Hooded Oriole Icterus cucullatus The southern California lifestyle ...
Dog with Icterus
description
Transcript of Dog with Icterus
![Page 1: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/1.jpg)
Dog with Icterus
Dennis B. DeNicola, DVM, PhD, DACVPChief Veterinary Educator
IDEXX Laboratories
![Page 2: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/2.jpg)
“Coalie”5 years oldSpayed femaleLhasa Apso
Presented with clinical history of anorexia, lethargy and icterus
![Page 3: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/3.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoWBC = 72.99 K/L HIGH ( 5.50 – 16.90 )LYM = 2.77 K/L ( 0.70 – 4.90 )MONO * 16.70 K/L HIGH ( 0.10 – 1.40 )NEU * 51.57 K/L HIGH ( 2.00 – 12.00 )EOS = 1.51 K/L HIGH ( 0.10 – 1.49 )BASO = 0.44 K/L HIGH ( 0.00 – 0.10 )
%LYM = 3.8 %%MONO = 22.9 %%NEU * 70.7 %%EOS * 2.1 %%BASO = 0.6 %HCT = 19.8 % LOW ( 37.0 – 55.0 )RBC = 2.73 M/L LOW ( 5.50 – 8.50 )HGB = 5.8 g/dL LOW ( 12.0 – 18.0 )RETIC = 215.4 K/L
%RETIC = 7.9 %MCV = 72.4 fL HIGH ( 60.0 – 72.0 )RDW = 21.1 % HIGH ( 14.7 – 17.9 )MCHC = 29.2 g/dL LOW ( 31.0 – 37.0 )MCH = 21.10 pg ( 19.50 – 24.50 )PLT = 83 K/L LOW ( 175 – 500 )
MPV = 29.78 fLPCT = 0.2 %PDW = 25.3 %Differential algorithm issues. Confirm with blood smear
![Page 4: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/4.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoErythronHCT = 19.8 % LOW ( 37.0 – 55.0 )
RBC = 2.73 M/L LOW ( 5.50 – 8.50 )
HGB = 5.8 g/dL LOW ( 12.0 – 18.0 )
RETIC = 215.4 K/L
%RETIC = 7.9 %
MCV = 72.4 fL HIGH ( 60.0 – 72.0 )
RDW = 21.1 % HIGH ( 14.7 – 17.9 )
MCHC = 29.2 g/dL LOW ( 31.0 – 37.0 )
MCH = 21.10 pg (19.50 – 24.50)
![Page 5: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/5.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoErythronHCT = 19.8 % LOW ( 37.0 – 55.0 )
RBC = 2.73 M/L LOW ( 5.50 – 8.50 )
HGB = 5.8 g/dL LOW ( 12.0 – 18.0 )
![Page 6: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/6.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoErythronHCT = 19.8 % LOW ( 37.0 – 55.0 )
RBC = 2.73 M/L LOW ( 5.50 – 8.50 )
HGB = 5.8 g/dL LOW ( 12.0 – 18.0 )
Anemia Moderately severe
![Page 7: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/7.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoErythronHCT = 19.8 % LOW ( 37.0 – 55.0 )
RBC = 2.73 M/L LOW ( 5.50 – 8.50 )
HGB = 5.8 g/dL LOW ( 12.0 – 18.0 )
RETIC = 215.4 K/L
%RETIC = 7.9 %
Anemia Moderately severe, regenerative
![Page 8: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/8.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoErythronHCT = 19.8 % LOW ( 37.0 – 55.0 )
RBC = 2.73 M/L LOW ( 5.50 – 8.50 )
HGB = 5.8 g/dL LOW ( 12.0 – 18.0 )
RETIC = 215.4 K/L
%RETIC = 7.9 %
MCV = 72.4 fL HIGH ( 60.0 – 72.0 )
RDW = 21.1 % HIGH ( 14.7 – 17.9 )
MCHC = 29.2 g/dL LOW ( 31.0 – 37.0 )
MCH = 21.10 pg (19.50 – 24.50)
Anemia Moderately severe, regenerative, macrocytic and
hypochromic with moderate anisocytosis
![Page 9: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/9.jpg)
Erythron – Data InterpretationAnemia
Moderately severeMacrocytic (increased MCV) Hypochromic (decreased MCHC)Regenerative (increased Reticulocyte Count)Moderate anisocytosis (increased RDW)
![Page 10: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/10.jpg)
Erythron – Data InterpretationAnemia
Moderately severeMacrocytic (increased MCV) Hypochromic (decreased MCHC)Regenerative (increased Reticulocyte Count)Moderate anisocytosis (increased RDW)
No significant morphologic features to help identify underlying etiopathogenesis
![Page 11: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/11.jpg)
Erythron – Data InterpretationAnemia
Moderately severeMacrocytic (increased MCV) Hypochromic (decreased MCHC)Regenerative (increased Reticulocyte Count)Moderate anisocytosis (increased RDW)
No significant morphologic features to help identify underlying etiopathogenesis
Additional clinical information – recent bleeding into gastrointestinal tract
![Page 12: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/12.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoLeukonWBC = 72.99 K/L HIGH ( 5.50 – 16.90 )
LYM = 2.77 K/L ( 0.70 – 4.90 )
MONO * 16.70 K/L HIGH ( 0.10 – 1.40 )
NEU * 51.57 K/L HIGH ( 3.00 – 12.00 )
EOS * 1.51 K/L HIGH ( 0.10 – 1.49 )
BASO * 0.44 K/L HIGH ( 0.00 – 0.10 )
%LYM = 3.8 %
%MONO * 22.9 %
%NEU * 70.7 %
%EOS * 2.1 %
%BASO * 0.6 %
Differential algorithm issues. Confirm with blood smear.
![Page 13: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/13.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoLeukonWBC = 72.99 K/L HIGH ( 5.50 – 16.90 )
![Page 14: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/14.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoLeukonWBC = 72.99 K/L HIGH ( 5.50 – 16.90 )
Leukocytosis Marked
![Page 15: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/15.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoLeukonWBC = 72.99 K/L HIGH ( 5.50 – 16.90 )
LYM = 2.77 K/L ( 0.70 – 4.90 )
MONO * 16.70 K/L HIGH ( 0.10 – 1.40 )
NEU * 51.57 K/L HIGH ( 3.00 – 12.00 )
EOS * 1.51 K/L HIGH ( 0.10 – 1.49 )
BASO * 0.44 K/L HIGH ( 0.00 – 0.10 )
%LYM = 3.8 %
%MONO * 22.9 %
%NEU * 70.7 %
%EOS * 2.1 %
%BASO * 0.6 %
![Page 16: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/16.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoLeukonWBC = 72.99 K/L HIGH ( 5.50 – 16.90 )
LYM = 2.77 K/L ( 0.70 – 4.90 )
MONO * 16.70 K/L HIGH ( 0.10 – 1.40 )
NEU * 51.57 K/L HIGH ( 3.00 – 12.00 )
EOS * 1.51 K/L HIGH ( 0.10 – 1.49 )
BASO * 0.44 K/L HIGH ( 0.00 – 0.10 )
%LYM = 3.8 %
%MONO * 22.9 %
%NEU * 70.7 %
%EOS * 2.1 %
%BASO * 0.6 %
Leukocytosis Marked with neutrophilia,
monocytosis, eosinophilia and basophilia
Normal lymphocytes
![Page 17: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/17.jpg)
Leukogram InterpretationMarked leukocytosis
Neutrophilia, Monocytosis, Eosinophilia, BasophiliaInflammation with prominent tissue demand for macrophages
Potential relatively established inflammation since no obvious lymphocytopenia (“glucocorticoid influence”)
![Page 18: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/18.jpg)
Erythron – Blood Film
![Page 19: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/19.jpg)
Erythron – Blood Film
![Page 20: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/20.jpg)
Erythron – Blood Film
![Page 21: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/21.jpg)
Erythron – Blood Film
![Page 22: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/22.jpg)
Erythron – Blood Film
![Page 23: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/23.jpg)
Erythron – Blood Film
![Page 24: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/24.jpg)
Erythron – Blood Film
![Page 25: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/25.jpg)
Erythron – Blood Film
![Page 26: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/26.jpg)
Leukogram InterpretationMarked leukocytosis
Neutrophilia, MonocytosisMild neutrophil toxicityInflammation with prominent tissue demand for macrophages
Potential relatively established inflammation since no obvious lymphocytopenia (“glucocorticoid influence”)
![Page 27: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/27.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoThrombonPLT = 83 K/L LOW ( 175 – 500 )
ThrombocytopeniaModerate
![Page 28: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/28.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoThrombonPLT = 83 K/L LOW ( 175 – 500 )
MPV = 29.78 fL
ThrombocytopeniaModerate with enlarged platelets
![Page 29: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/29.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoThrombonPLT = 83 K/L LOW ( 175 – 500 )
MPV = 29.78 fL
PCT = 0.2 %
PDW = 25.3 %
ThrombocytopeniaModerate with enlarged platelets and variably-sized platelets
![Page 30: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/30.jpg)
Erythron – Blood Film
![Page 31: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/31.jpg)
Thrombon - InterpretationModerate thrombocytopenia
Clumped platelets at feathered edgePossible underestimation of numbers
Enlarged and variably-sized plateletsSuggesting bone marrow response to a peripheral
demand
– Peripheral consumption (Inflammation, DIC, etc.)– Peripheral destruction
![Page 32: Dog with Icterus](https://reader036.fdocuments.in/reader036/viewer/2022081511/5681572e550346895dc4cb09/html5/thumbnails/32.jpg)
“Coalie” - 5 Year-old, Lhasa ApsoWBC = 72.99 K/L HIGH ( 5.50 – 16.90 )LYM = 2.77 K/L ( 0.70 – 4.90 )MONO * 16.70 K/L HIGH ( 0.10 – 1.40 )NEU * 51.57 K/L HIGH ( 2.00 – 12.00 )EOS = 1.51 K/L HIGH ( 0.10 – 1.49 )BASO = 0.44 K/L HIGH ( 0.00 – 0.10 )
%LYM = 3.8 %%MONO = 22.9 %%NEU * 70.7 %%EOS * 2.1 %%BASO = 0.6 %HCT = 19.8 % LOW ( 37.0 – 55.0 )RBC = 2.73 M/L LOW ( 5.50 – 8.50 )HGB = 5.8 g/dL LOW ( 12.0 – 18.0 )RETIC = 215.4 K/L
%RETIC = 7.9 %MCV = 72.4 fL HIGH ( 60.0 – 72.0 )RDW = 21.1 % HIGH ( 14.7 – 17.9 )MCHC = 29.2 g/dL LOW ( 31.0 – 37.0 )MCH = 21.10 pg ( 19.50 – 24.50 )PLT = 83 K/L LOW ( 175 – 500 )
MPV = 29.78 fLPCT = 0.2 %PDW = 25.3 %Differential algorithm issues. Confirm with blood smear