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Anemia, Thrombocytes, and Blood Parasites. Clinical Pathology. Autoimmune Hemolytic Anemia (AIHA). Antibodies directed against RBC membrane antigens and Ab- coated RBC’s are removed from circulation.

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Autoimmune hemolytic anemia aiha
Autoimmune Hemolytic Anemia (AIHA)

  • Antibodies directed against RBC membrane antigens and Ab- coated RBC’s are removed from circulation.

  • Hemolytic process results in varying degrees of anemia depending on antibody type, speed of development, and duration of the disease process.

  • Female dogs are more commonly affected than males.

  • Certain breed predispositions include: Poodles, Cocker Spaniels, Terriers, Old English Sheepdogs, Lhasa Apsos, and Shih Tzus.

  • Rare in cats, usually associated with FeLv or Hemobartonella.

Aiha continued
AIHA continued

  • The spleen is the primary site for removal of RBC’s coated with IgG while the liver removes RBC’s coated with IgM.

  • Onset of anemia may be acute or gradual.

  • Complications:

    • DIC

    • Pulmonary Thromboembolism

Causes of aiha
Causes of AIHA

  • Primary AIHA: autoantibodies directed against RBC’s with no underlying disorder, most common.

  • May occur in association with immune mediated thrombocytopenia.

  • Secondary AIHA: Ab production initiated by drugs, vaccines, infectious diseases and neoplastic disorders.


  • History and Physical Exam

  • CBC

    • Regeneration

    • Spherocytes

    • Autoagglutination

    • Anemia (PCV<20%)

  • Coombs Test

  • Splenomegaly and Hepatomegaly seen on radiographs.

Therapy for aiha
Therapy for AIHA

  • Corticosteriods:

    • Reduces clearance of Ab coated RBC’s by inhibiting function of macrophages in the spleen and liver.

      • Prednisone at dose of 2 mg/kg/day divided BID.

  • Blood transfusions in life-threatening situations.

  • Other immunosuppressive drugs

    • Cyclophosamide

    • Azathioprine

    • Cyclosporine

  • Splenectomy

    • Indicated if anemia is nonresponsive to immunosuppressive drugs.

Classification of nonregenerative anemia
Classification of Nonregenerative Anemia

  • Primary failure of erythropoiesis

  • Secondary failure of erythropoiesis

  • Nuclear maturation defects

  • Hemoglobin synthesis defects

  • Aplastic anemia

  • Marrow infiltration

Primary failure of erythropoiesis
Primary Failure of Erythropoiesis

  • Patient stops producing red blood cells

  • Circulating blood has few reticulocytes, normocytic, normochromatic RBC’s.

  • Bone marrow normal except for hypoplasia of erythroblasts.

  • May be immune-related or caused by certain drugs or neoplasia.

Secondary failure of erythropoiesis
Secondary Failure of Erythropoiesis

  • Caused by a chronic disorder such as renal failure, liver disease, inflammatory disease, neoplasia, and endocrine disorders.

  • Bone marrow is normal or has slight erythroid hypoplasia.

Nuclear maturation defects
Nuclear Maturation Defects

  • Associated with folate and B12 deficiency (rare).

  • Macrocytic, normochromic anemia due to a defect in DNA synthesis.

  • Megablastic erythroblasts in bone marrow.

  • Check serum folate and supplementation is the cure.

Hemoglobin synthesis defect
Hemoglobin Synthesis Defect

  • Primary associated with iron deficiency.

  • Microcytic, hypochromic anemia due to decrease Hb production in individual cells.

  • Iron deficiency can result from a poor diet, poor absorption, and following an incident of marked blood loss.

Aplastic anemia
Aplastic Anemia

  • Bone marrow failure due to marrow necrosis and/or inflammation.

  • Bone marrow is acellular or hypocellular resulting in anemia, thrombocytopenia, and leukopenia.

  • Causes:

    • Ehrlichia canis

    • FeLv

    • Parvovirus

    • Estrogen

    • Phenylbutazone

    • Radiation

    • Chemotherapy

Marrow infiltration
Marrow Infiltration

  • Neoplasia: crowding of marrow elements with neoplastic cells.

  • Myelofibrosis: hypoplasia of marrow elements with replacement by collagen (sequel to damaged marrow).

  • Osteopetrosis: inherited disorder with increased bone density.

Thrombocyte platelets
Thrombocyte = Platelets

  • Platelets are produced by fragmentation of megakaryocytes in bone marrow

  • 150-200 platelets are formed from one megakaryocyte.

  • Lifespan: 7-10 days

  • Normal count: 200,000 – 500,000/mm3

  • Thrombocytopenia- most common cause of bleeding in dogs.

  • Normal hemostatis depends on adequate platelet number and function

  • Important role in primary hemostatis involving interaction between injured blood vessel wall and platelets

When thrombocytopenia is found
When Thrombocytopenia is found

  • Make sure you had a good stick, if not recollect sample from a large peripheral vein.

  • If yes, perform coagulation test, CBC, tick panel.

  • If those are normal, then check bone marrow

Immune mediated thrombocytocenia
Immune Mediated Thrombocytocenia

  • Most common in middle-aged female dogs, less common in cats.

  • May be primary cause similar to AIHA.

  • Secondary causes are drugs, viruses, immune complexed, infectious disease, etc.


  • Test platelets

    • Platelet count

    • Bleeding time

  • Test Coagulation Factors

    • Activated Clotting Time (ACT)

    • Activated Partial Thromboplastin Time (PTT)

    • Prothrombin Time (PT)

Disorders of blood coagulation factors
Disorders of Blood Coagulation Factors

  • Von Willebrand disease (vWD): factor VIII decreased.

    • An additional portion of the molecule which is important in platelet function is decreased or absent.

    • Abnormal platelet function.

    • Increased mucosal surface bleeding time.

    • Excessive surgical bleeding.

    • Chronic, low grade bleeding possible.

    • PTT may be mildly prolonged

    • Antigen test

Buccal mucosal bleeding time
Buccal Mucosal Bleeding Time

  • Normal clotting time 2-4 minutes

  • Platelet dysfunction at 10-12 minutes

  • Begin timing immediately after making cut. Wound should not be wiped or disturbed until it has clotted.

Cuticle bleeding time
Cuticle Bleeding Time

  • Normal time is 2-8 minutes

  • Begin timing at the time the nail is cut. Discrete drops of blood should fall from wound. A steady stream indicates that the wound is too far in the cuticle.

Equine infectious anemia eia
Equine Infectious Anemia (EIA)

  • Contagious and potentially fatal viral disease in horses.

  • No vaccine or treatment exists.

  • Transmitted by biting insects such as horseflies and deerflies.

  • Can also be transmitted by dirty needles.

  • Also called Swamp Fever

  • Two stages:

    • Acute

      • Develops severe, acute signs within 2-3 weeks. Signs occur rapidly and cause only a slight increase in temperature, 30% of horses die at this stage

    • Chronic

      • Temperature > 105˚ F

Clinical signs of eia
Clinical Signs of EIA

  • Petechial hemorrhage

  • Depression

  • Weight loss

  • Edema in legs and abdomen

  • Anemia

Coggins test
Coggins Test

  • Checks for antibodies to the virus

  • Positive Test Options

    • 1. Retest

    • 2. Euthanize

    • 3. Sale for immediate slaughter

    • 4. Lifetime Quarantine

Texas law and reactors
Texas Law and Reactors

  • Retest in 30 days at TVMDL

  • Official reactors are permanently marked by using a National Uniforms Code branded on the left shoulder or neck.

  • Quarantine should be at least 200 years from other equine

  • All exposed equines must be tested

Common blood parasites you should know
Common Blood Parasites you should know

  • Ehrlichia platys

    • Brown dog tick transmits

  • Erhlichia canis

    • Common in TX

    • Transmitted by Brown dog tick

    • 3 stages of disease

      • (acute, subclinical, and chronic)

  • Hemobartonella felis

    • FIA (feline infectious anemia)

    • Rickettsial organism

    • Transmitted by fleas, ticks, blood transfusions, queen to kitten.

  • Hemobartonella canis

    • Rarely seen in dogs

  • Cytauxzoon felis

    • Fatal disease characterized by anemia

    • Thought to be transmitted by ticks

  • Anaplasma marginale

    • Rickettsial organism

    • Transmitted mechanically through equipment

  • Babesia bigemina

    • Reportable in cattle

    • Texas fever, Redwater fever, Cattle tick fever

  • Babesia canis

  • Babesia Gibsoni