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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Properly Done Blood Tests
| I know this comes up often here, mistakes that alter the values on a CBC. In a healthy dog, this isn't much of an issue. The vet sees an out of range value and knows that the automated analyzer just made a mistake or that the tech didn't get the sample correctly or handle it properly. In our very ill dogs, these out of range values can determine what changes are made in the medication protocol. If the vet makes assumptions about those values and alters the meds, there can be serious consequences if they have been mislead by the wrong values. Here is a link to a 4 page report on this very topic from DVM Magazine. It isn't an easy read, but I know there are few folks here who can skim this and get a good understanding of what is involved. My take is: 1. Very sick dogs should have the best techs doing the draw. 2. The vet should do a blood smear and examine it under a microscope. 3. A PCV should always be done in addition to the automated laser analyzer test. my best patrice Beyond the numbers: Things your CBC machine won't tell you, but you need to know (Proceedings) http://tinyurl.com/4avk8tu |
| Patrice NYS |
| Thanks Patrice for the article...it's very good. You are correct in understanding...I'm sure I didn't get everything but what I did understand was great. How are we supposed to ask/insist or monitor how these tests are being done. The last few days Clyde was in the hospital I had a call from Dr. Kruger saying that the nurse/technician on the night shift gave Clyde an overdose of aspirin...instead of giving .20 he was given 200. Then the following day when I asked for the request sheet to be completed for a Thyroid test they listed another animals meds rather than Clydes...here are two examples of someone not paying attention--do you have any suggestions on how to address the CBC or any lab draw issue? Thanks for all the attention you give us, Kathy |
| Kathy |
| Kathy, My approach has always been to be as gracious and appreciative of my vets as possible. When I found a tech that was genuinely interested in Chance and took great care with taking the blood sample, I would thank them profusely. When the next time came around I would attempt to schedule my appointments so that this particular test would be done by them. "Chance just loves Judy so much, when is she available?" You can tell when a tech is having trouble, they spend way too long with the tourniquet, they keep trying to "roll" the vein, they are tentative when inserting the syringe and then when they miss they try to find another limb to work with. This isn't always a fault in their technique, but if you see this time and time again, ask the vet privately for someone else. Always ask to be present for the test, but stay out of the way unless they ask for help. If you remain cool they won't mind you being there. You can say you are interested in how it is done. Bring cookies for rewards. As for asking the vet for something special or different, well I always defer to their experience and knowledge. But I will bring in something I have printed and ask them for their advice "is something we should try?" So printing this particular article and highlighting just a few of the important steps in taking a blood sample and asking your vet what they think of this "since you know so much about this" would be the way I would approach it. After a while your vet clinic will see you as a knowledgeable owner who can make appropriate decisions about your dog's care and won't be so resistive. If you can't make this leap of faith with your regular vet after trying a few times, find another vet at the clinic or another clinic. Finally, a dog that is very anemic may have very low blood volume and will be dehydrated. It is extremely difficult to get a proper blood test when they are like this. Avoid feeding your dog 12 hours before the test, but make sure they are *really* well hydrated a few hours before the test. my best patrice |
| Patrice NYS |
| Thank-you Patrice, I will read the article asap! I really appreciate anything I can get to help Dylan. I know both my vet and vet tech really care. They have been treating Dylan for arthritis and general care for some time now. She loves going in for her adequan injection (arthritis) despite being totally averse to pain and having been totally afraid of people at one time in her life. Her relationship with the tech is so nice for Dylan, as people provoke anxiety and in this case it works both ways where their affection for each other is mutual. I will look into the methods of the lab they use. I know all too well that accuracy is important. From my experience with my sife's Crohn's Disease and from what I have read so far since Dylan was diagnosed, there is good care, care, and bad care on this one. I get great care from my vet and she always respects what I know or have learned. She will read what I ask her to if she thinks she needs to. I don't know how knowledgeable yet she is on AIHA/IMHA, but I will be finding out more as we go, I am sure. I am known for asking questions and always knowing something about my dog's problems. I also make the decisions, always. Thanks again, Richard |
| Richard Burnaby |
This thread was discussed between 25/02/2011 and 24/03/2011
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