Veterinary Medicine - August 2007 - (Page 538)

Immune-mediated thrombocytopenia O P E E R - R E V I E W E D presentation and diagnosis, in Proceedings. Annu Am Coll Vet Intern Med Forum 2004;36-38. 14. Rozanski EA, Callan MB, Hughes D, et al. Comparison of platelet count recovery with use of vincristine and prednisone or prednisone alone for treatment for severe immune-mediated thrombocytopenia in dogs. J Am Vet Med Assoc 2002;220:477-481. 15. Bailiff NL, Norris CR. Clinical signs, clinicopathological findings, etiology, and outcome associated with hemoptysis in dogs: 36 cases (1990-1999). J Am Anim Hosp Assoc 2002;38:125-133. 16. Stockman SL, Scott MA. Hemostasis. In: Fundamentals of clinical pathology. 1st ed. Ames: Iowa State Press, 2002;157-225. 17. Brockus CW, Andreasen CB. Erythrocytes. In: Latimer KS, Mahaffey EA, Prasse KW, eds. Veterinary laboratory medicine: clinical pathology. 4th ed. Ames: Iowa State University Press, 2003;3-45. 18. Abrams-Ogg AC. Management of hemorrhage due to thrombocytopenia, in Proceedings. Annu Am Coll Vet Intern Med Forum 2002;577-579. 19. Cohn LA. Immune mediated blood dyscrasias: therapeutic options, in Proceedings. Annu Am Coll Vet Intern Med Forum 2004;39-42. 20. Plumb DC. Doxycycline. In: Plumb DC, ed. Veterinary drug handbook. 5th ed. Stockholm: Blackwell Publishing, 2005;286-289. 21. Abrams-Ogg AC. Triggers for prophylactic use of platelet transfusions and optimal platelet dosing in thrombocytopenic dogs and cats. Vet Clin North Am Small Anim Pract 2003;33:1401-1418. 22. Kidd LB, Salavaggione OE, Szumlanski CL, et al. Thiopurine methyltransferase activity in red blood cells of dogs. J Vet Intern Med 2004;18:214-218. 23. Grundy SA, Barton C. Influence of drug treatment on survival of dogs with immune-mediated hemolytic anemia: 88 cases (19891999). J Am Vet Med Assoc 2001;218:543-546. 24. Mason N, Duval D, Shofer FS, et al. Cyclophosphamide exerts no beneficial effect over prednisone alone in the initial treatment of acute immune-mediated hemolytic anemia in dogs: a randomized controlled clinical trial. J Vet Intern Med 2003;17:206-212. 25. Bianco D, Armstrong PJ, Washabau RJ. Treatment of severe immune-mediated thrombocytopenia with human intravenous immunoglobulin in 5 dogs, in Proceedings. Annu Am Coll Vet Intern Med Forum 2007. 26. Scott-Moncrieff JC, Reagan WJ. Human intravenous im- munoglobulin therapy. Semin Vet Med Surg (Small Anim) 1997;12:178-185. 27. Miller E. The use of danazol in the therapy of immune-mediated disease of dogs. Semin Vet Med Surg (Small Anim) 1997;12:167-169. 28. Straw B. Decrease in platelet count after vaccination with distemper-hepatitis (DH) vaccine. Vet Med Small Anim Clin 1978;73:725-726. EXTRA See for a guide to performing bone marrow aspiration in dogs and cats. CE You can earn two hours of Continuing Education credit from Kansas State University by answering the following questions on immune-mediated thrombocytopenia. Circle only the best answer for each question, and transfer your answers to the form on page 546. Article #1 1. Which is not a common physical examination finding in a dog with primary immune-mediated thrombocytopenia? a. Hemothorax b. Petechiae c. Bruising d. Epistaxis e. Melena topenia because: a. It requires special equipment to prepare. b. It has a limited shelf life. c. It is not available to some practitioners. d. The transfused platelets are rapidly destroyed. e. All of the above thromboplastin time d. Detection of antiplatelet antibodies e. Detection of fibrin degradation products 8. Which diagnostic test is not indicated in a dog with a platelet count of 9,000/µl? a. Buccal mucosal bleeding time b. One-stage prothrombin time c. Activated partial thromboplastin time d. Fibrin degradation products e. Ocular examination 2. The initial therapy of choice for primary immune-mediated thrombocytopenia is: a. Azathioprine b. Cyclophosphamide c. Prednisone d. Doxycycline e. Splenectomy 5. The likelihood of hemorrhage due to thrombocytopenia increases when the platelet count is less than: a. 200,000/µl b. 175,000/µl c. 150,000/µl d. 75,000/µl e. 50,000/µl 9. Potential side effects of azathioprine include all of the following except: a. Bone marrow suppression b. Sterile hemorrhagic cystitis c. Hepatopathy d. Pancreatitis e. Susceptibility to infection 3. The appropriate initial dose of prednisone for a dog with primary immunemediated thrombocytopenia is: a. 0.2 mg/kg/day tapered after three to four weeks b. 0.5 to 1 mg/kg/day tapered after three to four days c. 0.5 to 1 mg/kg/day tapered after three to four weeks d. 2 to 4 mg/kg/day tapered after three to four days e. 2 to 4 mg/kg/day tapered after three to four weeks 6. Which finding on a blood smear supports a diagnosis of immune-mediated thrombocytopenia? a. 1 or 2 platelets per HPF b. The absence of platelet clumps c. Microthrombocytes d. Macrothrombocytes e. All of the above 10. Which mechanism may cause thrombocytopenia in patients with neoplasia? a. Decreased production of platelets by the bone marrow b. Secondary immune-mediated platelet destruction c. Sequestration of platelets in the vasculature d. Development of disseminated intravascular coagulation e. All of the above 7. Which is most helpful in confirming a diagnosis of primary immune-mediated thrombocytopenia? a. Spherocytosis b. Prolongation of the one-stage prothrombin time c. Prolongation of the activated partial 4. Platelet-rich plasma is seldom used in dogs with immune-mediated thrombocy- 538 August 2007 VETERINARY MEDICINE http://www.vetstreamcanis.com/ACI/August/VMD2/teq00529.asp http://www.vetstreamfelis.com/ACI/August/VMD2/teq00529.asp

Table of Contents Feed for the Digital Edition of Veterinary Medicine - August 2007

Contents A Veterinary Medicine Interview Veterinary Voices Idea Exchange Diagnosis and Treatment of Solar Dermatitis in Dogs Diagnostic Imaging for Linear Foreign Bodies in Cats Overcoming the Diagnostic and Therapeutic Challenges of Canine Immune-Mediated Thrombocytopenia Ophthalmic drugs: What’s new? CE Form Product Preview Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - August 2007

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