Clinical Pathology Chapter 5
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If reticulocytes are high u have regenerative anemia (rbc are larger)
If reciulocytes are lower than normal u have non regenerative anemia
If u have chronic renal failure, why r they anemic erthrpoietin. Kidneys aren't producing it.
- chromic - color
- normal normachromic
- high is hyperchromic
- normal mcv is normacidic
- high mcv is macrocidic
microcidic anemia - lower than normal color MCV
- An increase in either RBC count, the total hemoglobin, and or hematocrit.
- Bad because blood should have a certain balance. RBC's go into body parts. like molasses.
Polycythemica Results in
- sludging- increased blood viscosity and inhibits proper blood flow.
- Maybe absolute or relative
Symptoms for Polycythemia Vera ( a cancer)
- Hematemesis (vomiting of blood) and hematachezia (Blood in stool)
- (RBC are being squeezed into brain bladder)
Diagnosis for Polycythemia
- High PCV and RBC parameters
- Bone marrow is overproducing RBC
Treatment for polycythemia
- Chemotherapy (hydroxyurea) chemo drug
# RBC are actually increased
Absolute Primary Polycythemia
also known as
- Polycythemia Rubra Vera
- A neoplastic condition where the bone marrow increases the production of all cell lines, but mostly RBC's
- Decreased erythropioten (hormones secreted by the kidneys) levels
- Rare condition in dogs, cats and cattle
Secondary Polycythemia (absolute) develops in response to what
- Develops in response to hypoxemia (reduction of oxygen) and an increase in erythropoietin (Hormones secreted by kidneys) stimulation
- Seen when animals move to higher elevations
- Any condition which decreases blood flow to the kidneys Decreased blood flow to the kidney is interpreted as hypoxemia and stimulates the release of erythropoietin
- Conditions such as heart failure and renal arterial thrombosis (blood clotting)
Red Cell Storage Pools
What percentage is not circulating
where are they stored
rbc production takes how many days
- 30-40% of rbc are not circulating: they are held in reserve in the bone marrow and spleen
- These reserves helo the body respond quickly to acute needs sonce RBc production in the bone marrow takes 3-6 days.
- Premature release of RBC from these storage pools can result in an absolute polycythemia
what is the cause of Relative Polycythemia
Most common cause is dehydration
what happens to the RBC in Relative Polycythemia
the actual total body mass of RBCs remains the same, but there is a decrease in the plasma level. TP is normal.
- Decrease in the fluid part of the blood
- Common in any condition where there is loss of body fluids, dehydration, or shift in fluid distribution.
- (Dehydration) Vomiting, diarrhea, polyuria, excessive sweating
- (HGE) Stress
- in Shock, there is vascular pooling and fluid shifts out of the vasculature, resulting i hemoconcentration.
where are WBC storage pools
What percentage is not in circulation
- in the bone marrow and along the wall throughout the bloodstream.
- Between 50- 75% of neutrophils are not circulating :rather they are adhered along the blood vessel walls.
Define margination or pavementing
- Neutrophils are not circulating. They are adhered along the blood vessel wall.
- Marginated Neutrophils constitute the "Marginal Pool"
- Movement of WBC from the bone marrow reserves, and back and forth between the bloodstream and the marginated pool can result in rapid changes to WBC differential and total WBC readings.
(CNP) Circulating Neutrophil pool
CNP Neutrophils last 6-7 hours in circulation and 4 days in tissue.
Form of Leukocytosis, an increase in circulating neutrophils.
When the neutrophilia includes and increased number of band cells (immature Neutrophils) it is called
What causes neutrophilia
Epinephrine- induced neutrophilia (physiological neutrophilia) Stress and anxiety
Corticosteroid -induced neutrophilia (stress neutrophilia) or medication as prednisone (used to treat inflammatory conditions)
Neutrophilia induced by tissue demand for phagocytic function (inflammatory disease) pain, surgery, trauma
Corticosteroid induced neutrophilia occurs _ or __
- It occurs naturally (stress) or due to steroid injection
- Mobilization of marginal and maturation pools
- Steroids also inhibit Neutrophils from leaving the blood stream
- No Left Shift (no increase in band cells)
- Causes include stress secondary to pain, anesthesia, surgical manipulation, trauma, neoplasia and hyperadrenocorticism(Cushings Disease- too much glucocorticoid is produced)
- Results in the characteristic "stress Hemogram"
Mechanisms of Neutrophilia
- Epinephrine- induced neutrophilia (physiological neutrophilia)
- Fear, exercise, excitement, strange surroundings, causes release of epinephrine from adrenal medulla (fright or flight)
- Mobilization of cells from marginal pool only (no left Shift)
- Transient 20- 30 min
- Only in healthy animals
the reproduction or multiplication of similar forms, especially of cells
Neutrophilia induced by tissue demand for phagocytic function
- (inflammatory disease-infection)
- The magnitude of inflammatory neutrophilia is determined by the balance between the rates of bone marrow release and tissue emigration. If the rate of bone marrow release exceeds the rate of emigration excee3ds the bone marrow release rate neutrophila occurs.
- Generally results in a left shift.
Regenerative left shift
- if mature cells continue to outnumber immature cells.
- Mature neutophils outnumber bands , and are elevated or normal.
Degenerative left shift
- If immature cells start to outnumber mature cells, there is a left shift without a neutrophilia.
- Excessive neutrophil consumption → bands and/or less mature forms outnumber mature neutrophils.
Neutropenia is the decrease in
Causes for neutropenia
- caused by overwhelming tissue demand for phagocytes (infection)
- Neutropenia is casued by granulopoietic hypoplasia (reduced production neutropenia)
- Sequestration neutropenia (shock)
Mechanisms of neutropenia
- Neutropenia caused by overwhemlming tissue damand for phagocytes.
- Neutropenia is a marked decrease in the number of neutrophils.
- Transit time in the bloodstream markedly reduced
- Large number of immature neutrophils
- Seen in peracute pyogenic bacterial infections (peritonitis, bovine mastitis, aspiration pnemonia) and in some viral diseases (cancer Distemper and Infectious Hepatitis)
Neutropenia caused by granulopoietic hypoplasia (reduced production neutropenia)
- Diminished bone marrow and release
- Occurrence of immature neutrophils in the blood stream is variable.
- Seen in infections (FIP, Toxoplasmosis, Canine Erhlichiosis) Seen in intoxication (cancer Chemotherapy)
- May be genetic (grey collie neutropenia)
cause of Sequestration Neutropenia
- Neutropenia suddenly and transiently occurs because the neutrophils marginate
- Causes include anaphylactic shick and endotoxemia
What is Lymphocytosis
an increase in circulating lymphocytes
Mechanisms of Lymphocytosis
- Physiologic (epinephrine-induced) lymphocytosis
- Chronic infections
- Lymphosarcoma and or leukemia virus infection
- Enlargement of lymph nodes do not necessarily cause a corresponding change in blood lymphocyte count
a decrease in circulating lymphocytes
- Stress and steroid related
- Loss of lymphatic fluid (chylothorax- loss into the thoracic cavity)
- Cancer Chemotherapy
- Congenital T-cell Immunodeficiency
Increase in circulating Monocytes
- Stress and steroid related
- Chronic Inflammation
- Granulomatous diseases
A decrease in circulating monocytes
- seen in pancytopenic conditions
- Not generally clinical significant in standard leukograms
- ( a tabulation of the leukocytes present in a blood sample)
An increase in circulating Eosinophils
Eosinophilia- Allergin reaction or parasite
- Parasitism in which sensitization has occured, or where host tissue -parasite contact is lond and intimate.
- Seen in specific eosinophilic Granuloma Complex in cats (excessive Eosinophils)
- Eosinophilic enterocolitis
- Immediate hypersensitivity disorders
Decrease in circulating eosinophils
- Stress and steroid related
- All pancytopenic conditions
The Stress Leukogram
- Increased total WBC (15,000-35,000)
- Neutrophilia No left Shift
The Inflammatory Leukogram
- Increased Total WBC (20,000- 35,000)
- Neutrophilia with significant left shift and toxic neutrophils.
- Eosinophenia (may be diseased-stress related)
- Generally a monocyte (depending on type of disease)
What is ACT?
- Activated coagulation time (ACT) of whole blood in normal dogs
- Clotting time
- Average time is 77.5 seconds
- PROTOCOL Dispense 2ml of freshly drawn whole blood into each of three siliceous earth vacutainers (Becton Dickinson) and commence timing immediately. Jugular venupuncture is recommended to minimise the delay between sampling and commencing timing. Gently invert each tube five times. Tilt each tube gently at 10 second intervals and observe the blood as it spreads along the length of the tube. The ACT is the mean time taken to the appearance of the first unmistakable clot in each of the three tubes (this precedes the formation of a solid clot involving the whole sample).
Prothrombin time (PT)
is a blood test that measures how long it takes blood to clot
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