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    Anemia DiagnosticTree PDF

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    guadialvarez
    This document presents a diagnostic tree or flowchart for evaluating anemia in dogs and cats. The tree begins with differentiating between regenerative and nonregenerative anemia based on reticulocyte count and red blood cell indices. It then provides decision points and considerations for identifying potential causes of anemia based on physical exam, bloodwork, blood smear, and diagnostic testing findings. These include blood loss, immune-mediated hemolytic anemia, infection, neoplasia, inflammation, and deficiencies. The tree aims to methodically guide veterinarians through evaluating anemia to determine its underlying etiology.

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    Anemia DiagnosticTree PDF

    Uploaded by

    guadialvarez
    331 views2 pages
    This document presents a diagnostic tree or flowchart for evaluating anemia in dogs and cats. The tree begins with differentiating between regenerative and nonregenerative anemia based on reticulocyte count and red blood cell indices. It then provides decision points and considerations for identifying potential causes of anemia based on physical exam, bloodwork, blood smear, and diagnostic testing findings. These include blood loss, immune-mediated hemolytic anemia, infection, neoplasia, inflammation, and deficiencies. The tree aims to methodically guide veterinarians through evaluating anemia to determine its underlying etiology.

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    This document presents a diagnostic tree or flowchart for evaluating anemia in dogs and cats. The tree begins with differentiating between regenerative and nonregenerative anemia based on reticulocyte count and red blood cell indices. It then provides decision points and considerations for identifying potential causes of anemia based on physical exam, bloodwork, blood smear, and diagnostic testing findings. These include blood loss, immune-mediated hemolytic anemia, infection, neoplasia, inflammation, and deficiencies. The tree aims to methodically guide veterinarians through evaluating anemia to determine its underlying etiology.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    331 views2 pages

    Anemia DiagnosticTree PDF

    Uploaded by

    guadialvarez
    This document presents a diagnostic tree or flowchart for evaluating anemia in dogs and cats. The tree begins with differentiating between regenerative and nonregenerative anemia based on reticulocyte count and red blood cell indices. It then provides decision points and considerations for identifying potential causes of anemia based on physical exam, bloodwork, blood smear, and diagnostic testing findings. These include blood loss, immune-mediated hemolytic anemia, infection, neoplasia, inflammation, and deficiencies. The tree aims to methodically guide veterinarians through evaluating anemia to determine its underlying etiology.

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    56...............................................................................................................................................................................

    NAVC Clinicians Brief / July 2010 / Diagnostic Tree


    Di agnost i c Tr ee / INTERNAL MEDICINE
    Anemia
    Aggregate reticulocyte count > 60,000/mcL (cats)
    or > 80,000/mcL (dogs)?
    Evidence of increased MCV, MCHC, or RDW?
    Regenerative anemia
    Peer Reviewed
    Caroline M. Kiss, DVM, &
    Bess J. Pierce, DVM, Diplomate ABVP & ACVIM
    Virginia-Maryland Regional College of
    Veterinary Medicine
    ANEMIA
    Do history and physical examination
    identify a cause of blood loss?
    No Yes
    Low to low-normal total
    solids or albumin and
    globulin?
    Yes
    Blood smear evaluation
    No
    Spherocytes or
    autoagglutination
    Heinz bodies or
    eccentrocytes
    Blood parasites
    Unremarkable
    RBC morphology
    Primary or
    secondary
    IMHA
    Rule out underlying
    infectious, neoplastic,
    drug, or toxic process
    Anemia/
    oxidative
    damage
    Rule out onions, garlic,
    zinc,

    acetaminophen,
    propylene glycol
    Rule out
    Mycoplasma, Babesia,
    or Ehrlichia
    Rule out occult
    hemorrhage, IMHA,
    enzymopathies,
    hereditary anemias,
    hemophagocytic
    syndromes, and
    hypophosphatemia
    Microangiopathic
    anemia*
    Rule out hemangio-
    sarcoma, DIC, vasculitis,
    splenic torsion, heat
    stroke, dirofilariasis
    Nonregenerative anemia
    Significant
    acanthocytes, schistocytes
    DIC = disseminated intravascular coagulation; FeLV = feline leukemia virus; FIV = feline immunodeficiency virus; IMHA = immune-mediated
    hemolytic anemia; MCHC = mean corpuscular hemoglobin concentration; MCV = mean cell volume; NRBC = nucleated red blood cell;
    RBC = red blood cell; RDW = red cell distribution width
    * Microangiopathic anemia occasionally presents as nonregenerative anemia
    Spherocyte-like RBC morphology may be noted in zinc toxicity; however, Heinz bodies are usually more prevalent
    Yes No
    Blood loss
    (23 days post acute or
    chronic without iron
    deficiency)
    Rule out gastrointestinal parasites
    or ulceration, coagulopathy, throm-
    bocytopenia, neoplasia, or trauma
    Diagnostic Tree / NAVC Clinicians Brief / July 2010...............................................................................................................................................................................57
    Infectious
    cause
    Ehrlichia
    Anaplasma
    Parvovirus
    FeLV
    FIV
    Depression
    by disease
    1
    Anemia of inflam-
    matory disease
    Cancer-associated
    anemia
    Chronic liver &
    kidney disease
    Critical illness
    Hypothyroidism
    Hypoadrenocorticism
    Nonregenerative Anemia
    Is animal presenting with acute clinical
    signs of anemia (eg, weakness, pallor,
    tachypnea, tachycardia, etc)?
    Preregenerative anemia
    Low to low-normal
    total solids or albumin
    and globulin levels?
    No
    Yes
    Acute
    blood loss
    Rule out
    neoplasia, trauma,
    coagulopathy,
    thrombocytopenia,
    or gastrointestinal
    ulceration
    Acute
    hemolytic
    disease
    Rule out primary
    or secondary
    IMHA, blood para-
    sites, Heinz body
    anemia, microan-
    giopathic anemia
    True nonregenerative anemia
    Do history, physical examination, and diagnostic
    tests indicate that another disease process is occurring?
    Bone marrow aspirate
    or core biopsy
    Bone marrow
    neoplasia
    Aplastic anemia
    Pure red cell aplasia
    Myelonecrosis
    Myelophthisis
    Myelodysplastic
    syndrome
    Presence of NRBCs with or
    without basophilic stippling?
    Lead poisoning
    Low to low-normal total
    serum iron and high to high-
    normal transferrin levels?
    Yes No
    Iron deficiency
    anemia
    Rule out chronic
    blood loss
    Rule out anemia
    due to inflammatory
    disease, chronic liver
    disease, or folate or
    cobalamin deficiency
    See Aids & Resources, back page, for references and suggested reading.
    Yes Yes
    Yes No
    Presence of microcytosis
    or hypochromasia?
    Yes No
    Yes No No
    Diagnosis Result Investigation

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