Page 82 - WSAVA2017
P. 82

82
An Urban Experience
Differential diagnosis:
· Thrombocytopenia
· Myeloproliferative disease (FeLV; immune mediated; drug induced e.g. oestrogen, cytotoxics; bone marrow aplasia)
· Primary immune mediated thrombocytopenia
· Secondary immune mediated thrombocytopenia (infections, neoplasia, drugs)
· Consumptive disorders (DIC, sepsis, haemorrhage)
· Sequestration (splenic torsion)
· Angiostrongylus
· Thrombocytopathia
· Drugs (NSAIDs, aspirin, synthetic colloids, β-lactam antibiotics)
· Uraemia
· Hepatic disease
· Ehrlichia
· Hereditary
· Angiostrongylus
· vWD
· Vascular – vasculitis
· Angiostrongylus Treatment:
· Thrombocytopenia
· Fresh whole blood, platelet rich plasma, platelet concentrates, cryopreserved platelets
· Thrombocytopathia
· Fresh whole blood, platelet rich plasma, platelet concentrates, cryopreserved platelets
· Desmopressin – lasts 30 – 60 minutes
· vWD
· Fresh frozen plasma
· Cryoprecipitate
· Desmopressin - lasts 30 – 60 minutes
Secondary haemostatic disorders:
Diagnostic tests:
· Clinical signs: Cavitary haemorrhage, haematoma, GIT, muscle, joint haemorrhage
· Prothrombin time (PT)
· Extrinsic and common pathways
· Require 70% of factor VIIa to decrease to be prolonged
· Prolonged PT, normal APTT – most likely vitamin K deficiency as tests for FVIIa which is the vitamin K dependent factor with the shortest half-life
· Activated partial thromboplastin time (APTT)
· Intrinsic and common pathways
· Require 70% of one of the factors to decrease to be prolonged
· Prolonged APTT, normal PT – NOT vitamin K deficiency
· Activated clotting time (ACT)
· Intrinsic and common pathways
· Use diethyl earth tube. Place 2mL of blood in a pre-warmed tube. Invert every 10 seconds and observe clot to form while keeping the tube warm in a water bath.
· Normal: 60 – 110 seconds (dog), 50 – 75 seconds (cat)
· Requires 90% of factors to decreased to be prolonged
· Factor measurements
· FVII, FVIII, FIX, FX, FXI, FXII
· Takes up to 2 weeks for results
 42ND WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS AND FECAVA 23RD EUROCONGRESS
  

















































   80   81   82   83   84