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Susy, a 1 y.o. FN Sp. Spaniel

Susy, a 1 y.o. FN Sp. Spaniel. History 7d of anorexia 2 episodes of Vomiting Dull, poss abdominal discomfort 1d of hyperpnoea Urine discoloured (very dark). Clinical Findings Dull depressed, recumbent Jaundiced & Pale mm, CRT =2s, HR=140 Grade 2/6 murmur.

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Susy, a 1 y.o. FN Sp. Spaniel

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  1. Susy, a 1 y.o. FN Sp. Spaniel History 7d of anorexia 2 episodes of Vomiting Dull, poss abdominal discomfort 1d of hyperpnoea Urine discoloured (very dark)

  2. Clinical FindingsDull depressed, recumbent Jaundiced & Pale mm, CRT =2s, HR=140 Grade 2/6 murmur

  3. What are your differentials?

  4. Place these differentials in Order of likelihood A Haemolytic anaemia B Chronic Blood loss C Bone marrow disease D Leptospiral toxins E MycoplasmaHaemofelis

  5. Place these differentials in Order of likelihood A Haemolytic anaemia B Leptospiral toxins CMycoplasmaHaemofelis D Chronic Blood loss E Bone marrow disease

  6. What do you want to do? ACheck PCV & Total Protein B Haematology & Biochemistry C Radiograph thorax and abdomen D Slide agglutination test

  7. Rapid Blood Results Using microhaematocrit centrifuge HCT 11% Using refractometer Total Solids 61g/l

  8. Blood Smear

  9. Haematology Results RBC 1.2 5.5-8.5 HCT 9.44 37-55% Hb 3.39 12-18 MCV 78.5 60-77 MCH 28.2 19.5-24.5 MCHC 35.9 32-36 Strongly regenerative blood picture Numerous spherocytes and late normoblasts

  10. Haematology Results WBC 58.3 6-12 Neut 33.2 3-11.8 Bands 10.4 Lymph 1.2 1-4.8 Mono 1.2 0.15-1.35 Eosino 0.6 0.1-1.25 Baso 0 Rare PLT 159 200-500

  11. What is the cause of the leucocytosis?

  12. What tests do we need to perform to confirm Primary IMHA?

  13. Slide Agglutination Test

  14. Should we do a Coomb’s test?

  15. What tests do we need to perform first? Rule out exposure to toxins  Check smear  Rule out systemic disease  Diagnostic Imaging: Thorax & Abdomen  (Bone marrow) x

  16. Blood Transfusion Volume Required = Bl Vol (ml) x (Req PCV - Recip PCV) PCV of donated blood Blood volume = 90 ml/kg Volume Req = 25 x90 x (18-11) = 350ml 45

  17. PCV on treatment Days

  18. Outcome Immune mediated haemolytic anaemia Dexamethasone IV then Prednisolone (2mg/kg) Clinically normal

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