Rabbit Medicine and Surgery: Self-Assessment Color Review, Second Edition, Q&A 06

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Student tip: This case is an advanced scenario, instructing the practitioner beyond teaching at vet school.

A rapid Romanovsky-type (Rapid-Diff) stained blood smear from a 7-year-old neutered female Dwarf Lop house rabbit, with a severe regenerative anaemia, is shown (see image). The PCV was 0.14 l/l (14%); Hb was 27 g/l (2.7 g/dl). The rabbit was presented with gradually increasing lethargy and decreased appetite of several weeks’ duration.

Question	Answer		Article
Characterize the anaemia from the red cell morphology.	Polychromatic, anisocytotic anaemia.		Link to Article
What stain may be used to differentiate reticulocytes more accurately?	New methylene blue.		Link to Article
What is the most likely cause of this anaemia, and give a differential diagnosis.?	Plumbism (lead toxicosis). In this case it occurred because the rabbit gnawed at painted skirting boards in the house. Although currently manufactured house paints do not contain lead salt pigments, in many cases old paint layers are not removed but simply painted over with new paint. The serum lead level in this case was 12.0 µmol/l. Other less frequent differentials for a regenerative anaemia include blood loss due to trauma, intestinal or internal haemorrhage, intravascular haemolysis or severe flea infestation. Chronic disease and neoplasia such as uterine adenocarcinoma are more likely to manifest as a non-regenerative anaemia.		Link to Article
What other haematological and biochemistry abnormalities may occur with this condition?	Lead toxicosis may also manifest in cytoplasmic basophilic stippling, and the regenerative response may lead to the presence of nucleated erythrocytes and metarubricytes on blood smears. Resultant hepatic damage may result in elevations in alkaline phosphatase (ALP), ALT and bilirubin levels.		Link to Article

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