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126 Cards in this Set
- Front
- Back
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These two dyes are used for identification of reticulocytes.
What are they staining? |
new methylene blue brilliant cresyl blue
RNA
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What are the two types of reticulocytes produced in cats |
aggregate punctate |
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What are aggregate reticulocytes?
WHat do they look like |
Similar to reticulocytes in dogs indicate an active regenerative response
They are clumping/coalesceing of blue dots |
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What are punctate reticulocytes
What do they look like |
reticulocytes that have been in circulation for 1 day
The blue dots are not clumping/coalesceing |
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WHy do you need an absolute reticulocyte count and how is it calculated |
retics affected by anemia % reticsx RBC /100 = reticulocytes |
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What is the prefered expression of erythroid regeneration |
absolute reticulocyte count |
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Although not as accurate as the absolute reticulocyte count, what else can be suggestive of regernative response (CBC) |
MCV RDW (red cell distribution width) |
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These two findings suggest a platelet problem |
petechia and epistasis (surface bleeding) |
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These two findings suggest a coagulopathy |
hematomas and cavity bleeding |
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This is the total blood volume of dogs and cats ___ of the body weight
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8-10%
6-8% |
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What % of the body weight be donated and well tollerated |
20% |
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What percentage of actue blood loss secondary to hemorrhage will cause cardiovascular signs |
20% |
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How long will it take an anemia to become macrocytic and regenerative |
3 days |
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How long to see a maximal reticulocyte response? |
4-7 days |
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What 3 things are the hallmark of acute blood loss |
anemia hypoproteinemia reticuloytosis |
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10 mls of whole blood per lb of body weight will increase the Hct ___% |
10 % |
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These type of blood losses are regenerative (list of diseases) (11) |
acute blood loss iron deficiency anemia IMHA inherited erythroid defects Hb disorders Erythrocyte membrane abnormalities Phosphofructokinas deficiency Pyruvate kinase deficiency Neonatal isoerythrolysis Infection associated hemoysis Methemoglobinemia |
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What is a common cause of iron deficiency anemia |
chronic external blood loss |
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Iron depleted occurs when iron stores are depleted but these two iron levels are normal |
serum iron blood hemoglobin concentration |
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iron defidient erythropoiesis has a mild anemia and ____ serum iron levels |
low |
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What is iron deficiency anemia? |
most advanced stage
absent iron stores low serum iron concentration low hemoglobin low Hct |
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What might be some causes of chronic external blood loss that may result in IDA (4) |
severe flea hook/whip GI blood loss nursing animals
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This is a classical manifestation of iron deficiency (C/S)
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pica - dirt, clay, feces, and metal
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What can detect GI blood loss if it is not evident? |
occult fecal blood test |
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Animals with this disease are exercise intollerant, have pica, and possibly have cardiomegaly |
chronic blood loss anemia (IDA) |
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On CBC, what is noted with IDA
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hypochromic
microcytic |
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What other abnormality noted on CBC can occur with chronic blood loss? |
thormbocytosis |
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What are serum iron levels with chronic blood loss? |
5-60 (normal 60-230 ug/dL) |
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What 3 things can cause false normal serum iron concentrations
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hemolyzed samples
iron supplementation recent tranfusion |
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What occurs with cardiomegaly with TX secondary to IDA |
resolve with TX |
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TX for IDA How long must be treated? |
ferrus sulfate with a meal iron dextran IM (anaphylaxis)
weeks to months, but iron store may never return to normal |
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What is the normal RBC life span in dogs |
100-120 |
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Normal RBC life span in cats |
70-78 |
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What level must bilirubin be for jaundice |
2 mg/dL |
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THese are two hallmark features of intravascular hemolysis and indicate a more severe disorder |
hemoglobinuria hemoglobinemia |
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These two breeds have insignificant microcytosis and macrocytosis |
microcytosis - Akitas Macrocytosis - poodles |
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Mean Corpuscular Volume (MCV) abnormalities |
microcytosis macrocytosis |
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What form of heme cannot carry oxygen? How is it able to carry oxygen |
ferric form (Fe +3) reduced to Fe+2 by cytochrome b5 reductase system
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Animals with methemoglobin reductase deficiency have these clinical signs (Hg disorders) |
- cyanotic mm - blood remains dark after air exposure |
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This condition in DSH and Siamese have pigmented and pink-flurorescent teeth and bones (congential pink tooth). |
porphyrias deposition of heme products in teeth/bones |
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THese are overhydrated, cup-shaped erythrocytes with a slitlike pallow on blood film
Associated with this disease in general and specificially |
stomatocytes
RBC membrane defects Alaskin Malamute - chondrodysplastic dwarfism |
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How do RBC generate energy?
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anerobic glycolysis (Embden-Meyerhof pathway)
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This is a chronic hemolytic disorder accentuated by a hemolytic crises and an exertional myopathy |
phosphofructokinase deficiency (PFK) |
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Dogs with PFK who have excessive panting, barking, extensive excerise and high temperatures can develope these 2 C/S
MOA |
hemoglobinuria hyperbilirubinuria
elevated temp and alkalosis causes lysis of PFK deficient cells resulting in crisis of severe anemia
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What breed of dog is PFK common in? |
English springer spaniels less commonly in cockers |
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HOw is PFK diagnosed |
PCR DNA test |
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These are two regulatory enzymes in the anerobic glycosis pathway |
phosphofructokinase (PFK) pyruvate kinase (PK) |
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This RBC enzymatic deficiency has mild C/S despite a persistent hemolytic anemia and high regerneation |
pyruvate kinase deficiency |
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Aniamls with this RBC enzymatic deficiency can possibly lead a normal life |
PFK phosphofructokinase deficiency |
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What occurs with phyruvate kinase deficiency (RBC level) |
lack the adult erythrocyte isoenzye R-PK and express a fetal M-PK form that is dysfunctional |
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Besides a highly regenerative anemia and mild C/S what occurs about 1 year of age with PK deficiency |
unexplaned myelofiborisis and osteosclerosis of the BM |
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What do PK dogs die from |
anemias and generalized hemosiderosis (Fe overload) with associated liver failure before 8 years of age |
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DX of PK |
molecular screnning test |
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What is special about feline erytrocytic PK deficency
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hemolytic anemia no ostosclerosis |
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Is TX availible for feline PK deficiency? |
prednisone and spleenectomy |
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____ binds to the RBC to cause IMHA |
IgG or IgM +/- complement |
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Why are spherocytes formed?
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phagocytes remove a portion of the membrane leaving RBC with reduced surface area/volume ratio
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What are different proposed infectious causes of IMHA
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viral - FeLV, FIV, FIP, URI, GI
bacterial - lepto, M. hemofelis parasitic- Babesiosis, leishmaniasis, HWD, Tick |
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What are different RX proposed causes of IMHA (7) |
sulfonamides cephalosporin penicillin VX Propylthiouracil mehimazole procainamide |
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What are Immune/Endocrine Dz proposed to cause IMHA |
SLE hypothyroidism
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What are breeds that have a genetic predisposition for IMHA? (6)
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american cockers
english springer spaniel old english sheep dog irish setter poodle dachshund |
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What age are dogs with IMHA
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young adult to middle-aged
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Although rare, cold-reacting antierythrocytic AB causing skin lesions such as: ____ may not show hemolysis |
acrocyanosis gangrenous necrosis or ear, nose, tail tip and nail beds |
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Labratory results with IMHA (4) (non RBC)
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leukocytosis (degree of necrosis
+/- thrombocytopenia (Evans/DIC) hyperbilirubinemia/uria increase liver enzymes |
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DX of IMHA (3) Need 1 of the 3 |
Marked spherocytosis true autoagglutination Positive direct Coombs' Test |
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Spherocytes in smaller numbers can be seen with these other diseases |
zinc intoxication hypophosphatemia microangiopathic hemolysis |
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Do cats get spherocytes? |
no, due to the small size and lack of central pallor |
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What is macroscopic agglutination
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autoagglutination in EDTA or on a glass slide
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What is microscopic agglutination |
stained blood smear or saline wet mount |
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Coomb's test AKA what dose it test for |
direct antiglobulin test detect AB, complement or both on the RBC surface |
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What can a Coombs' test not differentiate between |
primary or secondary IMHA |
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If a dog with suspected IMHA is negative on Coombs' test, what is next |
look for other causes of anemia |
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Causes of FN Coombs' Test |
not enough AB bound to RBC Labratory error |
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Will a few days of therpay cause a negative Coombs' test? |
it should still be positive |
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TX for IMHA |
TX underlying cause Transfusion (DEA 1.1 negative) steroids cyclophsophamide azathioprine cyclosporine leflunomide/mycophenolate danazol splenectomy anticoagulation TX if DIC - heparin |
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WHy do dogs die of IMHA |
overwhelming hemolysis and thromboemboli and infections |
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How do glucocorticoids help with IMHA |
interfere with the macrophage Fc recepots and impair clerance of AB coated RBCs |
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When should spleenectomy not be considered |
pets receiving immunotherpay in addition to prednisone. |
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When is anticoagulation therapy instituted |
after evidence or suspicion of thormboemboli |
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Mortality rate for IMHA |
20-75% |
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Negative prognostic facotors for IMHA |
rapid drop in PCV high serum bilirubin non-regenerative anemia persistent autoagglutination thromboembolic complications |
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This cat blood type developes strong naturally occuring anti antibiodies against___ |
B against A |
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Kittens born to this Queen and Tom are at high risk for feline neonatal isoerythrolysis.
What happens to these kittens |
B queen and A tom
AB and A kittens are born healthy, but detiorated after ingesting colostrum |
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TX for feline NI |
TX is rarely successful |
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When do dogs develope NI alloantibodies |
If bitch has received blood products |
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How long after first blood transfusion can alloantibodies form |
4 or more days after transfusion. |
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What are the blood groups in dogs |
DEA 1.1 1.2 3 4 5 7 |
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Blood type in cats |
A AB B |
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How is a major crossmatch for a blood transfusion performed |
RBC (d) and plasma (r) - if agglutination occurs, receipient will chew up RBC and is an incompatable donor. |
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What is the large form of hemobartonellosis |
Mycoplasma haemofelis |
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The small form of hemobartonellosis |
M. haemominutum (less pathogenic) |
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This is feline infectious anemia |
Mycopsama hemofelis |
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Transmission of M. haemofelis |
unknown blood sucking ectoparasites? |
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How dose M. Haemofelis cause anemia? Stages of anemia
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opportunistic organism that causes illness under predisposing conditions. CYCLIC
Parasitized RBC sequestered by spleen and removed
parasitic incubation acutre parasitemia recovery/carrier stage - life
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DX of M haemofelis |
no serologic testing PCR testing blood smears - ear or shortly after collection |
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TX for M. haemofelis : clinical response seen in...
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doxycyline 3 weeks
clinical response with in days remain carrier (dosen't clear parasite) although relapses are uncommon |
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This is the dog version of hemobartonellosis
transmitted by (vector)
Develope C/S only if |
Haemobaronella canis
brown dog tick
only develope dz if have a serious dz or spleenectomized |
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Cytauxzoonosis
____ are found in RBC |
piroplasms/merozites |
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Cytauxzoonosis ___ are found in macrophages |
shizogony |
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Large ____ form in vessel walls of organs and causes vascular occlusion |
schizonts |
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TX of Cytauxzoonosis |
diminazene imidocarb high mortality |
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Babesia is endemic in these 2 breeds
what age are more succeptible |
Grey hounds Pit bulls
Puppies 8m of younger |
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Vector for Cytauxzoonosis |
suspect Lone star tick |
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Vector for babiesiosis |
ticks |
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What causes problmes with babesiosis that results in the anemia |
parasites dammage contributes to anemia, but the secondary IMHA and oxidative dammage are more pathogenic |
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DX of Babesiosis |
DNA testing organisms in erythrocytes |
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This has single or large paris of piriform organisms in RBC |
B. canis
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This has single intracellular organism in RBC |
B. gibsoni |
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What is the best way to see parasitized RBCs |
few erythrocytes are parasitized, examine the buffy coat or ear prick |
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TX for Babesia |
imidocarb dipropionate +/-prednisone tick control |
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What compounds can cause methemoglobin formation (4) and can also cause Heinz Body formation
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benzocaine containing skin products
layrngeal/nasopharngeal sprays phenazopyridine (numbs bladder) acetaminophine (cats) |
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Why do cats get methemoglobinemia with acetominophine |
They cannot conjugate drugs with glucuranides and their sulfate conjugation and glutathione pathways are rapidly saturated and depleted
instead of excreting acetaminophen as a glucuronide conjugate, they produce reactive metabolite that causes RBC dammage - Heinze body and methemoglobinemia |
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Although labratory tests can determine methemoglobinemia, what is an in house meaurement that can determine if it is clinically important |
drop of blood on a filter paper remains brown after exposure to air the control venous sample turns red then methemoglobin concentration exceeds 10% |
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What % of methemoglobin conctration will the MM appaer cyanotic but no serious signs?
C/S are seen at this % |
10%
40% |
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Heinz body represent |
irreversibly denatured and precipitated hemoglobin in RBC |
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What other RBC morphology might be noted with Heinz body anemia? |
eccentrocytes (moon shaped zone caused by shift of Hb to one side of the cell) |
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These are a few food items to causes of Heinz body formation |
onion garlic
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These systemic disease have been implicated with these systemic diseases |
hyperthyroidism LSA cancers DM (ketoacidosis) |
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These household items can cause RBC membrane dammage |
naphthaline (mothballs) toilet bowel deoderizers |
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pennies from this year cause life threatoning intravascular hemolysis |
since 1983 |
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besides zn toxicosis, what other heavy metal can cause acute intravascular hemolysis and methemoglobinemia |
acute copper toxicosis fulminat hepatic failure by copper storage toxicosis in Bedlington terriers |
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What is the TX for acetominophen |
n-acetylcysteine increases the sulfate availibility for conjugation and provides cysteine for gluthione regeneration and metabolism of toxic metaboties |
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What level of phosphorous cause hemolysis |
less than 1 mg/dL but in clinical practice can occur with values less than 2.5 mg/dL |
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What diseases can cause severe hypophosphatemia induced hemolysis |
DM hepatic lipidosis starvation-refeeding syndrome phosphate-binding antacids |
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TX for hypophasphatemia induced hemolysis |
IV sodium or potassium phosphate
must measure P and Ca q 6 hours and then switched to oral |
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schistocytes occur with this anemia |
microangiopathic hemolytic anemia |
