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Anaemia

By : Dr Pallav Shekhar

Asstt Professor

Veterinary Medicine

UNIT-1

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Definition and Etiology

Anaemia is defined as an absolute decrease in the red cell mass as measured by RBC count, hemoglobin concentration, and PCV.

It can develop from loss, destruction, or lack of production of RBC

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Anaemia- Classification

  • Anemia is classified as

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  • Regenerative

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  • Non regenerative

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Regenerative anaemia

  • In a regenerative anemia, the bone marrow responds appropriately to the decreased red cell mass by increasing RBC production and releasing reticulocytes.

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  • Anaemias due to hemorrhage or hemolysis are usually regenerative.

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Non – regenerative anaemia

  • In a non regenerative anaemia, the bone marrow responds inadequately to the increased need for RBC.

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  • Anaemias that are caused by decreased erythropoietin or an abnormality in the bone marrow are non regenerative

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Classification

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Developmental process of RBC

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Regenerative anaemia

Regenerative

anaemia

Blood Loss

External

Internal

Hemolysis

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Blood Loss

Blood Loss

External

Internal

Trauma, Surgery, External Tumors

External parasites.

Trauma, Surgery, Coagulopathies, Gastric ulceration, Internal tumors Internal parasites

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Hemolysis

Hemolysis

Immune mediated

Neoplasia

Drugs and Toxins & Vaccination

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Toxic Cause of hemolysis

Drugs

Plant products

Chemicals

Acetaminophen, benzocaine, dapsone, nitrofurans, primaquine, propofol, quinacrine

Bracken fern

sweet clover

Lead

Aspirin, naproxen

onions,

Selenium

Amphotericin, cephalosporins, chloramphenicol, estrogen, fenbendazole, griseofulvin, meclofenamic acid, phenobarbital, phenothiazine, phenylbutazone, , quinidine, sulfonamides, thiacetarsamide

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Copper

Zinc

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Infectious cause

Bacterial

Viral

Rickettsial

Protozoal

Clostridium

Leptospira

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Equine infectious anaemia.

Feline leukemia virus

Mycoplasma

Anaplasma

Ehrlichia

Babaesia

Theileria

Trypanosoma

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Non-regenerative anaemia

Non-Regenerative

anaemia

Nutritional deficiencies

Fe, Cu, Vit B12, B6, Riboflavin,

Niacin, Vit E & Vit C def.

Chronic diseases

Chronic Inflammation, infection, neoplasia, liver disorder, Hypo-hyperadrenocorticism, hypothyroidism

Renal diseases

Chronic renal disease

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Clinical signs :

  • Lethargy and exercise intolerance
  • Mucous membrane pallor
  • Tachycardia
  • Low grade haemic murmur
  • Prominent femoral pulse
  • Tachypnoea
  • Episodic collapse (excitement or stress-induced )
  • Jaundice (in haemolytic anemia)

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Pathogenesis of anemia

  • Reduced oxygen carrying capacity of the blood.
  • Inadequate tissue oxygenation
  • Development of clinical signs
  • Compensatory mechanism

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Diagnosis:

  • Hb and PCV value measurement

  • Complete Blood Count
    • Red Blood Cell morphology
    • Reticulocyte count
    • Erythrocytic Indices
    • Platelet count

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Packed Cell Volume

  • ⮚ PCV - 30 to 37 – mild anemia,
  • ⮚ PCV - 20-29- moderate anemia
  • ⮚ PCV - < 20 – severe anemia

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PCV - < 12 poor prognosis

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Red cell morphology

Type of anemia

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Red cell morphology

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Acute blood loss

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Normocytic , normochromic

No evidence of regeneration for 3-4 days.

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Chronic blood loss

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Hypochromasia, microcytic if iron deficiency present

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Hemolytic

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Spherocytosis

 

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Non-regenerative

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Normocytic, normochromic

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Reticulocyte count��Indicates degree of regeneration��

Erythrocytic Indices

  • Mean Corpuscular Volume (MCV)

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  • Mean Corpuscular Hemoglobin Concentration (MCHC)

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Platelet count < 20,000/ µl

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  • Thrombocytopenia
  • DIC
  • Intramedullary or extramedullary suppression of platelet production.

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Faecal examination/ faecal occult blood test ��Severe upper gastrointestinal bleeding - black, tarry feces�

Bone marrow Evaluation

Nonregenerative anemia

Leukopenia

Unexplained thrombocytopenia

Pancytopenia

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Treatment of anemia

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  • Emergency stabilization
  • Blood transfusion
  • Specific treatment of underlying cause

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Blood transfusion

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  • PCV < 15%
  • Selection of donor animals
  • Major and minor cross
  • Blood collection
  • Blood transfusion

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Other treatments-� Anabolic Steroids

  • Nandrolone decanoate ( 1 to 2 mg/kg/week, im

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  • Oxymetholone – 1-5 mg/kg, PO, every 18-24 hr

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  • Stanozolol (dogs: 1-4 mg, PO, bid)

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Hemostatics

  • Astringents
  • Epinephrine and norepinephrine
  • Vitamin K
  • Calcium therapy
  • Desmopressin

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  • , Component therapy:

Fresh Frozen Plasma and Platelet therapy