1. Anemia / Erythrocyte Disorders
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Anemia / Erythrocyte Disorders
Laboratory Procedures
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The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

2. Anemia =a condition of reduced oxygen carrying capacity of erythrocytes.

3. Decreased production of RBC’s Increased destruction of RBC’s
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Erythrocyte disorders are frequently diagnosed in the dog and cat and may be associated with:
Decreased production of RBC’s
Increased destruction of RBC’s
Inappropriate loss of RBC’s
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

4. 12/2/2018 1:48 PM
Diagnosis
A systemic diagnostic approach to anemia is necessary and should include:
A good history
Physical exam
Complete blood count
Blood film / slide analysis
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

5. Treatment
Treatment should be aimed at correcting the primary disorder and supporting the patient.
IT IS IMPORTANT TO ESTABLISH WHETHER THE ANEMIA IS REGENERATIVE OR NONREGENERATIVE.
Reticulocyte counts are evaluated to determine if the anemia is regenerative or nonregenerative.

6. Regenerative v. Nonregenerative
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Regenerative v. Nonregenerative
Regenerative Anemia :
Increased reticulocytes, nRBCs. aniscocytosis, polychromasia & Howell-Jolly bodies
Indicates the bone marrow has responded to a demand for RBCs by increasing production and releasing into the circulation adequate numbers of immature RBCs = polychromatophils.
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

7. Polychromatophils
Bluish to reddish-blue cytoplasm
Slightly larger than mature RBCs
When stained with New Methylene Blue = Reticulocytes

8. Reticulocytes
Irregular net-like structures in polychromatophils when stained with New Methylene Blue = reticulum
Reticulum is irregular clumps of ribosomal RNA and organelles, such as mitochondria.
Most species only have one form of reticulocyte, however cats have TWO.

9. Nonregenerative : Decreased Reticulocyte Count ;
Caused by inadequate production of RBCs by bone marrow.

10. Canine Reticulocytes when stained with New Methylene Blue
Aggregate Only
NOTE : Polychromatophils are larger than adult RBCs

11. Feline Reticulocytes Puncate v. Aggregate
The aggregate reticulocytes mature into punctate reticulocytes within hours; punctate reticulocyte circulate for at least several days (7-10 days) before all the RNA is lost.
The reticulocyte count in cat blood should only include the percentage of aggregate reticulocytes; punctate reticulocytes are not counted as they do not reflect the most recent bone marrow response (e.g. an anemic cat with only punctate reticulocytes is not actively regenerating at this time, but has shown some bone marrow regeneration in the past 7-10 days).

12. Anemia -- Hemorrhage
Hemorrhage = the escape of blood from a ruptured vessel. Hemorrhage can be external or internal.
Most common cause is trauma
Can also be caused by thrombocytopenia : petechial hemorrhages on earflaps, mucous membranes, and on nonhaired areas such as the abdomen.
TX : steroid tx, plasma or whold-blood transfusions, and avoidance of trauma.

13. Iron-Deficiency Anemia
Iron is important in the body because it is the main constituent of hemoglobin.
Caused by chronic external blood loss.
Severe flea infestations, GI parasites, gastric ulcers and bleeding tumors can cause significant blood loss over time.
The iron and hemoglobin lost with this external bleeding result in the formation of altered RBCs and decreased life span.
TX: correct blood loss + iron supplements

14. Remember Hemoglobin Molecule?

16. Hemolytic Anemia
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Hemolytic Anemia = the increased destruction of erythrocytes.
Caused by immune components attaching directly or indirectly to the RBC membrane, altering its structure.
The body, in an attempt to regain homeostasis, begins to remove these altered cells.
In cats, the most common cause of hemolytic anemia is
haemobartonellosis / mycoplasma, a blood born parasite.
In dogs, the most common cause is an underlying inflammatory process.
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

17. Toxin-Induced Anemias / Heinz Body Anemias
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Toxin-Induced Anemias / Heinz Body Anemias
Oxidation and denaturation of hemoglobin in RBCs result in the formation of protuberances from the RBC membrane called Heinz Bodies.
The most common cause of Heinz body formation in the dog is onion toxicity.
Acetaminophen (Tylenol) toxicity also results in Heinz body anemia in dogs and cats.
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

19. Immune-Mediated Hemolytic Anemia
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Immune-Mediated Hemolytic Anemia
The specific cause of IMHA is unknown.
Accelerated RBC destruction occurs because of the presence of antibodies that attach to the RBC membrane.
These cells are removed by the immune system, resulting in anemia.
Found most commonly in dogs 2-8 yrs of age, poodles, OE Sheepdogs, Irish setters and cocker spaniels.
4X more prevalant in females than in males.
© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.
The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

20. 30% to 40% of all dogs will die despite TX.
TX : Glucocorticoids!! & meds to prevent gastric ulceration 2° to glucocorticoid TX .
Relapses are common.
On blood slide evaluation : marked autoagglutination, spherocytes, hemolyzed plasma.

22. Anemia is also classified by RBC size and Hemoglobin Concentration
Size Classifications
Normocytic (RBCs of normal size)
Macrocytic (RBCs larger than normal)
Microcytic (RBCs smaller than normal)

23. Hemoglobin Concentration:
Hypochromic (reduced hemoglobin concentration)
Normochromic (normal hemoglobin concentration)

24. Macrocytic (large Rbcs), hypochromic (reduced hemoglobin concentration) anemia suggests REGENERATION.
Iron deficiency also results in hypochromic anemia, but is characterized by microcytosis (small RBCs).
Most other types of anemia are normochromic.