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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.
diagnosis
Diagnosis
  • 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.
coagulopathy
Coagulopathy
  • 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
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