Blood disorders

What is anemia?

not enough RBCs

What are the 2 classifications of anemia?

1. Regenerative anemias
2. Non-regenerative anemias

Regenerative anemias

bone marrow is trying to keep up! More RBC actively being made

Non-regenerative anemias

bone marrow doesn't make RBCs

What are 7 categories (variations abound) of anemias?

1. acute
2. chronic
3. traumatic
4. toxic
5. infectious
6. heritable
7. neoplastic (cancerous)

What type of anemia is typically associated with trauma?

Typically regenerative anemia

Pyruvate Kinase deficiency​

disorder of the lysosome

Pyruvate kinase is an important ___ for cells to gain energy from ATP​

enzyme

Why is the lifespan of red blood cells (RBCs) dramatically shorter?

RBCs do not have a nucleus or mitochondria to assist in ATP production.

Which dog breeds are predisposed to Pyruvate Kinase deficiency?

Beagle, Cairn Terrier, Pug, West Highland White Terrier.

What is the prognosis for individuals with Pyruvate Kinase deficiency?

Poor long-term prognosis, typically less than 5 years.

What breeds are most commonly affected by Phosphofructokinase Deficiency?

English Springer, Spaniels, and Cocker Spaniels

What are 3 common symptoms of Phosphofructokinase Deficiency?

1. Anemia
2. muscle cramping
3. rhabdomyolysis

rhabdomyolysis

A breakdown of muscle tissue that releases a damaging protein into the blood

How does Phosphofructokinase Deficiency affect ATP production?

leads to an ATP issue similar to that seen in Pyruvate Kinase deficiency.

Is the presentation of Phosphofructokinase Deficiency always constant?

No, it may be episodic.

What is the prognosis for dogs with Phosphofructokinase Deficiency?

The prognosis is somewhat better

What management strategies are recommended for dogs with Phosphofructokinase Deficiency?

Exercise restriction and removal from breeding populations.

What is Cytauxzoon felis?

A protozoan parasite that can cause anemia in cats.

What are Babesia and Anaplasma?

Tick-transmitted rickettsial diseases that can lead to anemia.

What is Mycoplasma (Hemobartonella)?

A bacterial infection that can cause destruction of red blood cells, leading to anemia.

How can hookworm infestation lead to anemia?

Hookworms can cause direct loss of red blood cells through feeding on the host's blood.

What role do flea and tick infestations play in anemia?

They can contribute to anemia by causing blood loss and transmitting diseases that damage red blood cells.

What are common clinical features of anemia caused by these infections?

Jaundice and pallor

What are 2 viral diseases that affect red blood cells (RBCs) and bone marrow?

1. Feline Leukemia (FELV)
2. Feline Immunodeficiency Virus (FIV)

What potential conditions can arise from viral infections in the bone marrow?

Leukemia, lymphoma, red blood cell aplasia, and myelodysplasia

myelodysplasia

defective development of the bone marrow or spinal cord

Aplasia

lack of development of an organ or tissue

Leukemia

cancer of white blood cells

lymphoma

A cancer of the lymphatic system

What type of immune response can occur against red blood cells in infectious anemias?

Immune-mediated attacks against RBCs

What can cause loss of red blood cells aside from immune-mediated attacks?

Lack of bone marrow platelet production

How do viral diseases like FELV and FIV affect the bone marrow?

hijacks the cells for their own purposes, disrupting normal function.

IMHA stands for?

immune mediated hemolytic anemia

What are autoantibodies in the context of IMHA?

Autoantibodies are formed against the body's own red blood cells.

primary IMHA

idiopathic

idiopathic

unknown, all other causes are ruled out

secondary IMHA

infections, cancers, drugs, vaccines, toxins

What is the mortality rate associated with IMHA?

30% - 80%.

IMHA has an extremely ___ mortality rate

high mortality rate

What are some known risk factors for developing secondary IMHA?

Known risk factors include infections, cancers, drugs, vaccines, and toxins.

What is a typical characteristic of IMHA?

It is typically regenerative

regenerative IMHA

the bone marrow cannot keep up with the destruction of red blood cells.

What are common presentations of IMHA?

Weakness, fever, pallor, or jaundice.

What causes jaundice in IMHA patients?

Bilirubin breakdown product from the destruction of red blood cells

characteristics of urine and feces in IMHA due to bilirubin breakdown

Dark orange or red urine and feces.

In which breed is IMHA most commonly recognized?

Cocker Spaniel

What is the typical age and gender of dogs affected by IMHA?

middle-aged, spayed females

How long do owners typically notice symptoms of IMHA before seeking help?

within 24-48 hours.

What is a primary symptom of IMHA?

Marked anemia

What are spherocytes?

Red blood cells of different sizes

What is autoagglutination?

The clumping together of red blood cells

What screening methods are used for secondary causes of IMHA?

Tick PCR, imaging, and other diagnostic tests.

What is the primary goal of treating IMHA?

shut down the 'haywire' immune system using

What medication is given to treat IMHA

immunosuppressive medications

What supportive care measures are recommended for IMHA?

Fluids, transfusions, doxycycline, and antithrombotics.

Why is antithrombotic treatment important in IMHA?

inflammation in the body can lead to hypercoagulation and clot formation.

How many different blood groups do dogs have?

13

What is the most important blood group for dog blood typing?

Dog Erythrocyte Antigen (DEA) 1.1.

DEA 1.1 Negative donors

loosely considered 'universal donors.'

Can DEA 1.1 Positive donors donate to all recipients?

No, DEA 1.1 Positive donors can only donate to positive recipients.

Why is it important to blood type cats before a transfusion?

Cats produce alloantibodies against RBCs that do not match their blood types

alloantibodies

antibodies against RBCs that do not match their blood types​

What are the 2 major blood types in cats?

1. A
2. B

What is a minor cat blood type?

AB

What percentage of cats in the US are estimated to be Type A?

95%

What is the purpose of crossmatching before a transfusion?

ensure compatibility between donor and recipient blood.

What does a major crossmatch test?

tests donor cells against recipient plasma.

What does a minor crossmatch test?

tests donor plasma against recipient cells.

What do commercial test kits primarily assess in crossmatching?

only assess the major crossmatch.

What is whole blood?

blood product that contains all components of blood, including plasma and cells.

What are Packed RBCs?

Red blood cells separated from plasma, used for transfusion.

What does Fresh Frozen Plasma contain?

proteins and clotting factors, but no cells.

What are the challenges associated with using platelets in veterinary medicine?

Cost, accessibility, and rapid breakdown of transfused platelets in circulation.

What formulations exist for platelets in veterinary medicine?

Some platelets are cryopreserved and lyophilized to extend their usability.

What are 4 blood products for transfusion?

1. whole blood
2. Packed RBCs
3. Fresh Frozen plasma
4. Platelets

What is the immune system's response to foreign blood during a transfusion?

It is an antibody-mediated response.

'first transfusion is free'

Dogs are less likely to have pre-existing antibodies to other blood types.

What must be done prior to transfusion in cats?

Blood type the donor and recipient.

What should be done for any dog receiving more than one transfusion?

Crossmatching should be performed.

What is the normal range for platelet count?

150,000 - 400,000

What condition is characterized by too few platelets?

Thrombocytopenia (TCP).

Common causes of thrombocytopenia

1. Production issues
2. consumption
3. destruction
4. sequestration

What is sequestration?

large number of RBCs become trapped in the spleen

What are some production issues that can lead to Thrombocytopenia?

Bone marrow disorders, toxins, and some drugs.

What causes consumption-related Thrombocytopenia?

Bleeding and disseminated intravascular coagulation (DIC).

What is DIC

disseminated intravascular coagulation

Another term for DIC

death is coming

What are some conditions that can cause destruction of platelets?

Immune thrombocytopenic purpura (ITP) and certain tick-borne diseases.

What is sequestration in the context of Thrombocytopenia?

Hypersplenism, where platelets are hidden in the spleen, often associated with myeloproliferative diseases.

What triggers the destruction of platelets in Immune Mediated Thrombocytopenia?

The body makes antibodies against its own platelets.

What symptoms may occur with platelet counts less than 50K PLT?

Petechiation and ecchymoses may be observed.

What is a potential risk when platelet counts drop below 25K

Spontaneous hemorrhage is possible anywhere in the body.

Ecchymosis

A type of bleeding that appears as a large bruise, typically caused by the rupture of small blood vessels.

Petechiae

Small, pinpoint red or purple spots on the skin resulting from minor bleeding, often associated with capillary rupture.

Primary ITP

IDIOPATHIC; most common in dogs, rare in cats.

Secondary ITP

1. Infectious
2. Inflammatory
3. Neoplastic
4. Drug or vaccine induced

Cavalier King Charles Spaniels condition characteristics

1. Asymptomatic

2. Thrombocytopenia

3. Macrothrombocytosis

What is macrothrombocytosis?

A condition where many of the platelets are abnormally large.

How many Cavalier King Charles Spaniels have this platelet disorder?

30-50%