______ volume determines what percent of whole blood is made up of red blood cells via centrifugation
Pack Cell volume
______ are immature red blood cells
*if we know how many reticulocytes are present then we know if the anemia is regenerative
If a patient has regenerative anemia, what are the other two possible causes for the anemia?
Blood loss or Blood destruction
*Bone marrow is working because it is regenerative
A cat presents with Lethargy and polydypsia. The cat has a regenerative anemia and an increased ________, therefore this is most likely a blood destructive anemia
*Bone marrow is working properly since the anemia is regenerative and the total protein is increased. With blood loss you normally lose protein
The lymphopenia in this Leukogram is due to _____
*Most sick animals will have a lymphopenia
Low lymphocytes are very common in _____ animals
The most common cause of Heinz Body anemia is _______ toxicosis
What species is most susceptible to Heinz body formation?
Only thing that causes high Albumin in a patient
If a patient has high glucose and low phospohorous, what disease should we be thinking about?
*phosphorus is eliminated through the kidneys
If ALT enzyme is increased, there is usually damage to what organ?
*ALT is a liver enzyme
A lethargic and polydypsic cat comes into the clinic. He is anemic and
you see heinz body formation on a blood film. The cats has a high measured Glucose and a low Phosphorous. Bilirubin, Cholesterol, and ALT are all above the reference interval. Most electrolyte counts are low. What is the most likely diagnosis in this cat?
Diabetic cat with ketoacidosis and secondary heinz body formation
True/False: Electronic counting machines can distinguish banned neutrophils from segmented neutrophils
Banned neutrophils are an indication of _______
When Red blood cells are counted manually after centrifugation it is known as the Pack Cell Volume. What is it known as when the Red blood cells are calculated with an equation?
The _____ the RDW, the more variable the sizes of red cells that are present
Patient is having periodic episodes of weakness and presents with an enlarged abdomen. What is the diagnosis?
Hemangiosarcoma in the abdomen
*Rupturing every couple days leading to weakness
An increased MCV coincides with a _____ anemia
*Increased number of reticulocytes leads to an increased MCV
If you see Acanthocytes and Schistocytes in a blood film you should be suspicious of what disease?
Spherocytes are diagnostic for ______
Immune mediated hemolytic anemia
What is the diagnosis in this dog?
Immune mediated Hemolytic anemia
*Spherocytes are very diagnostic for IMHA
Dogs with immune mediated hemolytic anemia usually have _____, which is commonly the cause of death in these animals
What is the diagnosis in this puppy that is not growing adequately?
Hookworm leading to chronic blood loss
*Do a fecal exam to confirm diagnosis
What is the main cause of a Microcytic anemia?
If an animal has a non regenerative anemia with a normal total protein, what is the most likely cause of anemia?
Bone marrow insufficiency
What is the diagnosis for this patient that is bleeing from the gums?
Bone Marrow failure
*Bleeding due to severe thrombocytopenia
What is the best anticoagulant to use for a CBC because it preserves cell morphology?
*Lavendar/purple top tube
What color tube conains the anticoagulant EDTA, which preserves cell morphology, and is used for blood collection for CBC?
Someone collects blood for CBC into a lavender tube, they end up deciding just to run a chemical profile and poor the blood into a red top tube. How will the chemical profile come back?
Extermely high potassium
Extermely low calcium
* Animal would not be alive if calcium was this low
If you are out in the field and cannot get a blood sample to the lab for about 4-5 hours, you should use a ____ top tube because it will inhibit glucose metabolism
*Glucose decreases 10% per hour in a red top tube
If blood for a CBC sits at room temperature for ____ hours or more, erythrocytes will swell resulting in increased MCV
A _____ machine is a good way to mix blood before performing any test on the blood
*Stirs up the blood samples to make sure the cells are not settled
The percentage of whole blood composed of erythrocytes that is measured after centrifugation that maximally packs RBCs
Packed cel volume
______ will cause plasma to appear opaque and will interfere with readings. Usually associated with an animal that was not fasted prior to blood collection
Red coloration in plasma is due to the presence of _____ that could be caused by intravascular hemolysis or improper blood collection
*If PCV is not decreased then most likely improper technique
You should expect to see a difference in your serum protein versus your plasma protein due to _____ proteins that are present in plasma and not serum
If total protein and PCV are both decreased, suggests ______
Albumin and Globulin make up _____
*Added together they make up the total protein
True/False: The most common stain used for a blood film is a combination of the Wright and Giemsa stain
Best to use ____ procedure when staining a blood film in order to avoid precipitate
In what area of a blood film should the differential cell count be performed?
This blood film shows a lot of smaller ball shaped Red blood cells. What is this diagnostic for?
Immune mediated hemolytic anemia
Multiply the total nucleated cell concentration by the percentage of each leukocyte type to yield the ____ concentration of each type of nucleated cell within the blood sample
Total nucleated cell count = 10,000
80% are segmented neutrophils
What is the absolute concentration of segmented neutrophils?
(80% * 10,000)
If platelets appear to be decreased, check the _____edge of the blood film for platelet clumps
If MCV is 70 and you have 7 million red blood cells, what is your calculated hematocrit?
(70x7) / 10
True/False: If your patient has an increased Mean Cell hemoglobin concentration then they are very sick
*There is a glitch in the system- there is no such thing as an increased MCHC because red cells can only have so much hemoglobin
Increases in Mean cell hemoglobin Concentration are always ______. Erroneosly high reading due to hemolysis, lipemia or presence of Heinz bodies
*Red cell can only hold so much hemoglobin
Usually decreases in Mean Cell hemoglobin Concentration are due to presence of reticulocytes that are still making hemoglobin and is associted with a _____ anemia
Measurement taken when leukocytes are passed through a flow cell that is intersected by a laser beam. Physical properties of the cells scatter light to different degrees which provides you the size of the cell as well as different properties
Light Scatter Measurement
(aka Flow Cytometry)
Counting in which cells are suspended in an electrolyte medium that conducts electricity where deflections in current are proportional to the size of the cell
(Electronic cell counting)
Curve established for each population of cells which must be set specifically for each species
Size distrbution curve
True/False: Size distribution curves provide seperate curves for each population of leukocytes and the size distribution curve is unique for each species
Members of the ____ family are unique in that they have high MCHC as well as having oval shapen red blood cells
True/False: On a size distrubtion curve, larger red cells are further to the right, while smaller red cells fall towards the left
Describes the relative width of the Size distribution curve
Red cell distribution width (RDW)
What are the two main things that will increase RDW?
Population of Large blood cells
Population of Small blood cells
Small or microcytic red blood cells are characterisitic of _____anemia
Larger or macrocytic red cells are characterisic of a _____anemia
*Bigger immature cells being released
The _____ the RDW, the more variation in red blood cell size
What kind of stain will cause reticulocyte organelles to clump and contain a blue hue making it easier for diagnosis?
Brilliant Cresyl blue
What species typically does not have any reticulocytes in health but can release reticulocytes during a regenerative anemia?
What species does not have reticulocytes in health and will not release reticulocytes during regenerative anemia?
*Never want to do a reticulocyte count on a horse
True/False: A dog that has a PCV of 15% should be releasing more reticulocytes than a dog that has a PCV of 25%
How long does it take after a patient becomes anemic before you see a signficant increase in reticulocytes?
*If reticulocytes are not see, the anemia may just be too acute and the bone marrow has not responded yet with production of reticulocytes
Band Neutrophils and Metamyelocytes in the peripheral blood is an indication for _____
This is a _____ cell that is a sign for regenerative anemia
Rare to have _____ released into the blood, when you do see them you know inflammation is occuring
True/False: We can diagnose leukemia if all the lymphocytes in circulation are either B or T cells, without a good mixture of them
Dogs with ______ often have increased numbers of Large granular lymphocytes
Functions are related to immune complex reactions, such as allergic inflammation and defence against parasites
Most common reason to see Howell Jolly bodies
What three stages of neutrophil maturation are within the proliferative pool in the bone marrow?
What three stages of neutrophil maturation are within the Maturation pool of the bone marrow?
*Do not divide
Unvaccinated kitten that comes into the clinic with vomiting, diarrhea and a decrease in all leukocyte counts most likely has what disease?
Increased concentration of immature _____ in the blood is referred to as a left shift
True/False: If you have a left shift that is orderly, there will be more segmented than banned neutrophils and more banned neutrophils than metamyelocytes
Presence of neoplastic cells in the blood or bone marrow
The most commonly acquired change in leukocyte morphology is a neutrophil ____ change in which an accelerated rate of production of neutrophils occurs due to inflammation. Neutrophils appear abnormal with a blue cytoplasm
*toxic changes to neutrophils- neutrophils look different due to accelerated production and release from bone marrow
True/False: The rate of production of toxic neutrophils increases during times of inflammation
Relatively unimportant finding that is a result of normal aging of the neutrophil and use of corticosteroids
True/False: Neutrophil degeneration is usually due to bacteremia or sepsis
*Neutrophils are falling apart due to bacterial toxins
Anomaly that is an inherited disorder in which neutrophils failure to segment but does not make any clinical difference. Associated with eosiniphils that also fail to segment
Condition in which the lysosomes fuse with neutrophils forming large pink granules within the cytoplasm of the neutrophil that is common in persian cats
Chediak Higashi Syndrome
Inherited disorder in which an enzyme is missing due to genetic abnormality and you begin to see lysosomes that are full of material that have not been degraded appropriately
Lysosomal Storage disorder
What species it is common to see a neutropenia during inflammation due to their low number of neutrophils in their bone marrow storage pool
*very common to see neutropenia with acute inflammation in a cow
True/False: Dogs don’t have as many neutrophils stored within their bone marrow. If the dog is not releasing neutrophils into the peripheral blood during inflammation it is not a concern up until day 5
*This is true for ruminants- normal inflammatory process in ruminants.
During excitement, increased blood flow shifts leukocytes from the marginated pool to the circulating pool leading to ______
If you draw blood from an excited animal what should you see?
25% of cats that come into the veterinary clinic will likely have a _____ becaused they are having an excitement reaction
If you see an animal with a lymphopenia, a neutrophilia as well as band neutrophils, what kind of Leukogram is this?
Stress AND inflammation
True/False: With stress the neutrophilia can be greater than 2 times the upper limit of the reference interval
*Cannot be greater than 2 times the reference
During a stress response, if the neutrophilia is greater than two times the reference interval we will assume it is due to _____
If the neutrophilia is greater than two times the reference interval and we see banned neutrophils, it must be due to _____
If we see circulating lymphoblasts on a blood film the animal probably has a lymphoblastic ____
If there are greater than _____ lymphocytes in any species we can be comfortable that we are dealing with a Leukemia
When you see a dog with severe lymphocytosis, what two things could this be?
Ehrlichiosis or Lymphoid Leukemia
What is an example of irreversible bone marrow injury?
Feline Leukemia virus
*causes complete bone marrow suppression
Chemotherapy drugs, Parvovirus, and panleukopenia can all lead to _____ bone marrow problems
*Leads to a reversible neutropenia
Most common cause of Lymphopenia?
*Animals are either stressed or recieveing gluococorticosteroids
What is the most common cause of Eosinophilia?
There is a ____ tumor that is common in dogs that has an eosinophilic chemoattractant, leading to Eosinophilia
Mast Cell tumor
True/False: Basophilia usually accompanies Eosinophilia
Dog 1 is an unvaccinated puppy with vomiting and diarrhea. Toxic neutrophils were seen in the blood film. What is your diagnosis?
*Toxic neutrophils and Band neutrophils mean inflammation.
What kind of leukogram is this for Dog 2?
Stress and Inflammation
*Lymphopenia and Banned neutrophils
What type of Leukogram do we have for Dog 3?
*Lymphopenia is present. Neutrophilia doesn’t exceed twice the reference interval so not inflammation
What type of Leukogram is this for Dog 4?
Stress and Inflammation
*Lymphopenia and Banned Neutrophils. Also segmented neutrophils are over twice the reference interval
Cat 1 has just made his first visit to the vet. What kind of Leukogram is this?
What is the diagnosis for Cat 2?
*Has over 30,000 lymphocytes
Which of these 3 dogs has the worst prognosis?
*His bone marrow is not keeping up with the demand for neutrophils- Very low segmented neutrophil count
What is the diagnosis for the Dog?
*Normally dogs with pyometra will have a high neutrophil count
What type of Leukogram is this for a Cat?
Older dog that is sick with increased urination and increased drinking. What kind of Leukogram is this?
Stress and Inflammation
*Neutrophilia that exceeds two times the reference interval and Lymphopenia
is the anemia in this dog regenerative?
*Reticulocyte count is not increased
Most common cause of nonregenerative anemia in domestic animals
Anemia Chronic disease
What are possible reasons that this dog has a nonregenerative anemia?
Anemia of renal disease
Anemia of inflammatory disease
*No erythropoeitin production in Kidney
What kind of Leukogram does Canine A have?
*Band Neutrophils are present with a normal lymphocyte count
What if your diagnosis in Canine B?
*Lymphocytes over 30,000
Dog with coughing and exercise intolerance. What is your diagnosis?
*Eosinophilia and Basophilia
When we see and increased MCV that almost always means _____ anemia
If we see macrocytic anemia, we should be thinking _____
Microcytic anemia is always due to an _____ anemia
What is the cause of Hypochromasia?
Venom from this animal will cause Red blood cells to become type III Echinocytes
Red cell shape change that we can see in cats with hepatic lipidosis and sometimes in dogs with hemangiosarcoma
Schistocytes, which are red cell fragments, are commonly seen in what two condtions?
Vascular tumors- Hemangiosarcoma
If an animal present with a lot of schistocytes and is thrombocytopenic then the patient most likely has _____
*with DIC you get a lot of microclot formation leading to
In an animal that has schistocytes and decreased platelets, think_____
Most common disorder to see keratocyte formation
Iron deficiency anemia
Eccentrocytes formation is often seen in conjunction with Heinz body formation due to ingestion of _____ in dogs
What is the most common cause of heinz body formation in a cat?
What food can lead to heinz body formation in animals?
Animal that ingest pennies will get zinc toxicosis that can lead to ______ formation
Heniz body formation
What can cause Heinz body formation when ingested by horses that is very common and often fatal?
WILTED red maple leaves
What is the most common reason for heinz body formation in sheep?
*Eat forage that is high in copper and when stressed they release the copper leading to heinz body formation
Basophilic stippling is normal in what species?
Most common cause of basophilic stippling in small animals
*Especially if the animal has GI and Neuro signs
Nucleated Red blood cells are mainly seein with ____anemia. If you see more than 3-4,000 per microliter then you may have a red cell leukmia
What organ has macrophages that normally remove the nucleus of red blood cells, where if this organ is non-functioning or has been removed there will be an increase in Nucleated Red blood cells and Howell jolly bodies within peripheral blood
If you see Rubricytes or anything earlier in the blood then you should start worrying about a ______
Red Cell Leukemia
Protozoal parasite common in cats that is usually fatal because the parasites replicates in macrophages leading to macrophage hyperplasia that causes tissue dysfunction due to the massive number of macrophages
Very rare red blood cell parasite that is only see in in dogs who have had their spleen removed or the spleen in non functioning
*organisms form chains
Red cell parasite common in cats that are ring shaped with a central area of palor inside of red cells. These parasites ride on the outside of red blood cells and antibodies directed against the parasite puncture the red cells leading to intravascular hemolysis and anemia
Red cell parasite that is economically important in cattle that leads to severe hemolytic anemia and can cause death
Agglutination occurs when what specific antibody attaches to the Red blood cell?
How do you differentiate Rouleaux formation from Agglutination?
Add a drop of isotonic saline to blood
*If rouleaux- blood cells will disperse, but if agglutination they will stay clumped together
What is the diagnoses in this dog with a Hematocrit of 10.8%
Bone Marrow Failure
*All three bone marrow cell lines are decreased- Neutrophils, Red cells, and platelets
A dog from S.t kitts that has bone marrow failure and a high globulin concentration. What is the number one differential diagnosis?
Old dog with polyuria and polydypsia and a non regenerative anemia. What is your diagnosis?
*Lack of erythropoetin and dog cannot concentrate his urine so he is drinking more water
If a patient has a regenerative anemia, what laboratory evaluation will help to determine if anemia is due to blood loss or blood destruction?
*If animal is loosing blood acutely then we expect to see decreased protein
A ______ can tell us the size of the cells as well as the amount of hemoglobin inside the cells
In a Cytogram, Large cells go to the top and _____ cells go to the left
What is the diagnosis with this histogram?
Iron deficiency anemia
*Curve is shifted left = microcytic
In this histogram, the majority of Red cells are _____
Test that can be performed when we believe an animal has Immune mediated hemolytic anemia but we are not seeing agglutination and are unsure if seeing spherocytes
A dog with _____ will have periodic episodes of weakness
With ____ blood loss, the protein will decrease along with the PCV
About 25% of dog with Hemangiosarcoma will have _____ and schiztocytes
This is a blood film from a dog with ______ that is bleeding into his abdomen
*Lot of acanthocytes
True/False: Acute blood loss causes thrombocytopenia
*blood loss does not cause SIGNIFICANT thrombocytopenia- platelets will only decrease slightly in actue blood loss
True/False: If platelet count is below 30,000 then the patient is bleeding because of thrombocytopenia
Trauma, Coagulation disorders, Bleeding tumors, and Thrombocytopenia are examples of ____ blood loss
GI ulcers and blood consuming parasites will lead to ____ Blood loss
90% of the time a patient has chronic blood loss, the source of the blood loss is the _____
True/False: If Iron deficiency anemia has been going on for a long time then your RDW will be wide because most of the cells will be microcytic
*RDW will be narrow
In Iron deficiency anemia, the reticuloctes will have a _____ MCV
*Small reticulocytes due to Iron deficiency
Keratocyte formation is associated with what type of anemia?
If you have an anemic patient that is microcytic and has a low serum iron, that is enough to diangose _____
Iron deificency anemia
What is your diagnosis in this dog knowing that on a blood film you saw numerous Acanthocytes and Schistocytes?
*Bleeding into the abdomen
1 year old female pointer that has had abdominal pain the majority of its life and has been on steroids for weeks to months. If basing diagnoses on the steroid use, what is the most likely cause of pain in the abdomen and anemia?
Bleeding GI ulcers
*Ulcers perforated leading to chronic blood loss
If you see a lot of neutrophils that are degenerative and falling apart you want to look around for _____
Chronic blood loss in the intestine of a very old cat is most likely due to ____
What kind of leukogram is this?
Stress and Inflammation
What disease is the most common cause of blood destruction in a dog in the United States?
Immune mediated hemolytic anemia
IMHA, Heinz body anemia, and RBC parasites commonly cause blood ______
True/False: Usually in Blood destruction the total protein will be normal
What breed of dog has the highest incidence of IMHA?
True/False: If agglutiantion is already present on a blood film, it is indicated to perform a coombs test
*Contraindicated if agglutination is already present
Syndrome characterized when patients with IMHA have antibodies directed against there red blood cells as well as their platelets
_____ is very common in patients with IMHA, and is usually the main cause of death
A mismatched blood transfusion may be causing _____formation because the blood transfusion triggered IMHA
Whenever a patients has an MCV that is way too high to be possible, there is probably _____
5 year old Cocker Spaniel comes into the clinic that is icteric and has agglutination based on the MCV. What is your diagnosis?
*Cocker spaniel and agglutination
What does this RDW curve represent?
What kind of Leukogram is this?
Stress and Inflammation
If and animals specific gravity is between _____, it is called isostenuric and means the animal is not able to concentrate their urine which may indicate kidney damage
Specific type of Immune mediated hemolytic anemia in which a neonates red cell antigens come in contact with the mother and she produces antibodies agains the neonates red cells. Foal get hemolytic anemia after ingesting the mothers colostrum
Common blood cell parasite of cats that causes severe anemia
If a cat has Mycoplasma Haemofelis and the anemia is not regenerative, what two diseases should we test for?
Feline Leukemia Virus
Feline Immunodeficiency Virus
*These two viruses could have predisposed the cat to M.Haemofelis infection due to immunosuppression
Opportunist red blood cell parasite of dogs that have been splenectomized and no longer have a spleen
Red blood parasite of cattle that typically only causes severe anemia if the animal is splenectomized
In what species is it normal to see basophilic stippling with regenerative anemia?
Most common way that horses gets Heinz body anemia
Ingestion of Wilted Red maple leaves
Acetaminphen toxicity in cats, not only causes heinz body formation, but can also cause ______
Cats that have been poisoned with Acetometaphine that have ______ will have mucous membranes that get a brownish color or a tube of blood that appears brown
*Iron in the ferric state and unable to carry oxygen
What species stores copper in their liver and when stressed release the copper from the liver leading to copper toxicosis that can be fatal?
True/False: Copper toxicosis in sheep can lead to heinz body formation
Toxicity that occurs in cattle that is common in cases where cattle have unlimited access to water leading to decreased osmolaltiy and the red cells become susceptible to lysis
What two infectious agents commonly cause generalized bone marrow suppresion (aplastic anemia)
Feline leukemia Virus
Drugs that commonly cause generalized bone marrow suppression targeting rapidly replicating cells
*aka anti-neoplastic drugs
What infectious agent can result in either generalized bone marrow suppression or specifically red cell suppression?
Feline Leukemia Virus
In what type of anemia is iron stored and not released to red cell precursors so you end up getting decreased red cell production?
Anemia of Inflammatory disease
What can you tell based on the Reticulocyte count and MCV for this cat?
Agglutination is occuring
*MCV and Retics are too high to make sense
What kind of a Leukogram is this?
Stress and Inflammation
15 year old Terrier with periodic episodes of weakness. What is the diagnosis?
What kind of Leukogram is this in January?
Inflammatory and Excitment
If you see a high MCV in a cat with a non regenerative anemia and no agglutination then test the cat for ____
Feline Leukemia Virus
*can result in big Red blood cells that are not maturing
What is the diagnoses in this 11 year old cat with non regenerative anemia, an increased MCV, and increased bands and segmented neutrophils. A blood film showed evidence of nucleated red blood cells back to rubriblasts in the peripheral blood
Red cell Leukemia
*Cat is very anemic- non regenerative. Bone marrow problem- since neutrophils are still being produced at high numbers it must be specifically a red cell leukemia
If we see Rubriblasts and Prorubriblasts in a blood film of an animal that has normal neutrophil counts, what is the diagnosis?
Red cell Leukemia
In this case of non-regenerative anemia, the Leukogram shows that the bone marrow is making neutrophils and platelets. A biochemical profile shows that the dog is very azotemic and a urine analysis shows that the dog’s specific gravity is 1.008. What is the most likely diagnosis?
Renal failure related anemia
*Lack of Erythropoeitin
*Only thing the bone marrow is not making is Red blood cells
In the dog, what are the two most common places to do a bone aspirate?
In a normal animals, bone marrow is made up of ____% hematopoetic cells and ____% fat
50% for eech
True/False: When doing a bone marrow aspirate, you should stop after collecting about 2-3 drops of bone marrow in order to decrease your changes of blood contamination
Neutropenia, Thrombocytopenia, and Non regenerative anemia are all associated with ______ failure
What is the range of a normal M:E ratio
1:1 to 3:1
*You should see 1 to 3 myeloid precursors for every erythroid precursor
Increased M:E ratio can be due to what 2 things?
Animal with very high M:E ratio. Neutrophil count is 83,000 with a PCV of 35%. What is the cause of the increased ratio?
Dog has a decreased M:E ratio with a PCV of 20% and a neutrophil count of 12,000. What is the cause of the decreased ratio?
*Increased production of red cell precursors
What are the three causes for a decreased M:E ratio?
Lack of production of neutrophils