Clinical Pathology - Veterinary Hematology

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Normocytic, normochromic anemias with normal or increased neutrophils and platelets

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1. anemia due to lack of erythropoietin (EPO) - seen in chronic renal failure.
2. Anemia of inflammation - common, mild anemia.
3. FeLV-associated anemia- can be normocytic or macrocytic.
4. Immune-mediated anemia (PRCA - pure red cell aplasia)

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Normocytic, normochromic anemias with decreased neutrophils and platelets (pancytopenia)

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1. aplastic anemia with infections causes, from drugs/toxins, irradiation, or idiopathic.
2. myelophthhisic anemia - bone marrow replaced by neoplastic cells or nonhematopoietic tissue (myelofibrosis)
3. Endotoxemia with secondary bleeding can mimic this as well

Front 3

Microcytic, hypochromic or normochromic anemia with variable number of neutrophils and platelets

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1. Iron deficiency anemia - from chronic blood loss, nursing animals getting Fe deficient milk, serum Fe and serum ferritin low.
2. Anemia of inflammation - Fe low but ferritin increased.
3. Portosystemic shunt- unknown cause for microcytosis (with low Fe sometimes and normal to increased ferritin)
4. Pyridoxine (B6) and copper deficiency.
5. Some breeds, like the akita have mirocytic RBCs but are not anemic

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Macrocytic, normochromic anemias with variable neutrophils and platelets

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1. Vitamin B12 and folic acid deficiency.
2. FeLV infection (lack reticulocytosis)
3. Congenital dyserythropoiesis of Herefords
4. Poods have macrocytosis as breed disorder

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Polycythemia

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1. Relative Polycythemia is due to dehydration adn splenic contraction (RBC count and total protein will all be increased with dehydration_
2. Primary Absolute Polycythemia - myeloprliferative dype of disease, erythropoietin levels are normal to decreased.
3. Appropriate Secondary absolute polycythemia - chronic hypoxia of cardiac and/or pulmonary disease leads to increased erythropoietin production- check PaO2 levels
4. Inappropriate secondary absolute polycythemia- Paraneoplastic EPO-like production or renal cysts which cause increased EPO production

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Degenerative left shift

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Number of immature neutrophils exceeds mature neutrophils. Leukocyte count is normal or decreased. Poor prognosis, but commoonly in cows due to small marrow storage pool of neutrophils

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Leukemoid response

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Marked neutrophilia and left shift

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Physiologic neutrophilia

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mature neutrophilia due to epinephrine release. May also see lymphocytosis

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Corticosteroid-induced neutrophilia

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mild to no left shift, accompanied by lymphopenia, eosinopenia, monocytosis (sespecially in dogs). decreased migration of neutrophils and increased marrow release of neutrophils

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Inflammatory neutrophilia

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due to cytokines released during tissue injury or mediators released by infectious agents. See mature neutrophilia or neutrophilia with left shift

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Neutrophilia induced by hemorrhage, hemolysis

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probably due to both inflammation and to endogenous corticosteroid effects

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Neutrophilia from myeloproliferative disease- neoplastic proliferation of neutrophils

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uncommon and only diagnosed when alternatives are ruled out

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Neutropenia

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1. margination due to endotoxemia
2. excessive tissue demand
3. immune-mediated destruction of neutrophils
4. decreased production (drug induced, viral, myelophthisic effect)
5. Maturation arrest in bone marrow - precursors present but not progressing toward mature storage pool. (possibly viral or myelodysplasia)
6. In coditions that also affect bone marrow, a panleukopenia may be present as well

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Monocytosis

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1. Often occrus with neutrophilia
2. both acute and chronic stages of inflammatory disease
3. May be seen secondary to corticosteroids

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Eosinophila

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1. Hypersensitivity or parasites
2. Mast cell rich organs become inflamed (GI lungs, uterus, skin)
3. Associated with some neoplasms

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Eosinopenia

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1. May occur in response to corticosteroids
2. Of little siginifcance if other WBC counts are normal

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Basophilia

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1. Usually occurs with eosinophilia
2. In blood, must differentiate from mastocytosis (check nuclear shape)

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Basopenia

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Not a significant finding

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Lymphocytosis

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1. Physiologic (ie. younger animals, species differences, epinephrine in young, healthy animals)
2. antigenic stimulation
3. Lymphoproliferative disease- lymphocytic leukemia, stage V lymphoma

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Lymphopenia

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1. Corticosteroids due to redistribution of recirculating lymphocytes
2. Acute systemic infection (ie viral)
3. Endotoxemia
4. Immunosuppressive drugs - corticosteroids, chemotherapy
5. Loss of lymph- thoracic duct trauma, lymphangiectasia
6. Hereditary immunodeficiency (ie SCID)

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Physiologic Leukocytosis

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Corticosteroid Leukocytosis

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Inflammatory Leukocytosis

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Endotoxemia

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