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Dog with Lethargy and Depression

Dog with Lethargy and Depression. Dennis B. DeNicola, DVM, PhD, DACVP Chief Veterinary Educator IDEXX Laboratories. “Ryan”. 7.5 years old Neutered male Labrador Retriever Presented with clinical history of recent (several days) onset lethargy and depression.

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Dog with Lethargy and Depression

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  1. Dog with Lethargy and Depression Dennis B. DeNicola, DVM, PhD, DACVP Chief Veterinary Educator IDEXX Laboratories

  2. “Ryan” • 7.5 years old • Neutered male • Labrador Retriever • Presented with clinical history of recent (several days) onset lethargy and depression

  3. “Ryan” - 7.5 Year-old, Labrador Retriever WBC = 88.43 K/L HIGH ( 5.50 – 16.90 ) LYM = 9.45 K/L HIGH ( 0.70 – 4.90 ) MONO = 5.82 K/L HIGH ( 0.10 – 1.40 ) NEU = 70.34 K/L HIGH ( 2.00 – 12.00 ) EOS = 2.34 K/L HIGH ( 0.10 – 1.49 ) BASO = 0.48 K/L HIGH ( 0.00 – 0.10 ) %LYM = 10.7 % %MONO = 6.6 % %NEU = 79.5 % %EOS = 2.7 % %BASO = 0.5 % HCT = 19.8 %LOW ( 37.0 – 55.0 ) RBC = 2.58 M/L LOW ( 5.50 – 8.50 ) HGB = 9.3 g/dL LOW ( 12.0 – 18.0 ) RETIC = 145.6 K/L %RETIC = 5.6 % MCV = 76.8 fL HIGH ( 60.0 – 72.0 ) RDW = 22.2 % HIGH ( 14.7 – 17.9 ) MCHC = 47.0 g/dL HIGH ( 31.0 – 37.0 ) MCH = 36.03 pg HIGH ( 19.50 – 24.50 ) PLT = 747 K/L HIGH ( 175 – 500 ) MPV = 19.62 fL PCT = 1.5 % PDW = 30.3 % Differential algorithm issues. Confirm with blood smear

  4. “Ryan” - 7.5 Year-old, Labrador Retriever Erythron HCT = 19.8 %LOW ( 37.0 – 55.0 ) RBC = 2.58 M/L LOW ( 5.50 – 8.50 ) HGB = 9.3 g/dL LOW ( 12.0 – 18.0 ) RETIC = 145.6 K/L %RETIC = 5.6 % MCV = 76.8 fL HIGH ( 60.0 – 72.0 ) RDW = 22.2 % HIGH ( 14.7 – 17.9 ) MCHC = 47.0 g/dL HIGH ( 31.0 – 37.0 ) MCH = 36.03 pg HIGH (19.50 – 24.50 )

  5. “Ryan” - 7.5 Year-old, Labrador Retriever Erythron HCT = 19.8 %LOW ( 37.0 – 55.0 ) RBC = 2.58 M/L LOW ( 5.50 – 8.50 ) HGB = 9.3 g/dL LOW ( 12.0 – 18.0 ) • Anemia • Moderately severe

  6. “Ryan” - 7.5 Year-old, Labrador Retriever Erythron HCT = 19.8 %LOW ( 37.0 – 55.0 ) RBC = 2.58 M/L LOW ( 5.50 – 8.50 ) HGB = 9.3 g/dL LOW ( 12.0 – 18.0 ) RETIC = 145.6 K/L %RETIC = 5.6 % • Anemia • Moderately severe, regenerative

  7. “Ryan” - 7.5 Year-old, Labrador Retriever Erythron HCT = 19.8 %LOW ( 37.0 – 55.0 ) RBC = 2.58 M/L LOW ( 5.50 – 8.50 ) HGB = 9.3 g/dL LOW ( 12.0 – 18.0 ) RETIC = 145.6 K/L %RETIC = 5.6 % MCV = 76.8 fL HIGH ( 60.0 – 72.0 ) RDW = 22.2 % HIGH ( 14.7 – 17.9 ) MCHC = 47.0 g/dL HIGH ( 31.0 – 37.0 ) MCH = 36.03 pg HIGH (19.50 – 24.50 ) • Anemia • Moderately severe, regenerative, macrocytic and “hyperchromic” with moderate anisocytosis

  8. Erythron – Data Interpretation • Anemia • Moderately severe • Macrocytic (MCV) • “Hyperchromic” (MCHC) – hemolytic specimen • Regenerative (Reticulocyte Count) • Moderate anisocytosis (RDW)

  9. Erythron – Blood Film

  10. Erythron – Blood Film

  11. Erythron – Blood Film Rouleaux Agglutination

  12. Saline Agglutination Test Saline Solution Agglutination Rouleaux

  13. Erythron – Blood Film

  14. Erythron – Blood Film

  15. Erythron – Blood Film Interpretation • Anemia • Moderately severe • Regenerative • Polychromasia • Anisocytosis • Immune mediated extravascular hemolysis • Spherocytosis • Suggestion of autoagglutination • Requires saline dilution confirmation

  16. “Ryan” - 7.5 Year-old, Labrador Retriever Leukon WBC = 88.43 K/L HIGH ( 5.50 – 16.90 ) LYM = 9.45 K/L HIGH ( 0.70 – 4.90 ) MONO = 5.82 K/L HIGH ( 0.10 – 1.40 ) NEU = 70.34 K/L HIGH ( 3.00 – 12.00 ) EOS = 2.34 K/L HIGH ( 0.10 – 1.49 ) BASO = 0.48 K/L HIGH ( 0.00 – 0.10 ) %LYM = 10.7 % %MONO = 6.6 % %NEU = 79.5 % %EOS = 2.7 % %BASO = 0.5 % Differential algorithm issues. Confirm with blood smear.

  17. “Ryan” - 7.5 Year-old, Labrador Retriever Leukon WBC = 88.43 K/L HIGH ( 5.50 – 16.90 ) • Leukocytosis • Marked

  18. “Ryan” - 7.5 Year-old, Labrador Retriever Leukon WBC = 88.43 K/L HIGH ( 5.50 – 16.90 ) LYM = 9.45 K/L HIGH ( 0.70 – 4.90 ) MONO = 5.82 K/L HIGH ( 0.10 – 1.40 ) NEU = 70.34 K/L HIGH ( 3.00 – 12.00 ) EOS = 2.34 K/L HIGH ( 0.10 – 1.49 ) BASO = 0.48 K/L HIGH ( 0.00 – 0.10 ) %LYM = 10.7 % %MONO = 6.6 % %NEU = 79.5 % %EOS = 2.7 % %BASO = 0.5 % Differential algorithm issues. Confirm with blood smear. • Leukocytosis • Marked with increases in all leukocyte forms

  19. Leukon – Blood Film

  20. Leukon – Blood Film

  21. Leukon – Blood Film

  22. Leukon – Blood Film

  23. Leukon – Blood Film

  24. Leukogram Interpretation • Marked leukocytosis • Increases in all leukocyte forms • Marked neutrophilia with possible slight left shift • Inflammation with evidence of systemic antigenic stimulation (lymphocytosis) and tissue demand for macrophages (monocytosis)

  25. “Ryan” - 7.5 Year-old, Labrador Retriever Thrombon PLT = 747 K/L HIGH ( 175 – 500 ) • Thrombocytosis • Mild

  26. “Ryan” - 7.5 Year-old, Labrador Retriever Thrombon PLT = 747 K/L HIGH ( 175 – 500 ) MPV = 19.62 fL • Thrombocytosis • Mild with enlarged platelets

  27. “Ryan” - 7.5 Year-old, Labrador Retriever Thrombon PLT = 747 K/L HIGH ( 175 – 500 ) MPV = 19.62 fL PCT = 1.5 % PDW = 30.3 % • Thrombocytosis • Mild with enlarged platelets and variably-sized platelets

  28. Thrombon

  29. Thrombon - Interpretation • Mild thrombocytosis • Clumped platelets at feathered edge • Probable underestimation of numbers • Enlarged and variably-sized platelets • Suggesting bone marrow response to a peripheral demand

  30. “Ryan” - 7.5 Year-old, Labrador Retriever WBC = 88.43 K/L HIGH ( 5.50 – 16.90 ) LYM = 9.45 K/L HIGH ( 0.70 – 4.90 ) MONO = 5.82 K/L HIGH ( 0.10 – 1.40 ) NEU = 70.34 K/L HIGH ( 2.00 – 12.00 ) EOS = 2.34 K/L HIGH ( 0.10 – 1.49 ) BASO = 0.48 K/L HIGH ( 0.00 – 0.10 ) %LYM = 10.7 % %MONO = 6.6 % %NEU = 79.5 % %EOS = 2.7 % %BASO = 0.5 % HCT = 19.8 %LOW ( 37.0 – 55.0 ) RBC = 2.58 M/L LOW ( 5.50 – 8.50 ) HGB = 9.3 g/dL LOW ( 12.0 – 18.0 ) RETIC = 145.6 K/L %RETIC = 5.6 % MCV = 76.8 fL HIGH ( 60.0 – 72.0 ) RDW = 22.2 % HIGH ( 14.7 – 17.9 ) MCHC = 47.0 g/dL HIGH ( 31.0 – 37.0 ) MCH = 36.03 pg HIGH ( 19.50 – 24.50 ) PLT = 747 K/L HIGH ( 175 – 500 ) MPV = 19.62 fL PCT = 1.5 % PDW = 30.3 % Differential algorithm issues. Confirm with blood smear

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