268. A very painful encapsulated abscess in the neck of a Shih Tzu. Complete Blood Count

10 Dec 2010.

CHUBBY – DOG – Shih Tzu 9 Y/O Male. A very painful encapsulated neck abscess  

 CBC interpretation: Haematology Profile: Description: The CBC is commonly performed on an automated haematology analyzer using well mixed whole blood that is added to a chemical (EDTA – Ethylenediaminetetraacetic Acid) to prevent clotting.

 A CBC is a group of tests used to quantify the number of RBCs, WBCs and platelets, provide information about their size and shape, measure the haemoglobin content of RBCs, determine the percentage and absolute number of the five white blood cell types, and identify early and abnormal blood cells.

These tests are performed simultaneously. Analysis (Haematology): Haematology Result Unit Ref. Range Haemoglobin 18.4 g/dL 12.0 – 18.0 Red Cell Count 7.7 X10^12 / L 5.5-8.5 Total White cell count 8.3 X10^9 / L 6.0 – 17.0 Differential Count % Absolute V. Unit Neutrophils 68.19 5.66 X10^9 / L Lymphocytes 21.08 1.75 X10^9 / L Monocytes 6.14 0.51 X10^9 / L 

 Eosinophils 3.49 0.29 X10^9 / L 

 Basophils 0.96 0.08 X10^9 / L PCV 0.48 0.37 – 0.55 MCV 63 fL 60 – 77 MCH 24 Pg 20 – 25 MCHC 38 g / dL 32 - 36 RDW 15.7 % Platelets 491 X10^9 / L 200 - 500 

 Haemoglobin: 18.4 g/dL • This value is lightly above reference range but it should not be of much significance as the red blood cell count, PCV, MCV, MCH, RDW are all within normal limits. 

• Haemoglobin concentration is normally used to diagnose anaemia, which can be caused by microcytic RBCs, which are smaller than usual in size and unable to carry sufficient Oxygen. Macrocytic anaemia usually occurs when the division of RBC precursor cells in the bone marrow is impaired. The most common cause of macrocytic anaemia are vitamin B12 deficiency, folate deficiency and liver disease. Normocytic anaemia may be caused by decreased production of RBCs (any cause of bone marrow failure), increased destruction of RBCs (haemolytic anaemia) or loss of blood. 

 Total White Cell Count: 8.3 x 10^9 / L (within normal limits) • 

Normal white cell count usually indicates that the animal is not in any threat of infectious diseases and foreign bodies. • An elevated white cell count usually occurs in infection, allergy, systemic illness, inflammation, tissue injury and leukemia.

 • A depressed white cell count may occur in some viral infections, immunodeficiency states and bone marrow failure.

 • The white blood cell differential count will reveal which WBCs are affected the most • Neutrophils are the most abundant granulocytic cells and are phagocytic cells that aid in the removal of bacteria and antibody-coated antigens • Lymphocytes are the 2nd most abundant monocytic WBCs and originate from the lymphoid tissues and are NOT phagocytic. They are responsible for initiating and regulating the immune response by the production of antibodies and cytokines.

 • Monocytes are the largest monocytic WBCs and are phagocytic cells that process and present antigens to lymphocytes, an event required for lymphocyte activation 

• Eosinophils are granulocytic WBCs that have cytoplasms filled with granules that contain peroxidise, hydrolases and basic proteins that aid in the destruction of phagocytised cells. They are increased in allergic and parasitic infections

 • Basophils are granulocytic WBCs that contain large amounts of histamine, heparin and acid mucopolysaccharides. They mediate the allergic response by releasing histamine.

 Platelets: 149 x 10^9 / L (Below reference range of 200-500) • Platelets are disc-shaped structures formed from the detachment of cytoplasm from megakaryocytes. They aid in the coagulation process by attaching or adhering to the walls of injured blood vessels, where they stick together to form the initial platelet plug. 

• A low platelet count may occur in patients with viral infections, lymphoma or animals taking certain drugs such as quinine and quinidine. • Decreased platelet production is also a cause of thrombocytopenia, and may be due to aplastic anaemia, leukemia, lymphoma or bone marrow fibrosis. • 

A low platelet count can occur due to increased destruction and can result in antibody production that is often drug-induced (heparin treatment being a prominent cause)

 • In relation to this case, Chubby’s decreased platelet count might be auto-immune, resulting in platelet destruction and decreasing his ability to clot blood and predisposing him to conditions such as TTP (Thrombotic thrombocytopenic purpura) and DIC (Disseminated intravascular coagulation). 

BIOCHEMISTRY RESULTS: BIOCHEMISTRY RESULT UNIT REF. RANGE Total Cholesterol 4.75 Mmol / L HDL Cholesterol 3.72 Mmol / L LDL Cholesterol 0.20 Mmol / L Cholesterol / HDL Ratio 1.28 Mmol / L Triglycerides 1.83 Mmol / L Glucose 4.1 Mmol / L 3.9 – 6.0 SGPT / ALT 59 U / L < 59 SGOT / AST 41 U / L < 81 Calcium 2.06 Mmol / L 1.50 – 3.60 Uric acid 0.01 Mmol / L