veterinary clinical pathology

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THROMBOCYTOPENIA

Thrombocytopenia is characterised by a low platelet count within the blood. Platelets are manufactured within the Bone Marrow are essential for maintaining haemostasis or in more simpler terms the bodies ability to clot and protect itself from haemorrhage. Thrombocytopenia can be a life threatening condition if not addressed.

WHAT CAUSES THROMBOCYTOPENIA?

 There is no breed, age or sex prevalence concerning this condition. There are five main types of cause:

1) Decreased production of platelets -  This can be caused by types of medication such as oestrogen meds or chloramphenicol. However, the most common cause is aplastic anaemia which occurs when there is a failure in the bone marrow or when the patient is suffering from Leukaemia. Cancer patients undergoing chemotherapy and radiation can also suffer from this type of thrombocytopenia. 

2) Increased blood clotting - Increased blood clotting can be caused by several conditions such as Disseminated Intravascular Coagulation where blood clots form in small blood vessels resulting in poor tissue perfusion and ultimately organ damage. Endotoxic shock can also cause this as well and vasculitis and certain types of cancer i.e Haemangiosarcoma.

3) Destruction of platelets - This is usually caused by autoimmune disease, where the bodies own immune system attacks and destroys its own platelets.This type of condition is more common in dogs and rarely seen in cats. Platelets can also be prematurely destroyed if the patient is suffering from diseases such as Ehrlichiosis and Babesiosis caused by infected tick bites and Heartworm. 

4) Sequestration (The removal of platelets from circulation) - Splenomegaly or a splenic torsion can cause the spleen to function abnormally and in some cases collect and retain up to 90% of the total platelet volume.

5) Haemorrhage due to trauma

WHAT ARE THE CLINICAL SIGNS?

  • Pyrexia
  • Lethargy and appetite loss
  • Heart Murmur
  • Haematuria
  • Excessive coughing
  • Epistaxsis
  • Collapse
  • Petechiae - pinpoint haemorrhages usually seen on the mucus membranes
  • Bruising easily
  • Melena or fresh blood in stools

HOW DO YOU DIAGNOSE THROMBOCYTOPENIA?

Taking a full clinical history to rule out a recent trauma is important as they will enable the clinician to rule out internal haemorrhage due to trauma, in addition information can be gathered to access whether the patient could be suffering from any infectious disease or have contracted any disease such as Babesiosis.Full blood analysis to include biochemistry, haematology and coagulation times should be carried out, in addition to this a 4DX profile testing for 6 vector-bourne diseases is recommended. Radiographs and Abdominal ultrasound can rule our internal haemorrhage and allow for a cancer screen. Additionally a bone marrow aspirate can be carried out. 

WHAT TREATMENT IS AVAILABLE?

In severe cases a blood transfusion is recommended, however in the UK the only source of platelets is from a whole blood transfusion. This must be carried out within four hours of collection and only when the platelet count is very low and bleeding into areas such as the respiratory system is evident. This is a salvage procedure and unfortunately very rarely makes a difference in severely thrombocytopenia patients due to the lack of active platelets in one unit of whole blood. 

In patients suffering from immune mediated thrombocytopenia, steroids or other immunosuppressing drugs are used and often these can successfully control the condition, although relapses are common. 

NURSING CONSIDERATIONS

  • Careful handling and minimal restraint
  • No neck leads to prevent pulling and avoidable bruising around the neck
  • No jugular/arterial blood sampling to prevent haemorrhage
  • Padded kennel again to prevent bruising from laying on hard floor
The Herbs that Herbalists Take

By Matthew Hamm

In the ever-growing market of herbal medicine, it’s getting more difficult to decide what herbs to buy. When companies come out with new products that seem better than other brands, how does the consumer decide which product is best? For the average herbal consumer, the world of herbal medicine is made even more confusing by the constant release of contradicting studies, along with the addling advice of know-it-all friends. We asked some leading herbal professionals what herbs they take, how they take them, and their tips on choosing what’s best for you.

Herbs in Teas, Cooking and Tinctures

Randy Kidd, D.V.M., believes in the power of herbs. Kidd, author of the “Pet corner” column in Herbs for Health, holds doctorates in veterinary medicine and veterinary and clinical pathology, and practices holistic veterinary medicine. He takes an experimental approach when using different herbs.

“I take one week a month to really learn one herb—I try to use it in everything,” he says. “I take it at various times of the day in varying amounts. The idea is to see how this one herb affects me individually.”

Kidd does not take his herbs in capsule or tablet form because he doesn’t feel that pill forms take full advantage of an herb’s potential. Most of the herbs Kidd uses are in teas and in his cooking. The most common herbs in his teas include licorice root (Glycyrrhiza glabra), hawthorn (Crataegus spp.), burdock root (Arctium lappa), nettle (Urtica dioica), and echinacea (Echinacea spp.). Kidd enjoys cooking with garlic (Allium sativum), turmeric (Curcuma longa), sage (Salvia officinalis), and oregano (Origanum vulgare).

Kidd buys most of his herbs in bulk from Frontier Herbs, a company located in Norway, Iowa, because nearly all of their products are organically certified and he feels that Frontier has the best quality control in the country. He is currently test- growing several culinary and medicinal herbs to see what grows best in his soil and climate. Kidd is attempting to organically certify his thirty-acre farm and in the future wants to develop his own line of herbal products.

Some people need herbs to help their bodies keep up with their busy schedules. Mindy Green, an herbalist, aromatherapist, writer, and esthetician consults for companies in the natural products industry as well as directing education programs at the Herb Research Foundation in Boulder, Colorado. She takes herbs to promote her own good health.

“I like to use herbs preventively, supporting the body before it creates a specific condition,” she says. Green home-grows her own nettles and eats them as a steamed green or dries them for soup in the winter. Green also has a daily habit of drinking 1 quart of her special bone-building and osteoporosis-preventing tea blend. Her recipe consists of equal parts of nettle, oatstraw (Avena sativa), horsetail (Equisetum arvense), alfalfa (Medicago sativa), and red clover (Trifolium pratense). She uses ¼ cup of the dry herbal mixture to 1 quart of water, steeps the tea for one hour, and drinks the mixture throughout the day. For premade products, Green uses Herb Pharm’s Super Echinacea tincture or tablets and Sambucol elderberry (Sambucus nigra) extract from Nature’s Way for colds and the flu.

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