8: Lab Evaluation of Anemias

physical signs of anemia

pale MM, weakness/exercise intolerance, tachycardia/pnea, murmurs, slow CRT, icterus, hemoglobinuria, hemorrhage

what do we analyze to come to conclusions that anemia is occuring?

blood/plasma appearance, protein concentration, reticulocyte counts, erythrocyte indicies/morphology, bone marrow evaluation, Coomb's test, serum bilirubin/iron

what does microhematocrit test tell us?

PCV/HCT and buffy coat info

HCT normal, TPP low - causes?

GI protein loss, proteinuria, liver disease

HCT normal, TPP high - causes?

increase globulins, dehydration (masking anemia)

HCT low, TPP low - causes?

substantial blood loss, overhydration

HCT low, TPP normal - causes?

RBC destruction/decreased production, chronic hemorrhage

HCT low, TPP high - causes?

inflammatory disease, myeloma/other lymph diseases

what is hemodilution?

expansion of vascular space due to pregnancy/neonatal anemia

what can cause hemodilution anemia in NON-PREGNANT animals?

overhydration, splenomegaly, anestesia, heparin

first step in determining anemias

use reticulocyte count, polychromasia, marrow evaluations. want to determine REGENERATIVE vs. NON-REGENATIVE

2nd step in determining anemias

use MCV/MCHC values. looking for classifications (micro/normo/macrocytic, hypo/normochromic)

what species should you NOT use reticulocyte count for when determining anemia?

HORSES AND RUMINANTS

aggregate reticulocytes

contain clumps of dark purple-blue stained aggregates of reticulum

punctate reticulocytes

only seen in cats, have small, sparse dots

reticulocytosis

an increase of immature erythrocytes in the blood

reticulocytosis is present - causes?

mycoplasma, Babesia, Howell-Jolly bodies, nRBCs, large platelet clumps, Heinz bodis

true or false: MCV/MCHC changes occur SLOWLY

TRUE

retic-HGB

average Hb in 1 reticulocyte (depends on size and Hb concentration)

low retic-HGB present in a dog - what does this mean?

Fe deficiency, iron-limited erythropoiesis from inflammation, liver shunt

relative/raw reticulocyte count

% of erythrocytes that are reticulocytes

reticulocytosis is present in an anemic animal. what does this show?

REGENERATIVE ANEMIA

regenerative anemia

hemorrhage/increased RBC destruction occurring

how long does it take for reticulocytes to be released from bone marrow?

3-4 days

if it has been at least 3-4 days, and reticulocytosis has NOT occurred, what can we infer?

nonregenerative anemia. decreased RBC production

non-regenerative anemia

bone marrow responds inadequately to the increased need for RBC

what species has BOTH aggregate and punctuate reticulocytes?

cats

do horses respond to anemia with reticulocytes?

NO

ruminant response to hemorrhagic anemia

sluggish

what does severe anemia do to EPO?

increases it

EPO

erythropoietin; promotes growth of red blood cells

what produces a greater reticulocyte response, RBC destruction or hemmorhage?

RBC destruction

what causes a loss in total body iron?

hemorrhage

MCV high, MCHC low, MCH normal. swollen RBCs present - what is it?

hereitary stomatocytosis

MCV low, MCHC low, MCH low - what is it?

chronic Fe deficiency

MCV/RDW an polychromasia increased. absolute reticulocytosis present. what is it?

REGENERATIVE ANEMIA

in cats, what lives longer? aggregate or punctuate reticulocyte?

puncutate

reticulocytosis is occurring - what could be happeneing?

hemorrhage or RBC destruction