PRESENTATION
BROCHURE
Clinical Cases of
Haematology, Biochemistry, and Blood Gas Analysis in Small Animals
Rafael A. Pérez Écija
Clinical Cases of
Clinical Cases of Haematology, Biochemistry, and Blood Gas Analysis in Small Animals Haematological analysis is one of the most widely used diagnostic tests in small animal veterinary clinics and forms part of most working protocols. This is because it provides a broad array of information about the patient’s general health and therefore ensures the most suitable therapeutic measures are applied in each case. In other instances, a haematological assessment aids in the diagnosis of different diseases. The interpretation of haemograms, serum biochemistry, blood gas analyses, or blood smears can often represent a clinical challenge, so the author has written this guide to illustrate various clinical situations and how to resolve them.
Haematology, Biochemistry, and Blood Gas Analysis in Small Animals
Rafael A. Pérez Écija
TARGET AUDIENCE:
ESTIMATED
RETAIL PRICE ✱ Small animal vets. Cardiology ✱ Veterinary nurses ✱ Veterinary students FORMAT: 17 × 24 NUMBER OF PAGES: 184 NUMBER OF IMAGES: 140 BINDING: Hardcover
€65
Author RAFAEL ALEJANDRO PÉREZ ÉCIJA Head of laboratory services at the University of Córdoba’s Veterinary Teaching Hospital and a veterinary surgeon in the hospital’s Haematology and Oncology Service.
KEY FEATURES:
➜ Includes a wide variety of real-life clinical cases. ➜ Practical approach based on actual cases. ➜ Helpful guide for both students and practitioners to learn more about haematological analysis.
Presentation This book provides veterinary surgeons with a compilation of clinical cases related to haematology, blood transfusion, biochemistry, and blood gas analysis in small animals. It includes practical information such as the anamnesis for each case, the patient’s clinical history, their clinical signs, and the results of laboratory tests, before presenting the reader with an approach to the presumptive diagnosis and an evaluation of blood smears. Every example is completed with the resolution of the clinical case, so each may be used for self-assessment. The work describes clinical cases that fall within three subject areas – haematology, biochemistry, and blood gas analysis. It combines both cases that are commonly observed in veterinary clinics with rarer situations, all accompanied by explanatory images, diagrams, tables, and decision trees to offer veterinary surgeons a schematic means of interpreting haematological abnormalities.
The author Rafael Alejandro Pérez Écija Dr Pérez obtained a PhD in veterinary medicine and a masters in animal health from the University of Córdoba, Spain. In 2015, he was awarded the European Diploma in Veterinary Pathology from the European College of Veterinary Pathologists (ECVP). He is currently the head of laboratory services at the University of Córdoba’s Veterinary Teaching Hospital and a veterinary surgeon in the hospital’s Haematology and Oncology Service. His main areas of interest are veterinary medicine, haematology, immunopathology, and clinical pathology in small animals and horses. Dr Pérez is a member of the European College of Veterinary Pathologists, the Spanish Society of Veterinary Internal Medicine, the Spanish Society of Veterinary Pathology, and the European Society of Veterinary Clinical Pathology.
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He has participated in several national and European research projects, had work published in peer-reviewed scientific journals in the fields of veterinary haematology and pathology, and has collaborated in the publication of several books about clinical pathology and haematology, endocrinology, histopathology, cytology, and sample taking. He has also spoken at numerous conferences and courses concerning veterinary internal medicine.
Table of contents 1. Introduction: how to use this manual 2. Abbreviations 3. Clinical cases in haematology Case 1. Case 2. Case 3. Case 4. Case 5. Case 6. Case 7. Case 8. Case 9. Case 10. Case 11. Case 12. Case 13. Case 14. Case 15.
Puppy with diarrhoea Routine monitoring in a Greyhound Cat with generalised weakness Routine monitoring in a cat Dog with generalised weakness and cough Ataxic and disoriented dog Dog with yellow mucous membranes Elderly dog with extreme weakness Depressed dog with yellow mucous membranes Dog with fever spikes Puppy with respiratory problems Dog with subcutaneous haemorrhaging Elderly dog with polydipsia/polyuria Newborn puppy with extreme weakness and no suckling reflex Findings in a dog’s routine blood test
4. Clinical cases in biochemistry Case 16. Case 17. Case 18. Case 19. Case 20. Case 21. Case 22. Case 23. Case 24. Case 25.
Dog with bloody diarrhoea Elderly dog with a limp Dog with abdominal pain Highly depressed and disoriented dog Cat with polydipsia/polyuria Cat with dysuria Dog with generalised lymphadenomegaly Dog with icteric mucous membranes Emergency treatment of a dog struck by a vehicle Dog with foul-smelling diarrhoea
5. Clinical cases in blood gas analysis Case 26. Case 27. Case 28. Case 29. Case 30.
Dog with chronic diarrhoea Dog with neurological signs Dog with chronic vomiting Cat with dyspnoea Puppy with vomiting and diarrhoea
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+34 976 461 480
Clinical Cases of
Haematology, Biochemistry, and Blood Gas Analysis in Small Animals
Rafael A. Pérez Écija
case 5.
Bitch with general weakness and a cough
case 5.
Bitch with general weakness and a cough
Clinical history and physical examination rectal temperature
A 15-year-old, mixed-breed, non-neutered female dog presented at the clinic with a persistent cough present for two months and a clinical picture of generalised weakness and apathy. Upon auscultation, no abnormal noise was perceived. The mucous membranes were slightly pale.
38.3 °c
heart rate
160 bpm
Breathing frequency
50 bpm
capillary filling time
less than 2 seconds
Haemogram Test hct rBc hB % retic McV rdw Mchc Mch wBc neu Band lYM Mono eos Baso Plt MPV
Result
Reference range
26% 4.06 M/μl 8.5 g/dl 2% 64 fl 13% 33 g/dl 26 pg 12.5 k/μl 9.2 k/μl 0.38 k/μl 1.41 k/μl 0.77 k/μl 0.38 k/μl 0 k/μl 54 k/μl 7.46 fl
37–54 5.50–7.80 13.0–18.0 0.5–1.5 62–74 12.0–15.0 32–36 22–27 6.0–16.0 3.0–12.0 0–0.45 1–4.80 0.18–1.70 0.12–1.50 0–0.1 200–500 6.70–11.1
LOW
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NORMAL
HIGH
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■ ■
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?
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What alterations can be observed in the blood count of this animal?
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haeMatologY clinical cases
a
b linfocitos Monocitos ■ granulocitos
wBc
rBc
■ ■
38 77 81
25
400
200
c Plt
Figure 1. Histograms of the patient blood, classifying 2
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the elements detected according to size (horizontal axis) and abundance (vertical axis); (a) graphic representation of the white series; (b) of the red series; and (c) platelets.
50
Blood smear
?
Figure 2. Microscopic image of the blood smear from the animal. Diff-Quick stain. 400×.
What alterations can be observed in the blood smear of this animal? 36
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case 5.
Bitch with general weakness and a cough
Figure 3. Latero-lateral chest radiograph of the patient.
?
In view of this radiograph, what would be the diagnosis?
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haeMatologY clinical cases
solution to the case
Anaemia with microangiohepatic fragmentation caused by lung metastasis.
What alterations can be observed in the blood count of this animal?
POINT OF INTEREST The presence of schistocytes in the blood smear usually indicates fragmentation of the red cells, which may be micro- or macroangiopathic. Schistocytes (with an abnormal and elongated shape) must be differentiated from acanthocytes (with asymmetric and irregularly distributed protrusions on their surface).
The animal shows a regenerative normochromic normocytic anaemia with thrombocytopenia. The histograms of the animal (Fig. 1) show regenerative anaemia (asymmetry to the right of the erythroid curve, due to the presence of numerous reticulocytes; (Fig. 1b) and true thrombocytopaenia (typical curve shape, absence of platelet aggregates forming a ‘ladder shape’; (Fig. 1 C). The leukocyte histogram (Fig. 1a) is normal for dogs.
MAIN CAUSES OF ERYTHROCYTE FRAGMENTATION: disseminated intravascular coagulation (DIC), valvular heart disease, glomerular disease, highly vascularised tumours (hemangiosarcomas), Dirofilaria immitis, etc.
What alterations can be observed in the blood smear of this animal? The blood smear (Fig. 2) shows the presence of anisocytosis, poikilocytosis, y schistocytes. a
b
Figure 4. Difference between acanthocytes (a, b) and schistocytes (c).
c
In view of this smear, what would be the diagnosis? Considering the distinctive findings of erythroid fragmentation observed in the haemogram (Fig. 4), together with the presence of thrombocytopaenia and the image compatible with cannon ball-type lung metastasis, the most likely diagnosis would be a highly vascularised malignant tumour with metastases in the lung (Fig. 5), possibly a hemangiosarcoma.
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solution to the case
anaeMia with MicroangiohePatic FragMentation caused BY lung Metastasis.
Figure 5. Latero-lateral chest X-ray of the patient, showing numerous round–ovalshaped areas with an interstitial pattern in the lung field, compatible with the presence of metastases in the lung parenchyma.
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