Immune-Mediated Hemolytic Anemia in an American Cocker Spaniel - PowerPoint PPT Presentation

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Immune-Mediated Hemolytic Anemia in an American Cocker Spaniel

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Title: PowerPoint Presentation Author: Veterinary Pathobiology Last modified by: VetLab Created Date: 5/11/2006 9:05:30 PM Document presentation format – PowerPoint PPT presentation

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Title: Immune-Mediated Hemolytic Anemia in an American Cocker Spaniel


1
Immune-Mediated Hemolytic Anemia in an American
Cocker Spaniel
Peter Christopherson1, Elizabeth Welles1,
Ellen Behrend2, and Elizabeth Spangler1
Auburn University College of Veterinary Medicine,
Department of Pathobiology1 and Department of
Clinical Sciences2
http//www.zimfamilycockers.com/
2
  • Signalment History
  • 3-year-old, spayed female, American Cocker
    Spaniel
  • Dark red urine for 3 weeks
  • Pruritic with sore footpads
  • Tx Antibiotics Ketoconazole
  • Physical Exam
  • Lethargy and mild weight loss
  • Pruritic dermatitis
  • Dirty ears
  • Prominent popliteal lymph nodes
  • Diagnostics
  • CBC, chemistry panel, coagulation profile
  • Urinalysis with aerobic culture
  • Thoracic/abdominal radiographs and abdominal
    ultrasound
  • Aspirate of popliteal lymph nodes
  • Titers and PCR for tick borne diseases

3
Parameter Patient Value 4/18/07 Ref Interval
HCT () 22.4 ? 37-55
MCV (fL) 78.8 ? 60-77
MCHC (g/dL) 27.7 ? 32-36
RDW 18.3 11-17
Platelets (/uL) 227,000 164,000-510,000
MPV (fL) 16.6 8.4-13
Reticulocyte 11.26 0-1.5
Reticulocyte Count (/uL) 320,000? 0-60,000
Nucleated RBC(/100 WBC) 5
WBC (/uL) 57,040 ? 6,000-17,000
Neutrophils (/uL) 44,491 ? 3,000-11,400
Bands (/uL) 3,993 ? 0-300
Monocytes (/uL) 6,274 150-1,350
4
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5
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6
Interpretation
  • Moderately regenerative anemia with marked
    spherocytosis consistent with immune-mediated
    hemolytic anemia
  • Inflammatory leukogram

7
IMHA
  • Primary or secondary
  • Predilections breed, sex, age, blood type
  • RBC destruction
  • IgG, IgM, or complement
  • Spherocyte formation
  • Intravascular hemolysis

8
Schalms Veterinary Hematology 2000, Fig. 118.1
pg 800
9
Schalms Veterinary Hematology 2000, Fig. 118.3
pg 803
10
Laboratory Findings
  • Anemia usually regenerative
  • Spherocytes
  • Inflammatory leukogram
  • Thrombocytosis or thrombocytopenia
  • May see hyperbilirubinemia/icterus
  • /- evidence of intravascular hemolysis

11
Spherocytes
  • Loss of RBC membrane without loss of cell volume
  • Partial phagocytosis
  • Identifiable on canine blood smears
  • Cells are round with smooth margins
  • Decreased diameter and central pallor
  • Ddx snake envenomation, bee sting, zinc
    toxicity, inherited membrane or enzyme defects

Bessis M Blood Smears Reinterpreted,
Springer-Verlag, 1977, pgs 53 97
12
Acknowledgements References
Uschi Wohlfert, Debbie Czerkawski, Amy Hall,
Donna Shiver, and Stephany Spencer

1. Latimer KS, Mahaffey EA, and Prasse KW.
Duncan Prasses Veterinary Laboratory Medicine
Clinical Pathology, 4th edition. Iowa State
Press, 17, 2003. 2. Stockham SL and Scott MA.
Veterinary Clinical Pathology, 1st edition. Iowa
State Press, 122-126, 2002. 3. Weiss DJ and
Brazzell JL. Detection of Activated Platelets in
Dogs with Primary Immune-Mediated Hemolytic
Anemia. J Vet Intern Med 20 682-686 2006. 4.
Piek CJ, Junius G, Dekker A, Schrauwen E,
Slappendel RJ, and Teske E. Idiopathic
Immune-Mediated Hemolytic Anemia Treatment
Outcome and Prognostic Factors in 149 Dogs. J
Vet Intern Med 22366-373 2008.
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