Lecture 4

Question 1

What happens when the tissue demand for neutrophils outweighs the bone marrow supply

Answer 1

Neutropenia

Question 2

What happens when the bone marrow supply of neutrophils outweighs the tissue demand of neutrophils

Answer 2

Neutrophilia

Question 3

What would you expect with a moderate inflammatory response

Answer 3

Neutrophilia
Left shift
Regenerative

Question 4

What would you expect with an acute severe inflammatory response

Answer 4

Severe leukopenia with left shift neutropenia

Degenerative

Question 5

Who would respond faster to inflammation?

Answer 5

Dogs > cats > horses> bovine

Question 6

What might you see with chronic inflammation in a dog

Answer 6

Leukemoid response- very high WBCs

Question 7

During acute inflammation, what should you think of neutropenia based on species

Answer 7

Dogs and cats- very severe lesion

Horses- maybe a severe lesion

Bovines- usual finding

*foals and calves are more similar to dogs and cats

Question 8

What does fibrinogen do during inflammation?

Answer 8

Should increase with active inflammation (more noticeable in large animals)

In large animals, fibrinogen often precedes neutrophilia/penia

If decreased, think DIC

Question 9

What would result in a HIGHER inflammatory response

Answer 9

Better vascularized tissue, pyogenic infectious agent, closed inflammation, large area

Question 10

What factors would cause a lower inflammatory response?

Answer 10

Low vascularity, nonpyogenic, open inflammation, small area

Question 11

If there is a neutrophilia with left shift and/ or toxicity, what should you think?

What if there’s also a lymphopenia?

Answer 11

Inflammation

Combined inflammation and stress response

Question 12

If there is a neutrophilia with NO left shift/toxicity, what should you do next?

Answer 12

Check lymphocytes

Low lymphocytes (mild to moderate)= stress response

Normal or mod increased lymphocytes= excitement response

Question 13

What are some things to think of when there is a lymphocytosis

Answer 13

Physiologic response (epinephrine)

Prolonged antigenic stimulation

Bovine leukemia virus in cows

Lymphocytic leukemia **need morphology

Question 14

In what species is lymphocytosis most common with an excitement response?

Answer 14

Cats and horses

Question 15

What things might cause lymphocytosis due to prolonged antigenic stimulation?

Answer 15

Certain infectious diseases
Hypersensitivity disease
Autoimmune disease

Question 16

What should you look at when there at is a lymphocytosis

Answer 16

Severity and morphology

Mild and small lymphocytes= excitement response or antigenic stimulation (E. canis)

Moderate and small lymphocytes= well differentiated lymphocytic leukemia or antigenic stimuation (E. canis)

Any concentration and large/ poorly differentiated cells= poorly differentiated lymphocytic leukemia

Question 17

Neutropenia

Answer 17

Very grave consequences

Caused by excessive tissue demand due to inflammation

Common cattle but very serious in nonruminants

Question 18

Common causes of neutropenia

Answer 18

Gram negative bacteria, endotoxemia, large trauma, decreased marrow production due to stem cell injury, increased margination, autoimmune destruction

Question 19

Neutropenia due to reversible stem cell injury

Answer 19

Severe and acute stem cell injury due to viral tropism for rapidly dividing cells

Parvo, feline panleukopenia, increased risk for rottweilers, damages GI and marrow stem cells, profound neutropenia so risk of secondary infection and sepsis

Chronic ehrlichiosis
Chemicals and drugs
Estrogen- endogenous or exogenous

Question 20

Irreversible stem cell injury leading to neutropenia

Answer 20

FeLV infection, idiopathic, myelodysplasia, myeloproliferative, marrow replacement (fibrosis, metastasis)

Question 21

Increased margination leading to neutropenia

Answer 21

Not important clinically
Transient
Endotoxemia
Anaphylaxis
But these diseases should be showing other signs besides neutropenia that are much more important

Question 22

When there is a neutropenia, what should you look for next?

Answer 22

Anemia and platelets

Question 23

If there is a neutropenia, no anemia, and adequate platelets, what should you look for?

Answer 23

Left shift or not

Left shift +/-toxic changes= acute inflammation

No left shift +/- toxic change= acute viral infection or acute marrow injury

Question 24

What does it mean if there is a neutropenia and any combination of nonregenerative anemia, thrombocytopenia, and/or neoplastic cells?

Answer 24

Chronic marrow injury

Question 25

Lymphopenia causes

Answer 25

Usually stress response

Severe bacterial infection esp. in horses

Loss of lymphocyte rich fluid like in chylous effusions

Acute viral infections (necrosis of lymphoid organs, distemper virus, bovine viral diarrheal virus)

Metastasis and granulomatous inflammation- uncommon

Rare immunodeficiencies (only if less than 1000/microliter

Question 26

Monocytosis

Answer 26

Accompanies acute and chronic inflammation- should be interpreted as increased tissue demand for macrophages

May be component of canine stress leukogram

Monocytic leukemia- uncommon

Question 27

Monocytopenia

Answer 27

Not important at all

Question 28

Eosinophilia

Answer 28

NAACP

Inflammation of tissues that are rich in mast cells- skin, GI, respiratory, female genital

Neoplasia- mast cell tumor, T cell lymphoma, rare eosinophilic leukemia

A- allergy/ hypersensitivity

A- Addisons

C- collagen and other weird diseases; hypereosinophilic disease

P- parasites with tissue migration phase

Question 29

Eosinopenia

Answer 29

Not very important except in stress leukogram

Question 30

Basophilia

Answer 30

Uncommon
Often parallels eosinophilia
Heartworm disease
Mast cell disease
Rare- leukemia

Question 31

Basopenia

Answer 31

Super unimportant

Question 32

Why might you seen mast cells in the blood other than mast cell tumor?

Answer 32

Inflammatory skin disorders (flea bite hypersensitivity, atopy, sarcoptic mange, food allergy, secondary pyoderma)

Parvoviral enteritis
Fibrinous pericariditis and pleuritis
Aspiration pneumonia
Acute pancreatic necrosis
IMHA
Renal failure associated with acute inflammation
GI torsion
Hemorrhage secondary to hemophilia