589760
| Pregunta | Respuesta |
| What does a stress lekogram present with? | -increased neurtrophils -increased monocytes -decreased lymphocytes -drecreased eosinophils |
| How is the Diagnosis of IMHA made? | animal being anaemic, there being evidence of RBC regeneration, spherocytosis (in dogs, not seen in the cat as they dont naturally have central pallor so cant differentiate one from a normal rbc) present and positive side agglutination test. |
| Other than anemia what may be seen on a blood profiled of an animal with IMHA? | leukocytosis present (non specific bone marrow stimulation from pumping out a lot of platelets and new red blood cells by accident also makes some white blood cells also the anemia damages the organs which allows more bacteria to grow and causes a stress leukogram to be produced) and evidence of DIC also. |
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Babesia (image/png)
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Babesia |
| what may cause a seconary IMHA? | Babesia, mycoplasma, neoplasia, inflammatory disease, drug exposure and recent vaccination |
| Where should blood be taken from when looking for pathogens? | the extrematies such as ear tips |
| How should primary IMHA be differentiated from secondary IMHA? | Blood sample, chest x-ray, re-expose to suspected causative agent?!?! and abdominal ultra sound |
| what are the pathogens which cause feline infectious anaemia? | -mycoplasma haemofelis -candidatus mycoplasma turicensis -candidatus mycoplasma haemominutum |
| when making a blood smear looking for FIA organisms what should not be done? | An EDTA tube should not be used as this will lead to to death and lysis of he organisms making them non recognisable |
| whats the gold standard for detecting FIA? | PCR is though its expensive |
| what are the treatment options and side effects for FIA? | -Doxycycline (upto 6 weeks) or Enrofloxaxin for 2 weeks, enrofloxacin can cause blindness and doxycycline can cause strictures +/- steroids, will stop IMHA bu increase he pathogens |
| which animals are thought to be more represented by IMHA? | american cocker spanials, poodles, old english sheep dogs, irish setters and collies |
| what will the majority of dogs with IMHA have concurrently? | Immune mediated Thrombocytopenia |
| what are signs of a poor prognosis with IMHA? | icterus (DIC/other organ involvement), thrombocytopenia/petechiation, elevated urea (caused by GIT bleeds???) and band neutrophils present |
| which antibody has a better prognosis with IMHA IgM or IgG? | I wont change the plan plan but IgM is worse than IgG. |
| what should be always tested for if the animal has IMHA? | DIC -APPT/PT (remember APPT goes up first in DIC) -fibrinogen (decrease in DIC) -FDPs and D dimers (up in DIC) -platelet count (down in DIC) |
| Why should animals with IMHA receive fluids? | the Haemaglobin is excreted trough and damages the kidneys |
| what are the pros and cons of oxhaemaglobin? | it is a strong colloid, its haemoglobin without the membrane so theoretically the body cant affect it, although it causes a bizzare color which makes it impossible to check how the animal is progressing, they also contain no clotting factors either. |
| What are the pros and cons of giving a transfusion to a do with IMHA? | It contains clotting factors and improves symptoms although adding fuel to the fire |
| What is the immnesuppresive does of steroids and an anti inflammatory does? | An immunsuppresive does of prednisolone is 2-4mg/kg (1/8 of this for dexamethasone!) and an anti-inflammatory does of prednisolone is 0.5mg/kg. |
| what are the drugs given which prevent RBC destruction in IMHA? | Steroids and Azothioprine |
| How long does it take for azothioprine to work? | 2 weeks |
| What are the side effects of azothioprine? | Extremely hepaotoxic and causes Bone marrow suppression |
| what is the 3rd immune suppressing drug which is only available at referral centers? | mycopheylate mofetil, its extremly expensive, and cant be given to anything smaller than a spaniel |
| What should be given to prevent hypercoagulability? | ultra low does asprin or cloprigrel |
| How is DIC treated and how does this work? | low molecular weight heperin which neutralizes factor Xa |
| What are the blood products available for use? | -whole blood -fresh plasma/plasma -packed red cells -cryoprecipitate -platelet rich plasma |
| When is blood products required? | PCV <10% and if the Bone Marrow response is minimal |
| When is whole blood necessary? | In sever anaemia and when clotting factors are also needed |
| When would fluids be used over whole blood? | If the only problem is hypovolemia |
| when would packed red blood cells be used over whole blood? | If the animal is normovolemic but severely anaemic |
| how long do rbc's last from a transfusion? | 60-90 days |
| when would concentrated plasma be given over whole blood? | -when the main problem is a lack of the required clotting factors |
| what is the only indication for packed red blood cells? | non regenerative anaemia- when the clotting isnt an issue |
| what are cat blood groups? | -A -B -AB |
| what is the most common blood group for cats? | A |
| What blood group are all siamese cats? | A |
| why is a blood giving set needed for transfusions? | It contains a clot filter |
| what temperature should blood transfusions be given at and how is this best achieved? | -body temperature -water bath -DONT MICROWAVE!!! creates black pudding |
| How can a blood transfusion be given? | IO or IV |
| What are the blood transfusion rate of administration for a relatively normal animal and a cardiac/renal patient? | cardiac and renal paitents; 2ml/kg/h 'normal' animals; 5-10ml/kg/hour |
| What side effects may occur with a blood transfusion? | haemolysis, acute hypersensitivity reactions, pyrexia, bacterial contamination, hypocalcemia, V+, circulatory overload and transmission of infectious diseases |
| What should be monitored if giving a blood transfusion? | vocalization, pyrexia, depression, dyspnoea, heart rate, erythema, pruritus or convulsions. |
| how should a transfusion reaction be managed? | stop transfusion, although maintain IV access, check the bag for haemolysis, check the matching is correct and possibly restart on a slower rate. |
| how long should the animal be monitored for when they are on a transfusion? | 5 days after it has stopped, as delayed transfusion reactions can occur |
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