8 – WBC 2

Question 1

Degenerative left shit

Answer 1

• When immature neutrophils are more than or equal to mature neutrophils
  o Mature neutrophils often WRI or decreased (not always a neutrophilia)
• *bone marrow is NOT meeting tissue demand
• Often in poor clinical condition

Question 2

Toxic change

Answer 2

• Abnormally rapid maturation in bone marrow
• Cytoplasmic changes
  o Foamy cytoplasm
  o Basophilic cytoplasm
  o Dohle bodies
  o Toxic granulation
• *graded by severity 1+ to 4+ (we won’t be asked to do it)

Question 3

Classification of inflammation

Answer 3

• Want to classify it based on type of inflammatory process
  o Often occur within a certain time frame (NOT ALWAYS THOUGH)
• Dynamic process
• *Serial CBCs are useful

Question 4

Inflammatory patterns: 4 types

Answer 4

• Peracute to acute: severe inflammation
• Acute inflammation
• Chronic/established inflammation
• Combined patterns

Question 5

Peracute to acute, severe

Answer 5

• Neutropenia: neutrophils are migrating into tissues
• Left shift possible
• +/- toxic change
• *neutropenia is usually transient
  o Bone marrow releases neutrophils from storage pool
• *often don’t see in clinic (or on CBC)

Question 6

Neutropenia: cattle

Answer 6

• Little bone marrow reserve, low marrow responsiveness
• Neutropenia may persist for days
  o *does NOT indicate poor prognosis

Question 7

Acute inflammation

Answer 7

• Usually acute duration but not always
• Can be a prolonged timeframe
• *Active need for neutrophils at site of inflammation
  o EXPECT A LEFT SHIFT
• Neutrophils WRI or increased
• +/- toxic change
• +/- monocytosis

Question 8

Chronic/established inflammation

Answer 8

• Neutrophilia (often marked)
• Usually very MILD left shift
• Usually NO toxic change
• +/- monocytosis
• *bone marrow is on top of things
  o Reflects granulocytic hyperplasia in bone marrow (takes time)

Question 9

Combined patterns

Answer 9

• Inflammation and stress
  o Neutrophilia and left shift
  o Lymphopenia
• Acute on chronic inflammation
  o Moderate to marked neutrophilia (+/- marked monocytosis)
  o Moderate left shift (+/- toxic change)

Question 10

Extreme neutrophilia

Answer 10

• > 50 x10^9/L in dogs
• Focal suppurative lesions
  o Peritonitis, pyometra, prostatitis, pneumonia, abscesses
  o Secondary to IMHA or neoplasia
• **DDx: neutrophilic leukemia
  o “leukemoid response”

Question 11

Serial leukograms: what will a good prognosis look like?

Answer 11

• *Trends help with prognosis
• Increased in neutrophils number (or even resolution of neutropenia)
• Decreased in magnitude of left shift
• Resolution of toxic change
• Resolution of lymphopenia