bleeding SA

What are the stages of haemostasis?

1. Primary haemostasis (platelet plug) 2. Secondary haemostasis (fibrin plug) 3. Clot lysis.

What are the clinical signs of primary haemostatic disorders?

Petechia, mucosal bleeds, multiple sites of bleeding.

What investigations are used for primary haemostatic disorders?

Haematology (platelet count), BMBT, vWF.

What are the causes of thrombocytopenia?

Defective platelet production, accelerated platelet removal (IMTP, DIC), platelet loss (splenomegaly, acute ongoing hemorrhage).

What is thrombocytopathia?

A disorder that causes defects in platelet function, which can be inherited or drug-induced.

What is the diagnosis for vWF dysfunction?

Normal platelet count, prolonged BMBT, low vWF antigens.

What breeds are predisposed to vWF dysfunction?

Dobermans.

What is a common treatment for vWF deficiency?

Plasma transfusion, cryoprecipitate, desmopressin for type 1.

What are clinical signs of secondary haemostatic disorders?

Deep bleeds, single site bleeds, haematomas, mucosal bleeds.

How is secondary haemostatic disorders investigated?

WBCT, OSPT, APTT, specific factor assays.

What is Haemophilia?

A congenital disorder caused by deficiency in factor 8 or factor 9, resulting in increased APTT.

What is a common acquired cause of secondary haemostasis disorders?

Vitamin K antagonism.

What factors are affected by vitamin K antagonism?

Factors 2, 7, 9, and 10.

What does increased APTT indicate?

Can indicate haemophilia, hepatic disease, or vitamin K antagonism.

What is the initial approach to a bleeding patient?

Consider signalment and observe clinical signs.

What would indicate primary coagulopathy during an examination?

Petechiae or ecchymoses, bleeding from mucosal surfaces.

How is buccal mucosal bleeding time used in investigations?

Increased time indicates primary coagulopathy.

What does an increased whole blood clotting time indicate?

Thrombocytopenia or vitamin K antagonism.

What should you avoid when managing a bleeding patient?

Avoid SC and IM injections.

What care should be taken with bleeding patients?

Minimize movement, provide cage rest, handle gently.

What is DIC?

Disseminated intravascular coagulation, a state of pathologic coagulation.

What are potential triggers for DIC?

Endothelial damage, platelet activation, tissue procoagulants.

What diseases are known to cause DIC?

Bacterial sepsis, FIP, babesia, neoplasia, pancreatitis.

What are the two types of DIC?

Overt DIC (compensated) and overt DIC (decompensated).

What lab findings are indicative of DIC?

Thrombocytopenia, hypofibrinogenemia, schistocytes.

What is the treatment for DIC?

Treat the underlying cause.

What can thrombosis cause?

Hypoxia and tissue damage.

How can fibrinolysis be tested?

Testing fibrinogen, FDP, D-dimer.

What does an increased D-dimer indicate?

An activated pro-thrombotic state such as DIC or thromboembolic disease.

What does BMBT measure?

The time it takes for bleeding to stop from a small incision in the buccal mucosa.

What is a common sign of secondary coagulopathy?

Deep or cavity bleeds, often seen in haematomas.

What is the significance of low vWF antigens?

Indicates a possible vWF dysfunction, particularly in Dobermans.

What does normal platelet count rule out?

IMTP in the context of bleeding disorders.

How does hepatic disease affect coagulation?

Increases OSPT and APTT due to decreased production of clotting factors.