Canine IMHA Diagnostics and Management Quiz

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Questions and Answers

Which of the following is a common presenting complaint in dogs with Immune-Mediated Hemolytic Anemia (IMHA)?

Frequent urination and excessive thirst

Profound lethargy and collapse episode (correct)

Excessive barking and restlessness

Increased appetite and weight gain

What is the median age for the development of Immune-Mediated Hemolytic Anemia (IMHA) in dogs?

10 years

2 years

4 years

6 years (correct)

What is the main secondary cause of Immune-Mediated Hemolytic Anemia (IMHA) in cats?

Feline calicivirus

Feline Immunodeficiency Virus (FIV)

Feline Leukemia Virus (FeLV) (correct)

Feline infectious peritonitis (FIP)

In cats, what percentage of cases of Immune-Mediated Hemolytic Anemia (IMHA) are non-regenerative?

50% Signup and view all the answers

What is the diagnostic approach mentioned for confirming the diagnosis of Immune-Mediated Hemolytic Anemia (IMHA)?

Work backwards from anemia to confirm the diagnosis Signup and view all the answers

Which species shows a slight male predisposition for Immune-Mediated Hemolytic Anemia (IMHA)?

Cats Signup and view all the answers

Which diagnostic test often sees false negatives due to insufficient antibodies present, or false positives due to a recent transfusion or other inflammatory disease

Direct Coombs' test Signup and view all the answers

Which of the following is not considered a risk factor for infectious diseases causing IMHA?

Regular vaccination Signup and view all the answers

What is the recommended treatment approach for suspected infections causing IMHA?

Doxycycline at 10 mg/kg/day for 28 days Signup and view all the answers

Which of the following is not considered a neoplastic cause of IMHA?

Mycobacterial infection Signup and view all the answers

What is the recommended diagnostic approach for neoplastic causes of IMHA?

Advanced imaging with fine-needle aspiration (FNA) of lymphoid structures and bone marrow Signup and view all the answers

Which of the following is not an important risk factor for toxicity causing IMHA?

Regular exercise Signup and view all the answers

What is the recommended treatment approach for onion/garlic toxicity causing IMHA?

Supportive care, potential transfusions, and antioxidants Signup and view all the answers

What is the mainstay of immune-suppressive therapy for IMHA?

Corticosteroids Signup and view all the answers

Which medication is highlighted as a potential toxin for dogs?

Methimazole Signup and view all the answers

What are the therapeutic goals for managing IMHA?

Improving red blood cell mass, minimizing pigment impact on organs, mitigating thromboembolic risk, and suppressing the immune system Signup and view all the answers

What are the criteria for administering blood transfusions in dogs with IMHA?

Clinical signs of compensation or decompensation due to anemia Signup and view all the answers

What does the text emphasize in managing complications of IMHA?

IV fluid support Signup and view all the answers

What does the text address in relation to thromboprophylaxis in IMHA?

The high risk of pulmonary thromboembolism and the use of anticoagulants and platelet inhibitors Signup and view all the answers

What is emphasized in the different protocols for thromboprophylaxis in IMHA?

The need for a practical approach based on the presence or absence of evidence of thromboembolism Signup and view all the answers

What is the recommended approach for tapering Prednisone?

Reduce Prednisone dose by 20-25% every 2-3 weeks and check CBC or PCV/TS prior to each taper Signup and view all the answers

When is it recommended to consider a taper of the adjunctive immune-suppressive after discontinuing Prednisone?

After one month without steroid and if the patient remains stable Signup and view all the answers

What is the relapse rate after discontinuing all medications?

20-25% Signup and view all the answers

When should the patient be rechecked in the first year of remission?

Every 3 months Signup and view all the answers

What should be done if a relapse of hemolysis is noted during the taper of Prednisone?

Increase Prednisone back to the most recent effective dose Signup and view all the answers

According to Swann et al 2019, when should Clopidogrel be discontinued?

When Prednisone is discontinued Signup and view all the answers

What is the recommended frequency of rechecks for the second year of remission?

Every 4 months Signup and view all the answers

When should adjunctive medications (cyclosporine and clopidogrel) be continued at unchanged doses?

During the taper of Prednisone Signup and view all the answers

What is the recommended approach if a relapse of hemolysis is severe during the taper of Prednisone?

Increase Prednisone back to the starting dose Signup and view all the answers

Study Notes

Approach to Secondary Causes of Anemia

The text discusses a systematic approach to identifying secondary causes of anemia in dogs, including infection, neoplasia, toxicity, and drug reactions.
It outlines the level of clinical suspicion and risk factors for each potential cause, offering a structured approach for investigation.

Identification of Potential Toxins

The text highlights the importance of investigating potential toxin exposure, particularly from medications that may be present in the client's home.
It lists specific medications, such as antibiotics and methimazole, that could be ingested inappropriately by the dog.

Diagnostic Process for Anemia

It describes a case study of a dog named Murphy and the diagnostic steps taken to confirm the diagnosis of immune-mediated hemolytic anemia (IMHA).
The diagnostic process includes assessing environmental exposure, vaccination history, and reviewing the medical records.

Therapeutic Goals for IMHA

The text outlines the therapeutic goals for managing IMHA, including improving red blood cell mass, minimizing pigment impact on organs, mitigating thromboembolic risk, and suppressing the immune system.
It emphasizes the importance of balancing therapeutic effects with potential adverse effects when managing IMHA.

Blood Transfusion Considerations

The text discusses the criteria for administering blood transfusions in dogs with IMHA, emphasizing the importance of clinical signs of compensation or decompensation due to anemia.
It specifies the types of blood products, such as packed red blood cells or fresh whole blood, that may be used for transfusions.

Complications of IMHA

It highlights the potential complications of IMHA, including pigment accumulation leading to organ damage such as pigment nephropathy and bilirubin encephalopathy.
The text underscores the importance of IV fluid support in managing these complications.

Thromboprophylaxis in IMHA

The text addresses the hypercoagulable state associated with IMHA and the high risk of pulmonary thromboembolism in affected dogs.
It discusses the use of anticoagulants (heparin, rivaroxaban) and platelet inhibitors (aspirin, clopidogrel) for thromboprophylaxis in IMHA.

Different Protocols for Thromboprophylaxis

It outlines various protocols for thromboprophylaxis in IMHA, including the use of rivaroxaban, aspirin, heparin, clopidogrel, and low-molecular-weight heparin.
The text emphasizes the need for a practical approach to thromboprophylaxis based on the presence or absence of evidence of thromboembolism in IMHA.

Immune-Suppressive Therapy in IMHA

The text underscores the use of corticosteroids as the mainstay of immune-suppressive therapy for IMHA due to their broad properties and evidence-based efficacy.
It also mentions adjunctive immune-suppressive agents such as az

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Description

"Diagnostics and Management of Canine Immune-Mediated Hemolytic Anemia" Quiz Test your knowledge of secondary causes of anemia, toxin identification, diagnostic processes, therapeutic goals, blood transfusion considerations, complications, thromboprophylaxis protocols, and immune-suppressive therapy for canine immune-mediated hemolytic anemia (IMHA). This quiz covers essential concepts for veterinary professionals dealing with IMHA cases.