Erythrocytes II: Hemolytic Anemias

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Questions and Answers

What is the primary result of hemolytic anemia?

  • Increased red blood cell destruction (correct)
  • Decreased platelet production
  • Increased clotting factor synthesis
  • Decreased white blood cell production

Which of the following is a common mechanism of hemolytic anemia?

  • Immune-mediated destruction (correct)
  • Vitamin B12 deficiency
  • Decreased erythropoietin production
  • Iron deficiency

What is the primary difference between intravascular and extravascular hemolysis?

  • Extravascular hemolysis results in hemolyzed plasma.
  • Extravascular hemolysis is always immune-mediated.
  • Intravascular hemolysis occurs within blood vessels. (correct)
  • Intravascular hemolysis only affects erythrocytes.

What is a typical finding in intravascular hemolysis?

<p>Hemoglobinuria (A)</p> Signup and view all the answers

What role does haptoglobin play in intravascular hemolysis?

<p>It binds free hemoglobin. (A)</p> Signup and view all the answers

What is the primary process in extravascular hemolysis?

<p>Red blood cell destruction by macrophages (B)</p> Signup and view all the answers

Which finding is commonly associated with extravascular hemolysis?

<p>Clear plasma (B)</p> Signup and view all the answers

Which of the following is a potential cause of hemolytic anemia?

<p>Hypophosphatemia (B)</p> Signup and view all the answers

Which of the following clinical signs is associated with hemolytic anemia?

<p>Lethargy (A)</p> Signup and view all the answers

Which of these findings is MOST indicative of Immune-Mediated Hemolytic Anemia (IMHA)?

<p>Antibodies binding to red blood cells (B)</p> Signup and view all the answers

What is the typical mechanism of red blood cell destruction in IMHA?

<p>Extravascular phagocytosis (A)</p> Signup and view all the answers

Which of the following can cause IMHA?

<p>Incompatible blood transfusion (C)</p> Signup and view all the answers

What clinical finding is often observed in dogs with IMHA but is less common in other species?

<p>Spherocytosis (B)</p> Signup and view all the answers

In a dog with IMHA, what does agglutination of red blood cells indicate?

<p>Presence of antibody on the RBC surface (B)</p> Signup and view all the answers

Which test is used to detect the presence of antibodies on the surface of red blood cells?

<p>Coombs' test (D)</p> Signup and view all the answers

What can cause a false negative result on a Coombs' test?

<p>Corticosteroid treatment (C)</p> Signup and view all the answers

What is the primary risk associated with neonatal isoerythrolysis?

<p>Incompatibility between maternal and offspring blood types (B)</p> Signup and view all the answers

In which species is neonatal isoerythrolysis a concern due to naturally occurring antibodies?

<p>Cats (A)</p> Signup and view all the answers

What is the significance of 'rouleaux' formation on a blood film?

<p>It can be a normal finding in horses and cats. (A)</p> Signup and view all the answers

How does a saline dilution test help differentiate between rouleaux and agglutination?

<p>Rouleaux disperses, while agglutination remains. (C)</p> Signup and view all the answers

Which term describes red blood cell destruction caused by mycoplasma?

<p>hemotropic (B)</p> Signup and view all the answers

How are hemotropic mycoplasmas generally transmitted?

<p>Arthropod vectors (C)</p> Signup and view all the answers

Which domestic animal is affected by Mycoplasma haemocanis?

<p>dogs (A)</p> Signup and view all the answers

What is the main method for definitively diagnosing hemotropic mycoplasma infections?

<p>PCR analysis (D)</p> Signup and view all the answers

What is the drug of choice for treating hemotropic mycoplasma infections?

<p>Tetracycline/doxycycline (A)</p> Signup and view all the answers

What are the vectors that transmits Cytauxzoon felis?

<p>Ticks (A)</p> Signup and view all the answers

Which species is most severely affected by Cytauxzoon felis infection?

<p>Cats (A)</p> Signup and view all the answers

What is the morphology of Babesia organisms seen within red blood cells?

<p>Signet ring (D)</p> Signup and view all the answers

Which tick genus primarily transmits Babesia canis?

<p>Rhipicephalus (C)</p> Signup and view all the answers

In the US, which canine population shows the HIGHEST incidence of Babesia gibsoni?

<p>Pit Bulls (A)</p> Signup and view all the answers

Which disease is diagnosed using the Coggins test?

<p>Equine Infectious Anemia (B)</p> Signup and view all the answers

What primary mechanism does acetaminophen toxicity cause that can lead to hemolytic anemia?

<p>Oxidation of hemoglobin (A)</p> Signup and view all the answers

How does zinc toxicity cause hemolytic anemia?

<p>It induces oxidation of RBCs. (A)</p> Signup and view all the answers

Ingestion of what type of tree leaves is particularly toxic to horses and causes marked anemia with Heinz bodies?

<p>Red maple (C)</p> Signup and view all the answers

What is the primary consequence of hypophosphatemia that leads to hemolytic anemia?

<p>Decreased ATP levels in red blood cells (C)</p> Signup and view all the answers

Pyruvate kinase (PK) deficiency primarily affects which cellular process?

<p>ATP production (A)</p> Signup and view all the answers

Which of the following breeds is predisposed to pyruvate kinase deficiency?

<p>Basenji (A)</p> Signup and view all the answers

What term describes red blood cell destruction caused by water intoxication?

<p>Osmotic hemolysis (C)</p> Signup and view all the answers

A blood smear from a dog with suspected IMHA shows numerous spherocytes and strong autoagglutination, yet the initial Coombs' test is negative. What is the MOST likely explanation for this?

<p>The prozone effect overwhelmed the test, preventing crosslinking (B)</p> Signup and view all the answers

A veterinarian is evaluating a blood smear and observes structures resembling small, dot-like organisms on the surface of erythrocytes. Further investigation reveals that these organisms lack a cell wall and are susceptible to tetracycline antibiotics. Which of the following infectious agents is MOST consistent with these findings?

<p><em>Mycoplasma haemofelis</em> (C)</p> Signup and view all the answers

Researchers are investigating a novel treatment for pyruvate kinase (PK) deficiency in Basenji dogs, focusing on enhancing ATP production within erythrocytes. Which of the following interventions would be MOST directly relevant to addressing the underlying pathophysiology of PK deficiency?

<p>Modulating the Embden-Meyerhof pathway to bypass the PK deficiency. (C)</p> Signup and view all the answers

What is the underlying mechanism of hemolytic anemia?

<p>Increased destruction of red blood cells. (D)</p> Signup and view all the answers

In intravascular hemolysis, where does the destruction of red blood cells primarily occur?

<p>Within the blood vessels. (D)</p> Signup and view all the answers

Which of the following is a characteristic finding specifically associated with intravascular hemolysis?

<p>Hemoglobinuria. (D)</p> Signup and view all the answers

What is the typical appearance of plasma in a case of intravascular hemolysis?

<p>Red-tinged or hemolyzed. (B)</p> Signup and view all the answers

Why might an artifactual increase in Mean Corpuscular Hemoglobin Concentration (MCHC) be observed in cases of intravascular hemolysis?

<p>Due to the presence of free hemoglobin in the plasma interfering with lab measurements. (D)</p> Signup and view all the answers

In extravascular hemolysis, where are the red blood cells primarily removed and destroyed?

<p>By macrophages in the spleen and liver. (A)</p> Signup and view all the answers

Which of the following findings is typically associated with extravascular hemolysis but NOT intravascular hemolysis?

<p>Hyperbilirubinemia. (D)</p> Signup and view all the answers

What type of anemia is typically observed in hemolytic conditions, unless it is peracute or bone marrow response is impaired?

<p>Regenerative anemia. (B)</p> Signup and view all the answers

Which of the following is NOT a major category of causes for hemolytic anemia?

<p>Nutritional deficiencies. (D)</p> Signup and view all the answers

Immune-mediated hemolytic anemia (IMHA) is primarily characterized by:

<p>Antibody and/or complement binding to red blood cells. (C)</p> Signup and view all the answers

In most cases of IMHA, red blood cell destruction occurs via which mechanism?

<p>Extravascular phagocytosis by macrophages via Fc receptors. (C)</p> Signup and view all the answers

Which of these conditions is LEAST likely to be a cause of secondary IMHA?

<p>Autoimmune disease. (B)</p> Signup and view all the answers

What is spherocytosis, a common finding in canine IMHA, and why is it significant?

<p>Spherical red blood cells lacking central pallor; suggests antibody-mediated membrane removal. (A)</p> Signup and view all the answers

What does the presence of agglutination in a blood sample strongly suggest in the context of hemolytic anemia?

<p>Antibody coating of red blood cells. (D)</p> Signup and view all the answers

Why is a saline dilution test important when evaluating agglutination?

<p>To differentiate true agglutination from rouleaux. (C)</p> Signup and view all the answers

What is the Coombs' test designed to detect?

<p>Antibodies or complement proteins on the surface of red blood cells. (C)</p> Signup and view all the answers

Which of the following factors can lead to a false negative Coombs' test result in a patient with IMHA?

<p>Corticosteroid administration. (D)</p> Signup and view all the answers

In feline blood types, which blood type is associated with strong naturally occurring antibodies against type A blood?

<p>Type B. (D)</p> Signup and view all the answers

Neonatal isoerythrolysis in cats is primarily a concern when:

<p>Type B queens have type A or AB kittens. (D)</p> Signup and view all the answers

Which canine blood group is considered the most clinically significant due to its high immunogenicity and involvement in transfusion reactions?

<p>DEA 1. (D)</p> Signup and view all the answers

What is the primary mechanism by which hemotropic mycoplasmas cause hemolytic anemia?

<p>Induction of immune-mediated destruction of infected red blood cells. (B)</p> Signup and view all the answers

What is the most reliable method for definitively diagnosing hemotropic mycoplasma infections?

<p>PCR analysis of blood. (C)</p> Signup and view all the answers

Which antibiotic class is typically used to treat hemotropic mycoplasma infections?

<p>Tetracyclines. (A)</p> Signup and view all the answers

Cytauxzoon felis is a protozoal parasite transmitted by ticks that causes severe hemolytic anemia primarily in which species?

<p>Cats. (B)</p> Signup and view all the answers

What is the typical morphology of Babesia organisms as seen within red blood cells on a blood smear?

<p>Signet ring or teardrop-shaped piroplasms. (B)</p> Signup and view all the answers

Babesia gibsoni infection is most commonly observed in which canine population in the United States?

<p>Pit bull breeds. (D)</p> Signup and view all the answers

What is the primary toxic effect of acetaminophen that leads to hemolytic anemia?

<p>Oxidative damage to hemoglobin and red blood cell components. (C)</p> Signup and view all the answers

Ingestion of red maple leaves primarily causes hemolytic anemia in horses due to:

<p>Oxidative damage to red blood cells. (A)</p> Signup and view all the answers

Hypophosphatemia leads to hemolytic anemia primarily by:

<p>Decreasing red blood cell ATP levels and membrane integrity. (C)</p> Signup and view all the answers

Pyruvate kinase (PK) deficiency is a hereditary condition affecting which crucial cellular process in red blood cells?

<p>ATP production via glycolysis. (D)</p> Signup and view all the answers

Which of the following dog breeds is known to have a predisposition for pyruvate kinase deficiency?

<p>Basenji. (D)</p> Signup and view all the answers

Osmotic hemolysis, also known as water intoxication-induced hemolysis, occurs when red blood cells are exposed to:

<p>Hypotonic solutions. (A)</p> Signup and view all the answers

In a case scenario of suspected IMHA with strong autoagglutination and spherocytes but an initial negative Coombs' test, what is the MOST probable explanation for the false negative?

<p>The prozone effect due to excess antibody. (D)</p> Signup and view all the answers

A veterinarian observes small, dot-like epicellular organisms lacking a cell wall on erythrocytes of a dog. These organisms are susceptible to tetracyclines. Which infectious agent is MOST likely?

<p><em>Mycoplasma haemocanis</em>. (D)</p> Signup and view all the answers

Researchers are investigating treatments for pyruvate kinase (PK) deficiency. Targeting which of the following metabolic pathways would be MOST directly relevant to improving erythrocyte function in PK-deficient dogs?

<p>Glycolysis (Embden-Meyerhof pathway). (C)</p> Signup and view all the answers

Considering the clinical findings of a three-day-old foal with weakness, dark urine, icteric mucous membranes and the provided lab data showing low PCV, RBC, high bilirubin and normal MCHC, which condition is MOST suspicious?

<p>Neonatal Isoerythrolysis. (D)</p> Signup and view all the answers

In the 'Luna' case (9-year-old miniature horse), the CBC results show macrocytic (high MCV) anemia. Considering hemolytic anemia is suspected, what is the MOST likely explanation for the increased MCV?

<p>Regenerative response with increased numbers of reticulocytes. (D)</p> Signup and view all the answers

Based on Luna's leukogram (high WBC, high Seg N, normal Lymphocytes and Monocytes), which interpretation is MOST consistent with hemolytic anemia and potential inflammation?

<p>Inflammatory leukogram with neutrophilia. (C)</p> Signup and view all the answers

The blood film from 'Luna' shows linear arrangements of red blood cells. What is the MOST appropriate term to describe this finding?

<p>Rouleaux. (D)</p> Signup and view all the answers

In the blood film of 'Luna', a red blood cell with a displaced hemoglobin and a clear 'bite-like' area is observed. What is the correct terminology for this morphologic abnormality?

<p>Eccentrocyte. (D)</p> Signup and view all the answers

Based on Luna's CBC and blood film findings (macrocytic regenerative anemia, eccentrocytes, rouleaux, inflammatory leukogram, hemoglobinuria), what is the MOST likely underlying mechanism of her hemolytic anemia?

<p>Oxidative RBC injury. (A)</p> Signup and view all the answers

Which of the following best describes the underlying cause of hemolytic anemias?

<p>Accelerated destruction of red blood cells. (D)</p> Signup and view all the answers

Which of the following is commonly observed in cases of intravascular hemolysis?

<p>Hemoglobinuria. (C)</p> Signup and view all the answers

Why might an artificial increase in MCHC present in cases of intravascular hemolysis?

<p>Due to light scattering from lysed red blood cell fragments. (D)</p> Signup and view all the answers

In the context of hemolytic anemia, what is the significance of haptoglobin?

<p>It binds free hemoglobin released during intravascular hemolysis. (A)</p> Signup and view all the answers

In extravascular hemolysis, liberated hemaglobin is...

<p>Metabolized within macrophages; therefore, plasma remains clear. (D)</p> Signup and view all the answers

Which of the following is a cause of hemolytic anemia related to immune dysfunction?

<p>Immune-mediated hemolytic anemia (IMHA). (A)</p> Signup and view all the answers

Which of the following best describes spherocytosis, a common finding in canine IMHA?

<p>Abnormally small, spherical red blood cells due to removal of cell membrane. (A)</p> Signup and view all the answers

What does agglutination suggest in the context of hemolytic anemia?

<p>Antibody or complement on the surface of red blood cells. (B)</p> Signup and view all the answers

Why is performing a saline dilution test important when evaluating a blood sample for agglutination?

<p>To distinguish true agglutination from rouleaux formation. (B)</p> Signup and view all the answers

Which factor can lead to a false negative Coombs' test result in a patient with IMHA?

<p>Steroid (immunosuppressive) treatment. (D)</p> Signup and view all the answers

Which is MOST likely to have naturally-occurring antibodies?

<p>Cats (D)</p> Signup and view all the answers

A veterinarian is presented with a feline patient that requires a blood transfusion. Why is it particularly important to perform blood typing in cats before transfusion?

<p>Type B cats have strong naturally occurring antibodies against type A blood. (C)</p> Signup and view all the answers

Which canine blood group is considered the most clinically significant and why?

<p>DEA 1; it elicits the strongest antibody response leading to transfusion reactions. (B)</p> Signup and view all the answers

A blood smear reveals the presence of small, epicellular organisms adhering to the surface of erythrocytes. Which diagnostic method would MOST accurately confirm the presence of hemotropic mycoplasmas?

<p>PCR analysis. (D)</p> Signup and view all the answers

What is the treatment of choice for infections caused by hemotropic mycoplasmas?

<p>Tetracycline/Doxycycline (A)</p> Signup and view all the answers

A cat from Oklahoma presents with severe hemolytic anemia. Which parasitic disease should be at the top of your differential list?

<p><em>Cytauxzoon felis</em> (C)</p> Signup and view all the answers

What is the MOST common presenting complaint in a horse with Red Maple Leaf Toxicity?

<p>Anemia (D)</p> Signup and view all the answers

Which of the following is the most accurate description of the mechanism of hypophosphatemia-induced hemolysis?

<p>Low ATP levels lead to decreased RBC membrane integrity. (C)</p> Signup and view all the answers

A young Basenji is evaluated for chronic lethargy and exercise intolerance. A blood smear reveals evidence of hemolytic anemia. Given the breed predisposition, which of the following enzyme deficiencies is MOST likely?

<p>Pyruvate kinase (PK) deficiency (A)</p> Signup and view all the answers

A veterinarian encounters a case of severe osmotic hemolysis following the administration of intravenous fluids. Which of the following scenarios is MOST likely to have caused this?

<p>Accidental administration of distilled water instead of isotonic saline. (C)</p> Signup and view all the answers

In acute blood loss, why might a complete blood count (CBC) appear normal immediately following the event?

<p>All blood components (plasma, red cells, protein) are lost proportionally, maintaining normal concentrations. (B)</p> Signup and view all the answers

Following acute blood loss, what physiological process leads to a decrease in packed cell volume (PCV) and plasma protein levels within 12-24 hours?

<p>Fluid shift from the extravascular space into the intravascular space and/or fluid therapy (C)</p> Signup and view all the answers

In a dog that experienced acute blood loss 4 days prior, which CBC findings would indicate a regenerative response?

<p>Increased MCV and decreased MCHC (C)</p> Signup and view all the answers

Why might the total protein level remain normal in a patient with internal blood loss, such as a hem abdomen?

<p>Protein is reabsorbed more easily than red cells from the peritoneal fluid. (C)</p> Signup and view all the answers

Which of the following best describes 'PEMA' in the context of IMHA?

<p>An immune response targeting red blood cell precursor cells in the bone marrow, resulting in a non-regenerative anemia. (D)</p> Signup and view all the answers

In a dog with IMHA, what does a positive saline agglutination test indicate?

<p>The presence of antibodies on the surface of red blood cells causing them to clump together. (B)</p> Signup and view all the answers

What is the purpose of performing a saline dilution test when assessing for agglutination?

<p>To differentiate true agglutination from rouleaux formation. (C)</p> Signup and view all the answers

In the context of anemia diagnostics, what does a positive Coombs' test indicate?

<p>The presence of antibodies or complement proteins on the surface of red blood cells. (A)</p> Signup and view all the answers

What factors can cause a false negative result when performing the Coombs' test?

<p>Prior treatment with corticosteroids or other immunosuppressants. (D)</p> Signup and view all the answers

Why are blood transfusions in cats more complicated than in dogs regarding naturally occurring antibodies?

<p>Cats have naturally occurring alloantibodies against certain blood types, whereas dogs typically do not. (A)</p> Signup and view all the answers

What is the primary concern regarding neonatal isoerythrolysis in kittens born to a type B queen?

<p>The kittens will ingest maternal anti-A antibodies in colostrum, leading to destruction of their type A red blood cells. (B)</p> Signup and view all the answers

What is the hallmark microscopic finding of hemotropic mycoplasma infections?

<p>Small, dot-like or ring-like structures adhering to the surface of red blood cells. (B)</p> Signup and view all the answers

A veterinarian suspects a cat has a hemotropic mycoplasma infection. Which diagnostic test would be MOST appropriate to confirm this?

<p>Polymerase chain reaction (PCR) to detect Mycoplasma DNA. (B)</p> Signup and view all the answers

Red maple leaf toxicity causes hemolytic anemia due to:

<p>Oxidative damage to red blood cells, leading to Heinz body formation and hemolysis. (A)</p> Signup and view all the answers

How does acute blood loss typically affect total protein (TP) levels?

<p>TP levels decrease due to proportional loss of all blood components. (A)</p> Signup and view all the answers

In intravascular hemolysis, what substance is released into the plasma due to red blood cell lysis?

<p>Hemoglobin (A)</p> Signup and view all the answers

Elevation of which complete blood count parameter is most likely an artifact found in laboratory analysis?

<p>Mean Corpuscular Hemoglobin Concentration (MCHC) (A)</p> Signup and view all the answers

In extravascular hemolysis, where are RBCs primarily destroyed?

<p>The liver and spleen (C)</p> Signup and view all the answers

What laboratory finding would you expect to see in a case of extravascular hemolysis?

<p>Icterus (A)</p> Signup and view all the answers

How does the regenerative response typically differ between hemolytic anemia and blood loss anemia?

<p>Hemolytic anemias usually have a better regenerative response due to the recovery and recycling of iron. (A)</p> Signup and view all the answers

Which of the following is an underlying cause of hemolytic anemias?

<p>Increased destruction of red blood cells (B)</p> Signup and view all the answers

What is meant by 'autoimmune' in the context of IMHA?

<p>The body is responding against a self-antigen. (A)</p> Signup and view all the answers

What is the clinical significance of observing spherocytes in a blood sample?

<p>In dogs, they suggest immune-mediated hemolytic anemia (IMHA). (C)</p> Signup and view all the answers

A canine patient presents with IMHA. The veterinarian wishes to assess for underlying trigger. Which of the following is LEAST likely to be an underlying cause of secondary IMHA?

<p>Trauma. (B)</p> Signup and view all the answers

Before performing a blood transfusion. Is pre-sensitization needed?

<p>Sensitization is needed between dogs and horses. (D)</p> Signup and view all the answers

What is the major incompatibility you should be worried about blood transfusions?

<p>It is a transfusion reaction and is life-threatening. (B)</p> Signup and view all the answers

What morphological characteristic helps distinguish Anaplasma marginale from Howell-Jolly bodies on a blood smear?

<p>Anaplasma marginale tends to be located on the margin of the red blood cell, while Howell-Jolly bodies are centrally located. (A)</p> Signup and view all the answers

A blood smear from a dog reveals many small, pale erythrocytes with reduced central pallor, suggestive of spherocytes. However, the veterinarian notes significant echinocytosis due to improper blood smear preparation. How does the presence of echinocytosis complicate the interpretation for spherocytes, and what steps can be taken to address this?

<p>Echinocytosis falsely enhances the appearance of spherocytes, so repeat a blood smear on a freshly collected sample will reduce or eliminate the echinocytosis. (B)</p> Signup and view all the answers

During a blood smear review, a veterinary technician identifies what appears to be rouleaux formation, but they are unsure if it is true rouleaux or agglutination. They perform a saline dilution test and find that the cell arrangements easily disperse with the addition of saline. What is the BEST interpretation of these findings?

<p>The cells dispersed, ruling out agglutination and confirming rouleaux, potentially due to inflammation or high globulin levels. (A)</p> Signup and view all the answers

Which feature is a protozoal disease?

<p>It is intercellular (A)</p> Signup and view all the answers

What are haptoglobins?

<p>Hemoglobin binding protein (B)</p> Signup and view all the answers

Regarding diagnostic testing for IMHA, a veterinarian reads two articles with differing protocols when running a saline-glutination on blood specimen. Article A's protocol is to mix 1 drop of blood with 1 drop of saline. Article B's protocol is to mix 1 drop of blood wth 10 drops of saline. Which statement below is MOST accurate?

<p>Article B may be considered more appropriate. Since more saline is applied to the blood specimen, more dilution is achieved and less likely to have false agglutination. (C)</p> Signup and view all the answers

What is the initial expected complete blood count (CBC) result during an acute blood loss event?

<p>Normal PCV and total protein. (B)</p> Signup and view all the answers

How does the body respond to restore normal blood volume after acute blood loss?

<p>Shift of fluid from the extravascular space to the intravascular space. (C)</p> Signup and view all the answers

How long after an acute hemorrhage would a regenerative response be expected in a patient with healthy bone marrow?

<p>Three to five days after the event. (C)</p> Signup and view all the answers

What characterizes the classic CBC and chemistry findings in a patient experiencing acute blood loss anemia after the compensatory fluid shift?

<p>Low hematocrit, low total protein. (B)</p> Signup and view all the answers

How might internal blood loss (e.g., hemoabdomen) affect total protein levels differently than external hemorrhage?

<p>Total protein might remain normal because proteins can be reabsorbed from the peritoneal fluid. (C)</p> Signup and view all the answers

Other than blood loss, what is another primary mechanism for regenerative anemia?

<p>Increased red cell destruction (hemolysis). (B)</p> Signup and view all the answers

What feature characterizes hemolytic anemia?

<p>Increased destruction of red blood cells. (B)</p> Signup and view all the answers

What are the two broad categories of hemolytic anemia based on the location of red blood cell destruction?

<p>Intravascular and extravascular. (C)</p> Signup and view all the answers

Under what condition might a hemolytic anemia be non-regenerative?

<p>If the bone marrow precursor cells are also being destroyed. (C)</p> Signup and view all the answers

What findings suggest a combination of intravascular and extravascular hemolysis?

<p>Hemolyzed plasma with RBC ghosts and spherocytes. (C)</p> Signup and view all the answers

In what circumstances is increased Mean Corpuscular Hemoglobin Concentration (MCHC) likely to be a real finding?

<p>Increased MCHC is likely an artifact. (A)</p> Signup and view all the answers

Red Blood Cell (RBC) ghosts are an indication of?

<p>Hemolyic Anemia. (C)</p> Signup and view all the answers

You observe hemolyzed plasma from a blood sample you took, what does this finding suggest?

<p>Intravascular Hemolysis. (B)</p> Signup and view all the answers

Which would not be a classic sign of intravascular hemolysis?

<p>Clear plasma. (D)</p> Signup and view all the answers

Which of the following findings is MOST indicative of intravascular hemolysis in a blood sample?

<p>Hemoglobinuria. (C)</p> Signup and view all the answers

In intravascular hemolysis, why does hemoglobinuria occur?

<p>Free hemoglobin passes through the glomerulus and into the renal tubules when the amount exceeds the binding capacity of haptoglobin. (A)</p> Signup and view all the answers

What protein binds to hemoglobin?

<p>Haptoglobin. (D)</p> Signup and view all the answers

What clinical scenario would most likely overwhelm the capacity of circulating haptoglobin?

<p>Acute, severe red maple leaf toxicity in a horse. (B)</p> Signup and view all the answers

In extravascular hemolysis, what is the appearance of the plasma?

<p>Clear. (C)</p> Signup and view all the answers

What causes icterus in extravascular hemolysis?

<p>Conversion of heme into bilirubin. (C)</p> Signup and view all the answers

In extravascular hemolysis, where might you observe the destruction of red blood cells?

<p>Spleen. (A)</p> Signup and view all the answers

With extravascular hemolysis, how does the process occur?

<p>Free hemoglobin never enters the blood. (C)</p> Signup and view all the answers

What is the predominant initial cause of immune-mediated hemolytic anemias?

<p>Idiopathic. (D)</p> Signup and view all the answers

In immune-mediated hemolytic anemia (IMHA), antibodies on the surface of red blood cells lead to destruction by which two main mechanisms?

<p>Extravascular hemolysis via macrophage phagocytosis and intravascular hemolysis via direct complement lysis. (C)</p> Signup and view all the answers

A patient with immune-mediated hemolytic anemia (IMHA) also has very low platelets. What might this comorbidity be referred to as?

<p>Evans syndrome. (C)</p> Signup and view all the answers

What are you observing if you are seeing inflammatory leukogram on a patient with IMHA?

<p>Less oxygen carrying-capacity. (D)</p> Signup and view all the answers

Why is it important to differentiate agglutination from rouleaux?

<p>Agglutination indicates immune-mediated disease, while rouleaux is often due to increased protein. (C)</p> Signup and view all the answers

What is the underlying cause of rouleaux?

<p>High protein or globulin levels. (D)</p> Signup and view all the answers

What can cause a cold agglutinin?

<p>Patient is cold but is not associated with IMHA. (C)</p> Signup and view all the answers

How is a saline dilution prepared to differentiate agglutination from rouleaux?

<p>Add ten drops of saline to one drop of blood. (D)</p> Signup and view all the answers

Is the Coombs test necessary if a autoagglutination is already present?

<p>No, it is unhelpful. (A)</p> Signup and view all the answers

What is the primary reason for false negatives in the Coombs test?

<p>Not enough antibody on the red cells to detect. (D)</p> Signup and view all the answers

An animal is on corticosteroids. Will you get a false positive or false negative in the Coombs test?

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Which of the following is the MOST accurate description of 'PEMA' in the context of IMHA?

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Why are cats considered different from dogs and horses when talking about blood transfusions?

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Why is it important to blood type cats?

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Will neonatal isoerythrolysis be seen once the animal is born?

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Which blood type poses a significant risk for neonatal isoerythrolysis if they produce kittens with type A or type AB blood?

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What is a reason to consider cross-matching?

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In a case of acute hemorrhage, why might a complete blood count (CBC) appear normal immediately following the event?

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A veterinarian observes, under a microscope, an elevated Heinz body count on a blood smear from a canine blood sample. Knowing that Heinz bodies indicate the red blood cell has undergone an oxidative change, which is the LEAST likely cause?

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After running a saline agglutination test on a canine blood sample, you observe under the microscope well-defined, clear separation between red blood cells as well as the noticeable 'coin-stacking' pattern. What is the MOST likely cause?

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Flashcards

Hemolytic Anemia

Anemia due to increased destruction of red blood cells.

Intravascular Hemolysis

RBC lysis occurs within blood vessels.

Intravascular Hemolysis Signs

Hemolyzed plasma, increased MCHC, RBC ghosts.

Hemoglobinuria

Hemoglobin passes directly into the urine, red discoloration of urine.

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Haptoglobin (Hp)

Haptoglobin binds free hemoglobin from lysed erythrocytes.

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Haptoglobin-hemoglobin complex

The Haptoglobin-hemoglobin complex is too large to pass into urine.

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Extravascular Hemolysis

RBCs are removed from blood by macrophages and destroyed

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Immune-Mediated Hemolytic Anemia (IMHA)

Antibodies bind to RBCs, leading to increased destruction

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Agglutination

Agglutination is the aggregation of RBCs in clusters.

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Saline Dilution Test for Agglutination

Saline dilution test will disperse rouleaux but not agglutination.

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Rouleaux

Stack-like or linear arrangements of RBCs seen on blood films

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Coombs' Test

Anti-immunoglobulin antibody is mixed with blood to induce agglutination of antibody-coated RBCs.

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Autoimmune Hemolytic Anemia cause

Autoimmune hemolytic anemia is generally idiopathic.

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Drug-Induced IMHA

Anemia caused by drug binding on RBC surface, inducing immune response.

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Neonatal Isoerythrolysis

Maternal antibodies against blood of offspring

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Animal Blood Groups

Cats: A, B, AB, Mik. Dogs: DEA 1.1, DEA 3, DEA 4, DEA 7, etc. Equine: A, C, D, K, P, Q, and U.

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Canine DEA 1

The DEA 1 is the most immunogenic/problematic.

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Feline Blood Type

Cats may be A, B or AB.

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Neonatal Isoerythrolysis in Cats

Type B queens with type A or AB kittens.

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Hemotropic Mycoplasmas

Transmitted by arthropods, have dot-like appearance on RBCs, cause anemia

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Hemotropic Mycoplasmas Diagnosis

Diagnosis of Hemotropic Mycoplasmas requires microscopic examination of blood or PCR.

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Canine Babesia Species

Babesia canis (B. vogeli), Babesia gibsoni, Babesia coco.

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Transmission of Babesia

Tick is a vector.

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Piroplasms

RBC protozoal infections have a 'signet ring' morphology.

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Trypanosomiasis

Protozoa: Trypanosoma cruzi infection

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Haemoproteus sp.

Low pathogenicity, vector is midges

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Avian Plasmodium

Transmitted by mosquitos, Gametocytes may resemble Hemoproteus sp

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Hemosregarins

These parasites have a similar appearance to Hemoproteus sp., but infect reptiles, amphobians, or fish

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Equine Infections Anemia

Retro virus causes IMHA

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Leptospirosis

Some serovars induce acute hemolysis

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Bacillary Hemoglobinuria

Clostridium haemolyticum causes proliferation.

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Heinz Bodies

Oxidation of globin chains of hemoglobin.

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Methemoglobin

Oxidation of Fe in heme.

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Eccentrocytes and Pyknocytes

Oxidation of RBC membranes.

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Oxidative RBC Injury Causes

Acetaminophen (especially cats), Onions, garlic.

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Hypophosphatemia

Low P levels lead to low ATP levels in RBCs and decreased membrane integrity

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PK Deficiency

Relatively rare, hereditary (autosomal recessive)

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PK Deficiency results

Affected animals have increased RBC destruction (extravascular hemolysis)

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Osmotic Hemolysis

With administration of hypotonic fluids or water toxicity

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Regenerative vs. Non-regenerative Anemia

Classify anemia by bone marrow response.

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Hemorrhage

Loss of blood from the body.

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Hemolysis

Increased destruction of red blood cells.

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Iron Deficiency

Chronic blood loss leads to a deficiency

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Initial Blood Loss

Blood parameters remain normal immediately after acute blood loss.

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Spleen's role in acute blood loss

Splenic contraction temporarily boosts hematocrit.

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Body's response to hypovolemia

Fluid shifts and fluid therapy dilute blood.

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Hemorrhagic Anemia CBC findings

Normal blood diluted with fluids.

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Early Hemorrhagic Anemia

May not be regeneration.

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Internal Blood Loss Anemia

Normal HCT, acute phase, masked loss.

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Autoimmune

Antibodies on RBCs target normal antigens.

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Precursor-Targeted IMHA (PIMA)

Targets bone marrow precursor cells in erythropoiesis.

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IMHA Severity

Can cause severe anemia.

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Spherocytes

Indicates extravascular hemolysis

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IMHA Leukogram

Inflammatory.

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Increased Liver Enzymes in IMHA

Hypoxic liver damage.

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Evans Syndrome

IMHA and ITP combination.

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Agglutination variability

Antibodies on RBC surfaces aren't always strong enough to agglutinate.

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Protein and Rouleaux formation

Red cells form rows due to proteins.

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Saline dilution principle

Dilute proteins and disrupt weak bonds.

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Cold Agglutination

Agglutination occurs at room temperature but disperses when heated.

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Autoagglutination and IMHA

Autoagglutination, definite diagnosis.

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False Negatives Coombs Test - causes

Lack of antibody detected.

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Prozone Effect

Excess reagent antibody prevents crosslinking

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Dal Antigen

Blood group antigen absent certain breeds, like Dalmatian.

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1st transfusion safe dogs/horses?

Not always.

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Type A blood to Type B cat reaction

Causes a strong, possibly fatal, transfusion reaction

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Cross-matching

Detects incompatibilities prior to transfusion.

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Major Crossmatch

Donor RBCs + patient serum. Checks for recipient antibodies.

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Minor Crossmatch

Patient RBCs + donor serum. Checks for donor antibodies.

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Infectious Organisms & Hemolytic Anemia

Parasitic. Can directly lyse cells or trigger immune response.

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Mycoplasma characteristics

Tiny bacteria on cell surface, no cell wall.

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Mycoplasma pathogenicity

Low pathogenicity, clinical when combined with immunosuppression.

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Mycoplasma haemocanis

Classically linear arrangement.

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Mycoplasma ovis ID

Difficult garbage, PCR confirm.

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Anaplasma marginale

Larger dots edge of cell.

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Protozoa

Intercellular w/ arth vectors.

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Babesia canis morphology

Usually tear drop shaped and show up in pairs like eyes.

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Babesia gibsoni

Hemolytic anemia, IMHA. Pitbulls.

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Cytauxzoon felis

Monocyte parasite bobcats deadly.

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Bovine Babesiosis

Direct hemolysis escaping, also IMHA.

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Trypanosoma cruzi

Doesn't affect RBC, see on CBC during heart disease

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Hemoproteus avian.

Large, Low pathogenicity.

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Plasmodium avia

Gametocytes like pro, mosq

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Haemogregarines reptile.

Enfe reptiles catchall group.

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Leukocytozoon avi.

Whole structure distorted RBC parasits

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Study Notes

  • Regenerative anemia is classified based on two basic mechanisms: blood loss (hemorrhage) and hemolysis (increased red cell destruction).

Hemorrhagic Anemias

  • Chronic hemorrhage can lead to an iron-deficient state and eventually result in non-regenerative anemia.

Hemolytic Anemias

  • Sometimes, destruction of both mature and immature cells (bone marrow precursor cells) can result in a non-regenerative anemia.
  • Hemolytic anemias can be intravascular, extravascular, or a combination of both and clues from a CBC, red cell shapes, and inclusions can aid in determining the type.

Blood Loss Anemia

  • Three-year-old Bichon, Phil, hit by a car, physical exam revealed multiple lacerations and hemorrhage, along with a fractured femur and pale mucous membranes, diagnosed with shock, pain, and hemorrhage.
  • Initial CBC showed everything within normal limits.
  • In acute blood loss, everything lost equally, including plasma, red cells, and protein, so CBC can appear normal initially.
  • The body compensates for hypovolemia through fluid shifts from extravascular to intravascular fluid and epinephrine release, which triggers the spleen to contract and release concentrated red cells and platelets, temporarily increasing the hematocrit.
  • Fluid shifts and fluid therapy dilute the remaining blood, leading to decreased packed cell volume (PCV) and decreased plasma proteins, typically seen 12-24 hours post-hemorrhage.
  • On day two, Phil's hematocrit decreased, presenting mild anemia, MCV and MCHC were normal, and protein levels also decreased, is not regenerative as expected time is 3-5 days.
  • On day six, the hematocrit increased, the MCV became macrocytic, the MCHC became hypochromic, and protein returned to the low end of the reference interval, indicating regeneration.
  • Early acute phase everything looks normal, low PCV and total protein are observed and if splenic contraction occurs a normal PCV with low protein could be seen.
  • Internal blood loss, such as with a hemoabdomen due to a sarcoma, might show normal protein levels because protein is reabsorbed more easily than red cells from peritoneal fluid.

Hemolytic Anemias: Causes

  • Common causes of increased red cell destruction include immune-mediated hemolytic anemia (IMHA), infectious diseases, oxidation injury to red cells, and fragmentation.
  • Fragmentation is typically associated with less severe anemias than IMHA and infectious causes.
  • Hemolytic anemias are generally considered regenerative because the bone marrow is unaffected and iron can be recycled.

Intravascular Hemolysis

  • Classic sign is hemolyzed plasma, can occur due to mishandling.
  • Artifactually increased MCHC detected and RBC ghosts are visible on blood films.
  • Hemoglobinuria occurs because free hemoglobin passes through the glomerulus unless haptoglobin is available, which is tested through heme/blood dipstick tests.
  • Hyperbilirubinemia and bilirubinuria are also observed due to increased breakdown products.
  • Haptoglobin binds free hemoglobin and prevents it from passing through the glomerulus.
  • Hemoglobinuric nephrosis, which results due to hemoglobin damaging the renal tubules occurs in cases of severe hemolytic anemias.

Extravascular Hemolysis

  • Characterized by clear plasma, absence of hemoglobinuria, and regenerative anemia, hyperbilirubinemia and bilirubinuria are still present.
  • Macrophages phagocytize antibody-coated RBCs, break them down, recover iron and heme, convert heme to biliverdin then bilirubin, and release bilirubin into the blood which leads to icterus.

Immune-Mediated Hemolytic Anemia (IMHA)

  • Biggest cause is idiopathic, other potential causes include infection, parasitic related.
  • Anemia typically presents as severe presentation.
  • Non-regenerative anemia can occur when targeting RBC precursor cells (precursor-targeted immune-mediated anemia or PIMA).
  • Agglutination of RBCs and a positive Coombs test, and spherocytosis (in dogs) are common findings.
  • The spleen removes parts of the cell membrane with bound antibody creating spherocytes.

IMHA: Other Findings

  • Inflammatory leukogram (neutrophilia, left shift, toxic changes) and increased liver enzymes (ALT, AST), is an inflammatory response to RBC destruction.
  • Concurrent immune-mediated thrombocytopenia could arise which is Evan's syndrome: IMHA + ITP.

Agglutination vs Rouleaux

  • Confirmation done through wet prep, through saline dilution.
  • rouleaux is an abnormal finding in dogs when there are high protein or globulin levels.
  • RBCs have negatively charged protein residues, repelling each other to prevent stacking Globulins have a net positive charge and can coat RBCs, neutralizing charges and allowing Rouleaux formation.
  • To differentiate, mix one drop of blood with ten drops of saline and examine microscopically.
  • Cold agglutinins, which can disperse with warming, can complicate the determination of true agglutination.

Coombs' Test (DAT)

  • Detects RBC antibodies, even without autoagglutination.
  • Induces agglutination of antibody-coated RBCs.
  • A positive result indicates the presence of antibodies on RBCs.
  • Conduct saline dilution before test, autoagglutination makes test redundant.
  • False negatives can occur due to too little Ab, corticosteroid treatment, Ab washing off.
  • False positives can occur due to a prozone effect with too much anti-Ab added and is avoided by diluting the sample.

Canine IMHA Diagnostic Flow Chart

  • Anemia confirmed and look for two or more signs of immune-mediated destruction: spherocytes, positive saline agglutination test (without washing), positive direct agglutination test (Coombs test), or flow cytometry.
  • If findings are found, look for signs of hemolysis: hyperbilirubinemia, bilirubinuria/icterus (rule out liver disease), hemoglobinemia, hemoglobinuria, RBC ghosts.
  • If hemolytic indicators present and diagnostic for IMHA.
  • If only one sign of destruction is indicated, assess for secondary presence of hemoglobinuria, hemoglobinemia, anemia, schizocytes, ghosts to confirm diagnosis.

Autoimmune Hemolytic Anemia

  • More common in middle-aged dogs, females, or neutered males as well as Cocker Spaniels.
  • Usually strongly regenerative, but not if antibodies are against RBC precursors.

Drug-Induced IMHA

  • Theory is drug binding on RBC surface forms a hapten, which induces an immune response.
  • Reported drugs include cephalosporins in dogs, penicillin in horses, levamisole in dogs, and sulfonamides in dogs and horses.

Blood Group Incompatibility-Induced Hemolysis

  • The amount of blood related antigens are complicated, name often derived by letters, or even dog breeds discovered with.
  • Transfusion reactions and neonatal isoerythrolysis involve immune responses against nonself blood cell antigens.
  • In dogs, DEA 1 is the most problematic and in horses, AA and QA blood groups are the most immunogenic.
  • Dogs and horses require presensitization through prior exposure , while cats do not.
  • Cats have A, B, and AB blood types, with most being type A.
  • Type B is rare overall like Abyssininan, Bermese, etc, B antigen even higher, exotic and British, short-haired, Cornish, and Devon Rex
  • Type A cats have small amounts of naturally occurring anti-B antibodies, leading to mild transfusion reactions if given type B blood.
  • Type B cats have large amounts of naturally-occurring anti-A antibody, leading to strong, potentially fatal transfusion reactions if given type A blood.
  • Transfusion reactions don't require sensitization of host.
  • Blood typing cards are available for cats and dogs (DEA 1.1)- agglutination on the pad corresponding with patient’s blood type.
  • Blood cross-matching is used to assess compatibility.
  • Major cross-match: donor RBCs + recipient serum to detect antibodies against donor RBCs
  • Minor cross-match: recipient RBCs + donor serum to detect antibodies against recipient RBCs in donor blood- less important.

Neonatal Isoerythrolysis (NI)

  • In horses, NI is due to blood type incompatibility between the mare and foal is mainly Aa and Qa blood groups are the most immunogenic.
  • Requires sensitization from a prior incompatible foal.
  • Foals receive antibodies against their own RBC antigens in colostrum, leading to hemolytic anemia.
  • In cats, NI occurs in type B queens with type A or AB kittens, and sensitization is not required and if a type B queen has type A or AB kittens the antibody will attack.
  • Kittens get anti-A antibodies in colostrum, leading to severe hemolytic anemia 4–48 hours after birth.

Infectious Organisms

  • Includes hemotropic mycoplasmas, RBC Anaplasmosis, and RBC Protozoal infections.

Hemotropic Mycoplasmas

  • Most have been reclassified as mycoplasmas, and previously Hemobartonella or Eperythrozoon.
  • Transmitted by arthropod vectors +/- vertical transmission.
  • Anemia occurs, especially in immunocompromised patients; most infections are subclinical.
  • Anemia occurs, especially in immunocompromised patients; subclinical infections are common.
  • Diagnostic conventions were mycoplasma hemo-whatever species.
  • Mycoplasma haemocanis, is found in dogs formerly Hemobartonella canis.
  • Mycoplasma haemofelis infects cats, as well as M. haemominutum, M. turicencis
  • Mycoplasma ovis infects sheep & goats.
  • Mycoplasma haemosuis infects pigs.
  • Mycoplasma (Eperythrozoon) wenyonii infects cattle, mainly causing mastitis rather hemotologic.
  • Anaplasma marginale looks similar (dots), but is intracellular.
  • Mycoplasma haemolamae infects llamas & alpacas.
  • Diagnosis is through microscopic examination of blood, but false negative results are possible, so PCR analysis of blood can be more beneficial/more specific.
  • Treatment includes tetracycline or doxycycline and organisms are resistant to β-lactam antibiotics.
  • Transmission of feline hemotropic mycoplasmosis occurs from Fleas, transfusions, etc.
  • M. hemofelis is more pathogenic than M. haemominutum & M. turicencis, and FeLV co-infection may increase severity.
  • In dogs, Mycoplasma haemocanis is transmitted by arthropods, transfusions, or maternal routes with carrier/asymptomatic state is common.
  • RBC Anaplasmosis involves Anaplasma marginale in cattle and Anaplasma ovis in sheep & goats, where dots appear on the margins for Anaplasm marginale.

RBC Protozoal Infections

  • Typically have a tissue stage, usually arthropod vectors (ticks).
  • Morphology is described as a “signet ring” with nucleus and cytoplasm referred as piroplasms.
  • Babesia canis vogeli*, Babesia gibsoni, Babesia coco infects dogs.
  • Cytauxzoon felis infects cats.
  • Babesia equi*, Babesia caballi infects horses.
  • Babesia bigemina, Babesia bovis infects cattle.
  • Babesia canis, or Babesia canis vogeli is carried by ticks (Rhipicephalus) and maternal transmission and causes hemolytic anemia with subclinical carriers, and is most common South and SE US- Grey hounds show positive incidents
  • Babesia gibsoni is most common in the US within pit bulls through ticks, dog bites, and maternal routes and causes hemolytic anemia/IMHA, ,PCR testing is more sensitive.
  • Cytauxzoonosis in cats is most common in SE and south central US and is carried by bobcats (uncommon in North Eeast), schizonts grow in macrophages, release merozoites that infect RBCs, schizonts are sometimes found in circulation, causes Hemolytic anemia/rapid death.
  • Bovine Babesiosis causes intravascular hemolysis by escaping merozoites, Increased osmotic fragility of RBCs, and Secondary immune mediated splenic removal of red blood cells.
  • Trypanosomiasis is when infection of Trypanosoma cruzi (Chagas disease)" infecting cardiac muscle tissue. Vector is the “Kissing bug” in South and Central America, Mexico, and the Southern US- effects are on Organisms that do not infect blood cells, but may be found in circulation.
  • RBC Parasites In Birds and Reptiles are infections from Protozoal parasites.
  • Hemoproteus sp. affects > 50% of erythrocytes parasitized without signs of disease with Insect vectors and Mature gametocytes exhibiting yellow-brown pigment granules.
  • Plasmodium sp. is transmitted by mosquitos that are parasites which are found in Gametocytes and Schizonts or trophozoites in blood cells in thrombocytes or lymphocytes.
  • Haemogregarines, Hemoproteus sp-like parasites, infect reptiles, amphobians, or fish through insect vectors and are usually have low pathogenicity.
  • Leucocytozoon sp. is a Common protozoal parasite in birds which may cause anorexia, dehydration, depression, hemolytic anemia, and hemoglobinuria where the Gametocytes seen in distorted RBCs.

Other Infectious Anemias

  • Equine Infectious Anemia is due to a Retrovirus leading to IMHA, immunosuppression, myelodysplasia and chronic infection can cause suppression of erythropoiesis and Coggins test for EIA testing.
  • Leptospirosis is transmitted through various serovars and induce acute hemolysis, mostly in calve, piglets, & lambs with IMHA and Hemolysins that produce Fever, anorexia, dyspnea, icterus, hemoglobinuria, anemia.
  • Bacillary Hemoglobinuria, also known as "red water disease” in cattle & sheep produce Clostridium haemolyticum/Clostridium novyi type D where GI tract proliferate due to Bacteria proliferate in anaerobic environment which affects creating RBC membrane damage. Intravascular hemolysis, hemoglobinuria, and gas gangrene may also result.

Oxidation RBC Injury/Hemolysis

  • Oxidation RBC Injury/Hemolysis manifests through Heinz bodies, Methemoglobin, Eccentrocytes and pyknocytes.
  • Common Causes of Oxidation RBC Injury include Acetaminophen, Onions & garlic, Zinc, Red maple leaves, Naphthalene, Kale & Brassica sp. (ruminants), Copper (sheep, goats), Phenothiazine (horses), Skunk musk, Crude oil (birds), Benzocaine, and Propofol.
  • Propofol can cause increased Heinz bodies in cats, but it typically does not result in anemia.
  • Methemoglobinemia is created when oxidation converts the Fe atoms to the ferric (Fe3+) state which disables oxygen binding, and in large amounts, gives blood a "chocolate brown" color sometimes reversible.
  • Acetaminophen in Cats Toxic dosage: ~10 mg/kg, reactive intermediate breakdown products deplete RBC glutathione and cause oxidation damage, unlike Dogs, where liver damage is more common with toxicity.
  • Zinc Toxicity coins (post-1982 US cents with zinc core- surface damage), other zinc metal objects, zinc oxide ointments- Leads to hemolytic anemia due to oxidant injury, marked by Spherocytes, eccentrocytes, Heinz bodies (high), and liver and kidney failure.
  • Red Maple Leaf Toxicity affects horses and camelids due to its fallen leaves toxicity which is marked by anemia with Heinz bodies along hemoglobinuria and if Lethal a 4-5 lb consumption.

Hypophosphatemia & PK Deficiency

  • Hypophosphatemia, Low P levels leading to low ATP levels in RBCs cause decreased membrane integrity which is seen in Postpartum cattle/sheep/goats, Dogs & cats with diabetes.
  • PK Deficiency, or Pyruvate Kinase Deficiency is a rare autosomal recessive Deficiency due to Decreased ATP by the Embden-Meyerhof pathway. Increased extravascular RBC destruction of RBCs, increased RBC production for Compensate and then eventually resulting in myelofibrosis and osteosclerosis then fatal about 3-4 years into life. Genetic tests test specific breed tests for Basenjis, Beagles, West Highland White terriers, and cairn terriers.
  • Osmotic Hemolysis due to With administration of hypotonic fluids that causes excess water to enter RBCs which effects the cells capacity. Excess drinking of water in calves post deprivation, as well as Accidental distilled water results in hemolytic issues.

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