Polycythemia: secondary

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Sections available in full article Introduction, Presenting signs, Acute presentation, Cost considerations, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Kyle Braund BVSc MVSc PhD FRCVS DipACVIM

Introduction

  • Cause : myeloproliferative disease , pathological or physiological response.
  • Signs : bleeding or often neurological.
  • Diagnosis : hematology, erythropoietin assay.
  • Treatment : manage underlying cause if physiological or chemotherapy if neoplastic.
  • Prognosis : reasonable; good if can eliminate underlying problem.

Diagnosis

Clinical signs

  • Ruddy mucous membrane color.
  • Ophthalmoscopic examination:
    • Retinal hemorrhage Retinal hemorrhage: Crossbred 6 years.
    • Retinal vessel tortuosity Blood vessel tortuosity: Rough Collie 6 months tricolor.
    • Retinal detachment Retinal detachment: Rough Collie 1 year tricolor.
  • Check for signs of dehydration.

Diagnosis

Differential diagnosis

  • Primary polycythemia Polycythemia: primary.
  • Renal disease Chronic renal failure.
  • Myeloma Myeloma (hyperviscosity syndrome).
  • Dehydration (artefactual increase in PCV).

Sequelae

Prognosis

  • Prognosis for other cases depends on underlying cause.

Expected response to treatment

  • Resolution of clinical signs.
  • Return of PCV to normal range.

Reasons for treatment failure

  • Incorrect diagnosis - primary polycythemia inappropriately managed.
  • Inability to detect or control underlying pathology.

Sources

Publications

Refereed papers

  • Crour S E et al(1995) Concurrent renal adenocarcinoma and polycythemia in a dog. JAAHA 31 (1), 29-33.
  • Quesnel A D & Kruth S A (1992) Polycythemia vera and glomerulonephritis in a dog. Can Vet J 33 (10), 671-672.
  • Campbell K L (1990) Diagnosis and management of polycythemia in dogs. Comp Cont Ed Pract Vet 12 , 543-549.
  • McGrath C J, Krawiec D R & Johnston S D (1982) Canine polycythemia vera, a review of diagnostic features. Vet Med 4 , 611-613.
  • Waters D J & Preuter J C (1986) Secondary polycythemia associated with renal disease in the dog 2 case reports and review of the literature. JAAHA 24 , 109-114.

Other sources of information

  • Hasler A H, Giger U (2000) Polycythemia. In: Textbook of Veterinary Internal Medicine. 5th edn. Eds: Ettinger S J & Feldman E C. W B Saunders, Philadelphia. pp 203-206.

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