What is the cause of Fe def. in neonates?
What is the cause of Fe def. in adults?
chronic blood loss
How is Fe def. treated?
Neonates: injectable iron
Adults: locate source of blood loss
In what species is Fe. anemia most life threatening?
baby pigs - no access to iron containing soil
5 x causes of Heinz body anemia in cat
APAP, propylene glycol, Lymphoma, Hyperthroidism, Diabetes
What are some inherited neutrophil abnormalities?
Birman Cat neutrophil granulation: Neuts have red granules
mucopolysaccharidoses: Neuts and lymphs have purple granules, lysosomal storage disease along with GM2 Ganliosidosis - progress neurological dz and cytoplastic granulation/vaculation
Mature hyposegmented neutrophils/eosinophils with coarse chromatin pattern
No segmented neutrophils are present in this animals and they are healthy
also affects eosinophils
pink stained fused lysosomes
typically affect Persians - slight tendency to bleed otherwise healthy
Acquired neutrophil abnormalities
Toxic change, hypersegmentation, degeneration, leukocyte agglutination, cytoplasmic vacuolation, presence of Dohle bodies
What is Sensitivity?
measure of frequency with which the test result is positive or abnormal with animals that have the disease
TP/((TP)(FN)) x 100
What is Specificity?
measure of frequency in which test shows negative or normal for those without disease
TN/((TN))(FP)) x 100
What are the lab abnormalities assoc. with IMHA?
decreased PCV, RBC's, hemoglobin concentration
excess hemoglobin in blood and urine
excess bilirubin in blood and urine
Spherocytosis most important
How do you tell blood loss from destruction?
If total protein is high: blood destruction
If total protein is low: blood destruction
however, body will reabsorb blood lost to body cavity
What are the causes of increased MCV?
Regenerative anemia - immature erythrocytes that are polychromatophilic, FeLV, myelodysplasia, Poodles, Alaskan Malamutes, Mini schauners, and Dutch partridge dogs, blood that has been sitting out too long
What is the most common cause of increased MCV?
What would cause an increased MCV in a cat with non regenerative anemia?
Hematologic abnormalities with Anemia of Inflammatory disease?
Microcytosis, decrease: serum Fe and total binding capacity
Increase: ferritin, hemosiderin, and storage in BM
inflammatory leukogram and normal to microcytic MCV's
What hematological abnormalities would you see with a dog with renal disease?
Anemia: moderate to severe, nonregenerative, normocytic
What causes toxic neutrophils?
inflammatory responses, regenerative anemia
immature neutrophils with organelles/ribosomes and Dohle bodies (fragments of endoplasmic reticulum)
What causes neonatal isoerythrolysis?
form of immune mediated hemolytic anemia
mom's Ab's against the neonate's blood group antigen
most common in horses (non thoroughbred ones)
What lab findings for lead poisoning?
Basophilic stippling: aggregation of ribosomes,
Typically associated with intensely regenerative anemia
What species is basophilic stippling seen with regenerative anemia?
Dogs/Cats with intensely regenerative anemia
What are some causes of falsely increased hemoglobin concentration?
Hemolysis, Lipemia, and very large number of Heinz bodies in cats
How would falsely increased hemoglobin concentration affect the MCHC?
(HGB/PCV)(100) = MCHC
What tests require lysis of erthyrocytes?
Hemoglobin, Unopette, Saline - for IMHA, and iron
RBC abnormalities in APAP tox?
Heinz body formation
RBC abnormalities in IMHA?
Spherocytes, Agglutination, and ghost cells
RBC abnormalities in Lead poisoning?
Basophilic stippling, Howell Jolly bodies, and Nucleated RBC's
RBC abnormalities in Hemagiosarcoma?
Acanthocytosis, Schistocytes, Mesothelial cells in abdomen, polychromasia
RBC abnormalities in Fe deficiency anemia?
microcytosis, schistocytes, hypochromatic keratocytes, and blister cells
RBC abnormalities in Rattlesnake envenomation?
echinocytes, type III, spheroechinocytes
What species would a degenerative left shift be less omnimous?
Why is degenerative left shift omnious in other species?
suggestive of an aggressive inflammatory lesion
What are the causes of lymphocytosis?
Lymphoma, lymphocytic leukemia, multiple myeloma, excitement (particularly in cats) and ERLICHOSIS
Lymphocytes are relatively normal in ruminants
What is the progression of Neutrophil maturation?
Proliferative: Myeloblast, Progranulocyte, Myelocyte, Maturation/storage: Metamyelocyte, Band Neutrophil, Neutrophil
At what concentration of lymphocytes/mL would you diagnose lymphoid leukemia?
What are causes of neutrophilia?
Stress, excitement, inflammation, granulocytic leukemia
What concentrations of Neutrophils/mL would you diagnose granulocytic leukemia?
neutrophils > 100,000 mL
What, other than magnitude, would you consider granulocytic leukemia?
marked neutrophilia, disorderly left shift, and anemia, blast crises: increased concentration of myeloblasts
Describe an excitement leukogram
neutrophilia with normal to higher end lymphocytes due to increased epi - marginated to circulating pool
NO LEFT SHIFT
lymphocytosis is hallmark of feline excitement response
Describe a stress leukogram
neutrophilia with lymphopenia (typical of sick animals) /eosinopenia
NO LEFT SHIFT
pain, illness, metabolic issues
tx with steroids or steroid producing tumors
Describe an inflammatory leukogram
neutrophilia with increase bands and monocytosis - when greatly increased (neut/mono's) - think myelomonocytic leukemia
What are two criteria that are indicative of an inflammatory leukogram?
2 x increase of neutrophils about normal limit and increased left shift
What is the most common cause of lymphopenia?
Stress - increase of cortisol, acute viral infections such as distemper and parvo
What lab. abnormalities are assoc. with anemia of inflammatory disease?
increased: neutrophils/bands and ferritin, and stainable Fe stores
decreased: serum iron and total binding capacity
What are 2 x causes of thrombocytopenia when assoc. with IMHA?
agglutination and DIC
Describe the different causes of polycythemia?
increase of concentration of RBC's
dehydration, decreased plasma volume, splenic contraction in poodles, greyhounds, and dachshunds, hypoxia - increase of erythropoietin, methemoglobinemia
What laboratory tests could you use?
arterial blood gas analysis - PaO2 < 60 mmHg, then hypoxia
kidney functioning - tumor of the kidney thus increasing erythropoietin
How do you calculate absolute # of various leukocytes?
TNCC x % of particular leukocyte = absolute #
How do you calculate the absolute # of reticulocytes?
RBC x %reticulolycte = absolute #
What type of blood tube is used for a CBC?
purple with EDTA
too much EDTA would result in Leptocytes/Codocytes
What type of blood tube is used for a Biochemical profile?
Sure Sep, red top, or Heparin (lead concentration)
What type of blood tube is used for coagulation tests?
Blue top with Citrate
What happens to lab results if one doesn't put enough blood in a purple tube?
erythrocytes shrink so you get an erroneous decrease in PCV and MCV, leptocytes and codocytes
What is the progession of red blood cell maturation?
Rubiblast, Prorubricyte, Metarubricyte, and mature erythrocyte
Dog: 24-48, Cat: Aggregates become punctates in 12 hours and punctates persist for 12 days - not counted
Anemia (non-regenerative) thrombopenia - will spontaneously bleed if < 10, 000, decreased WBC, lymphocytosis, large granular lymphocytes
Which species has the largest RBC?
Which species has the smallest RBC
What is the buffy coat?
white blood cells, platelets and NRBC's
What will artificially increase plasma protein?
Glucose, Lipemia, Urea, Cholesterol
Increased albumin is always due to?
How do you calculate a hematocrit?
(MCV)(RBC)/10 = HCT (PCV)
What causes an increase in MCHC?
Nothing - increases are ALWAYS artifactual
things erroneously can like lipemia, hemolysis, and heinz bodies but it can never truly happen
Round cell tumors
Mast cell tumors, Cutaneous lymphoma, histocytoma, and plasmacytoma
Red cell leukemia, Rubriblasts in peripheral blood
Acquired lymphocyte vacuolation
plants containing swainsonine - locoweed - which results in inhibition of lysosomal enzymes resulting in dz similar to alpha-mannosidosis
Causes of neutropenia?
consumption with inflammatory
Immune mediated destruction
Bone marrow problems either reversible or irreversible
reversible: canine parvo, feline panleukopenia, chemotheraputic drugs
What are inherited lymphocyte abnormalities?
MPS/GM2 gangliosidosis may result in cytoplasmic granulation/vacuolation
Fucosidosis, alpha mannosidosis, acid lipase deficiency, and Nieman Pick: vacuolation without granulation
MPS/acid lipase def do not cause severe progressive neuro
Aquired lymphocyte vacuolation
ingestion of plants containing swainsonine - locoweed - which results in inhibition of lysosomal enzymes resulting in what looks like alpha mannosidosis
What are eccentrocytes?
Shifting of hemoglobin to one side of cell
often seen with heinz bodies
dark blue rods or rings on surface of RBC
severe hemolytic anemia
regnerative unless with FeLV
Rare, "y" shaped, opportunistic: splenctomized or nonfunctional spleen
Spherocytes and Agglutination
Cytauxzoon felis: basophilic ring with nucleus, hemolytic and non regenerative anemia, leukopenia/thrombocytopenia
Babesia canis and gibsoni: intra/extravascular hemolysis
opportunists like canis: splenctomized or immune compromised
iatrogenic: one needle many cows
normal in horses, suggests increased globulin in small animals
To difference agglutination from rouleaux: add saline - if rouleaux will disperse and agglutination will persist
List ddx for spherocytosis
IMHA, mismatched blood transfusion, rattlesnake envenomation, heinz body anemia in horses (band 3 clustering (B3C)), zinc toxicosis (B3C), and bee stings (B3C)
Ruminants: marginale and centrale
tick borne rickettsial, fatal hemolytic anemia, immune mediated hemolytic destruction
Blood film: parasites and basophilic stippling in polychrom ery.
Protozoals cx: hemolytic anemia
RBC's in merozoite
Protozoan, RBC's - piroplasms, Macrophages - schizonts
trans by ticks, almost always fatal
What bacteria cause hemolytic anemia?
Clostridium perfringens A: "Yellow Lamb disease"
Clostridium haemolyticum: "Red Water Disease" in cattle
fluke creates a nice environment for bacterium
Pyruvate Kinase deficiency
Dogs: basenji, beagle, West Highland, and Cairn
decreased glucose utilization/ATP formation results in RBC destruction
English springer spaniels
dec. syn of 2,3-diphos., PCV normal, crisis when alkalemic
What causes "pink tooth" in cattle?
def. of uroporphyrinogen III co-synthase resulting in unability to syn. hemoglobin, accumulation of uroporyphrin/coproporphyrin in bones/teeth - photosensitivity
General Bone marrow suppression
FeLV, Ehrlichia, and Estrogen in dogs/ferrets, EIA
Different types of Erythroid hypoplasias
Renal: low erythropoietin
Inflammatory: inavailability of Fe?
Endocrine: Hypothyroidism, hypoadrenocorticism - Addison's
Relative: dehydration, fluid shift, excercise, excitement - splenic contractions
Absolute: increase EPO due to: chronic hypoxia and renal tumors
Primary (polycythemia vera): myeloproliferative disorder