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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Importance of Good Blood Draw
| Just back from the vet's for Chance's 2 week cbc. Excellent results! His hct is 33.3% and his PCV is 38%. Why the difference you ask? We have found that the automated blood analyzer is slightly inaccurate from repeated experiments. Why is this important? The process of *correctly* drawing blood, preparing it and putting it into the machine are extremely critical in the results. For a normal dog, it's not a big thing if the numbers are a little off, but in all of our cases, we make critical decisions on med dosages based on these numbers. If you are going to a crowded and crazy office for blood draws and the vet tech is nervous, your dog is hyper, they have to wait to get it into the analyzer, you might not get results that are accurate. If your cbc looks different from the last one, always ask for an additional pcv to be spun. It's an easy fast test, requiring very little blood. The examiner visually determines the pcv, rather than the machine. My vet charges me $8 to do this additional step. Patrice oh, and Chance is doing excellent! Growing back all his lost hair, putting on muscle, taking long walks, eating and sleeping well! Our vet has been doing research on all the dogs in her practice that no longer have a spleen and has discovered, with the exception on one dog, all of them have a lower, normal, hct. So it looks like we are probably never going to get much higher than where we are now. But his behavior is indicative that he is doing fine with these numbers. If you would like to read ALL about this process: http://www.idexx.com/animalhealth/analyzers/lasercyte/3minute_periph_blood_smear_eval.pdf snip> "Artifacts must be avoided for proper hematologic interpretation. Causes of artifacts include poor blood collection techniques, inadequate sample volumes, prolonged sample storage, and delayed sample analysis. Proper blood collection is vital to prevent erroneous results from sample clotting and cellular lysis. Obtain hematology samples from the largest blood vessel possible to minimize cellular trauma and to prevent the activation of clotting mechanisms. For accurate results, discard clotted samples and collect fresh samples. Common venipuncture sites in dogs and cats include the jugular, cephalic, and lateral and medial saphenous veins. Anticoagulants include EDTA, heparin, and citrate. EDTA is the preferred anticoagulant for blood film preparation because it preserves cellular detail better than other anticoagulants do and does not interfere with Romanowsky staining of WBCs. Inadequate sample volume is a common cause of inaccurate hematologic results. Properly fill anticoagulated blood collection tubes to avoid falsely decreased hematocrits and cell counts and to prevent RBC shrinkage. Hematologic samples must be analyzed as soon as possible to prevent artifacts created by exposure to anticoagulants and cell deterioration due to storage and shipment. Analyze samples within three hours or refrigerate them at 39.2 F (4 C) to avoid an artificially increased hematocrit, increased mean corpuscular volume, and decreased mean corpuscular hemoglobin concentration.1 Prepare blood films within one hour of collection to avoid morphologic artifacts. RBC crenation, neutrophil hypersegmentation, lymphocytic nuclear distortion, and general WBC degeneration including vacuolization in neutrophils may occur in aged samples." |
| Patrice New York State |
| Patrice, That is such GREAT NEWS! GO CHANCE! So you actually have them send out for the CBC and then have them do a PCV in the office?? And I agree about how important a good blood draw is. Our vet used to have this guy that did the blood draws and was very good with Holly, then he left and another girl took over, she had so much trouble just hitting the vein. Usually by the time it was over Holly was so upset, but good news is the guy is back and last blood draw went so smooth again! Linda |
| LInda Sapphire |
| testing -having problems posting. |
| jan philly |
| Patrice, Choe I just returned from the vet where, happy to say Choe's pcv was 40. However 2 weeks ago via a CBC that was sent out to a lab other than the vet clinic, the read was 44. Two weeks before that the pcv was 38. Very perplexing, as you note, what do to about varying the med (pred) dose when this up and down cycle occurs frequently. The (city) vet I go to is so busy that they do not look kindly requesting a second pcv run. They do however like to add on a 'tech fee' whatever that is of 13.00 a visit. The (sent out) lab work is much more expensive than the pcv test but I am not sure at this juncture if it indeed is accurate. I sent your post to my consulting vet. Anxious to hear her opinion. Thanks for researching. As I mentioned before we are educating one another and have information that clinicians sometimes have not researched. Jan |
| jan philly |
| Jan, That is great news about Choe! You know all three of these numbers are still in the safe range, Holly's have gone up and down just a little like this also and we have still continued to decrease the prednisone. In fact she goes back on Monday for bloodwork and hoping all will be okey, we are at every 3rd day on pred right now and still every day on Imuran. My vet told me before that depending on if they run a PCV or CBC out to the lab that even that is looked/read different, which is why the numbers sometimes vary. I to am so happy to have found this board, has helped me so much in how I speak to the vet, because he knows that I know what I am talking about and doesn't even question me anymore, just basically whatever I want done he will do. Again, so happy for Choe! High Paws from Holly! Linda |
| Linda Sapphire |
| GREAT NEWS, Patrice & Chance, Jan & Choe. Thanks, Patrice, for the information on blood draws. I'll know what to ask for now if Shadow's numbers seem odd. Keep up the good progress, Chance & Choe! Shadow & Sandy |
| Sandy Utah |
This thread was discussed between 09/11/2007 and 10/11/2007
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