9: Regenerative Anemias

regenerative anemia

blood loss/hemorrhage with enough time for RETICULOCYTE RESPONSE

regenerative anemia on a histology

increased polychromasia, anisocytosis, metarubricytosis. Prescence of Howell-Jolly bodies, basophilic stippling

what is the most VALID INDICATOR of regenerative anemia on histology?

POLYCHROMASIA

when is MCV often the highest?

hemolytic anemia

when is MCV often the lowest?

chronic blood loss

when does MCHC start to decrease?

when reticulocytes form

hemolytic anemia

increased RBC destruction

how does hemolytic anemia destroy RBCs?

macrophage phagocytosis or intravascularly

hemolytic anemia and external hemorrhage. which has the higher reticulocyte count?

hemolytic anemia

hemolytic anemia is present. what happens to TPP?

normal to increased

what conditions could hint at hemolytic anemia?

neutrophilia/monocytosis, bilirubiemia/hemoglobinemia/hemoglobinuria, Heinz bodies, poikilocytes, spherocytes, parasites present

mechanism of EV hemolysis

macrophage phagocytosis of intact RBCs

mechanism of IV hemolysis

RBC destruction WITHIN BLOOD VESSELS

true or false: bilirubinemia/uria and icterus MAY OCCUR with both EV and IV hemolysis

TRUE

hemoglobinemia/uria occurs with WHAT TYPE OF HEMOLYSIS?

IV (intravascular)

some causes of hemolytic anemia are

immune mediated RBC destruction, parasites, chemicals, fragmentation, etc

IMHA

immune mediated hemolytic anemia

primary IMHA

EV, could have autoagglutination, complement activation, macrophages phagocytosing

a way to confirm IMHA

Coomb's test

cause of primary IMHA

UNKNOWN

secondary immune mediated hemolysis is caused by what?

incompatible blood transfusions, pathogens

what causes neonatal isoerythrolysis?

mother has antibodies against antigen on newborn RBCs, passed through colostrum

cytauxzoon felis pathogen is present, what type of anemia are we seeing?

initially nonregenerative, if animal survives may later be regenerative

diseases causing erythrocyte fragmentation in dogs

DIC, caval syndrome, hemangiosarcoma, vasculitis, hemolytic uremia

histology clue or erythrocyte fragmentation

schistocytes/fragmented RBCs present

what causes hypoosmolality?

hypotonic IV/oral fluids, water intoxication

what does hypophosphatemia cause?

RBC ATP depletion

causes of blood-loss anemia

trauma, parasites, coagulation/platelet disorders, neoplasia, GI ulcers, IBD

external hemorrhage of blood-loss anemia occurred. what is lost?

RBCs, plasma proteins (TPP), Fe

what is RETAINED with INTERNAL HEMORRHAGE of blood-loss anemia?

Fe, some RBCs/proteins reabsorbed

acute hemorrhage has occurred. how long does it take for this to show on a blood panel with increased reticulocytes?

3-4 days

with treatment of acute hemorrhage, what should return to normal in the next week or so?

TPP

lab findings of acute hemorrhage

mature neutrophilia, mild thombocytopenia follow by thrombocytosis

HCT restoration/day in horse

0.4%

HCT restoration/day in cat

0.8%

HCT restoration/day in dog

1.6%

chronic blood loss has occurred. what type of anemia is this?

USUALLY REGENERATIVE (can become non-regenerative with severe Fe deficiency)

what is a common sign we see with chronic blood loss?

thrombocytosis

what species DOES NOT have a reticulocyte response to anemias?

HORSES