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71 Cards in this Set
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Mean Corpuscular Volume (MCV) - RBC Indices
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PCV x 10 / RBC = fl (femtoliters)
indicates the mean Volume for a group of RBC's usingg femtoliters Measure of the average size of the erythrocytes -Anisocytosis, macrocytosis, microcytosis |
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Mean Corpuscular Hemoglobin (RBC indices
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Hb (g/dl) / RBC x 10 = pg (Picograms)
Measurement of the mean WEIGHT of the hemoglobin in the average RBC. Reflective of hemoglobin carying capacity) |
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Mean Corpuscular Hemoglobin Concentration (MCHC) - RBC indices
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Measures the hemoglobin concentratinon in the average RBC (a ratio of weight of hemaglobin to the volume in which it is contained).
Often has to be manually calculated as the automated machines are incorrect Hb + PCV x 100 = g/dl |
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Reticulocyte counts
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An expression of the percentage of RBC's that are reticulocytes (immature)
Assesses the bone marrows response to anemia and blood loss This is the true and only hallmark of regeneration and there are two types -Punctate (polka dots, seen in cats and have single nuclear fragment) -Aggregate (most common, have multiple fragments) |
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Hyper segmentation
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A neutrophil with greater than 5 nuclear lobes
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Microfilaria
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Heartworm - mosquito's vector
Can tet for it from serology, modiffied knott's technique Scan for the larvae on 10x Once infected, adult female worms release larvae, microfilaria, into the bloodstream which is what's seen on a blood smear. adult hearworm antigen test done if seen |
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Platelet evaluation
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Counted in 10 different fields and average per field
8-12 normal platelets/hpf and for felines it's 10-12 platelets/hpf Clumping can occur and decrease the amount counted per/hpf Low platelet counts could indicate Immune mediated Thrombocytopenia (ITP) and DIC or hemorrhage |
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Granulopoiesis
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Generating of WBC that later become neutrophils, eosinophils, basophils and monocytes
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Neutrophils
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"Ground troops". Most numerous of the WBC
Takes 3-5 days to circulate Phagocytosis, release lysozymes that destroy bacteria. Can become toxic if they become defective, infected or lose their activity |
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Neutrophil appearance
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Clear to slightly pinkish cytoplasm.
Nucleus is divided into 5 or less lobes and indentations and condensed chromatin |
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Toxic neutrophils - Mild Toxicity
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Dohle bodies, mild cytoplasmic basophilia (blue staining)
Can be normal in cats |
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Dohle bodies
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Small round inclusions in the cytoplasm of a toxic neutrophil that usually come in pairs (normal in cats)
2 dots w/in a neutrophil |
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Toxic Neutrophils - Moderate toxicity
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Increase in cytoplasmic basophilia and foaminess
Appearance of toxic granulation and cytoplasm appears "frothy" |
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Toxic Neutrophils - Marked toxicity
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"Angry" looking neutrophils that are hard to diferentiate from monocytes and are often broken down or aged.
Chromatin has become very loose, and nucleus becomes more diffuse |
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Band neutrophils
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Young neutrophils released prematurely into bloodstream due to high demand. These are larger than adult neutrophils
Have a bend horshoe appearance. |
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Metamyelocytes
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Sometimes seen on very septic/infected animals and precursors to band neutrophils
Close to the appearance of band, but the nucleus is even less bent and larger |
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Left shift
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When there is presence of immature neutrophils (bands) or cells that appear to be young
Degenerative and regenerative left shifts Regenerative - occurs when bands presenbt with elevated leukocyte count often seen in infections under control Degenerative - Occurs when bands present withg a normal to low leukocyte count. Means that majority of neutrophils are immature cells, so body cannot keep up with the neutrophil consumption. Often occurs with sepsis, parvo, pyometra, etc |
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Eosinophils
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Take 1-2 days to reach circulation
Short life span (<1hr, few days intissues) Regulation of allergic and acute inflammatory responses Can phagocytize bacteria and some parasites Often occurs with asthma, skin parasites and addisons |
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Eosinophil appearance
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Bright pinkish-red cytoplasmic granules with a segmented nucleus. Granules can vary in size and color
You will see PINK granules |
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Monocytes
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Highly phagocytic, esp with intracellular ogranimsms (fungi, protozoa, viruses)
Increased presence indicates a chronic inflammatory response |
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Monocyte appearance
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Ameboid nucleus that can assume any form
Cytoplasm is slightly blue and has ground glass or foamy appearance typically 1/3 larger than neutrophils |
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Reactive monocytes
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Have become activated to macrophage while in bloodstream. Cytoplasm is highly vacuolated and more abundant
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Lymphocytes
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Produced in bone marrow and mature in the lymphoid organs (lymph nodes, thymus) and in the gut
70% go back into recirculation and can live for up to 5 years. Immune systems police force - Immunologic armor of the body producing humoral antibodies and cellular immunity Young animals have increased # |
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Lymphocyte appearance
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Nucleus contains coarsely clumped chromatin and is generally round
Cytoplasm is clear to light blue Two sizes - small and large |
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Stimulated/reactive lymphocyte
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Often associated with immune response and is fairly common in blood of young animals (esp if recently vaccinated)
Generally largger and have basophilic cytoplasm (larger with more cytoplasm staining |
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Atypical lymphocyte
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usually seen with leukemia or lymphosarcoma
Cells very large and bizarre, cytoplasm is often basophilic and you will want to notify DVM if seen |
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Basophils
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Rarest of all the WBC. Normal to find none on differential
Many functions, some of which are not completely known. Play important role in allergies and histamine reactions to vaccines |
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Basophil appearance
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Intense reddish-violet granules that invariably fill the cytoplasm and mask the segmented nucleus
Granules often absent in canine and gray/blue hue to cytoplasm observed instead and a folded nucleus |
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Normal percentages of cell types
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-Neutrophils - 70%
-Lymphocytes - 20% -Monocytes - 5% -Eosin/baso - 5% Whenever one cell type falls or increases more than 20% it becomes a penia or philia (cytosis) |
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Neutropenia
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Low number of neutrophils. Often caused by severe inflammation or sepsis, bone marrow disorder, or viral disease
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Neutrophilia
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Increased number of neutrophils. Ogten occurs from inflammation, stress, steroids and tissue necrosis
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Lymphopenia
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Low number of lymphocytes. often caused by stress (glucocorticoids), viral disease, PLE, annd chemo
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Lymphocytosis
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Increased number of lymphocytes. Caused by stress (epi release), immune stimulation and leukemia
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Monopenia
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Low number of monocytes. LHard to classify becaue having no monocytes on the smear doesn't indicate disease
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Monocytosis
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Increased number of monocytes. Often caused by stresss, inflammation, and necrosis
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Eosinophilia or basophilia
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Increased number of eosinophils/basophils
Often occurs from parasitic infections, alllergies, mast cells, drug reactions and cancer |
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Normal canine RBC's vs Feline RBC's
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Canine - round and even in size with a prominent center pallor. Should stain a reddish color
Feline- smaller and more densely staining. No center pallor and normal for mild variation in cell size (anisocytosis) |
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Poikilocytosis
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Abnormal RBC shapes
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Acanthocytes
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AKA Spur cells
Irregular RBC with large, rounded, unevenly distributed projections Due to changes in lipid metabolsim, associated with liver disease Can be seen consistently in dogs with hemangiosarcoma of the liver |
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Echinocytes
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AKA Burr cells
Spiculated cells (multiple round edge protrusions) that are distributed evenly throughout the cell and are uniform in size and shape A lot of time is an artifact - pH changes during slow drying of cells (crenation) and metabolic disorders |
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spherocytes
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Small, round, dense RBC's that lack central pallor
Indicates an immune mediated response against antigens on RBC surface Cats lack central pallor so not detectable in cats Most commonly seen in IMHA |
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Schistocytes
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fragmented RBC's usually due to mechanial truama to circulating erythrocytes.
Indicates DIC or severe sepis/vascular disorders |
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Codocytes/Leptocytes
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"target cells" - looks like a target. Have an excess membrane and/or decreased volume, causing a fold or distortion of the membrane
Common in both regenerative and non-regenerative anemias |
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Signs of RBC regeneration
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Polychromasia
Target cells Anisocytosis Nucleated RBC's Howell-Jolly cells |
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Polychromasia
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Can signal regeneration of RBC's.
Aggregate reticulocyte and recent bone marrow production. Larger than adult RBC and bluish staining Need to confirm w/ new methylene blue stain |
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Basophilic stippling
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Dusting of RBC cytoplasm with dark blue/black granules
Residual RNA that has yet to be removed Seen in regenerative anemias in cats, lead poisoning in dogs, and can sometimes indicate lead toxicity and bone marrow disorders |
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Abssolute retic counts
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Are the key to regeneration
Dogs > 100,000/ul to be considered regenerative Cats > 60,000/ul to be considered regenerative |
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Nucleated RBC
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Lat stage before polychromasia. These are small and round with densely staining nucleus (almost perfectly round) and clear RBC background
Greater than 5 NRBC/100 WBC is significant IF present with regenerative anemia, most likely part of the erythroid response, if not, can indicate bone marrow or spenic dysfuntion >5/100 WBC abnormal in non-anemic animal Machine reads NRBC as WBC |
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Howell-Jolly bodies
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Pale blue inclusions in a RBC that are remnant fragments of nuclear chromatin
Often found in regenerative anemia and can be seen in spenic disorders. Can be normal to see a few in cats. Has only one single peice of fragment of nucleus Howell-Jolly seen on a dip quick slide |
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Non-regenerative anemia signs
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Lack of polychromasia and reticulocytes indicates animal is not regenerative and needs further diagnostics
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Hypochromasia
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Opposite of polychromasia - RBC's have very prominent central pallor and only a thimn membrane surrounding cytoplasm
Indicates Iron deficiency (Due to chronic loss) |
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Hemobart
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Parasite that lives on RBC's and causes destruction. Tx via fleas
Very hard to see, but will appear as chains of cocci-like objects on the periphery of RBC |
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Heinz bodies
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Single round protrusions of RBC membrane. Indicates oxidative damage which causes hemoglbin to denature
Cccasionally will detach from cell and you will see small pink bodies among RBC Associated with onion, tylenol and other oxidative toxins and easiest to see with new methylene blue stain |
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Plasma
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liquid portion of blood that accounts for about 45-78% of blood sample volume
About 93% water Contains: proteins, gasses, lipids, electrolytes and amino acids Ststemic drugs carried to site of action by plasma |
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Evaluation of protein in plasma: purposes.
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Hydration status, fluid status,inflammatory status, liver, kidney and GI function
Neonates tend to have lower than normal total proteins and geriatrics tend to have higher |
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RBC Maturation Stages
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1st = Rubriblast - each rubrriblast can make 16-32 reticulocytes
2nd = Prorubricyte 3rd = rubricyte 4th = Metarubricyte (Nucleated RBC) 5th = polychromatophil or reticulocyte (immature RBC that appear as large blue taiing cell when using difquick stain. reticulocytes can only be seen when using new methylene blue) 6th = Howell-Jolly cell (mature RBC with just 1 nuclear fragment) 7th = normal RBC 8th = old RBC (ghost or hypochromasia) |
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Polychromatic cells vs reticulocytes
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Polychromatic - seen as larger red blood cells that stain more blue in color
Reticulocytes - same as polychromatic cell that is stained with New Methyline Blue so the nuclear fragments can be seen |
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Effete RBC's
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Effete = damaged (having lost character, vitality or strength)
Primarily removed by macrophages in the liver, spleen, and bone marrow Secondary removed by intravascular hamolysis (rare) |
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RBC colors (normochromic, hypochromic, and hyperchromic)
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Normochromic - Normal redblue color with proper staining it should be red in color
Hypochromic - lacking color, apear like ghost cells and dont contain much substance Hyperchromic - very intense bluish staining often seen when reticulocytes are present |
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Keratocytes
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AKA Blister cells
Helmet shape (elvis hair) and often seen with oxidative injury or iron deficiency anemia Oxidative injury leads to lesion w/in the RBC which breaks open Can also be seen with hamgiosarcomas |
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Stomatocytes
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"Happy face" that results from membrane defects of the RBC. May be present in hemolytic anemia or other rare inhereted disorders
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Heinze bodies
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Observed in new methyline blue as it will show as a pale blue inclusions. DiffQuik will just show it as a bump-like projection
Formed when hemoglobin denatures and precipitates and can result from an oxidative injury due to oxidant drugs, toxic plants, and/or chemicals (onions, garlic), and sometimes IV hemolysis Can result from cancer or metabolic diseases (Lymphosarcoma, hyperthyroidism, diabetes mellitus) Small percent normal in cats |
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Mycoplasma Haemofelis
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Hemobartonella felis and canis
Causes feline infections anemias in cats and is very rare in dogs, often only seen in splenectomized dogs. Carried by fleas and is a parasite that invades RBC which causes anemia. Tx by doxacycline, flea meds, and possible blood transfusion |
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Babesia
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AKA Texas fever. Ticks vector for this and affects cattle and rarely horses (rare in this area)
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Anaplasma Marginale
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Appears as a Howell-Jolly in cattle only
Caused bby anaplasmosis in cattle, causing anemia |
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Cytauxzoon felis
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A rare cause of hemolytic anemia in cats. Small, irregular ring shapes in erythrocytes and lymphocytes of cats
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Regenerative Anemias
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1. Blood loss anemia
2. Hemoltic anemia (Immune mediated, Heinz body and infectous/parasitic In blood loss/hemorrhagic, RBC are lost from the body due to external bleeding. Hemolytic anemias - SHortened RBC lifespan, intravascular hemolysis seen with IMHA (killed off by immune system), Heinz body hemolytic anemia (RBC lifespan reduced through hemolysis), and infections hemolytic anemia (Hemobartonellosis and babesiosis) |
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Non-regenerative anemia
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1. Maturation defect
2. Hypoproliferative anemia (deficient erythropoietin (EPO) or a diminished response to it; they tend to be normocytic and normochromic) Maturation defect can be from acquired bone marrow abnormalities like FeLV, iron deficiency, and nuclear and cytoplasmic types Hypoproliferation (most common) can be caused by an inflammatory disease, decrease in EPO - end stage renal disease, Marrow toxicity, infections (parvo,FeLV, FIV, etc), and non-infectious (estrogen toxicity and chemo) |
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Polycythemia anemias - What is it? What are the different types?
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Measurements of RBC mass increased - More RBC's created
1. Relative = Elevated TP, RBC counts and hematocrit and/or loss of fluid from circulating blood (dehydration) 2. Absolute - Primary = "Polycythemia vera" which is a rare myeloproliferative disorder causing expanded RBC production in marrow. Blood gas values checked to rule this out 3. Absolute - Secondary = Increased production of EPO (erythropoieten hormone) that can be from diseases that reduce O2 in the tissues (heart disease, pneumonia), renal neoplasia. Has no blood morphologic abnormalities |
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Erythrocyte tests
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-RBC total count
-Hemaglobin measurement (HGB) -Hematocrit (HCT) -Mean Corpuscular Volume (MCV) -Mean Corpuscular Hemoglobin Concentration (MCHC) -Observed reticulocyte % Corpuscle = RBC's |
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Ehrlichia
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Many species capable of infecting dogs.
Ehrlichia platys affects only platelets and causes infectious thrombocytopenia Ehrlichia canis commonly infects monocytes and neutrophils Transmitted by the brown dog tick and appears as small clustures Can reult in neutropenia, thrombocytopenia and anemia |
