scholarly journals The diagnostic approach to anaemia in the dog and cat

2017 ◽  
Vol 65 (3) ◽  
pp. 149 ◽  
Author(s):  
SAVERIO PALTRINIERI
Keyword(s):  
Bone Marrow ◽  
Blood Loss ◽  
Infectious Diseases ◽  
Diagnostic Approach ◽  
Serological Tests ◽  
Immune Mediated ◽  
Microcytic Hypochromic Anaemia ◽  
Hypochromic Anaemia ◽  
Hb Concentration ◽  
Possible Cause

The term anaemia indicates a pathologic condition characterized by a decreased concentration of hemoglobin (Hb) in blood, usually associated with a decreased number of erythrocytes (RBC) and/or of hematocrit (Ht). Anaemia depends on two pathogenic mechanisms: 1) decreased RBC production due toxic, infectious or idiopathic bone marrow diseases or to metabolic, neoplastic or infectious diseases that secondarily affect erythropoiesis, leading to the so-called “non regenerative anaemia”, on which no reticulocytes are released in blood from bone marrow; 2) decreased lifespan of mature RBC due to acute blood loss or hemolysis that leads to “regenerative anaemia” in which reticulocytes are released in blood as an attempt to restore the RBC mass. A stepwise diagnostic approach to anaemic dogs and cats may allow first to identify which of the two mechanisms is involved in the pathogenesis of anaemia, then to identify the possible cause of decreased RBC production or of decreased RBC lifespan. This approach must include clinical data, information regarding gross appearance of the sample, actual values of RBC counts, Ht and Hb concentration, RBC indexes (MCV, MCH, MCHC, RDW) and the magnitude of the reticulocyte response. Morphology of blood cells and additional laboratory tests may further address the diagnosis. With rare exceptions, non regenerative anaemia is normocytic normochromic,while regenerative anaemia is macrocytic hypochromic and characterized by anisocytosis and polychromasia, since reticulocytes are larger and have less Hb than mature RBC. However, blood loss or hemolytic anaemia are initially “pre-regenerative” (normocytic and normochromic), then they shift to the macrocytic hypochromic pattern in a few days, when reticulocytosis becomes relevant. Microcytic hypochromic anaemia is usually associated with iron deficiency. Once anaemia is classified into one of the categories listed above, morphology of RBC may suggest the possible cause, especially in regenerative anaemia, when the shape of RBC may be consistent with oxidative damage (eccentrocytes, Heinz bodies), immune-mediated mechanisms (agglutination, spherocytes, schistocytes, etc) or infectious diseases (e.g. mycoplasmosis, babesiosis). If needed, bone marrow cytology, Coomb’s test or flow cytometric detection of anti-RBC antibodies, coagulation profiles or additional biochemical or serological tests may be used to finalize the diagnostic approach.

Reticulocyte Parameters in Microcytic Hypochromic Anaemias Using Beckman Coulter DxH800 – A Study from Kerala, India

2021 ◽  
Vol 8 (14) ◽  
pp. 888-892
Author(s):  
Blessy Mary Thomas ◽  
Sheila Das ◽  
Sunil Antony ◽  
Alice David
Keyword(s):  
Bone Marrow ◽  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Response To Therapy ◽  
Control Group ◽  
Blood Samples ◽  
Deficiency Anaemia ◽  
Chronic Disorder ◽  
Microcytic Hypochromic Anaemia ◽  
Hypochromic Anaemia

BACKGROUND Microcytic hypochromic anaemia is commonly due to iron deficiency, anaemia of chronic disorder [ACD] and thalassaemic syndromes. Reticulocyte count reflects the erythropoietic activity of bone marrow and is thus useful in both diagnosing anaemias and monitoring bone marrow response to therapy METHODS All samples were selected from routine blood counts, and sent for investigation of anaemia, over a period of two years. These samples were run on the DxH800 (Beckman Coulter). 385 cases were selected for the study. Blood analysis for all these cases had been requested by general practitioners to investigate anaemia. These blood samples had been collected in ethylenediaminetetraacetic acid (EDTA) anticoagulant vacutainers and processed within 2 hours of collection. Determination of red cell and reticulocyte parameters in all blood samples, was performed using the Beckman Coulter 7-part analyser [Unicell DxH 800]. RESULTS Of the 156 cases of microcytic hypochromic anaemia studied, iron deficiency anaemia (IDA) was present in 91 cases, anaemia of chronic disorder (ACD) in 50 cases, beta thalassemia trait (BTT) in 15 cases. Of the 50 ACD cases, 37 were associated with IDA. The control group comprised of 229 adult medical students (143 women and 103 men) with a median age of 18.84 ± 0.98 years. We also had 4 cases of other haemoglobinopathies, which were microcytic hypochromic, but were not included in our study as the number of cases was too less to be analysed. CONCLUSIONS New reticulocyte parameters are useful for evaluation of iron status and diagnosing iron deficiency anaemias. They also are reliable parameters for recognising subsets of anaemic patients thereby improving the management of anaemia. KEYWORDS Reticulocyte, Microcytic, Hypochromic, Anaemia, Beckman Coulter

Diagnostic bone marrow sampling in cats. Currently accepted best practices

2017 ◽  
Vol 19 (7) ◽  
pp. 759-767 ◽  
Author(s):  
Christopher G Byers
Keyword(s):  
Bone Marrow ◽  
Clinical Practice ◽  
Best Practices ◽  
Infectious Diseases ◽  
Evidence Base ◽  
Practical Relevance ◽  
Comprehensive Review ◽  
Hematologic Disorders ◽  
Immune Mediated ◽  
Sampling Procedures

Practical relevance: Hematologic disorders are relatively common in cats, as inflammatory, immune-mediated and infectious diseases have the potential to impact erythroid, myeloid and thrombopoietic lines within the bone marrow. Clinical challenges: Clinicians often benefit from information obtained from bone marrow cytology and histopathology in diagnosing hematologic disorders in feline patients. However, these sampling procedures are ones that many veterinarians are intimidated by and thus not comfortably performing in clinical practice. Audience: This review, aimed at all veterinarians who treat cats, highlights the reasons a clinician may elect to sample bone marrow, and details the collection of bone marrow for both cytology and histopathology. Potential complications and limitations of each procedure are also reviewed. Evidence base: The collection of bone marrow for cytology and histopathology is not new to feline medicine and several research studies have investigated various sampling modalities in cats. This article offers a comprehensive review of the currently accepted best practices.

scholarly journals Verification of Healthcare Personnel Immunity as a Strategy for Measles Preparedness

2020 ◽  
Vol 41 (S1) ◽  
pp. s431-s432
Author(s):  
Rachael Snyders ◽  
Hilary Babcock ◽  
Christopher Blank
Keyword(s):  
Infectious Diseases ◽  
Multidisciplinary Team ◽  
The United States ◽  
Transmission Risk ◽  
Healthcare Personnel ◽  
Serological Tests ◽  
Preparedness Plan ◽  
Vaccine Preventable Diseases ◽  
Measles Outbreaks ◽  
Centralized Database

Background: Immunization resistance is fueling a resurgence of vaccine-preventable diseases in the United States, where several large measles outbreaks and 1,282 measles cases were reported in 2019. Concern about these measles outbreaks prompted a large healthcare organization to develop a preparedness plan to limit healthcare-associated transmission. Verification of employee rubeola immunity and immunization when necessary was prioritized because of transmission risk to nonimmune employees and role of the healthcare personnel in responding to measles cases. Methods: The organization employs ∼31,000 people in diverse settings. A multidisciplinary team was formed by infection prevention, infectious diseases, occupational health, and nursing departments to develop the preparedness plan. Immunity was monitored using a centralized database. Employees without evidence of immunity were asked to provide proof of vaccination, defined by the CDC as 2 appropriately timed doses of rubeola-containing vaccine, or laboratory confirmation of immunity. Employees were given 30 days to provide documentation or to obtain a titer at the organization’s expense. Staff with negative titers were given 2 weeks to coordinate with the occupational heath department for vaccination. Requests for medical or religious accommodations were evaluated by occupational heath staff, the occupational heath medical director, and the human resources department. All employees were included, though patient-interfacing employees in departments considered higher risk were prioritized. These areas were the emergency, dermatology, infectious diseases, labor and delivery, obstetrics, and pediatrics departments. Results: At the onset of the initiative in June 2019, 4,009 employees lacked evidence of immunity. As of November 2019, evidence of immunity had been obtained for 3,709 employees (92.5%): serological evidence of immunity was obtained for 2,856 (71.2%), vaccine was administered to 584 (14.6%), and evidence of previous vaccination was provided by 269 (6.7%). Evidence of immunity has not been documented for 300 (7.5%). The organization administered 3,626 serological tests and provided 997 vaccines, costing ∼$132,000. Disposition by serological testing is summarized in Table 1. Conclusions: A measles preparedness strategy should include proactive assessment of employees’ immune status. It is possible to expediently assess a large number of employees using a multidisciplinary team with access to a centralized database. Consideration may be given to prioritization of high-risk departments and patient-interfacing roles to manage workload.Funding: NoneDisclosures: None

Granulocytopenia Associated With Thymoma in a Domestic Shorthaired Cat

2008 ◽  
Vol 44 (4) ◽  
pp. 210-217 ◽  
Author(s):  
Janean L. Fidel ◽  
Indira S. Pargass ◽  
Michael J. Dark ◽  
Shannon P. Holmes
Keyword(s):  
Bone Marrow ◽  
Radiation Therapy ◽  
Immune Suppression ◽  
Bone Marrow Examination ◽  
Coarse Fraction ◽  
External Beam ◽  
Mass Treatment ◽  
Left Shift ◽  
Immune Mediated ◽  
Blood Neutrophils

A 5-year-old, spayed female cat was referred because of a mass in the cranial mediastinum noted on thoracic radiographs. A thymoma was diagnosed following ultrasound and biopsy of the mass. Treatment was initiated with coarse-fraction radiation therapy using external-beam therapy (four fractions of 5 Gy). The mass responded, but granulocytopenia developed. Bone marrow examination showed a myeloid to erythroid ratio of approximately 1:1, with a left shift within the myeloid line. These findings, as well as the lack of toxic changes within the peripheral blood neutrophils, suggested immune-mediated destruction of peripheral granulocytes. Immune suppression with prednisone and cyclosporine was instituted. After 7 weeks, the neutrophil count returned to normal. The tumor was removed, and cyclosporine was reduced and eventually discontinued 3 weeks postsurgery.

Iron preparations for children

1966 ◽  
Vol 4 (3) ◽  
pp. 9-11
Keyword(s):  
Bone Marrow ◽  
Iron Deficiency ◽  
Blood Smear ◽  
Binding Capacity ◽  
Iron Binding ◽  
Iron Stores ◽  
Plasma Iron ◽  
Hypochromic Anaemia ◽  
Iron Binding Capacity

We have discussed iron preparations for adults in earlier articles;1 much of the information applies equally to children. Iron is not a ‘tonic’ and should be given only to prevent or correct iron deficiency. Estimation of the haemoglobin and inspection of a blood smear are the minimum investigations necessary before iron is prescribed in therapy. When deficiency is suspected in the absence of hypochromic anaemia, plasma iron and iron-binding capacity should be estimated and/or the bone marrow examined for haemosiderin crystals which disappear when iron stores are depleted.

Immune-Mediated Neutropenia in a Miniature Poodle

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Benjamin Brunson
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspirate ◽  
Clinical Signs ◽  
Response To Therapy ◽  
Tertiary Referral Center ◽  
Immune Mediated ◽  
Specialized Equipment ◽  
History Of ◽  
Light Sedation ◽  
The Right

ABSTRACT A 10 yr old spayed female toy poodle was presented to a tertiary referral center for a 10 day history of waxing and waning lethargy, vomiting, diarrhea, and anorexia. An immune-mediated neutropenia (IMN) was suspected to be the underlying cause of her clinical signs. A bone marrow aspirate was obtained from the chostochondral junction of the 11th and 12th ribs on the right side and provided a definitive diagnosis of IMN. A positive response to therapy and repeat blood work further confirmed the diagnosis. Obtaining bone marrow aspirates from the chostochondral junction is a safe, cheap, and reliable method of diagnosing IMN and can be performed in the private practice setting with light sedation and minimal need for specialized equipment.

scholarly journals Some viral, rickettsial and leptospiral infections diagnosed in Serbia. A serological study

1954 ◽  
Vol 52 (2) ◽  
pp. 129-150 ◽  
Author(s):  
A. L. Terzin ◽  
M. N. BordjoŠki ◽  
M. V. Milovanović ◽  
Lj. V. Stojković ◽  
M. M. Dimić
Keyword(s):  
Infectious Diseases ◽  
Infectious Mononucleosis ◽  
Influenza A ◽  
Q Fever ◽  
Soluble Antigen ◽  
Serological Tests ◽  
Marked Rise ◽  
Cold Agglutinins ◽  
Type Antigen ◽  
Virus Pneumonia

An analysis is given of the serological tests performed over a period of 15 months with viral, rickettsial and leptospiral antigens. The analysed material is made up of about 9400 tests performed on 4036 samples of serum obtained from 2430 patients and 536 animals.The incidence of the various diseases, the distribution of the positive results according to diseases, and the height of the specific titres, as well as the height of the residual titres found in the material, are discussed and analysed in detail.The procedure for the preliminary screening of the material, as well as the methods used in performing the different serological tests, are described and discussed.A few examples of possible double infections are quoted, namely atypical virus pneumonia with influenza, and influenza A with B.An analysis of the results of 1723 tests performed with influenza antigens on 909 samples of sera is presented.The results obtained from testing about 1000 sera for cold agglutinins and 482 sera for MG agglutinins are discussed in detail.Some cases of liver affections showed a marked rise in titre both of cold agglutinins and of MG agglutinins.The serum samples, numbering about 1050, drawn from normal persons or patients suffering from infections other than Q-fever, all gave titres lower than 1/64 when tested with Q-fever antigen, except the sera of four persons who were probably cases of recent inapparent infection.The geometrical mean of the titres found in sera drawn from acute Q-fever patients between the 29th and 60th days of their illness was 1/355. Of the 500 sera from various animals, 100 from sheep and eight from cows had titres of 1/8 to 1/64 against the Q-fever antigen.Thirty-four sera have been positive when tested with the soluble antigen of both the epidemic and the murine types of typhus but no serum has given a higher titre with the murine type antigen than with the epidemic type antigen. Of the thirty-four sera tested with both antigens the titres obtained with the epidemic antigen were higher than with the murine antigen in 28.The results obtained with 417 sera tested with the mumps antigen, and with the 222 sera tested with the lymphocytic choriomeningitis antigen are reported and discussed in detail.Great individual variation has been observed in the time of appearance and rise and fall of the Paul-Bunell titres. Consequently, it is advised that early and frequent blood samples should be obtained from patients who are suspected to be suffering from infectious mononucleosis. On the basis of the results of 316 Paul-Bunnell tests it is suggested that a titre of 1/20, if preceded or followed by a negative serum sample, should be taken as conclusive evidence of infectious mononucleosis.3080 human and 164 animal sera have been investigated for the presence of antibodies to various types of leptospirae. In both human and animal sera antibodies have been found most frequently against L. sejroe and L. pomona.The results of a few tests performed with toxoplasma antigen are mentioned briefly.We wish to express our gratitude to all our colleagues in Belgrade and other parts of the country who have provided us with information and additional samples of blood when requested, in particular Prof. K. Todorowich of the Infectious Diseases Hospital, Belgrade, and Drs Lj. Vuksich, M. Morelj, B. Arsich, D. Mehl and R. Papo of the Army Medical School, Belgrade.We wish to thank Dr R. Djorich of the Infectious Diseases Hospital, Belgrade, for the supply of material for testing for atypical virus pneumonia and aseptic meningitis, and Dr Ž. Perishich for help with our cases of infectious mononucleosis. Mrs Martha Milivojevich gave valuable assistance with the complement-fixation tests and with the compilation of material for this report.

Sign in / Sign up

Export Citation Format

Share Document