3. Non-regenerative Anemias.pdf

Nonregenerative anemias Anemia Regenerative Capacity Severity Any RBC morphology Regeneration Evident by reticulocytosis Nonregenerative Anemias Extramarrow Causes Normocytic, normochromic Most common cause of anemia Anemia of chronic disease Mild to mo...

Nonregenerative anemias Anemia Regenerative Capacity Severity Any RBC morphology Regeneration Evident by reticulocytosis Nonregenerative Anemias Extramarrow Causes Normocytic, normochromic Most common cause of anemia Anemia of chronic disease Mild to moderate anemia Renal failure Mild to severe anemia Endocrine diseases Hypothyroidism, hypoadrenocorticism, estrogen Acute hemorrhage Prior to peripheral blood reticulocytosis iron, B12, folate Nutritional deficiencies  Normocytic, normochromic Infections Ehrlichiosis, FIV, FeLV Toxins, drugs Nonregenerative Anemias Immune-mediated Marrow Disease Marrow neoplasia Myelodysplasia Myelofibrosis  Microcytic, hypochromic Blood loss (chronic, iron deficiency) Portosystemic shunt (anemia Nonregenerative uncommon or mild) Anemias Macrocytic, normochromic FeLV infection Folate and cobalamin deficiencies  Normocytic, Most common normochromic cause of Mild to moderate severity anemia PCV 25-36% Anemia of dogs Chronic Disease Disease duration for Clinical signs development are related to 1 week in cat primary 2 weeks in dog disease  Decreased renal erythropoietin production Anemia Of Also decreased RBC lifespan impaired response to erythropoietin Normocytic, normochromic GI loss Chronic Renal Mineral deficiencies Failure Treatment with May be severe erythropoietin Newer drug Molidustat Iron Deficiency Anemia  Many causes Bone Nonregenerative anemia Other cell lines affected in many Marrow instances Disease Bone marrow aspirate or biopsy necessary for diagnosis in many cases Immune-mediated Nonregenerative Anemia (PIMA) Immune response against RBC precursors Severe anemia May be Coomb’s positive (50%) May have evidence of hemolysis Bone marrow Either no erythroid precursors or arrest at specific stage of maturation Diagnosis: Exclude other causes Bone marrow appearance Treatment: Immunosuppression Aplastic Anemia Failure of bone marrow All cell line affected Pancytopenia Causes Infections (FeLV, ehrlichiosis) Drugs (chemotherapeutics, adverse reactions) Estrogens Diagnosis Bone marrow aspirate/biopsy Myelodysplasia Abnormal development of one or more hematopoietic cells lines May be a precursor to hematopoietic neoplasia Can be secondary to disease FeLV in cats Immune mediate disease Infectious causes Ehrlichia FeLV +/- mycoplasma hemofelis (can be non-regen because of FeLV) Fungal Septicemia  FELV Hematologic Disorders Neoplasia Leukemias Multiple myeloma Malignant histiocytosis Myelofibrosis Proliferative response of the bone marrow fibroblasts Idiopathic or secondary to injury Bone marrow necrosis Bone marrow biopsy Bone marrow aspirate and biopsy Milo “Milo” 5-year-old male castrated Mixed History: Milo has been playing and running less over the last month. His appetite has also progressively declined over the last 2 weeks and he appears to have lost weight. He stopped eating completely yesterday and was reluctant to get up this morning but could walk when encouraged. Milo has been healthy historically. He currently eats Royal Canin adult maintenance dry food and receives monthly heartworm and flea/tick prevention. Despite treatment with flea and tick prevention, his owner found a tick on him about 5 months ago. PE Problem list DDX Positive for Anaplasma Just means antibody exposure can treat with doxycycline or do PCR Which anaplasma would you suspect? What are the typical signs of this anaplasma sp? Redefine problems Bone marrow PIMA Precursor-targeted immune mediated anemia