“Algorithm Issues” in a Canine Hemogram Dennis B. DeNicola, DVM, PhD, DACVP Chief Veterinary Educator IDEXX Laboratories

11 year-old, intact male Beagle WBC = 18.69 K/L HIGH ( 5.50 – 16.90 ) LYM = 3.00 K/L ( 0.70 – 4.90 ) MONO = 2.73 K/L HIGH ( 0.10 – 1.40 ) NEU = 12.24 K/L HIGH ( 2.00 – 12.00 ) EOS = 0.62 K/L ( 0.10 – 1.49 ) BASO = 0.11 K/L HIGH ( 0.00 – 0.10 ) %LYM = 16.0 % %MONO = 14.6 % %NEU = 65.5 % %EOS = 3.3 % %BASO = 0.6 % HCT = 52.5 % ( 37.0 – 55.0 ) RBC = 7.80 M/L ( 5.50 – 8.50 ) HGB = 19.5 g/dL HIGH ( 12.0 – 18.0 ) RETIC = 38.9 K/L %RETIC = 0.5 % MCV = 67.3 fL ( 60.0 – 72.0 ) RDW = 15.5 % ( 14.7 – 17.9 ) MCHC = 37.2 g/dL HIGH ( 31.0 – 37.0 ) MCH = 25.03 pg HIGH ( 19.50 – 24.50 ) PLT = 156. K/L LOW ( 175 – 500 ) MPV = 29.38 fL PCT = 0.5 % PDW = 19.8 % Differential algorithm issues. Confirm with blood smear.

11 year-old, intact male Beagle Erythron HCT = 52.5 % ( 37.0 – 55.0 ) RBC = 7.80 M/L ( 5.50 – 8.50 ) HGB = 19.5 g/dL HIGH ( 12.0 – 18.0 ) RETIC = 38.9 K/L %RETIC = 0.5 % MCV = 67.3 fL ( 60.0 – 72.0 ) RDW = 15.5 % ( 14.7 – 17.9 ) MCHC = 37.2 g/dL HIGH ( 31.0 – 37.0 ) MCH = 25.03 pg HIGH (19.50 – 24.50 )

11 year-old, intact male Beagle Erythron HCT = 52.5 % ( 37.0 – 55.0 ) RBC = 7.80 M/L ( 5.50 – 8.50 ) HGB = 19.5 g/dL HIGH ( 12.0 – 18.0 ) RETIC = 38.9 K/L %RETIC = 0.5 % MCV = 67.3 fL ( 60.0 – 72.0 ) RDW = 15.5 % ( 14.7 – 17.9 ) MCHC = 37.2 g/dL HIGH ( 31.0 – 37.0 ) MCH = 25.03 pg HIGH (19.50 – 24.50 ) Hyperchromasia

11 year-old, intact male Beagle Erythron HCT = 52.5 % ( 37.0 – 55.0 ) RBC = 7.80 M/L ( 5.50 – 8.50 ) HGB = 19.5 g/dL HIGH ( 12.0 – 18.0 ) RETIC = 38.9 K/L %RETIC = 0.5 % MCV = 67.3 fL ( 60.0 – 72.0 ) RDW = 15.5 % ( 14.7 – 17.9 ) MCHC = 37.2 g/dL HIGH ( 31.0 – 37.0 ) MCH = 25.03 pg HIGH (19.50 – 24.50 ) Hyperchromasia Physiologically impossible Extracellular hemoglobin (hemolysis)

Erythron Interpretation No significant abnormalities Hyperchromasia Physiologically impossible Probable in vitro or in vivo hemolysis Extracellular hemoglobin present

11 year-old, intact male Beagle Leukon WBC = 18.69 K/L HIGH ( 5.50 – 16.90 ) LYM = 3.00 K/L ( 0.70 – 4.90 ) MONO = 2.73 K/L HIGH ( 0.10 – 1.40 ) NEU = 12.24 K/L HIGH ( 2.00 – 12.00 ) EOS = 0.62 K/L ( 0.10 – 1.49 ) BASO = 0.11 K/L HIGH ( 0.00 – 0.10 ) %LYM = 16.0 % %MONO = 14.6 % %NEU = 65.5 % %EOS = 3.3 % %BASO = 0.6 % Differential algorithm issues. Confirm with blood smear.

11 year-old, intact male Beagle Leukon WBC = 18.69 K/L HIGH ( 5.50 – 16.90 ) Mild leukocytosis

11 year-old, intact male Beagle Leukon WBC = 18.69 K/L HIGH ( 5.50 – 16.90 ) LYM = 3.00 K/L ( 0.70 – 4.90 ) MONO = 2.73 K/L HIGH ( 0.10 – 1.40 ) NEU = 12.24 K/L HIGH ( 2.00 – 12.00 ) EOS = 0.62 K/L ( 0.10 – 1.49 ) BASO = 0.11 K/L HIGH ( 0.00 – 0.10 ) %LYM = 16.0 % %MONO = 14.6 % %NEU = 65.5 % %EOS = 3.3 % %BASO = 0.6 % Differential algorithm issues. Confirm with blood smear. Mild leukocytosis Minimal neutrophilia

11 year-old, intact male Beagle Leukon WBC = 18.69 K/L HIGH ( 5.50 – 16.90 ) LYM = 3.00 K/L ( 0.70 – 4.90 ) MONO = 2.73 K/L HIGH ( 0.10 – 1.40 ) NEU = 12.24 K/L HIGH ( 2.00 – 12.00 ) EOS = 0.62 K/L ( 0.10 – 1.49 ) BASO = 0.11 K/L HIGH ( 0.00 – 0.10 ) %LYM = 16.0 % %MONO = 14.6 % %NEU = 65.5 % %EOS = 3.3 % %BASO = 0.6 % Differential algorithm issues. Confirm with blood smear. Mild leukocytosis Minimal neutrophilia Mild monocytosis

11 year-old, intact male Beagle Leukon WBC = 18.69 K/L HIGH ( 5.50 – 16.90 ) LYM = 3.00 K/L ( 0.70 – 4.90 ) MONO = 2.73 K/L HIGH ( 0.10 – 1.40 ) NEU = 12.24 K/L HIGH ( 2.00 – 12.00 ) EOS = 0.62 K/L ( 0.10 – 1.49 ) BASO = 0.11 K/L HIGH ( 0.00 – 0.10 ) %LYM = 16.0 % %MONO = 14.6 % %NEU = 65.5 % %EOS = 3.3 % %BASO = 0.6 % Differential algorithm issues. Confirm with blood smear. Mild leukocytosis Minimal neutrophilia Mild monocytosis Minimal basophilia

11 year-old, intact male Beagle Leukon WBC = 18.69 K/L HIGH ( 5.50 – 16.90 ) LYM = 3.00 K/L ( 0.70 – 4.90 ) MONO = 2.73 K/L HIGH ( 0.10 – 1.40 ) NEU = 12.24 K/L HIGH ( 2.00 – 12.00 ) EOS = 0.62 K/L ( 0.10 – 1.49 ) BASO = 0.11 K/L HIGH ( 0.00 – 0.10 ) %LYM = 16.0 % %MONO = 14.6 % %NEU = 65.5 % %EOS = 3.3 % %BASO = 0.6 % Differential algorithm issues. Confirm with blood smear. Mild leukocytosis Minimal neutrophilia Mild monocytosis Minimal basophilia

Leukogram Interpretation Mild leukocytosis Minimal neutrophilia Potential “normal” for this animal Potential physiologic (epinephrine) Potential minimal to mild inflammation Mild monocytosis Inflammation associated with tissue demand for macrophages Minimal basophilia Insignificant

11 year-old, intact male Beagle Thrombon PLT = 156 K/L LOW ( 175 – 500 ) MPV = 29.38 fL PCT = 0.5 % PDW = 19.8 %

11 year-old, intact male Beagle Thrombon PLT = 156 K/L LOW ( 175 – 500 ) Thrombocytopenia Mild

11 year-old, intact male Beagle Thrombon PLT = 156 K/L LOW ( 175 – 500 ) MPV = 29.38 fL PCT = 0.5 % PDW = 19.8 % Thrombocytopenia Mild with enlarged platelets

11 year-old, intact male Beagle Thrombon PLT = 156 K/L LOW ( 175 – 500 ) MPV = 29.38 fL PCT = 0.5 % PDW = 19.8 % Thrombocytopenia Mild with enlarged platelets and variably-sized platelets

Thrombon Interpretation Mild thrombocytopenia Probable bone marrow response to peripheral demand for platelets Enlarged platelets Variably-sized platelets Potential mechanism of thrombocytopenia Peripheral blood consumption Peripheral blood destruction

11 year-old, intact male Beagle WBC = 18.69 K/L HIGH ( 5.50 - 16.90 ) LYM = 3.00 K/L ( 0.70 - 4.90 ) MONO = 2.73 K/L HIGH ( 0.10 - 1.40 ) NEU = 12.24 K/L HIGH ( 2.00 - 12.00 ) EOS = 0.62 K/L ( 0.10 - 1.49 ) BASO = 0.11 K/L HIGH ( 0.00 - 0.10 ) %LYM = 16.0 % %MONO = 14.6 % %NEU = 65.5 % %EOS = 3.3 % %BASO = 0.6 % HCT = 52.5 % ( 37.0 – 55.0 ) RBC = 7.80 M/L ( 5.50 – 8.50 ) HGB = 19.5 g/dL HIGH ( 12.0 – 18.0 ) RETIC = 38.9 K/L %RETIC = 0.5 % MCV = 67.3 fL ( 60.0 – 72.0 ) RDW = 15.5 % ( 14.7 – 17.9 ) MCHC = 37.2 g/dL HIGH ( 31.0 – 37.0 ) MCH = 25.03 pg HIGH ( 19.50 – 24.50 ) PLT = 156. K/L LOW ( 175 - 500 ) MPV = 29.38 fL PCT = 0.5 % PDW = 19.8 % Differential algorithm issues. Confirm with blood smear. Confirm with blood smear

11 year-old, intact male Beagle Leukon WBC = 18.69 K/L HIGH ( 5.50 – 16.90 ) LYM = 3.00 K/L ( 0.70 – 4.90 ) MONO = 2.73 K/L HIGH ( 0.10 – 1.40 ) NEU = 12.24 K/L HIGH ( 2.00 – 12.00 ) EOS = 0.62 K/L ( 0.10 – 1.49 ) BASO = 0.11 K/L HIGH ( 0.00 – 0.10 ) %LYM = 16.0 % %MONO = 14.6 % %NEU = 65.5 % %EOS = 3.3 % %BASO = 0.6 % Differential algorithm issues. Confirm with blood smear. Mild leukocytosis Minimal neutrophilia Mild monocytosis Minimal basophilia

Leukon – Peripheral Blood Film Review

Leukon – Peripheral Blood Film Review

Leukon – Peripheral Blood Film Review

Leukon – Peripheral Blood Film Review

Leukon – Peripheral Blood Film Review

Leukon – Peripheral Blood Film Review

Leukon – Peripheral Blood Film Review

Leukon – Peripheral Blood Film Review

Leukon – Peripheral Blood Film Review Eosinophil Basophil Monocyte

Leukogram Interpretation Mild leukocytosis Probable normal neutrophil number Prominent mastocythemia Morphologically atypical mast cells suggesting a neoplastic process Other leukocytes likely in normal numbers

11 year-old, intact male Beagle Thrombon PLT = 156 K/L LOW ( 175 – 500 ) MPV = 29.38 fL PCT = 0.5 % PDW = 19.8 % Thrombocytopenia Mild with enlarged platelets and variably-sized platelets

Thrombon - Peripheral Blood Film Review

Thrombon Interpretation Mild thrombocytopenia Probable bone marrow response to peripheral demand for platelets Enlarged platelets Variably-sized platelets Potential mechanism of thrombocytopenia Peripheral blood consumption Peripheral blood destruction Comments following blood film review Interpretation above confirmed

11 year-old, intact male Beagle WBC = 18.69 K/L HIGH ( 5.50 - 16.90 ) LYM = 3.00 K/L ( 0.70 - 4.90 ) MONO = 2.73 K/L HIGH ( 0.10 - 1.40 ) NEU = 12.24 K/L HIGH ( 2.00 - 12.00 ) EOS = 0.62 K/L ( 0.10 - 1.49 ) BASO = 0.11 K/L HIGH ( 0.00 - 0.10 ) %LYM = 16.0 % %MONO = 14.6 % %NEU = 65.5 % %EOS = 3.3 % %BASO = 0.6 % HCT = 52.5 % ( 37.0 – 55.0 ) RBC = 7.80 M/L ( 5.50 – 8.50 ) HGB = 19.5 g/dL HIGH ( 12.0 – 18.0 ) RETIC = 38.9 K/L %RETIC = 0.5 % MCV = 67.3 fL ( 60.0 – 72.0 ) RDW = 15.5 % ( 14.7 – 17.9 ) MCHC = 37.2 g/dL HIGH ( 31.0 – 37.0 ) MCH = 25.03 pg HIGH ( 19.50 – 24.50 ) PLT = 156. K/L LOW ( 175 - 500 ) MPV = 29.38 fL PCT = 0.5 % PDW = 19.8 % Differential algorithm issues. Confirm with blood smear.