Interpreting in house Haemogram

Question 1

Rouleaux

Answer 1

Common in cats and can be assoc with high globulin

Question 2

Agglutination

Answer 2

Consistent with immune-mediated disease

Question 3

Significant haemogram findings in iron deficient patient

Answer 3

RBC are hypochromic and microcytic
Numerous platelets/Some are very large

Question 4

Nucleated RBCs are a sign of?

Answer 4

Regenerative anaemia
Altered bone marrow release
Reduced splenic clearance
Pb toxicity

Question 5

Suggest reasons for crenations/echinocytes/burr cells (spiky rbc)

Answer 5

Artefactual- Delayed smear/Drying artifact
Renal disease
Lymphoma

Question 6

Describe Leptocytes and why do they occur

Answer 6

Abnormal looking RBC with an expanded biconcave disk
Occurs during Iron deficiency anaemia, Anaemia of chronic disease or Liver disease and cells are trying to increase surface area

Question 7

Schistocytes

Answer 7

Fragmented RBCs

Question 8

Possible reasons for Schistocytes

Answer 8

Microangiopathic diseases (DIC)
Vascular anomalies/congential cardiac defects/heart failure
Glomerulonephritis
Haemangiosarcoma
Myelofibrosis

Question 9

Anisiocytosis

Answer 9

Cell size variation

Question 10

Spheroctes

Answer 10

RBC- Loss of central pallor and small

Question 11

Polychromasia

Answer 11

Multicolored red blood cells (RBCs) in a blood smear test. It’s an indication of red blood cells being released prematurely from bone marrow during formation

Question 12

Significant haemogram findings in IMHA patient

Answer 12

Platelets – few
Red cells – anisiocytosis (cell size variation), many spheroctes (loss of central pallor and small) (circled in red)
Polychromasia
Hypochromic cells

Question 13

Howell Jolly bodies

Answer 13

Nuclear remnants- Purple do tin middle of RBC
Normal in cats
Common post splenectomy or when reduced splenic function

Question 14

Heinz bodies

Answer 14

Oxidative damage
Look like red cells with noses
Easier to see with New Methylene blue stain
Normal in 10% of cat red blood cells
Uncommon as cause of anaemia in dogs

Question 15

Mycoplasma haemofelis

Answer 15

Multiple dots in RBC
Blood borne parasite
Common in cats
Transmitted by cat bites and possibly fleas
Cause of haemolytic anaemia in cats

Question 16

Describe how you perform staining with New Methylene Blue.

Answer 16

NMB is a supravital stain so cells have to be stained before they are smeared and air dried. Add one drop of stain to one drop of blood. Make a smear from the mixture

Question 17

What do blue areas represent when slides are stained with new methylene blue

Answer 17

Remnants of RNA found in immature RBC known as reticulocytes

Question 18

What is the term used for cells with a few blue spots and for ones that have many blue spots?

Answer 18

Punctate reticulocyte & Aggregate reticulocyte

Question 19

What is the significance of punctate reticulocyte seen in a slide

Answer 19

Represent previous release and are therefore not counted in a retic count in cats

Question 20

What is the significance of Aggregate reticulocyte seen in a slide

Answer 20

Represent recently released cells and so represent active regeneration.

Question 21

In a dog with immune-mediated anaemia, would you expect the reticulocyte count to increase or fall?

Answer 21

Increase – bone marrow should respond to low numbers of red cells and produce new ones

Question 22

List the reasons why an anaemic dog might have a low reticulocyte count.

Answer 22

Non-regenerative anaemia (bone marrow disease or anaemia of chronic disease)
Acute onset of anaemia – retics take 3-4 days to be present in circulation

Question 23

How to differentiate between blood smear of dog and cat

Answer 23

cat has no central pallor on RBC and large platelets compared to red cells

Question 24

What is the significance of PLT clump/aggregate

Answer 24

Will lower automated PLT count as clumps may be counted as RBC

Question 25

Acanthocytes

Answer 25

Dense, shrunken, and irregularly shaped red blood cells with spikes on the outside.