
| What are some clinical signs that indicate the location of bleeding? |
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Definition
-rectal exam: melena
-pettechiae or ecchymosis
-excessive fleas
-fluid wave: hemoabdomen
-dec ventral lung sounds: hemothorax |
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Term
| What are the 3 major diagnostics we run on a patient suspected of blood loss? |
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Definition
-CBC: platelet count! RBC morphology, retic count, indices, PCV
-Chem panel: dec TP, inc BUN
-PT/PTT |
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Term
| Is blood loss anemia usually non-regenerative or regenerative? Exceptions? |
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Definition
-regenerative
-acute or iron deficiency anemia |
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Term
| What does a UA of a blood loss anemia case look like? |
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Definition
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Term
| What can imaging show in cases of blood loss anemia? |
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Definition
-Thracic: pulmonary edema, hemothorax
-Abdominal radiographs: hemoabddomen
-Abdominal ultrasound: hemoabdomen, splenic or liver masses, GI ulceration, blood clot within bladder |
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Term
| What diagnostics do we run on GI bleeding? |
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Definition
-complete history: NSAID use
-fecal occult blood: if negative helps to rule-out GI blood loss |
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Term
| What diagnostics do we run for testing infectious diseases in suspected cases of blood loss anemia? |
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Definition
| -fecal float for intestinal parasites |
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Term
| What are the main 3 features of treatment of a case of blood loss anemia? |
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Definition
-blood transfusion
-STOP the bleeding
--treat the underlying cause |
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Term
How do we treat the following underlying causes of blood loss anemia:
a) GI
b) parasites
c) coagulopathy
d) iron deficiency anemia |
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Definition
a) acid suppressants, protectants
b) antiparasitic agents
c) treat underlying cause of severe thrombocytopenia, plasma and Vit K1 for secondary hemostasis abnormalities
d) iron supplementation (injectionn > oral) |
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Term
| What is erythrocytosis? What is a relative erythrocytosis? What about absolute? |
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Definition
-inc in circulating RBC mass (inc PCV or HCT)
-erythrocytosis due to hemoconcentration (dehydration)
-absolute: true inc in PCV (primary or secondary) |
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Term
| Which breed of dog normally exhibited erythrocyosis? |
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Definition
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Term
| What is the most common cause of relative erythrocytosis? Other causes? |
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Definition
-dehydration
-hemorhaggic enterocolitis |
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Term
| How do we diagnose and treat relative erythrocytosis? |
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Definition
-history/PE and TP
-IV fluid therapy |
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Term
| What are some characteristics of primary absolute erythrocytosis? |
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Definition
-polycythemia rubra vera (RARE)
-proliferation of RBCs in bone marrow
-low or undetectable Epo concentration
-often a diagnosis of exclusion |
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Term
| What are the two types of secondary absolute erythrocytosis? |
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Definition
| -appropriate vs inappropriate |
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Term
| Describe appropriate secondary absolute erythrocytosis. What are some common causes? |
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Definition
-Epo production in response to hypoxia
-secondary to dec tissue oxygenation" pulmonary disease, right-to-left CV shunts, high altitude |
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Term
| What is inappropriate absolute erythrocytosis? Common causes? |
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Definition
-Epo production in absence of hypoxia
-excessive Epo pdn/release: renal mass, other neoplasia, hyperadrenocorticism, hyperthyroidism |
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Term
| What clinical signs are often attributable to absolute erythrocytosis? |
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Definition
-PCV > 60-70%
-PU/PD
-neuro changes: behavioral, seizures, ataxia, blindness
-epistaxis, hyphema, retinal hemorrhages
-bright red mucous membranes
-may be normal!!! |
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Term
| How do we go about diagnosing absolute erythrocytosis? |
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Definition
| -Evaluate for underlying cause: rads, ultrasound, echo, arterial blood gass |
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Term
| What is the goal of treatment of erythrocytosis? |
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Definition
| -dec circulating RBC = dec blood viscosity |
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Term
| How do we treat erythrocytosis? |
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Definition
-manage underlying disease
-therapeutirc phlebotomy: admin equal vol of fluids
-hydroxyura
-possible medical leeches |
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