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Lin H, Zhan B, Shi X, Feng D, Tao S, Wo M, Fei X, Wang W, Yu Y. The mean reticulocyte volume is a valuable index in early diagnosis of cancer-related anemia. PeerJ 2024; 12:e17063. [PMID: 38435983 PMCID: PMC10909343 DOI: 10.7717/peerj.17063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
Background Cancer-related anemia (CRA) is a functional iron deficient anemia, and the early diagnosis will improve the prognosis of the patients. This prospective study aimed to investigate the utility of mean reticulocyte volume (MRV) in the early diagnosis of CRA. Methods A total of 284 first-diagnosed cancer patients were enrolled, and the subjects were assigned anemia and non-anemia groups by hemoglobin (Hb) concentrations. The mature RBC and reticulocyte indices were detected with BC-7500 blood analyzer, and the MRV, reticulocyte hemoglobin (RHE) content, and reticulocyte production index (RPI) were obtained. ROC curves were constructed in identifying anemia diagnosed by the combination of RHE and RPI. An adjusted multivariate analyse and quartiles were used to assess the associations of MRV with early CRA diagnosed by combining RBC indices (MCV, MCH and MCHC), respectively. Results No statistical differences were observed in MCV, RHE and MRV levels between anemia and non-anemia subjects (p > 0.05). MRV exhibited a complete or high correlation with the RHE levels (r = 1.000, p < 0.001), or MCV, MCH, and MCHC in anemia patients (R: 0.575-0.820, p < 0.001). ROC curves analyse indicated a highest area under curve of 0.829 (95% CI [0.762-0.895]) and 0.884 (95% CI [0.831-0.936]) for MRV in identifying anemia in male and female patients, respectively (p < 0.001). When the optimal cutoff values of MRV were set at 100.95 fl in males and 98.35 fl in females, the sensitivity and specificity were 1.00 and 0.68, and 1.00 and 0.73, respectively. The regression analyse showed that, when being as a categorical variable, MRV showed an odds ratio of 19.111 (95% CI [6.985-52.288]; p < 0.001) for the incidence of CRA. The incidence of overall anemia demonstrated a more significant decrease trend along with the increase of MRV quartiles (p-trend < 0.001). Conclusion This study revealed that the MRV can be used as a convenient and sensitive index in early diagnosis of cancer-related anemia, and decreased MRV level may be the powerful predictor of overt anemia in cancer patients.
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Affiliation(s)
- Huijun Lin
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Bicui Zhan
- Department of Clinical Laboratory, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
| | - Xiaoyan Shi
- Department of Clinical Laboratory, South Jinjiang Branch of Jinjiang Hospital, Jinjiang, Fujian, China
| | - Dujin Feng
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Shuting Tao
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Mingyi Wo
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Xianming Fei
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Weizhong Wang
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yan Yu
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
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2
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Moloney C, Stavroulaki EM, Augusto M. Reference intervals for reticulocyte indices, immature reticulocyte fraction, and the percentage of hypochromic red blood cells in adult large breed dogs using the ADVIA 2120 hematology analyzer. Vet Clin Pathol 2023; 52:755-760. [PMID: 37468943 DOI: 10.1111/vcp.13285] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/05/2023] [Accepted: 06/18/2023] [Indexed: 07/21/2023]
Abstract
Reticulocyte indices are used to characterize anemia, including the identification of regeneration. In people, the immature reticulocyte fraction (IRF), percentage of hypochromic red blood cells (%HYPO-RBC), and other reticulocyte indices have been used as earlier indicators of erythropoiesis and as valuable monitoring tools in the assessment of various therapies. The reference intervals (RI) of the IRF and %HYPO-RBC have not been reported in dogs. The objective of this study was to establish RIs for novel variables (IRF, %HYPO-RBC, and CH-delta) and assess RIs for more commonly reported reticulocyte indices in healthy dogs. RIs were calculated from blood results retrospectively collected from 106 client-owned healthy dogs at the time of induction into a blood donor program using the ADVIA 2120 hematology analyzer (Siemens Healthcare Diagnostics). For the calculation of RIs, appropriate tests were applied for outlier detection and normality assessment. For variables normally distributed, RIs and their respective 90% confidence intervals (CIs) were calculated using parametric methods, while for variables not normally distributed, robust methods were used and bootstrapping for calculating the 90% CIs. The following RIs were established: reticulocyte hemoglobin content (CHr) 24.5-28 pg, mean reticulocyte volume (MCVr) 85.9-99.3 fL, mean corpuscular hemoglobin concentration of reticulocytes (CHCMr) 271.0-306.3 g/L, IRF 10.4%-43.5%, CH-delta 0.5-4.3 pg, and percentage of hypochromic red blood cells (%HYPO-RBC) 0.10%-0.80%. The results of this study provide RIs for novel reticulocyte variables. Further studies are required to determine the clinical utility of IRF, %HYPO-RBC, and CH delta as early indicators of erythropoietic activity in canine patients.
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Affiliation(s)
- Conor Moloney
- Section of Veterinary Clinical Sciences, School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Evangelia M Stavroulaki
- Section of Veterinary Clinical Sciences, School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Monica Augusto
- Section of Veterinary Clinical Sciences, School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
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3
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Ceron JJ, Pardo-Marin L, Wdowiak A, Zoia A, Wochnik M, Szczubiał M, Bochniarz M, Tecles F, Martinez-Subiela S, Tvarijonaviciute A, Dąbrowski R. Divergences between serum C-reactive protein and ferritin concentrations in canine pyometra. BMC Vet Res 2023; 19:78. [PMID: 37344860 DOI: 10.1186/s12917-023-03630-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 06/05/2023] [Indexed: 06/23/2023] Open
Abstract
The main aim of this report was to investigate and compare the response of serum C-reactive protein (CRP) and ferritin, two positive acute phase proteins (APPs) which usually show an increase in inflammatory processes, in dogs with pyometra. For this purpose, two different studies were made. In the first one , both proteins were measured together in an APPs profile in 25 dogs with pyometra, 25 dogs with pancreatitis (as an example of a positive inflammatory control group), and in 25 healthy dogs. In the second study, to advance the knowledge of the changes and evolution of serum ferritin and CRP in dogs with pyometra after treatment, the concentrations of both APPs were analyzed in 30 dogs with pyometra at diagnosis and after ovariohysterectomy and in 10 clinically healthy female dogs before and after elective spaying. In both studies, bitches with pyometra showed significant increases in serum CRP, indicating an inflammatory condition, but not in serum ferritin despite being a moderate positive APP. This divergence between the dynamics of these APPs could be a useful tool for the suspicion of cases of canine pyometra.
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Affiliation(s)
- Jose J Ceron
- Interdisciplinary Laboratory of Clinical Pathology (Interlab-UMU), Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia, 30100, Spain
| | - Luis Pardo-Marin
- Interdisciplinary Laboratory of Clinical Pathology (Interlab-UMU), Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia, 30100, Spain
| | - Anna Wdowiak
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głeboka 30st, Lublin, 20-612, Poland
| | - Andrea Zoia
- Division of Internal Medicine, San Marco Veterinary Clinic, Viale dell'Industria 3, Veggiano, Padua, 35030, Italy
| | - Marco Wochnik
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głeboka 30st, Lublin, 20-612, Poland
| | - Marek Szczubiał
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głeboka 30st, Lublin, 20-612, Poland
| | - Mariola Bochniarz
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głeboka 30st, Lublin, 20-612, Poland
| | - Fernando Tecles
- Interdisciplinary Laboratory of Clinical Pathology (Interlab-UMU), Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia, 30100, Spain
| | - Silvia Martinez-Subiela
- Interdisciplinary Laboratory of Clinical Pathology (Interlab-UMU), Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia, 30100, Spain
| | - Asta Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Pathology (Interlab-UMU), Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia, 30100, Spain.
| | - Roman Dąbrowski
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głeboka 30st, Lublin, 20-612, Poland
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Pawsat GA, Fry MM, Behling-Kelly E, Olin SJ, Schaefer DMW. Bone marrow iron scoring in healthy and clinically ill dogs with and without evidence of iron-restricted erythropoiesis. Vet Clin Pathol 2023. [PMID: 37127847 DOI: 10.1111/vcp.13209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/11/2022] [Accepted: 10/22/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND There are few reports in dogs that have evaluated the utility of semi-quantitative scoring of bone marrow iron stores in conjunction with reticulocyte hemoglobin (CHr) to identify iron-restricted erythropoiesis due to absolute iron deficiency or iron sequestration. OBJECTIVES An established system for scoring iron stores in human bone marrow samples was applied to dogs. The objectives were to evaluate interobserver agreement (Κω ), determine marrow iron scores in dogs without detectable hematologic abnormalities, and assess combined interpretation of iron scores and CHr to evaluate for iron-restricted erythropoiesis. METHODS Four blinded observers independently scored iron in 139 Prussian blue-stained canine marrow samples from 0 (none) to 6 (very heavy), including healthy controls (n = 12), clinically ill dogs with (n = 100) and without (n = 16) detectable hematologic abnormalities, and dogs with experimental nutritional iron deficiency (n = 11). Additional medical record data were available for 118 dogs to evaluate for other evidence of iron deficiency (abnormal CHr, RBC indices, serum iron variables, external blood loss, or nutritional deficiencies). RESULTS Mean Κω was 0.69 (substantial agreement) for all samples but was 0.44 (moderate agreement) for samples with iron scores <3, indicating distinguishing scores 0-2 may not be reliable. Dogs without detectable hematologic abnormalities had scores from 3-5. Dogs with scores <3 and decreased CHr often had more indicators of iron deficiency vs dogs only having low iron scores or low CHr. CONCLUSIONS Evaluation of dogs with marrow iron score <3 for external blood loss or nutritional deficiencies is likely clinically worthwhile, particularly if there is also decreased CHr.
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Affiliation(s)
- Grace A Pawsat
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Michael M Fry
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Erica Behling-Kelly
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - Shelly J Olin
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Deanna M W Schaefer
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, Tennessee, USA
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5
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Betting A, Schweighauser A, Francey T. Diagnostic value of reticulocyte indices for the assessment of the iron status of cats with chronic kidney disease. J Vet Intern Med 2022; 36:619-628. [PMID: 35090061 PMCID: PMC8965245 DOI: 10.1111/jvim.16367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 01/08/2022] [Accepted: 01/11/2022] [Indexed: 12/01/2022] Open
Abstract
Background Reticulocyte indices have been suggested as alternatives to transferrin saturation (TSAT) for iron status assessment in humans and dogs but they have not been evaluated thoroughly in cats. Objectives To assess the value of the reticulocyte indices for the diagnosis of iron deficiency in cats with chronic kidney disease (CKD) and chronic hematuria associated with subcutaneous ureteral bypasses (SUBs). Animals Sixty‐four cats: 16 healthy, 14 CKD without SUB, and 34 CKD with SUB. Methods Prospective observational cross‐sectional study of cats presented for routine nephrology visits. Primary outcomes included assessment of the diagnostic values of erythrocyte indices (mean corpuscular volume, hemoglobin, and hemoglobin concentration: MCV, MCH, and MCHC) and reticulocyte indices (mean corpuscular volume, MCVr; corpuscular hemoglobin, CHr), using TSAT as reference. Results Iron deficiency was diagnosed in 9/64 cats (14%). A receiver‐operating characteristic curve analysis yielded a moderate discriminatory value for CHr in this diagnosis: area under the curve [AUC] = .75 (95% confidence interval, 0.48‐0.89); P = .006; sensitivity 67%, specificity 82% for a cutoff of 15.9 pg. This compared favorably to MCVr (AUC = .63; P = .29), MCV (AUC = .58; P = .45), MCH (AUC = .64; P = .19), and MCHC (AUC = .7; P = .03). Conclusion and Clinical Importance CHr added moderate value to the diagnosis of iron deficiency in cats with CKD.
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Affiliation(s)
- Adeline Betting
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Ariane Schweighauser
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Thierry Francey
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
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6
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Keiner M, Fuchs J, Bauer N, Moritz A. Evaluation of reticulocyte hemoglobin content (RETIC-HGB) for the diagnosis of iron-limited erythropoiesis in cats. Vet Clin Pathol 2021; 49:557-566. [PMID: 33617045 DOI: 10.1111/vcp.12925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Decreased reticulocyte hemoglobin content (CHr) (Siemens ADVIA 2120) reflects iron-limited erythropoiesis (ILE). RETIC-HGB (IDEXX ProCyte Dx) is a novel marker of ILE for veterinary use. OBJECTIVES We aimed to evaluate reference intervals (RIs) and the utility of RETIC-HGB and CHr in the diagnosis of feline ILE. MATERIALS AND METHODS RIs were established in 59 healthy cats. Intra-assay coefficients of variation (CVs) and correlations between RETIC-HGB and CHr were assessed. Two hundred and seventy-five cats were classified as having ILE or not based on low plasma iron or low transferrin saturation along with anemia and/or altered RBC indices. CHr, RETIC-HGB, and serum amyloid A (SAA) were compared between the groups. The sensitivity and specificity of RETIC-HGB and CHr to diagnose ILE were analyzed to determine the RI lower limits. RESULTS RIs for RETIC-HGB and CHr were 12.5-18.0 and 14.0-19.9 pg, respectively. The CV was 3% for both variables. RETIC-HGB and CHr were moderately correlated (rs = 0.59) with a bias of -1.2 picograms (pgs). Twenty of the 275 cats were classified as having ILE. Compared with non-ILE cats, ILE cats had significantly lower median RETIC-HGB (14.3 vs 15.2 pg, P = .0046) and mean CHr (14.7 vs 16.5 pg, P < .0001) values and significantly increased median SAA (44.6 vs 2.3 µg/dl, P < .0001) values. Using the lower RI limits resulted in a low sensitivity and relatively high specificity to diagnose ILE in cats. CONCLUSIONS ILE was characterized by decreased CHr and RETIC-HGB; however, sensitivity was low. The moderate correlation between RETIC-HGB and CHr is likely due to species differences and different methodology.
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Affiliation(s)
- Miriam Keiner
- Small Animal Clinic, Internal Medicine, Justus-Liebig-University, Giessen, Germany
| | - Jannika Fuchs
- Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology, Justus-Liebig-University, Giessen, Germany
| | - Natali Bauer
- Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology, Justus-Liebig-University, Giessen, Germany
| | - Andreas Moritz
- Small Animal Clinic, Internal Medicine, Justus-Liebig-University, Giessen, Germany.,Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology, Justus-Liebig-University, Giessen, Germany
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7
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Pawsat GA, Fry MM, Schneider L, Schaefer DMW. Comparison of iron staining and scoring methods on canine bone marrow aspirates. Vet Clin Pathol 2021; 50:132-141. [PMID: 33655512 DOI: 10.1111/vcp.12947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/15/2020] [Accepted: 08/01/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Insufficient iron for erythropoiesis can occur in multiple conditions, including absolute iron deficiency, which is often caused by chronic external hemorrhage in dogs. Distinguishing this from other causes of iron-restricted erythropoiesis allows appropriate intervention. Decreased marrow iron assessed by Prussian blue staining is a method to diagnose absolute iron deficiency, but scoring systems for marrow iron are not validated in dogs. OBJECTIVES Our objectives were to (a) evaluate the technical performance of two bone marrow iron scoring systems used in human medicine and (b) examine the effects of destaining and restaining on iron stores after Wright-stained marrow slides are destained and restained with a Prussian blue stain. METHODS Two marrow aspirate slides were included from each of 12 ill dogs in which marrow was collected during clinical evaluation. One slide was directly stained with Prussian blue. The other was first stained with Wright stain, then destained and restained with Prussian blue. Three blinded observers scored the presence of iron in each of the 24 randomized slides using the Gale (scale 0-6) and sideroblast methods (percentage score). Slides were then re-randomized and rescored. RESULTS For the Gale method, interobserver agreement was fair, and intraobserver agreement was substantial to perfect. There was less agreement using the sideroblast method, with a significant observer effect. Iron scores were significantly lower in destained slides compared with those stained directly. CONCLUSIONS Interobserver and intraobserver agreements were acceptable for the Gale method, but the sideroblast method should be used cautiously. A destaining procedure before Prussian blue staining could decrease marrow iron scores.
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Affiliation(s)
- Grace A Pawsat
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, TN, USA
| | - Michael M Fry
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, TN, USA
| | - Liesel Schneider
- Department of Animal Science, University of Tennessee, Knoxville, TN, USA
| | - Deanna M W Schaefer
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, TN, USA
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8
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Hunt A, Jugan MC. Anemia, iron deficiency, and cobalamin deficiency in cats with chronic gastrointestinal disease. J Vet Intern Med 2020; 35:172-178. [PMID: 33226151 PMCID: PMC7848310 DOI: 10.1111/jvim.15962] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/29/2020] [Accepted: 10/29/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Iron deficiency and cobalamin deficiency, as sequelae to chronic gastrointestinal (GI) disease, could result in anemia and increased morbidity in cats with chronic enteropathies. OBJECTIVE To evaluate iron deficiency in cats with chronic GI disease and its relationship with hypocobalaminemia, anemia, and disease severity. ANIMALS Twenty client-owned cats with primary GI disease. METHODS Prospective, cross-sectional study. Cats were enrolled at the time of evaluation for chronic GI disease, after exclusion of comorbidities. CBC with reticulocyte indices, iron metabolism (serum iron and ferritin concentrations, total iron binding capacity [TIBC]), serum methylmalonic acid (MMA), cobalamin, and folate concentrations, pancreatic lipase and trypsin-like immunoreactivity, and disease severity were evaluated. RESULTS Anemia (hematocrit <30%), iron deficiency, and cobalamin deficiency were diagnosed in 4/20, 7/20, and 8/20 cats, respectively. Hematocrit (rs = -.45; P < .05) and body condition score (rs = -.60; P < .01) negatively correlated with MMA. Median TIBC was lower in cats with increased vs normal MMA (218 μg/mL; range, 120-466 μg/mL vs 288 μg/mL; range, 195-369 μg/mL; P = .02). Hematocrit (rs = .51; P = .02), reticulocyte MCV (rs = .52; P = .02), reticulocyte hemoglobin content (rs = .71; P < .001), and percent transferrin saturation (rs = .79; P < .0001) positively correlated with serum iron concentration. CONCLUSIONS AND CLINICAL IMPORTANCE Functional iron deficiency was common in cats with chronic GI disease. Associations between hypocobalaminemia, iron parameters, and hematologic parameters warrant further investigation on the impact of iron deficiency on chronic GI disease morbidity in cats.
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Affiliation(s)
- Adam Hunt
- Department of Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Tennessee, USA
| | - Maria C Jugan
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
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9
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Martinez CR, Santangelo KS, Olver CS. Variability in the cleavage of exosome-associated transferrin receptor questions the utility of clinically useful soluble transferrin receptor assays for dogs, cats, and horses. Exp Hematol 2020; 86:43-52.e1. [PMID: 32417302 DOI: 10.1016/j.exphem.2020.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 10/24/2022]
Abstract
Whole transferrin receptor (TfR) is present in reticulocyte exosomes. Soluble transferrin receptor (sTfR) is cleaved from whole TfR in human plasma, with the remnant cytoplasmic domain (cTfR) remaining membrane associated. In humans, sTfR is a biomarker that can detect iron deficiency in the presence of inflammatory disease. This condition is still a diagnostic dilemma in veterinary species. We aimed to (1) confirm the presence of exosomes and exosome-associated TfR in the serum of dogs, cats, and horses; and (2) to assess and compare the proportion of cTfR to total (cTfR + whole) in exosomal membranes of healthy and diseased dogs and cats and in healthy horses to indirectly predict their anticipated levels of circulating sTfR. We used discarded serum and whole blood samples from canine and feline patients, separated into healthy and diseased groups based on the health status of each patient, and healthy equine participants from a previous study. Ultracentrifugation, followed in some experiments by OptiPrep discontinuous density gradient fractionation, was used to isolate exosomes. Exosomes and associated TfR were identified using TEM and Western blot for TfR, respectively. Densitometry tracings of Western blots of serum exosomes were used to measure the proportion of cTfR to total TfR. Extracellular vesicles compatible with exosomes were successfully isolated and expressed TfR. The proportion of cTfR in dogs was greater than 50%, indicating that a majority of the whole TfR was cleaved to produce sTfR (and remnant cTfR). There was significant interindividual variation and no significant difference between healthy and diseased animals. The proportion of cTfR in cats was very low at 11%, indicating that very little sTfR was likely produced. There was a small yet significant difference between healthy and diseased cats. Healthy horses do not appear to cleave exosome-associated TfR. Diagnosis of iron deficiency in the presence of inflammatory disease remains a challenge in veterinary medicine. Our results indicate that TfR is poorly or unpredictably cleaved in veterinary species, revealing that there are species differences in exosomal TfR handling. These data suggest that development of an assay for the detection and quantification of sTfR in the species investigated may not be warranted.
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Affiliation(s)
- Caitlyn R Martinez
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Kelly S Santangelo
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Christine S Olver
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO.
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10
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Herman N, Trumel C, Geffré A, Braun JP, Thibault M, Schelcher F, Bourgès-Abella N. Hematology reference intervals for adult cows in France using the Sysmex XT-2000iV analyzer. J Vet Diagn Invest 2018; 30:678-687. [PMID: 30027829 DOI: 10.1177/1040638718790310] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In order to develop bovine hematology reference intervals (RIs) in accordance with new international recommendations, we analyzed 156 blood specimens of healthy adult dairy and beef cows from 32 farms with a Sysmex XT-2000iV analyzer, and by manual scoring of platelet clumps and white blood cell (WBC) differential. We established RIs by the nonparametric method, and examined effects of age, production type (beef vs. dairy), and stage of lactation. RIs could not be determined for platelet count and indices because clumps were observed in 80% of specimens. Optical and impedance red blood cell (RBC) counts were similar, although statistically different. RIs for analyzer and manual WBC differentials were not different except for lymphocyte concentration, the subpopulations of which were counted manually. Hematocrit was higher in beef than dairy cattle, and hemoglobin was lower in early lactation. Increases in RBC count, mean corpuscular volume, mean corpuscular hemoglobin, and RBC distribution width were noted with increasing age, along with decreases in WBC count, neutrophils, and lymphocytes. Most RIs in our study, with the exception of neutrophils, were similar to those previously reported using a flow cytometry analyzer.
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Affiliation(s)
- Nicolas Herman
- Ecole Nationale Vétérinaire de Toulouse (ENVT; Herman, Braun, Thibault), Université de Toulouse, Toulouse, France.,Centre Régional d'Exploration Fonctionnelle et Ressources Expérimentales, Institut National de la Santé Et de la Recherche Médicale, Université Paul Sabatier, ENVT (Trumel, Geffré, Bourgès-Abella), Université de Toulouse, Toulouse, France.,Unité Mixte de Recherche Interactions Hôtes Agents Pathogènes, Institut National de la Recherche Agronomique, ENVT (Schelcher), Université de Toulouse, Toulouse, France
| | - Catherine Trumel
- Ecole Nationale Vétérinaire de Toulouse (ENVT; Herman, Braun, Thibault), Université de Toulouse, Toulouse, France.,Centre Régional d'Exploration Fonctionnelle et Ressources Expérimentales, Institut National de la Santé Et de la Recherche Médicale, Université Paul Sabatier, ENVT (Trumel, Geffré, Bourgès-Abella), Université de Toulouse, Toulouse, France.,Unité Mixte de Recherche Interactions Hôtes Agents Pathogènes, Institut National de la Recherche Agronomique, ENVT (Schelcher), Université de Toulouse, Toulouse, France
| | - Anne Geffré
- Ecole Nationale Vétérinaire de Toulouse (ENVT; Herman, Braun, Thibault), Université de Toulouse, Toulouse, France.,Centre Régional d'Exploration Fonctionnelle et Ressources Expérimentales, Institut National de la Santé Et de la Recherche Médicale, Université Paul Sabatier, ENVT (Trumel, Geffré, Bourgès-Abella), Université de Toulouse, Toulouse, France.,Unité Mixte de Recherche Interactions Hôtes Agents Pathogènes, Institut National de la Recherche Agronomique, ENVT (Schelcher), Université de Toulouse, Toulouse, France
| | - Jean-Pierre Braun
- Ecole Nationale Vétérinaire de Toulouse (ENVT; Herman, Braun, Thibault), Université de Toulouse, Toulouse, France.,Centre Régional d'Exploration Fonctionnelle et Ressources Expérimentales, Institut National de la Santé Et de la Recherche Médicale, Université Paul Sabatier, ENVT (Trumel, Geffré, Bourgès-Abella), Université de Toulouse, Toulouse, France.,Unité Mixte de Recherche Interactions Hôtes Agents Pathogènes, Institut National de la Recherche Agronomique, ENVT (Schelcher), Université de Toulouse, Toulouse, France
| | - Marion Thibault
- Ecole Nationale Vétérinaire de Toulouse (ENVT; Herman, Braun, Thibault), Université de Toulouse, Toulouse, France.,Centre Régional d'Exploration Fonctionnelle et Ressources Expérimentales, Institut National de la Santé Et de la Recherche Médicale, Université Paul Sabatier, ENVT (Trumel, Geffré, Bourgès-Abella), Université de Toulouse, Toulouse, France.,Unité Mixte de Recherche Interactions Hôtes Agents Pathogènes, Institut National de la Recherche Agronomique, ENVT (Schelcher), Université de Toulouse, Toulouse, France
| | - François Schelcher
- Ecole Nationale Vétérinaire de Toulouse (ENVT; Herman, Braun, Thibault), Université de Toulouse, Toulouse, France.,Centre Régional d'Exploration Fonctionnelle et Ressources Expérimentales, Institut National de la Santé Et de la Recherche Médicale, Université Paul Sabatier, ENVT (Trumel, Geffré, Bourgès-Abella), Université de Toulouse, Toulouse, France.,Unité Mixte de Recherche Interactions Hôtes Agents Pathogènes, Institut National de la Recherche Agronomique, ENVT (Schelcher), Université de Toulouse, Toulouse, France
| | - Nathalie Bourgès-Abella
- Ecole Nationale Vétérinaire de Toulouse (ENVT; Herman, Braun, Thibault), Université de Toulouse, Toulouse, France.,Centre Régional d'Exploration Fonctionnelle et Ressources Expérimentales, Institut National de la Santé Et de la Recherche Médicale, Université Paul Sabatier, ENVT (Trumel, Geffré, Bourgès-Abella), Université de Toulouse, Toulouse, France.,Unité Mixte de Recherche Interactions Hôtes Agents Pathogènes, Institut National de la Recherche Agronomique, ENVT (Schelcher), Université de Toulouse, Toulouse, France
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11
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Fuchs J, Moritz A, Grußendorf E, Lechner J, Neuerer F, Nickel R, Rieker T, Schwedes C, DeNicola DB, Russell J, Bauer N. Evaluation of reticulocyte hemoglobin content (RET-He) in the diagnosis of iron-deficient erythropoiesis in dogs. Vet Clin Pathol 2017; 46:558-568. [DOI: 10.1111/vcp.12547] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jannika Fuchs
- Department of Veterinary Clinical Sciences; Clinical Pathology and Clinical Pathophysiology; Justus-Liebig-University; Giessen Germany
| | - Andreas Moritz
- Department of Veterinary Clinical Sciences; Clinical Pathology and Clinical Pathophysiology; Justus-Liebig-University; Giessen Germany
| | | | | | | | | | - Thomas Rieker
- AniCura Small Animal Specialists; Ravensburg Germany
| | | | | | | | - Natali Bauer
- Department of Veterinary Clinical Sciences; Clinical Pathology and Clinical Pathophysiology; Justus-Liebig-University; Giessen Germany
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12
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Fuchs J, Moritz A, Grußendorf E, Lechner J, Neuerer F, Nickel R, Rieker T, Schwedes C, DeNicola DB, Russell J, Bauer N. Canine reticulocyte hemoglobin content (RET-He
) in different types of iron-deficient erythropoiesis. Vet Clin Pathol 2017; 46:422-429. [DOI: 10.1111/vcp.12499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Jannika Fuchs
- Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology; Justus-Liebig-University; Giessen Germany
| | - Andreas Moritz
- Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology; Justus-Liebig-University; Giessen Germany
| | | | - Jörg Lechner
- Small Animal Clinic; Nürnberg-Hafen Nürnberg Germany
| | | | | | - Thomas Rieker
- AniCura Small Animal Specialists; Ravensburg Germany
| | | | | | | | - Natali Bauer
- Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology; Justus-Liebig-University; Giessen Germany
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13
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Chikazawa S, Dunning MD. A review of anaemia of inflammatory disease in dogs and cats. J Small Anim Pract 2017; 57:348-53. [PMID: 27385622 DOI: 10.1111/jsap.12498] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 03/06/2016] [Accepted: 03/07/2016] [Indexed: 12/12/2022]
Abstract
Anaemia of inflammatory disease is a common cause of anaemia in routine veterinary practice. It is most often mild to moderate, normocytic, normochromic and non-regenerative. Shortened red cell life span, inhibition of iron metabolism and impaired bone marrow response to erythropoietin all contribute to its development. Although anaemia of inflammatory disease is a well-known cause of anaemia in dogs and cats, there is a lack of epidemiological information because specific diagnostic criteria have not been established in veterinary species. Anaemia of inflammatory disease is associated with a poor outcome in various disease states in human medicine; however, its clinical significance and treatment in veterinary medicine are not well understood. This review article describes anaemia of inflammatory disease in dogs and cats and considers its potential significance.
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Affiliation(s)
- S Chikazawa
- Department of Small Animal Internal Medicine, School of Veterinary Medicine, Kitasato University, 23-35-1 Towada, Aomori 034-8628, Japan
| | - M D Dunning
- Department of Medicine and Health Sciences, School of Veterinary Medicine, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD
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14
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Foy DS, Friedrichs KR, Bach JF. Evaluation of Iron Deficiency Using Reticulocyte Indices in Dogs Enrolled in a Blood Donor Program. J Vet Intern Med 2016; 29:1376-80. [PMID: 26340143 PMCID: PMC4858052 DOI: 10.1111/jvim.13598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 05/07/2015] [Accepted: 07/21/2015] [Indexed: 11/28/2022] Open
Abstract
Background People donating blood more than twice annually are at risk of developing iron deficiency. Little is known about the iron status of dogs enrolled in blood donor programs. Hypothesis Dogs donating blood ≥6 times annually will show evidence of iron deficiency based on their reticulocyte indices. Animals Thirteen dogs enrolled in a blood donor program donating ≥6 times over the preceding 12 months and 20 healthy nondonor control dogs. Methods Prospective observational study. Mature red blood cell (RBC) indices, reticulocyte indices, serum iron, serum ferritin, and total iron‐binding capacity (TIBC) were compared between groups. Results Packed cell volume (median 47%, range 40–52%, P < .01), hematocrit (median 46.4%, range 40.3–52.5%, P < .01), and reticulocyte count (median 16,000/μL, range 9,000–38,000/μL, P < .01) were significantly lower in the blood donor dogs. No statistically significant differences were noted in the mature RBC indices between groups. Both reticulocyte mean corpuscular volume (median 88.8 fL, range 83.4–95.5 fL, P = .03) and reticulocyte hemoglobin content (median 24.6 pg, range 23.1–26.6 pg, P < .01) were significantly lower in the blood donor group. Serum iron and ferritin were similar between groups; however, TIBC was significantly higher in the control group (median 403 μg/dL, range 225–493 μg/dL, P = .02). Conclusions The findings in dogs donating ≥6 times annually suggest the presence of iron‐deficient erythropoiesis in this population.
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Affiliation(s)
- D S Foy
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI
| | - K R Friedrichs
- Deptartment of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI
| | - J F Bach
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI
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15
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Abstract
Iron is an essential element and is used by every cell in the body. This article summarizes iron metabolism and disorders associated with iron metabolism in dogs and cats. The diagnostic tests currently in use for assessing iron status are discussed.
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Affiliation(s)
- Andrea A Bohn
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1619 Campus Delivery, Fort Collins, CO 80523, USA.
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16
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Hernández JD, Orós J, Artiles M, Castro P, Blanco A. Ultrastructural characteristics of blood cells in the Yellow-Bellied Slider Turtle (Trachemys scripta scripta). Vet Clin Pathol 2016; 45:106-9. [PMID: 26780166 DOI: 10.1111/vcp.12325] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The classification of blood cells from the Yellow-Bellied Slider Turtle (Trachemys scripta scripta) is relevant due to their increasing importance as pets and as object of study in clinical settings and research projects. However, no previous ultrastructural characterization of blood cells from turtles of the genus Trachemys has been reported. OBJECTIVES The objective of this study was to provide an ultrastructural characterization of blood cells of the Yellow-Bellied Slider Turtle. METHODS Blood samples from 10 healthy adult turtles (5 males and 5 females) were obtained and processed for transmission electron microscopy using standard methods. RESULTS Some erythrocytes had intracytoplasmic inclusions compatible with hemoglobin precipitates; mitochondria and ribosomes in the cytoplasm of erythrocytes were also observed. Five types of white blood cells were ultrastructurally identified: heterophils, eosinophils, basophils, lymphocytes, and monocytes. Heterophils were similar to those described from Sea Turtles, with only one morphologic variation of this cell. Eosinophils were homogeneous in size and had intracytoplasmic granules without crystalline structures. Basophils were ultrastructurally described for the first time for a turtle and had heterogeneous intracytoplasmic granules. Lymphocytes and monocytes were similar to those described from other chelonians. Some thrombocytes had an irregularly lobulated nucleus and intracytoplasmic canalicular structures. CONCLUSION This study provides the first ultrastructural classification of blood cells in Trachemys scripta scripta, as a baseline for further hematologic studies in this species.
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Affiliation(s)
- Juan D Hernández
- Unit of Veterinary Histology, Veterinary Faculty, University of Las Palmas de Gran Canaria (ULPGC), Arucas, Spain.,Serviexotic, Vega de San Mateo, Spain
| | - Jorge Orós
- Unit of Veterinary Histology, Veterinary Faculty, University of Las Palmas de Gran Canaria (ULPGC), Arucas, Spain
| | | | - Pedro Castro
- Unit of Veterinary Histology, Veterinary Faculty, University of Las Palmas de Gran Canaria (ULPGC), Arucas, Spain
| | - Alfonso Blanco
- Unit of Veterinary Histology, Veterinary Faculty, University of Córdoba, Córdoba, Spain
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17
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Radakovich LB, Santangelo KS, Olver CS. Reticulocyte hemoglobin content does not differentiate true from functional iron deficiency in dogs. Vet Clin Pathol 2015; 44:511-8. [DOI: 10.1111/vcp.12294] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Lauren B. Radakovich
- Department of Microbiology, Immunology, and Pathology; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO USA
| | - Kelly S. Santangelo
- Department of Microbiology, Immunology, and Pathology; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO USA
| | - Christine S. Olver
- Department of Microbiology, Immunology, and Pathology; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO USA
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18
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Evaluation of the Relationship between Selected Reticulocyte Parameters and Inflammation determined by Plasma C-reactive Protein in Dogs. J Comp Pathol 2015; 152:304-12. [DOI: 10.1016/j.jcpa.2015.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 01/12/2015] [Accepted: 01/15/2015] [Indexed: 11/29/2022]
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19
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Schaefer DMW, Stokol T. The utility of reticulocyte indices in distinguishing iron deficiency anemia from anemia of inflammatory disease, portosystemic shunting, and breed-associated microcytosis in dogs. Vet Clin Pathol 2014; 44:109-19. [DOI: 10.1111/vcp.12219] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Deanna M. W. Schaefer
- Department of Population Medicine and Diagnostic Sciences; Cornell University College of Veterinary Medicine; Ithaca NY USA
| | - Tracy Stokol
- Department of Population Medicine and Diagnostic Sciences; Cornell University College of Veterinary Medicine; Ithaca NY USA
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20
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Abstract
BACKGROUND Despite the popularity of canine blood donor (BD) programs, there is scarce scientific information regarding iron status in this canine population of dogs. OBJECTIVE To assess iron status in dogs used in a blood donor program. ANIMALS A total of 130 healthy dogs (75 BD, 55 controls [C]) were included. A subset of dogs (n = 12) were used to evaluate the effects of repetitive donations by having a second and more recent sample analyzed. METHODS Serum iron concentration (SI), unsaturated iron-binding capacity (UIBC), total iron-binding capacity (TIBC), and percentage transferrin saturation (%SAT) were obtained. Values were compared using a 2-way ANOVA (factors: BD status, breed). For the subset of BD, the first sample (less frequent donors -LD-, after a mean of 3.8 donations) was compared to a second sample (experienced donors -ED-, mean 13.6 donations) using a paired t-test. RESULTS SI (183.7 ± 55.3 μg/dL) and %SAT (55.7 ± 17.4%) were higher and UIBC (152.6 ± 73.3 μg/dL) was lower in BD dogs than in C (153.9 ± 51.7 μg/dL, 43.8 ± 17.8%, and 224.1 ± 120.6 μg/dL, respectively). Also, UIBC and TIBC were lower, and %SAT higher in Greyhounds when compared with non-Greyhounds. ED had decreased %SAT and increased UIBC and TIBC when compared with LD. CONCLUSIONS AND CLINICAL IMPORTANCE Our canine BD population did not have iron deficiency and had higher SI concentration than C. However, ED (~14 consecutive blood donations every ~8 weeks) developed a mild iron deficiency, although values were still within canine reference intervals. Greyhounds have higher %SAT than non-Greyhounds, which might be a breed-specific peculiarity.
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Affiliation(s)
- S. Zaldívar‐López
- Department of Veterinary Clinical SciencesCollege of Veterinary MedicineColumbusOH
- The Research Institute at Nationwide Children's HospitalColumbusOH
- Present address: Grupo de Genómica y Mejora AnimalDepartmento de GenéticaFacultad de VeterinariaUniversidad de CórdobaCórdobaSpain
| | - M.C. Iazbik
- Veterinary Medical CenterThe Ohio State UniversityColumbusOH
| | - L.M. Marín
- Department of Veterinary Clinical SciencesCollege of Veterinary MedicineColumbusOH
| | - C.G. Couto
- Department of Veterinary Clinical SciencesCollege of Veterinary MedicineColumbusOH
- Veterinary Medical CenterThe Ohio State UniversityColumbusOH
- Comprehensive Cancer CenterThe Ohio State UniversityColumbusOH
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21
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Bohn AA. Diagnosis of disorders of iron metabolism in dogs and cats. Vet Clin North Am Small Anim Pract 2013; 43:1319-30, vii. [PMID: 24144093 DOI: 10.1016/j.cvsm.2013.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Iron is an essential element and is used by every cell in the body. This article summarizes iron metabolism and disorders associated with iron metabolism in dogs and cats. The diagnostic tests currently in use for assessing iron status are discussed.
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Affiliation(s)
- Andrea A Bohn
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1619 Campus Delivery, Fort Collins, CO 80523, USA.
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22
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Chalhoub S, Langston C, Eatroff A. Anemia of renal disease: what it is, what to do and what's new. J Feline Med Surg 2011; 13:629-40. [PMID: 21872790 DOI: 10.1016/j.jfms.2011.07.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PATIENT GROUP It is estimated that 15-30% of geriatric cats will develop chronic kidney disease (CKD), and that 30-65% of these cats will develop anemia as their renal disease worsens. Anemia of renal disease is multifactorial in its pathogenesis, but the main cause is reduced production of erythropoietin, a renal hormone that controls the bone marrow's production of red blood cells, as kidney disease progresses. PRACTICAL RELEVANCE It is important to recognize the presence of anemia of renal disease so that adequate treatment may be instituted to improve quality of life and metabolic function. Erythrocyte-stimulating agents (ESAs), such as epoetin alfa, epoetin beta and darbepoetin alfa, have been developed to counteract the effects of decreased erythropoietin production by the kidneys. These treatments, which are the focus of this review, have 83% similarity in amino acid sequence to the feline hormone. On average, the target packed cell volume (>25%) is reached within 3-4 weeks of ESA therapy. CLINICAL CHALLENGES The use of ESAs has been associated with a number of complications, such as iron deficiency, hypertension, arthralgia, fever, seizures, polycythemia and pure red cell aplasia (PRCA). Darbepoetin has a prolonged half-life compared with epoetin and thus can be given only once a week, instead of three times a week. The incidence of PRCA appears to be decreased with darbepoetin use when compared with epoetin use in cats. EVIDENCE BASE There is limited published evidence to date to underpin the use of ESAs in cats. This review draws on the relevant publications that currently exist, and the authors' personal experience of using these therapies for over 5 years.
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Affiliation(s)
- Serge Chalhoub
- Charleston Veterinary Referral Center, 3484 Shelby Ray Court, Charleston, SC 29414, USA
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23
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McCown JL, Specht AJ. Iron Homeostasis and Disorders in Dogs and Cats: A Review. J Am Anim Hosp Assoc 2011; 47:151-60. [DOI: 10.5326/jaaha-ms-5553] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Iron is an essential element for nearly all living organisms and disruption of iron homeostasis can lead to a number of clinical manifestations. Iron is used in the formation of both hemoglobin and myoglobin, as well as numerous enzyme systems of the body. Disorders of iron in the body include iron deficiency anemia, anemia of inflammatory disease, and iron overload. This article reviews normal iron metabolism, disease syndromes of iron imbalance, diagnostic testing, and treatment of either iron deficiency or excess. Recent advances in diagnosing iron deficiency using reticulocyte indices are reviewed.
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Affiliation(s)
- Jennifer L. McCown
- PETS Referral Center, Berkeley, CA (J.M.); and University of Florida Veterinary Medical Center, Department of Small Animal Clinical Sciences, Gainesville, FL (A.S.)
| | - Andrew J. Specht
- PETS Referral Center, Berkeley, CA (J.M.); and University of Florida Veterinary Medical Center, Department of Small Animal Clinical Sciences, Gainesville, FL (A.S.)
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24
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Reticulocyte measurements in rat, dog and mouse whole blood samples using the Sysmex XT-2000iV. ACTA ACUST UNITED AC 2011. [DOI: 10.1007/s00580-010-1147-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Gavazza A, Rispoli D, Bernabò N, Lubas G. Retrospective and observational investigation of canine microcytosis in relationship to sex, breed, diseases, and other complete blood count parameters. ACTA ACUST UNITED AC 2010. [DOI: 10.1007/s00580-010-1127-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Marchetti V, Lubas G, Lombardo A, Corazza M, Guidi G, Cardini G. Evaluation of erythrocytes, platelets, and serum iron profile in dogs with chronic enteropathy. Vet Med Int 2010; 2010. [PMID: 20798868 PMCID: PMC2926671 DOI: 10.4061/2010/716040] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Accepted: 06/25/2010] [Indexed: 01/06/2023] Open
Abstract
The aim of this study is to evaluate iron status, erythrocyte, and platelet modifications in dogs with chronic enteropathy (CE). Dogs were grouped as food-responsive diarrhea (FRD, n = 11), antibiotic-responsive diarrhea (ARD, n = 5), and steroid-responsive diarrhea (SRD, n = 6) relating to therapeutic-response. Clinical and haematological findings, evidence of gastrointestinal blood loss, and iron metabolism were evaluated before and after treatment. A mild normocytic or microcytic anemia and thrombocytosis were identified, respectively in 18.0% and 31.8% of CE dogs. No significant differences between pre- and posttreatment of hematocrit, haemoglobin, and mean corpuscular volume, platelet count and mean platelet volume were found. Statistical analysis pointed out significant differences between pre- and posttreatment in serum iron (P < .03) and unsaturated iron binding capacity (UIBC) (P < .01). No significant correlations were found between these parameters and canine Inflammatory Bowel Disease activity index and pattern of CE as well.
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Affiliation(s)
- Veronica Marchetti
- Department of Veterinary Clinics, University of Pisa, via Livornese lato monte, I-56122 San Piero a Grado, Pisa, Italy
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27
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Paltrinieri S, Preatoni M, Rossi S. Microcytosis does not predict serum iron concentrations in anaemic dogs. Vet J 2009; 185:341-3. [PMID: 19632869 DOI: 10.1016/j.tvjl.2009.06.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 05/19/2009] [Accepted: 06/21/2009] [Indexed: 10/20/2022]
Abstract
To determine whether microcytosis can be used to predict hyposideremia in dogs, mean corpuscular volume (MCV), iron and total iron binding capacity (TIBC) were measured in 12 control and 45 anaemic dogs. Hyposideremia was found in all dogs with chronic haemorrhage and occasionally in other dogs but mainly associated with inflammation. An ROC curve analysis demonstrated that microcytosis did not discriminate hyposideremic dogs or hyposideremic dogs with normal TIBC from non-hyposideremic dogs. At the optimised cut-off value determined using the ROC curve (MCV=60.9 fL), diagnostic sensitivity, specificity, and positive and negative likelihood ratios were 44.4%, 84.6%, 2.89 and 0.66 for hyposideremia, and 60.0%, 83.0%, 3.53 and 0.49 for hyposideremia not associated with decreased TIBC. The results indicate that microcytosis may not be a hallmark of hyposideremia in dogs.
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Affiliation(s)
- Saverio Paltrinieri
- Department of Veterinary Pathology, Hygiene and Public Health, University of Milan, Italy.
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28
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Bauer N, Moritz A. Evaluation of three Methods for Measurement of Hemoglobin and Calculated Hemoglobin Variables with the ADVIA 120® and ADVIA 2120® Systems in Goats. J Vet Diagn Invest 2008; 20:593-7. [DOI: 10.1177/104063870802000509] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The present study investigated 3 methods of hemoglobin (Hb) determination in goats using the ADVIA 120 and ADVIA 2120 systems. Ethylenediaminetetraacetic acid anticoagulated caprine blood samples (n = 40 goats) were subjected to Hb determination via the cyanmethemoglobin methods in both instruments and a novel, cyanide-free, colorimetric method with the ADVIA 2120. Statistical analysis of the data included a linear regression, Passing-Bablok regression, and Bland-Altman diagram. Colorimetric Hb results determined with both analyzers had excellent correlation ( r = 0.98); however, a mean proportional bias of −19.1% was present in comparison to the reference method. There also was excellent agreement between cellular Hb concentrations when measured with both analyzers ( r = 0.96), and the constant bias was close to zero. However, imprecision was higher compared to colorimetric methods. Excellent to fair agreement was evident for all calculated erythrocyte and Hb variables. Because of the excellent correlation between the ADVIA 120 and ADVIA 2120, the cyanide-free method of Hb determination could be used with caprine blood specimens; however, the proportional bias must be considered.
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Affiliation(s)
- Natali Bauer
- Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology, Justus-Liebig University Giessen, Giessen, Germany
| | - Andreas Moritz
- Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology, Justus-Liebig University Giessen, Giessen, Germany
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29
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Bauer N, Moritz A. Evaluation of three methods for measurement of hemoglobin and calculated hemoglobin parameters with the ADVIA 2120 and ADVIA 120 in dogs, cats, and horses. Vet Clin Pathol 2008; 37:173-9. [DOI: 10.1111/j.1939-165x.2008.00039.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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