Hematologic, prostaglandin F2α -metabolite, serum amyloid A, and serum iron changes in horses with experimentally induced endotoxemia.

BACKGROUND: Endotoxemia is a common and severe disease of horses. Most previous studies have monitored changes caused by a bolus dose of endotoxin over short time periods. OBJECTIVES: We aimed to describe inflammatory responses to endotoxin with inflammatory and hematologic markers monitored over a longer time than has been performed in the past using more prolonged endotoxin exposures. METHODS: Escherichia coli O55:B5 endotoxin was administered as a 6-hour continuous intravenous infusion of lipopolysaccharide (LPS) to eight horses. Blood cell counts, and prostaglandin F2α -metabolite (PGM), serum amyloid A (SAA), and serum total iron concentrations were monitored for up to 3 or 6 days. RESULTS: An immediate and severe decrease in neutrophils and monocytes occurred in all horses, which subsequently changed to a moderate to strong neutrophilia and monocytosis that persisted for more than 78 hours postinfusion (PI) of LPS. Lymphocyte and eosinophil numbers decreased gradually and then normalized after 66- and 78-hours PI, respectively. Mild to moderate, biphasic thrombocytopenia occurred. A pronounced, transient increase in PGM occurred between 1 and 7 hours, peaking at 2 hours. Serum amyloid A began to increase after 6 hours PI and remained elevated after 72 hours PI. Serum iron was decreased between 6 and 48 hours. The clinical signs were most prominent during the first 24 hours PI and subsided within 48 hours PI. CONCLUSIONS: Neutrophilia, monocytoses, and high SAA concentrations were present in horses even after the clinical signs had subsided. Serum iron normalized before SAA. Knowledge of these findings is imperative when interpreting laboratory results in horses with possible endotoxin exposure.

Hepatozoon canis infection causing a strong monocytosis with intra-monocytic gamonts and leading to erroneous leukocyte determinations.

In this case report, a Swedish flat-coated retriever was diagnosed with an extensive Hepatozoon canis infection. The dog had a prominent monocytosis (14.0 × 109 /L) with H canis gamonts detected in most monocytes, but none were found in the neutrophils. On the hematology system ADVIA 2120 peroxidase (PEROX) cytogram, most leukocytes were seen as a distinct cell population above the lymphocytes, which indicated that most of the cells were larger than lymphocytes and had weak myeloperoxidase staining. This distinct cell cluster appeared to be of a single cell type but was incorrectly divided by the ADVIA 2120 into lymphocytes, monocytes, and large unstained cells (LUC). The total leukocyte counts on the ADVIA 2120 WBC basophil (BASO) channel were much higher than that on the WBC PEROX count. The WBC BASO cytogram appeared abnormal with two parallel cell populations, so the BASO WBC count was considered erroneous. Polymerase chain reaction and DNA sequencing verified H canis infection. The dog was treated with subcutaneous imidocarb dipropionate (6 mg/kg) injections every other week. Post-treatment hematology analyses indicated that the percentage of parasitized leukocytes decreased from 40% to 5% about 4 weeks after the start of treatment and were not found in any monocytes 6 weeks after the beginning of the treatment. In conclusion, H canis infection in this dog was associated with a strong monocytosis, and gamonts were present in many monocytes, which caused aberrant automated leukocyte counts to occur.

Time-related changes in equine neutrophils after experimental endotoxemia: myeloperoxidase staining, size, and numbers.

BACKGROUND: Neutrophil myeloperoxidase content is determined by the Advia 2120 hematology system by staining characteristics. Changes in myeloperoxidase staining are shown by location of neutrophils on Advia peroxidase dot plots and as myeloperoxidase index (MPXI). Significant changes in MPXI have been reported during severe inflammation in horses, dogs, and people but conclusions were inconsistent. OBJECTIVES: Infusion of endotoxin was used to initiate an inflammatory stimulus under controlled conditions and over a longer time period than in previous studies to document kinetics of changes in neutrophil numbers, morphology, and myeloperoxidase staining. Identification of consistent time-related changes may allow better interpretation of changes in neutrophil characteristics during inflammation. MATERIALS: Five Standardbred trotting horses received an intravenous infusion over a 6-hour period with Escherichia coli endotoxin. Neutrophil count, MPXI, neutrophil characteristics in Advia 2120 Perox dot plots and neutrophil morphology in blood smears were monitored with repeated sampling for up to 10 days. RESULTS: Endotoxin infusion immediately caused severe neutropenia which converted to neutrophilia 14 hours after start of endotoxin infusion. Neutrophilia was still present 78 hours after start of infusion. Large "giant" neutrophils first appeared in blood smears and Advia Perox dot plots after 36-48 hours. A marked and consistent decrease in MPXI was seen in all horses 6 days (150 hours) after endotoxin exposure. CONCLUSIONS: Endotoxemia caused prominent, time-related changes in equine neutrophil characteristics including emergence of giant neutrophils and markedly decreased MPXI several days after endotoxin infusion.

Reducing error in feline platelet enumeration by addition of Iloprost to blood specimens: comparison to prostaglandin E1 and EDTA.

BACKGROUND: Prostaglandin E1 (PGE1) and Iloprost inhibit platelet aggregation and should prevent or minimize preanalytic error with feline platelet enumeration. OBJECTIVES: The objective was to compare the relative effectiveness in reducing errors in platelet enumeration by adding Iloprost to feline EDTA blood specimens in comparison to adding PGE1 or EDTA alone. In addition, a grading system for platelet aggregation in blood smears was evaluated for effectiveness in predicting prominent errors and compared to ADVIA's PLT-CLM flag. Finally, the use of plateletcrit in feline blood with platelet aggregation was evaluated. METHODS: Blood specimens from 35 cats were included. Blood was collected into EDTA tubes with or without Iloprost or PGE1, and was rapidly mixed. Platelet count (PLT), plateletcrit (PCT), mean platelet volume (MPV), and platelet flags were determined with an ADVIA 2120. Manual PLT was performed with a Leucoplate stain. PLT was determined by an IDEXX VetAutoread hematology analyzer (QBC). RESULTS: Neither addition of Iloprost nor PGE1 to EDTA blood specimens completely prevented platelet aggregation. Iloprost-treated specimens had the least severe aggregation. PGE1 was better than EDTA alone. Significant errors in PLT results were consistently identified by the grading system. ADVIA's PLT-CL flag usually predicted significant errors in PLT. QBC PLT results showed high imprecision. Manual PLT error was smaller than ADVIA PLT in EDTA specimens with aggregation. CONCLUSIONS: Adding Iloprost to feline blood specimens improved platelet enumeration accuracy. A grading system for severity of platelet aggregation and usually the ADVIA's PLT-CL alarm predicted specimens with significant errors in platelet enumeration.

Comparison of a Schmidt and Haensch refractometer and an Atago PAL-USG Cat refractometer for determination of urine specific gravity in dogs and cats.

BACKGROUND: The performance of a digital Atago PAL-USG Cat refractometer (Atago) was compared with a Schmidt and Haensch, Goldberg type refractometer (S+H). MATERIALS AND METHODS: Specific gravity of 47 canine and feline urine samples was determined with both refractometers and the results were compared with Passing-Bablok and Bland-Altman plots. In addition, the specific gravity of dilutions of 10% glucose, 10% NaCl, and 3% albumin solutions was determined and compared with expected values. RESULTS: Both refractometers consistently reported 1.000 with distilled water. The correlation between both refractometers based on Passing-Bablok plots of 47 urine samples was excellent (r = .99), but, in the Bland-Altman plots, there was a significant, proportional, negative error for the Atago readouts. This was also illustrated by the fact that 10 urine samples with an S+H result of > 1.030 were read out between 1.023 and 1.028 by Atago. Schmidt and Haensch results of various glucose solutions matched exactly expected values, but Atago results were lower. Likewise, S+H results with diluted NaCl solutions were closer to expected results than Atago results. In contrast, Atago results with dilutions of 3% albumin were closer to expected results than S+H results. DISCUSSION: The Atago refractometer reported lower specific gravity results in urine and standard solutions of glucose and NaCl, which could adversely affect clinical decisions concerning normal renal function based on solute concentrations determined in canine and feline urine samples.

Theileria annae in a young Swedish dog.

A severe regenerative anemia was detected in a 12-week-old mixed breed puppy in Sweden. A small protozoan parasite was observed in erythrocytes on a blood smear. It was initially suspected to be Babesia gibsoni based on its size and because B. gibsoni was previously recorded in Sweden. Surprisingly, specific polymerase chain reaction analysis identified the protozoan as Theileria annae. T. annae is endemic in Northwest Spain, is very uncommonly reported elsewhere and has never been recorded in Scandinavia. T. annae has been identified in dogs used for dog fighting, and it is thought to be transmitted by dog bites. This puppy was a mixed pit bull terrier. Pit bull terriers are sometimes used for dog fighting. T. annae has been reported to be transmitted vertically, and in light of the puppy's age, this transmission was suspected in the present case.

Enumeration of feline platelets in ethylenediamine tetra-acetic acid anticoagulated blood with the ADVIA 2120 system and two manual methods: Leucoplate and Thrombo-TIC.

A manual method (Thrombo-TIC; Bioanalytic GmbH, Umkirch/Freiburg, Germany) was advertised to disaggregate platelet clumps and to make human platelets spherical to improve platelet enumeration. The current study's hypothesis was that this method would perform better than current methods for feline blood anticoagulated with ethylenediamine tetra-acetic acid (EDTA), which often contains platelet aggregates. Platelet concentrations (PLTs) were determined in 21 feline blood samples by 3 methods. Thrombo-TIC was compared to the manual method (Leucoplate; Sobioda, Montbonnot-Saint-Martin, France) currently used in the authors' laboratory along with an ADVIA 2120 (Siemens AG, Eschborn, Germany) optical platelet concentration. Feline blood samples often contained platelet aggregates. ADVIA flagged for platelet aggregates in 11 of the 21 feline blood samples, and examination of blood smear revealed platelet aggregates in 14 of the 21 samples. The hemocytometers displayed more platelet aggregates with the Thrombo-TIC method than with Leucoplate. The method giving the greatest PLT was considered most accurate. The Leucoplate median PLT (238 × 10(9)/1) was greater than Thrombo-TIC (202 × 10(9)/1) or ADVIA (157 × 10(9)/1). Intra-assay precision was determined for the 3 methods using the 21 feline blood samples. Median Thrombo-TIC and Leucoplate precision (7.4% and 7.3% coefficient of variation [CV], respectively) were similar and not much worse than ADVIA (5.9% CV). The Thrombo-TIC method did not appear to perform better than the current manual method (Leucoplate). Leucoplate appeared least affected by platelet aggregation in feline blood. The ADVIA automated PLT appeared to be most negatively affected by platelet aggregation. The Thrombo-TIC method did not appear to prevent platelet aggregation in feline EDTA blood samples and, thus, is not recommended for such use.

Validation of Advia plateletcrit for assessing platelet mass in dogs, including Cavalier King Charles spaniels.

BACKGROUND: Determination of the plateletcrit (PCT) is the most effective way to evaluate platelet mass in dogs, such as Cavalier King Charles spaniel (CKCS) dogs, with macrothrombocytopenia. The IDEXX VetAutoread hematology analyzer, which performs quantitative buffy coat (QBC) analysis, has been validated to determine platelet mass in CKCS dogs. The Advia 2120 reports a PCT, but the validity of this value has not been evaluated for dogs with macrothrombocytopenia. OBJECTIVES: The goal of this study was to validate MPV and PCT determined by the Advia 2120 in dogs, including CKCS dogs, comparing values with those obtained from QBC analysis. METHODS: Advia PCT was compared with QBC results from 43 CKCS dogs and 15 dogs of other breeds in one study. Advia PCT, platelet count, and MPV were evaluated to identify biologic patterns in 31 clinically healthy CKCS dogs and 66 dogs of 3 other breeds and to generate values used for comparisons. RESULTS: Advia PCT agreed well with QBC results in general, but had a negative bias and appeared to underestimate PCT in CKCS dogs with the lowest PCTs. Advia PCT and MPV results followed expected biologic patterns in CKCS dogs and dogs of other breeds with MPVs being highest in dogs with the lowest platelet counts. CONCLUSIONS: Advia 2120 PCT and MPV satisfactorily identified changes in platelet mass and size in CKCS dogs, but PCTs were lower than expected, especially in CKCS dogs with the lowest PCTs, when compared with QBC results.

Errors in basophil enumeration with 3 veterinary hematology systems and observations on occurrence of basophils in dogs.

BACKGROUND: Most automated hematology analyzers cannot detect canine or feline basophils. However, many veterinary laboratories continue to report basophils as part of the automated 5-part differential leukocyte count for dogs and cats. OBJECTIVES: The study objectives were to evaluate the performance of the Sysmex XT-2000iV, Advia 2120, and CELL-DYN 3500 hematology analyzers in detecting basophils using blood from dogs, cats, and rabbits with basophilia and to investigate the concurrence of basophilia and other hematologic changes, sex, and breed in dogs. METHODS: One or more of the 3 hematology analyzers was used to analyze 11 canine blood samples with prominent basophilia (≥ 5%) based on a manual differential count. In addition, samples from 2 cats and 4 rabbits with basophilia were analyzed with the Advia 2120. Leukocyte cytograms were inspected for the likely location of basophil cell clusters. In a retrospective study of canine patients, reports of hematologic results that included a manual leukocyte differential count were identified using the laboratory information system and examined for the occurrence of basophilia and other hematologic changes, sex, and breed of the dogs. RESULTS: Canine basophils were not detected by the Sysmex XT-2000iV or CELL-DYN 3500 analyzers, and neither canine nor feline basophils were detected by the Advia 2120. The Advia was able to detect basophils in rabbits. On the Sysmex cytogram canine basophils were found slightly above or together with neutrophils. On the Advia Perox cytogram canine basophils were located in upper part of the lymphocyte box and in the area of large unstained cells (LUC). Dogs with marked basophilia often had concurrent eosinophilia, and basophilia may be found more frequently in Rottweiler dogs than in other breeds. In 5 dogs with marked basophilia and without eosinophilia, marked thrombocytosis and anemia were noted. CONCLUSIONS: Canine basophils were not detected by these automated hematology analyzers, and careful analysis of instrument graphical displays or increased LUC (Advia) may guide the need to examine a blood smear for basophils.

Canine differential leukocyte counting with the CellaVision DM96Vision, Sysmex XT-2000iV, and Advia 2120 hematology analyzers and a manual method.

BACKGROUND: For differential leukocyte counts, automated blood smear evaluation systems have been too slow or inaccurate to replace or supplement the manual differential count. The CellaVision DM96Vision (DM96V), a new instrument, is an automated image analysis system that is rapid and accurate enough to be used for enumerating human leukocytes and may be useful for analysis of canine blood. OBJECTIVES: The aims of this study were to evaluate the performance of the DM96V in differential counting of canine leukocytes, to compare its performance with that of other methods, and to analyze interoperator variability. METHODS: Four methods of determining the leukocyte differential count of 108 canine blood samples were compared based on agreement, precision, and errors as well as relative performance. Differential counts were obtained using the DM96V, the manual method, and automated methods performed by the Advia 2120 and Sysmex XT-2000iV. RESULTS: All leukocyte types were detected by the DM96V and the manual method, and all 4 methods had similar mean and median results in most cases. The automated methods were more precise than either the DM96V or manual method when comparing identification of a single type of leukocyte, especially neutrophils and lymphocytes. However, precision of the automated methods was only fair for monocytes, and the Advia and Sysmex failed to identify basophils. The Advia reported fewer monocytes and eosinophils than did the other methods. Significantly fewer lymphocytes were identified by the manual method than by the Sysmex, Advia, and DM96V. The DM96V occasionally presented duplicate images of the same neutrophils. CONCLUSIONS: The CellaVision DM96V is a satisfactory system for facilitating canine differential leukocyte counting. The DM96V differential count was more similar to the manual count than to automated counts, which were more precise but had errors and omissions in detecting some types of leukocytes.

Artifactual changes in equine blood following storage, detected using the Advia 120 hematology analyzer.

BACKGROUND: Delayed analysis of blood samples may be caused by restricted access to laboratories. Artifactual changes may occur in the measured analytes as a consequence of delayed analysis and may complicate interpretation of the data. OBJECTIVE: The purpose of this study was to characterize artifactual changes in equine blood, due to storage, using the Advia 120 hematology analyzer. METHODS: Samples of blood from 5 horses were analyzed using the Advia 120 soon after collection and again after 24 and 48 hours of storage at either 4 degrees C or ambient laboratory temperature ( approximately 24 degrees C). RESULTS: Delayed analysis of equine blood samples resulted in increased numbers of normocytic hypochromic RBCs, increased numbers of macrocytic hypochromic RBCs, misclassification of granulocytes as mononuclear cells using the basophil reagent method, and pseudothrombocytosis, due to misclassification of ghost RBCs as platelets. The latter artifact was corrected by an amended version of the software. Many of the artifactual changes were identified by morphology flags. CONCLUSIONS: Characteristic changes in cytograms produced by the Advia 120 allowed recognition of artifactual changes in stored equine blood samples. These changes were less pronounced in samples stored at 24 degrees C than at 4 degrees C.

Artifactual effects of hypernatremia and hyponatremia on red cell analytes measured by the Bayer H*1 analyzer.

Hypernatremia in two cats and hyponatremia in a dog were associated with artifactual changes in red blood cell (RBC) indices and hematocrit (HCT) determined on a Bayer H*1 hematology analyzer. The RBC cytograms and histograms revealed a population shifted towards macrocytic, hypochromic RBC in the hypernatremic cats, and towards microcytic, hyperchromic RBC in the hyponatremic dog. Reference intervals for the difference between manual packed cell volume (PCV) and analyzer-derived HCT in normonatremic dogs, cats and horses were established. The difference between PCT and HCT was outside the reference values for all three patients. Quality control measures, such as measuring PCV, and reviewing cytograms and histograms are essential for detecting spurious changes in automated hematology measurements caused by abnormalities in serum sodium concentration and osmolality.

Hematopathology in dogs experimentally infected with a Swedish granulocytic Ehrlichia species.

Seven, adult, female beagles were inoculated with a Swedish granulocytic Ehrlichia organism closely related to Ehrlichia equi and E. phagocytophila. Blood and bone marrow changes were evaluated throughout the acute phase of infection. All dogs developed moderate to severe thrombocytopenia during the parasitemic period. The mean platelet volume and platelet distribution width increased, and large platelets were seen on blood smears when platelet numbers were low. In bone marrow, absolute numbers of megakaryocytes and immature megakaryocytes were increased. These results suggested the thrombocytopenia was caused by increased platelet destruction. The dogs also developed mild, normocytic, normochromic anemia, with simultaneous decreases in serum iron concentration and total iron-binding capacity that resembled the anemia of inflammation. In bone marrow, there was a slight increase in immature erythroid cells and no erythroid hypoplasia; iron stores were normal to increased. Myeloid hyperplasia was seen in all infected dogs, despite neutropenia in peripheral blood. Lymphopenia occurred early in the parasitemic period, but lymphocytes responded strongly and numbers increased above baseline levels by the end of parasitemia. Blast-transformed lymphocytes (5% to 20%) were seen in peripheral blood for a few days. Experimentally-induced canine granulocytic ehrlichiosis caused cytopenias of short duration, coincident with the appearance of ehrlichial inclusions in neutrophils.