Haematology Tests

Haematology Tests

 

Clinical Pathology Reference Ranges


Red Blood Cells (RBC)

 

Every undergraduate and many laypersons understand that Packed Cell Volume (PCV l/l or %) rises in dehydration and shock and falls in (extreme) haemorrhage. PCV is, however, probably the least useful RBC measure in the elite athlete. As noted previously, it is a labile parameter influenced by splenic contraction following exercise or excitement and blood biochemistry is a better means of evaluating hydration status. Identification of the anemia that is associated with chronic infection is the entity that is of most importance in evaluating RBC criteria in the elite equine athlete.


From a practical point of view, anemia can be suspected where Haemoglobin (Hb g/l) values are < 12 for thoroughbreds and 11 for sport horses. Care must be exercised here, however, as older thoroughbreds e.g. mature National Hunt/jump racing horses can be so relaxed on sampling that their Hb values can be misleadingly low. Equine erythrocytes do not follow the patterns associated with regeneration in other species. Anisocytosis and reticulocytosis are only seen, in the author’s experience, in the most extreme and long-standing anemia. Serial evaluation of RBC, Hb, and total protein is probably the best way to follow a post-anemic erythropoetic response.


White Blood Cells (WBC)

 

In elite horses leucocytosis and leucopaenia can be defined as WBC > 10.0 x 109/ L and < 6.0 x 109/ L respectively. Values lying close to these values should be interpreted with caution given the potentially confusing effects of catecholamine-induced mobilization of cells in this series and the need for appropriate filling of EDTA tubes. Failure to fill correctly can result in an incorrect coagulant to blood ratio with consequently misleading WBC values. Evaluation of the individual components of the WBC series is usually much more informative than reliance on WBC counts in isolation, hence the need for EDTA samples, rather than lithium heparin for Haematology as referred to previously.


Neutrophils / Polymorphonuclear cells (PMNL)

 

PMNL’s are marginated in numbers on the endothelium of the peripheral blood vessels and are released into the circulation in response to stress, infection, and inflammation. PMNL values are often reported as the percentage of Neutrophils (N %) in a differential cell count. When reported in this way, the Neutrophil: Lymphocyte ratio in mature adult elite horses is somewhere around a 60%:40% ratio, respectively. Neutrophilia and neutropaenia are better identified by recourse to absolute PMNL counts. Neutrophilia, when accompanied by hyperfibrinogenaemia, is usually noteworthy when PMNL’s are > 7.0 x 109 / L. It is impossible to meaningfully differentiate between the neutrophilia of stress and that of infection and inflammation, without a concurrent measure of acute-phase proteins such as fibrinogen. Neutropaenia can be defined as PMNL’s < 2.0 x 10 9 / L, when they can be a very disturbing indicator of impending catastrophes, e.g. colitis/laminitis/peritonitis, etc. Immature neutrophils, whether toxic or band form, are associated with the presence of pus-forming infections and are best evaluated using manual differential counts derived from fresh blood smears.


Lymphocytes

 

Lymphocytosis (Lymphs > 5.0 x 109 / L) is a feature of chronic bacterial infections and the secondary phase of bacterial infection that often follows from primary viral infections. Lymphopaenia (Lymphs < 1.0 x 10 9 / L) may be seen in septic shock and severe viral infections and although reported as such, is seldom of much use in the author’s experience in the identification of lymphosarcoma.


Monocytes

 

Monocytes are macrophage precursors. Monocytosis (Monocytes > 0.5 x 109 / L) can reflect cellular responses to chronic bacterial infections.


Eosinophils

 

Eosinophilia (Eosinophils > 0.5 x 109 / L) can be seen in parasitism and allergy. It may also be seen in chronic eosinophilic granulomatous enteritis.