clinpath removals

SERUM IRON INCREASE: (HAGIN)

-        Hemolytic anemia

-        Accidental Lysis of erythrocytes

-        Glucocorticoid excess

-        Iron overload

-        Non-regenerative anemia

SERUM IRON DECREASE: (RIHAH)

-        Renal disease

-        Iron deficiency

-        Hypothyroidism

-        Acute/ chronic inflammation

-        Hypoproteinemia

INCREASE IN PLASMA PROTEIN, GLOBULIN

-        Inflammation (fibrinogen)

-        Immune mediated disease

-        Lymphoid neoplasm

-        Dehydration (albumin)

-        Hemolytic anemia (PP)

DECREASE IN PLASMA PROTEIN, GLOBULIN

-        Protein losing uropathy

-        Exclusive hepatic disease

-        hemorrhage

DECREASE IN ALBUMIN, INCREASE GLOBULIN

-        Malabsorptive diaarhea

-        Extensive hepatic disease

3 main Plasma Proteins:

1. Albumin – moving substances

2. Globulin -  fights infection

3. Fibrinogen – protein liver

An increase in plasma protein is measured by REFRACTOMETRY = due to increased globulin (seen in inflammation, immune mediated disease, lymphoid neoplasm.

Increase in both albumin, globulin

-        - hypovolemia/ dehydration

DECREASE IN PP VALUES (due to decrease in albumin component)

• MALABSORPTIVE DIARRHEA

-        Albumin, globulin

• EXTENSIVE HEPATIC DISEASE

-        Albumin

• LACK OF PRODUCTION OF IMMUNOGLOBULIN IN GENETIC DISORDERS OF YOUNG ANIMALS:

• CHRONIC HEMORRHAGE

  • albumin, globulin

1.  STRESS LEUKOGRAM

-        Inflammation or stress

-        Marked ↑ segmented neutrophils

-        ↓ lymphocytes

-        ↓ eosinopenia

-        ↑ Monocytes

2.  PHYSIOLOGIC LEUKOGRAM

-      epinephrine release

-        ↑ neutrophils

-        ↑ lymphocytes

-        ↑

3.  INFLAMMATORY LEUKOGRAM

-        ↑ leukocytosis

-        ↑/↓ neutrophils

-        ↑ bands

-        ↑ monocytes

BONE MARROW DESTRUCTION:

Leukopenia

Immature cells are absent

LAHAT NG CELL TYPES MABABA

CLASSIFICATIONS OF LEUKOCYTIC RESPONSE

·        SHIFT TO THE LEFT

-        ↑ immature neutrophils

·        REGENERATIVE SHIFT TO THE LEFT

-        Absolute ↑ in neutrophils/ WBC count accompanied by the appearance of bands in the peripheral circulation

·        DEGENERATIVE LEFT SHIFT

-        N/ ↓ leukocyte count

-        ↑ bands exceeding segmenters

·        SHIFT TO THE RIGHT

-        ↑ segmenters

-        Occurs often in dogs with glucocorticoid therapy or HAC

*in bacterial infxn with septicemia = often no leukocytosis but more commonly a degenerative left shift

*Bacterial infxn with localization and pus formation stimulated marked neutrophila

BONE MARROW EXAMINATION

-        Biopsy at the iliac crest, trochanteric fossa, sternum, ribs

-        G18 cerebrospinal needles

-        Ratio of myeloid to erythroid (M:E) estimated by counting 300-500 cells and categorizing them

-        Interpretation is facilitated by PCV and WBC

-        M:E for dogs = 1:1

-        M:E for cats = 1.6:1

-        High M:E, normal WBC = erythroid hyperplasia

-        Low M:E, normal/ ↑ WBC = RBC regeneration

LEUKEMIA: “white blood’

-        Makapal buffy coat

-        Probably neoplastic and malignant proliferation of one of the leukocytic tissues

·        LEUKEMIC: ↑ leukocytes with many abnormal and immature cells

·        SUBLEUKEMIC: Normal/ ↓ leukocyte but with abnormal differential counts showing primitive cells (bands are seen)

·        ALEUKEMIC: Normal lahat; cells may not circulate in peripheral blood

CLASSIFICATION ACC TO DURATION OF DISEASE PROCESS

·        ACUTE

-        Usually subleukemic

-        Many undifferentiated cells in the marrow or blood

·        CHRONIC

-        May be leukemic or subleukemic

-        Blood counts vary depending on the course of disease

PANCREATIC FUNCTION TESTS

-        Pancreas = DIGESTIVE ENZYMES

§  Protease

§  Chymotrypsinogen

§  Procarboxypeptidase

-        Lipase

-active form na sha

-essential for digestion of lipids

-enhanced by bile

-        Amylase

-active form

-digestion of carbohydrates

-        Insulin

-secreted by beta cells

-potentiates transfer of monosaccharides

-RBC do not need insulin for transport

-        Glucagon

-secreted by alpha cells if may reduction sa glucose level in blood

-promotoes mobilization of energy producing metabolites

CBC/BLOOD CHEM

§  Leukocytosis w left shift

§  Relative polycythemia

§  Thrombocytopenia

§  Azotemia: decreased GFR; dehydration

§  Liver enzyme activities: increased ALT, AST, SAP

MICROSCOPI EXAMINATION

§  LUGOL’S STAINED SMEAR

-stain smear of feces + lugol’s iodine

-large blackish blue with blue green fringe: STARCH GRANULES = indicates amylase deficiency

-starch present in feces: AMYLORRHEA

-presence ng fat: STEATORRHEA

-presence ng protein:  CREATORRHEA

§  UNSTAINED LUGOL’S SMEAR

-detects protease deficiency

-undigested fibers with blunt ends and cross striations: MUSCLE FIBERS

-presence of muscle fibers:  DEFICIENCY IN PROTEIN DIGESTION

-test has no value if animal is vegetarian

§  MICROSCOPIC EXAM FOR FATS

- diluted feces are stained with SUDAN III

-fat globules will appear ORANGE or RED

-Glistening feces= LIPASE DEFICIENCY; Dogs with exocrine pancreatic deficiency

-Non-glistening=MALABSORPTION (no neutral fat)

§  GELATIN DIGESTION TEST

-detects protease (trypsin) action in feces

-Film test: less effective

-Liquefaction of gelatin tube

ENDOGENOUS SERUM SUBSTANCE

§  Serum folate & Vit b12

-Folate: JEJUNUM

-Vit B12: ILEUM

§  Pancreatic trypsinogen/ trypsin activity

-most specific test for EPI

-SERUM = preferred sample