Clinical Pathology

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Dog

Large

Central pallor

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Smaller

No central pallor

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Horse and Cat

Rouleaux in normal spp

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Poikilocytosis

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Macrocytic Hypochromic (regeneration)

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Microcytic Hypochromic (iron deficiency)

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Echinocytosis - numerous regular pin point projections

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Acanthocytes

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Schistocytes

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What causes poikilocytosis

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Turbulence

Abnormal microvasculature

DIC

Haemangiosarcoma

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Spherocytes

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Heinz bodies

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What are heinz bodies a feature of

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oxidative damage

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What are features of haemolytic anaemia

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Spherocytes

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Signs of regeneration

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Normoblasts

Reticulocytes, Howell-jolly bodies

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Normoblast (Top)

Reticulocytes (Middle and bottom)

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Reticulocytes

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Howell jolly bodies

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Mature neutrophil canine

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canine lymphocyte

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Canince monocyte

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Canine eosinophil

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Feline eosinophil

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Canine basophil

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Feline basophil

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What does inflammation cause?

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Shift to the left

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Equine eosinophil

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Equine basophil

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Equine monocytes

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Equine lymphocytes

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Equine neutrophil

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Lymphoid leukemia

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Advantages of a practice lab

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Useful for emergeny care - rapid results

Add interest to job

Impressive for clients

Lower cost per test

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Disadvantages of a practice lab

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Unreliable if quality control is poor

Some technical skill required

Interpretation required

Takes time and monmey

Artefacts may be misinterpreted leading to a false diagnosis

Safety issues must be observed

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What is precision

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How similar results of repeated assays on the same sample are

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What is accuracy

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How close assay results are to the true value

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What are the 3 main methods of quality assessment

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Quality assurance - external program - they send you samples and then tell you how far you are from true value and compare to other practices

Quality control - use commercial serum with known samples alongside patient samples

Repeat analtsis on the same asmple multiple times/different days

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What tubes should you use for routine haematology and platelets

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EDTA (purple)

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What tubes should you use for most biochem

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clotted sample (red)

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What tubes should you use for coagulation tests

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fluoride oxalate (grey/yellow)

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What tubes should you use for hormone tests

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heparin (green)

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What tubes do you use for serology

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Serum only (clotted)

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What do you use for virus isolation

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heparin (green)

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how does haemolysis interfere with tests

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altered pH and K

Alter analytes or reaction

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What does icterus interfere with

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Absorbance in biochem

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What is MCV

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Mean cell volume

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What does MCV indicate

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Macrocytosis if high or microcytosis if low

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What does MCHC indicate

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Hypochromia/normochromia

Haemaglobin content

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What are reticulocytes

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Immature RBC with clumps of RNA (reticulin)

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Causes of non regenerative anaemia

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Iron deficienct

Bone marrow aplasia/hypoplasia

Anaemia of inflammatory disease

Bone marrow neoplasm

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What would you see on a stress leukogram (SMILED)

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Segmented neutrophils

Monocytes increased

Lymphocytes and Eosnophils decreased

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What would you see if there was hypersensetivity

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Eosinophilia and basophilia

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What would you see if there was extreme neutrophillic leukocytosis

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severe
neutrophilia

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Enzymes we test for

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Alanine aminotransferase (ALT)
– Alkaline phosphatase (AP)
– Gamma glutamyltransferase (GGT)
– Creatine kinase (CK)
– Amylase and lipase

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Serum proteins we test for

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TP, albumin, globulin, acute phase proteins

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Polyclonal gammopathy

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Increase in multiple
immunoglobulins

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Monoclonal gammopathy

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Increase in a single
immunoglobulin

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Reasons for increased enzymes

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Membrane blebbing
Membrane rupture
Necrosis
Increased synthesis

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Electrolytes and blood gases we measure

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Na, K, Cl, Ca, PO4
, Mg
– H+
, HCO3
, PCO2
, PO2

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metabolites we measure

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Glucose, urea, creatinine, bile acids, bilirubin

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Hormones we measure

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Cortisol
– Total T4
– Free T4
– TSH
– ACTH
– Insulin

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What non pathological features would change results

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Age - higher AP and phosphate with bone growth

Breed - higher pcv and lower T4 sighthounds
Drugs - glucose and some anaesthetics
Exercise - CK release from mm