Anemia 2

Practical
Anemia according to major pathophysiological
mechanisms

1. Hemorrhagic Anemia
2. Hemolytic Anemia
3. Bone marrow response
Hemorrhagic Anemia

Loss of blood may due to any accidents, injuries or a surgery.

Acute Or Chronic
Clinical signs depend upon
• Amount of blood loss
• Duration of blood loss
• Site of hemorrhage
Acute Hemorrhagic Anemia
“Sudden loss of blood”
Sequence of events following blood loss
All parameters normal
2-3 hrs. Post Hemorrhage
Hypoxic conditions Hct increase up to 80%
3-4 hrs. Post Hemorrhage
• Decreased Hct
• Thrombocytosis
• Neutrophilia
48-72 hrs. Post Hemorrhage
• Thrombocytes normal
• Blood pic normal
• Immature RBCs in circulation
Reticulocytes
Metarubricytes

Duncan and Prasse's Veterinary

Laboratory Medicine 5th Edition
Chronic Hemorrhagic Anemia

• Anemia develops slowly

• Hct parameters dec before clinical signs
• Regenerative response is less intense
• Hypoproteinemia
• Persistent thrombocytosis
Differential features of anemia caused by
external and internal hemorrhage
• External blood loss prevents utilization of certain
components
• Internal hemorrhage intensely more regenerative
Hemolytic anemia
“Due to erythrocyte damage”
2 types
1. Intravascular hemolysis
2. Extravascular hemolysis
Clinical findings
• Acute hemolytic anemia clinical signs related to severity of anemia may
be dramatic
• Icterus
• Hemoglobinuria and hemoglobinemia
Laboratory findings
• Increase reticulocytes count faster than hemorrhagic anemia
• Plasma protein normal or increased
• Neutrophilic leukocytosis and monocytosis
• Hb degradation ( hemoglobinuria, hyperbilirubinemia)
• Abnormal erythrocyte morphology
 Heinz body

Poikilocytes Spherocytes
Atlas of Clinical Hematology 6th Edition
Extravascular hemolysis
RBCs sequestered in spleen and liver where phagocytized and lysed
Etiology
1. Immune mediated hemolytic anemia
2. Infectious agents
3. Drugs
4. Erythrocyte deformity
5. Inc. Macrophages activity
6. Dec. glycolysis
Poikilocytes Spherocytes

Parasitized RBCs

Atlas of Clinical Hematology 6th Edition

Intravascular Hemolysis
Etiology
1. Physical injury
2. Oxidative lysis
3. Osmotic lysis
4. Membrane alterations
Oxidant-induced hemolytic anemia in a cat
Hemolysis of RBCs

Atlas of Clinical Hematology 6th Edition