IMHA

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Bvms small animals (anaemia) Flashcards on IMHA, created by buzzybea1 on 28/02/2014.
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Flashcards by buzzybea1, updated more than 1 year ago
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Created by buzzybea1 about 10 years ago
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Question Answer
What does a stress lekogram present with? -increased neurtrophils -increased monocytes -decreased lymphocytes -drecreased eosinophils
How is the Diagnosis of IMHA made? animal being anaemic, there being evidence of RBC regeneration, spherocytosis (in dogs, not seen in the cat as they dont naturally have central pallor so cant differentiate one from a normal rbc) present and positive side agglutination test.
Other than anemia what may be seen on a blood profiled of an animal with IMHA? leukocytosis present (non specific bone marrow stimulation from pumping out a lot of platelets and new red blood cells by accident also makes some white blood cells also the anemia damages the organs which allows more bacteria to grow and causes a stress leukogram to be produced) and evidence of DIC also.
Babesia
what may cause a seconary IMHA? Babesia, mycoplasma, neoplasia, inflammatory disease, drug exposure and recent vaccination
Where should blood be taken from when looking for pathogens? the extrematies such as ear tips
How should primary IMHA be differentiated from secondary IMHA? Blood sample, chest x-ray, re-expose to suspected causative agent?!?! and abdominal ultra sound
what are the pathogens which cause feline infectious anaemia? -mycoplasma haemofelis -candidatus mycoplasma turicensis -candidatus mycoplasma haemominutum
when making a blood smear looking for FIA organisms what should not be done? An EDTA tube should not be used as this will lead to to death and lysis of he organisms making them non recognisable
whats the gold standard for detecting FIA? PCR is though its expensive
what are the treatment options and side effects for FIA? -Doxycycline (upto 6 weeks) or Enrofloxaxin for 2 weeks, enrofloxacin can cause blindness and doxycycline can cause strictures +/- steroids, will stop IMHA bu increase he pathogens
which animals are thought to be more represented by IMHA? american cocker spanials, poodles, old english sheep dogs, irish setters and collies
what will the majority of dogs with IMHA have concurrently? Immune mediated Thrombocytopenia
what are signs of a poor prognosis with IMHA? icterus (DIC/other organ involvement), thrombocytopenia/petechiation, elevated urea (caused by GIT bleeds???) and band neutrophils present
which antibody has a better prognosis with IMHA IgM or IgG? I wont change the plan plan but IgM is worse than IgG.
what should be always tested for if the animal has IMHA? DIC -APPT/PT (remember APPT goes up first in DIC) -fibrinogen (decrease in DIC) -FDPs and D dimers (up in DIC) -platelet count (down in DIC)
Why should animals with IMHA receive fluids? the Haemaglobin is excreted trough and damages the kidneys
what are the pros and cons of oxhaemaglobin? it is a strong colloid, its haemoglobin without the membrane so theoretically the body cant affect it, although it causes a bizzare color which makes it impossible to check how the animal is progressing, they also contain no clotting factors either.
What are the pros and cons of giving a transfusion to a do with IMHA? It contains clotting factors and improves symptoms although adding fuel to the fire
What is the immnesuppresive does of steroids and an anti inflammatory does? An immunsuppresive does of prednisolone is 2-4mg/kg (1/8 of this for dexamethasone!) and an anti-inflammatory does of prednisolone is 0.5mg/kg.
what are the drugs given which prevent RBC destruction in IMHA? Steroids and Azothioprine
How long does it take for azothioprine to work? 2 weeks
What are the side effects of azothioprine? Extremely hepaotoxic and causes Bone marrow suppression
what is the 3rd immune suppressing drug which is only available at referral centers? mycopheylate mofetil, its extremly expensive, and cant be given to anything smaller than a spaniel
What should be given to prevent hypercoagulability? ultra low does asprin or cloprigrel
How is DIC treated and how does this work? low molecular weight heperin which neutralizes factor Xa
What are the blood products available for use? -whole blood -fresh plasma/plasma -packed red cells -cryoprecipitate -platelet rich plasma
When is blood products required? PCV <10% and if the Bone Marrow response is minimal
When is whole blood necessary? In sever anaemia and when clotting factors are also needed
When would fluids be used over whole blood? If the only problem is hypovolemia
when would packed red blood cells be used over whole blood? If the animal is normovolemic but severely anaemic
how long do rbc's last from a transfusion? 60-90 days
when would concentrated plasma be given over whole blood? -when the main problem is a lack of the required clotting factors
what is the only indication for packed red blood cells? non regenerative anaemia- when the clotting isnt an issue
what are cat blood groups? -A -B -AB
what is the most common blood group for cats? A
What blood group are all siamese cats? A
why is a blood giving set needed for transfusions? It contains a clot filter
what temperature should blood transfusions be given at and how is this best achieved? -body temperature -water bath -DONT MICROWAVE!!! creates black pudding
How can a blood transfusion be given? IO or IV
What are the blood transfusion rate of administration for a relatively normal animal and a cardiac/renal patient? cardiac and renal paitents; 2ml/kg/h 'normal' animals; 5-10ml/kg/hour
What side effects may occur with a blood transfusion? haemolysis, acute hypersensitivity reactions, pyrexia, bacterial contamination, hypocalcemia, V+, circulatory overload and transmission of infectious diseases
What should be monitored if giving a blood transfusion? vocalization, pyrexia, depression, dyspnoea, heart rate, erythema, pruritus or convulsions.
how should a transfusion reaction be managed? stop transfusion, although maintain IV access, check the bag for haemolysis, check the matching is correct and possibly restart on a slower rate.
how long should the animal be monitored for when they are on a transfusion? 5 days after it has stopped, as delayed transfusion reactions can occur
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