Food Animal Anemia

What is the PCV, RBC, and Hb values that are indicative of anemia generally?

PCV: <24%

RBC: <5 x 10^6

Hb: <8

What are the THREE general clinical presentations of anemia?

1. Pale mucus membranes

2. Weakness/exercise intolerance

3. Mental depression/aggression (brain hypoxia)

True or False: You should transfuse every animal with a low PCV.

False! You should only transfuse patients with anemia that have CLINICAL evidence of condition.

True or False: Chronic disease anemia is relatively common in livestock.

True!

What are the TWO major causes of regenerative anemia?

1. Hemorrhage/blood loss

2. Hemolysis

Which is considered the most highly regenerative cause of anemia?

Hemorrhage

True or False: Blood loss can go from regenerative to non-regenerative if it becomes chronic enough.

True!

What are the FOUR major causes of non-regenerative anemia?

1. Chronic disease

2. Chronic renal failure

3. Nutrient deficiencies

4. Intrinsic bone marrow disease

What are the THREE general etiologies of anemia?

1. Blood loss

2. Hemolysis

3. Inadequate RBC production

What are the THREE common causes for blood loss anemia?

1. Intestinal parasites

2. Ectoparasites

3. Abomasal ulceration (esp. in stressed animals)

What are FOUR less common causes of blood loss anemia?

1. DIC

2. Moldy sweet clover toxicosis

3. Caval syndrome

4. Pyelonephritis (post-partum cows)

What is the thrombosis of the caudal vena cava, which leads to the lungs and sheds emoboli, creating epistaxis and subsequently anemia?

Caval syndrome

Name at least THREE of the 5 acute blood loss causes.

1. Trauma

2. Surgical procedures

3. Rupture of middle uterine a

4. Rupture of pulmonary vessel

5. Abomasal ulcers

Name at least FOUR of the 6 chronic blood loss causes.

1. Internal parasites

2. External parasites

3. Renal disease

4. Abomasal lymphosarcoma

5. Bladder neoplasia

6. Hemostatic dysfunction

How can you differentiate between a perforating and non-perforating ulcer?

Perf: no melena or dark stool; ileus/peritonits/poor-doer

Non-perf: melena or dark stool

How can you differentiate between ulcers and intussusception?

How would you treat them differently?

Ulcers: normal feces, dark color -> medical management

Intussusception: scant feces, dark color -> surgery

What makes up to HOTC complex?

Haemonchus contortus, Ostertagia, Trichostrongylus, Cooperia

(Also trichuris, nematodirus, and oesophagostomum)

What parasite is a massive blood feeder that can cause sudden death, as it may ingest up to 0.05 ml/day?

Haemonchus contortus

What are the TWO hallmarks of disease with Haemonchus contortus?

1. Anemia

2. Hypoproteinemia

What are the "4 P's?"

Permanent pasture perpetuates parasitism

True or False: Housing horses and goats together can actually be chill because horses ingest H. Contortus larvae and cannot become infected, reducing the intake by the goats.

True!

What is a major clinical sign of hypoalbuminemia related to parasites, especially in small ruminants?

Submandibular edema

What is a good way to assess mucus membranes in food animals?

FAMACHA (vulva, etc.)

What are the FIVE common causes of hemolytic anemia?

1. Anaplasmosis

2. Heinz body anemia (onion toxicity)

3. Bacillary hemoglobinuria (C. Hemolyticum)

4. Leptospirosis

5. Copper toxicosis

Name at least THREE less common causes of hemolytic anemia.

1. Babesiosis

2. Eperythrozoonosis

3. IMHA

4. Water intoxication

5. Postparturient hemoglobinuria

What organism infects RBCs and is endemic in SE US?

Anaplasma marginale

What demographic is anaplasmosis more severe in?

Older cattle (less frequent in young, more frequent in old)

What are the TWO major mechanisms of transmission of Anaplasma?

1. Tick vector (Dermacentor, Rhipicephalus, Ixodes)

2. Iatrogenic (transfer of blood- reusing needle, etc.)

What THREE things does Anaplasmosis severity depend on?

1. Persistence of organism in RBCs

2. Level of autoimmunization

3. Level of RBC regeneration

What might occur if an animal survives an Anaplasmosis infection?

Chronic carrier

When is a blood smear most helpful in diagnosis of Anaplasma?

Delayed clinical signs of not yet anemic (affected RBCs have not yet been lysed)

Name FIVE major clinical signs of Anaplasmosis.

1. Initial fever

2. Anorexia/decreased milk production

3. Hypoxemia (staggering/neuro)

4. Constipation

5. Icterus

True or False: You should expect hemoglobinuria with anaplasmosis.

False! Anaplasmosis does NOT cause hemoglobinuria, as it involves EXTRAVASCULAR hemolysis.

What is one major way to differentiate water intoxication from anaplasmosis?

Water intox: INTRAvascular hemoglobinuria

Anaplasmosis: EXTRAvascular hemoglobinuria

What is the most basic way to detect/diagnose anaplasmosis?

What is the better way to detect this, as it detects chronic carrier states and the basic way is often inaccurate?

Blood smear

Serology

What are the SIX major treatments/controls for anaplasmosis?

1. Avoid stress

2. Oxytetracycline

3. Chlortetracycline in feed

4. Blood transfusion (band-aid but can be life-saving)

5. Vector control

6. Vaccination

What kind of cow and when is it most susceptible to postparturient hemoglobinuria?

High-producing dairy cow, within 6 weeks of birth

What are the FOUR major clinical signs of postparturient hemoglobinuria?

1. Decreased milk production

2. INTRAvascular hemolysis (anemia) KNOW THIS

3. Jaundice

4. Hemoglobinuria

Explain the pathophysiology of the intravascular hemolysis seen in postparturient hemoglobinuria.

Low P -> low ATP -> not maintain osmotic gradient -> intravascular hemolysis

How can you differentiate hemoglobinuria from hematuria?

Centrifuge (sediment with hematuria)

Explain how animals with postparturient hemoglobinuria becomes hypophosphatemic.

Decrease Ca2+ -> pools Ca2+ out of bone -> pushes P into urine/saliva

What is the proposed mechanism behind postparturient hemoglobinuria?

Hypophosphatemia -> Decreased ATP synthesis by RBCs -> energy depletion and inability to Na+ pump -> INC Na+ rises -> cell swells and lyse

Oxidants or lack of antioxidants may be involved in postparturient hemoglobinuria, so —- and —- deficiency can contribute to disease.

Selenium

Copper

What are the FOUR major treatment steps of postparturient hemoglobinuria?

1. Phosphorus supplement (IV or oral; PHOSPHATES only)

2. Blood transfusion

3. Isotonic fluids (diuresis/renal support)

4. Selenium and Copper supplementation

What is the most common form of copper toxicosis that is associated with excess copper consumption for several months?

Chronic copper toxicosis

In chronic copper toxicosis, —- will appear clinically normal until the hemolytic crisis.

Death usually occurs ——— hours after the hemolytic crisis.

Sheep

24-48

True or False: Chronic copper toxicosis has high morbidity and low mortality.

False! Chronic copper toxicosis has LOW morbidity (<5%) and HIGH mortality (>75%).

What are the SIX major etiologies of chronic copper toxicosis?

1. Forages from high Cu/low Mo soil area

2. Poultry feed

3. Swine feed

4. Cattle and horse feed, mineral blocks, vitamin supplements

5. Copper sulfate foot baths

6. Liver disease

What is the pathophysiology of chronic copper toxicosis?

Excess dietary copper -> accumulate in liver -> lysosomes break down in liver once toxic level reached with STRESS -> Cu released in bloodstream -> Strong oxidizer that leads to INTRAvascular hemolysis

What are the FIVE major clinical signs of copper toxicity?

1. Icterus

2. Lethargy

3. Tachypnea

4. Tachycardia

5. Hemoglobinuria

What are the FIVE major treatments of chronic copper toxicosis?

1. Fluids

2. Transfusion

3. D-Penicillamine

4. Ammonium molybdate/sodium thiosulfate

5. Ammonium tetrathiomolybdate

What THREE things should you do if chronic copper toxicosis impacts your whole flock?

1. ID/eliminate Cu source

2. Sodium molybdate in feed

3. Ground gypsum in feed

What are the THREE major preventions of chronic copper toxicosis?

1. Education/avoidance

2. Spray feed with ammonium molybdate/sodium molybdate if cannot avoid Cu rich or Mo depleted forage

3. Dietary supplementation of vitamin E and selenium if deficient

What are the THREE major categories of inadequate RBC production?

1. Deficiencies in vitamins/minerals needed for RBC production

2. Systemic disease that interfere with erythropoiesis

3. Bone marrow damage/displacement

Name FIVE conditions associated with inadequate RBC production.

1. Iron deficiency anemia

2. Copper deficiency

3. Bracken fern toxicosis

4. Chronic renal failure

5. Myelofibrosis (pygmy goats)

How would you classify anemia of inflammatory disease, also known as anemia of chronic disease?

Non-regenerative normocytic, normochromic

What are THREE major consequences of anemia of inflammatory disease?

1. Decreased iron availability (Fe sequesters to restrain bacterial growth -> HEPCIDIN)

2. Decline in RBC survival

3. Decreased anemia response

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True or False: Blood transfusion is often a permanent therapy.

False! It is a TEMPORARY therapy, as the RBCs are short-lived.

Is matching necessary in ruminants?

Nope

Name TWO reasons why matching is not typically necessary in ruminants.

1. Cattle have large number of blood factors

2. Cross-matching by agglutination does not work

True or False: First transfusions are tolerated well, but subsequent transfusions carry more risk.

True!

What are THREE major indications to perform a blood transfusion?

1. Acute blood loss (PCV <12% over 12-24 hour period)

2. Clinical signs of severe anemia

3. RBC mass below what needed to carry oxygen to tissues

True or False: Animals with chronic blood loss can tolerate a PCV of 8%.

True!

How much blood is safe to remove from a donor and transfuse in a recipient?

How much is safe to transfuse?

10-15 mL/kg body weight

In most instances, you should replace ————-% of lost blood.

20-40%

What is the monitoring/test transfusion rate?

0.1 ml/kg/hr

What should you do if patient experiences anaphylaxis during a transfusion?

Epinephrine (1:1000) at 0.01-0.02 ml/kg