VETgirl Q1 2020 Beat e-Newsletter

TOP 10 TIPS TO EVALUATE ANEMIA IN SMALL ANIMAL PATIENTS

GARRET PACHTINGER, VMD, DACVECC Chief Operating Officer, Co-Founder VETgirl

KEY HIGHLIGHTS

1 As simple as it gets, anemia can be classified into three categories: • Blood loss

• Hemolysis (destruction) • Decreased production

Classification into one of these three categories is not simply academic, rather it allows the clinician to form a more targeted differential list for both the diagnostic workup and communication with the client. 2 Although fancy and more expensive diagnostics exist, one cannot ignore the cost-effective practicality of a simple packed cell volume (PCV) and total solids (TS) to evaluate anemia. For example, if the PCV and TS are both low, acute blood loss should be suspected. In contrast, a low PCV with normal total solids would be consistent with hemolysis or decreased red blood cell production. Here is a chart with a few examples of how PCV and TP together can help direct your diagnosis and treatment plan:

PACKED CELL VOLUME AND TOTAL SOLIDS

↑ PCV / ↑ TP

↓ PCV / Normal TP

↓ PCV / ↓ TP

Normal PCV / ↓ TP

• Blood loss • GI

• Protein-losing enteropathy (PLE) • Protein-losing nephropathy (PLN) • Acute blood loss • Liver disease / failure

Hemoconcentration • Hemolytic anemia

• Anemia of chronic disease • Pure red blood cell aplasia

• Body cavity (abdominal, thoracic, etc.)

3 Don’t forget a blood smear! If the blood smear shows polychromasia and anisocytosis, this often indicates a regenerative response. Conversely, the lack of those cells may indicate a non-regenerative response. A blood smear can also help evaluate WBC morphology and an estimated platelet count. (continued)

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