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Jensen AL, Krogh AKH, Nielsen LN. Comparison of visual assessments of anisocytosis in canine blood smears and analyzer-calculated red blood cell distribution width. Front Vet Sci 2023; 10:1258857. [PMID: 37808118 PMCID: PMC10551143 DOI: 10.3389/fvets.2023.1258857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/28/2023] [Indexed: 10/10/2023] Open
Abstract
Red blood cell distribution width (RDW) and visual assessments of anisocytosis assess variability in erythrocyte size. Veterinary studies on the correlation between the two methods and on observer agreement are scarce. The objectives were to assess the correlation of the grading of anisocytosis by means of conventional microscopy of canine blood smears to RDW, and to assess intra- and inter-observer variation in assessing the degree of anisocytosis. The study included 100 canine blood samples on which blood smear examination and RDW measurement were performed. RDW was measured on the Advia 2120i analyzer. The degree of anisocytosis was based on a human grading scheme assessing the ratio between the size of the representative largest red blood cell and that of the representative smallest red blood cell (1+ if <2x, 2+ if 2-3x, 3+ if 3-4x, and 4+ if >4x). Three observers participated and assessed the blood smears by conventional microscopy twice, 3 weeks apart by each observer. The correlation was assessed for each observer on each occasion using Kendahl-tau-b analysis. Intra-observer agreement was assessed using quadratically weighted kappa. Inter-observer agreement was assessed using free-marginal multi-rater kappa. Anisocytosis graded on blood smears correlated significantly with RDW values as assessed by Kendahl-tau-b ranging between 0.37 and 0.51 (p < 0.0001). Intra-observer agreement ranged from weak to moderate with resulting kappa-coefficients being 0.58, 0.68, and 0.75, respectively. Inter-observer agreement was weak (Kappa-values 0.44). The weak to moderate observer agreement in the visual assessment of anisocytosis indicates that the more precise and more repeatable RDW measurement should be used for clinical decision-making.
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Affiliation(s)
- Asger L. Jensen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Johnson MM, Gicking JC, Keys DA. Evaluation of red blood cell distribution width, neutrophil-to-lymphocyte ratio, and other hematologic parameters in canine acute pancreatitis. J Vet Emerg Crit Care (San Antonio) 2023; 33:587-597. [PMID: 37573255 DOI: 10.1111/vec.13325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 08/14/2023]
Abstract
OBJECTIVE To determine if RBC distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and other hematological parameters are associated with increased odds of in-hospital mortality, increased length of hospitalization (LOH), or disease severity as measured by the Canine Acute Pancreatitis Severity (CAPS) score in dogs with acute pancreatitis (AP). DESIGN Retrospective, multicenter study from January 2016 to August 2020. SETTING Four private emergency and specialty referral centers. ANIMALS On initial case search, 118 client-owned dogs were identified with a clinical diagnosis of AP. Out of these cases, 114 dogs met inclusion criteria, defined as sudden onset of ≥2 compatible clinic signs (lethargy, anorexia, vomiting, or abdominal pain), a specific canine pancreatic lipase concentration >400 μg/L, hospital admission, as well as CBC and serum biochemistry run within 48 hours of initial hospitalization. Disease severity was calculated and measured using the CAPS score, in addition to LOH and in-hospital mortality. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Clinical endpoints were in-hospital mortality, LOH, and disease severity, as evaluated by the CAPS score. Overall in-hospital mortality was 36.8%. NLR was significantly associated with survival, with a higher percentage being associated with an increased likelihood of nonsurvival (odds ratio: 1.1, 95% confidence interval: 1.0-1.2; P = 0.006, adjusted P = 0.04). Increased NLR was found to be significantly associated with a longer LOH based on the unadjusted P-value (P = 0.02) but was not statistically significant based on a P-value adjusted for multiple comparisons (P = 0.12). No significant associations were noted when RDW, platelet-to-lymphocyte ratio, WBC count, mean platelet volume, RDW-to-platelet ratio, or RDW-to-total serum calcium ratio was evaluated against outcome measures. CONCLUSIONS This study retrospectively evaluated the prognostic utility of several readily available hematological parameters in dogs hospitalized for AP. Dogs with an increased NLR may have a higher risk of in-hospital mortality and increased LOH, although future prospective studies are necessary to confirm these findings.
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Affiliation(s)
- Meghan M Johnson
- Emergency & Critical Care Service, BluePearl Specialty + Emergency Pet Hospital, Lafayette, Colorado, USA
| | - John C Gicking
- Emergency & Critical Care Service, BluePearl Specialty + Emergency Pet Hospital, Tampa, Florida, USA
| | - Deborah A Keys
- Kaleidoscope Statistics Veterinary Medical Research Consulting, Athens, Georgia, USA
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Kämpf S, Fenk S, Van Cromvoirt A, Bogdanov N, Hartnack S, Stirn M, Hofmann-Lehmann R, Reichler IM, Bogdanova A. Differences in selected blood parameters between brachycephalic and non-brachycephalic dogs. Front Vet Sci 2023; 10:1166032. [PMID: 37649563 PMCID: PMC10464621 DOI: 10.3389/fvets.2023.1166032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/11/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction Cranial and upper-airway anatomy of short-nosed, flat-faced brachycephalic dogs predisposes them to brachycephalic obstructive airway syndrome (BOAS). Periodic apnoea increased inspiratory resistance, and an inability to thermoregulate effectively are characteristic of BOAS, but internationally accepted objective markers of BOAS severity are missing. The objective of this study was to compare the selected blood parameters between non-brachycephalic (NC) and brachycephalic (BC) dogs, exploring the possibility of developing a blood test for BOAS severity grading in the future. Methods We evaluated blood biochemistry, complete blood cell counts, red blood cell (RBC) indices, reticulocyte counts, a blood-born marker of intermittent hypoxia (glutathione, NO production), RBC hydration, deformability, and blood markers of metabolic changes and stress between BC (n = 18) and NC (meso- and dolichocephalic, n = 22) dogs. Results Reticulocyte counts and the abundance of middle-fluorescence immature reticulocytes were significantly (p < 0.05) higher in BC dogs compared to NC dogs. BC dogs had significantly more NO-derived NO2 - /NO3 - in plasma than NC dogs. RBCs of BC dogs were shedding significantly more membrane, as follows from the intensity of eosin maleimide staining, and had a significantly higher mean corpuscular hemoglobin concentration than NC dogs. Intracellular reduced glutathione content in RBCs of BC dogs was significantly lower, while plasma lactate was significantly higher in BC dogs compared to NC dogs. Plasma cholesterol and triglycerides were significantly lower, and cortisol was significantly higher in BC dogs compared to NC dogs. Eosinophil counts were significantly lower and the neutrophil-to-lymphocyte ratio was higher in BC dogs compared to NC dogs. Discussion Taken together, our findings suggest that the brachycephalic phenotype in dogs is associated with alterations at the level of blood cells and, systemically, with oxidation and metabolic changes. The parameters identified within this study should be further investigated for their potential as objective indicators for BOAS.
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Affiliation(s)
- Sandra Kämpf
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Faculty of Vetsuisse, University of Zurich, Zürich, Switzerland
- Center for Clinical Studies (ZKS), Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
| | - Simone Fenk
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Faculty of Vetsuisse, University of Zurich, Zürich, Switzerland
- Center for Clinical Studies (ZKS), Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
| | - Ankie Van Cromvoirt
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Faculty of Vetsuisse, University of Zurich, Zürich, Switzerland
- Center for Clinical Studies (ZKS), Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
| | - Nikolay Bogdanov
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Faculty of Vetsuisse, University of Zurich, Zürich, Switzerland
- Center for Clinical Studies (ZKS), Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
| | - Sonja Hartnack
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
| | - Martina Stirn
- Clinical Laboratory, Department for Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
| | - Regina Hofmann-Lehmann
- Center for Clinical Studies (ZKS), Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
- Clinical Laboratory, Department for Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
| | - Iris Margaret Reichler
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
| | - Anna Bogdanova
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Faculty of Vetsuisse, University of Zurich, Zürich, Switzerland
- Center for Clinical Studies (ZKS), Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
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Miglio A, Valente C, Guglielmini C. Red Blood Cell Distribution Width as a Novel Parameter in Canine Disorders: Literature Review and Future Prospective. Animals (Basel) 2023; 13:ani13060985. [PMID: 36978525 PMCID: PMC10044289 DOI: 10.3390/ani13060985] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Red blood cell distribution width (RDW) is a quantitative laboratory parameter applied for the measurement of anisocytosis and is a reliable and inexpensive method for clinical classification of anemia. An increased RDW reflects a great heterogeneity in the size of red blood cells typical of regenerative and iron-deficiency anemia. In humans, numerous and recent studies have shown a relationship between increased RDW and the risk of morbidity and mortality in patients with various disorders. In particular, a strong association has been established between changes in RDW and the risk of adverse outcome in humans with diseases affecting different organs or systems. Following the human literature, some studies have recently been conducted trying to clarify the clinical role of RDW in various animal disorders, particularly in dogs. In this review, we summarize and critically evaluate the results of the studies based on the measurement of RDW in dogs. We also emphasize the need for further and more extensive studies on the use of this simple and inexpensive parameter in animals.
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Affiliation(s)
- Arianna Miglio
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy;
| | - Carlotta Valente
- Department of Animal Medicine, Production and Health, University of Padua, Viale dell’Università 16, 35020 Legnaro, Italy;
| | - Carlo Guglielmini
- Department of Animal Medicine, Production and Health, University of Padua, Viale dell’Università 16, 35020 Legnaro, Italy;
- Correspondence:
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Guglielmini C, Crisi PE, Tardo AM, Di Maggio R, Contiero B, Boari A, Fracassi F, Miglio A. Prognostic Role of Red Cell Distribution Width and Other Routine Clinico-Pathological Parameters in Dogs with Acute Pancreatitis. Animals (Basel) 2022; 12. [PMID: 36552403 DOI: 10.3390/ani12243483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
This study aimed to assess the prognostic value of red cell distribution width (RDW) RDW-to-calcium ratio (RDW/Ca), neutrophils-to-lymphocytes ratio (N/L), platelets-to-lymphocytes ratio (P/L) and other easy to obtain and inexpensive hematological and biochemical parameters in dogs with acute pancreatitis. This is a multicenter, retrospective cohort study including 70 client-owned dogs. The accuracy of clinical and laboratory variables to predict short-term death (i.e., dead by 14 days) was tested by calculating the area under the receiver-operating characteristic curve (AUC). Independent predictors of death were identified using the multivariable Cox proportional hazards regression model. The survival rate was 72.9% (51 dogs) and 19 dogs died within 14 days of admission from AP. RDW and blood urea nitrogen (BUN) had good accuracy to predict short-term dead with AUC of 0.74 and 0.70 at the cut-off of >12.7% and >42 mg/dL, respectively. According to the multivariable model, RDW (hazard ratio and 95% confidence interval [HR, 95% CI] = 5.08, 95% CI = 1.14−22.67; p = 0.03), BUN (HR = 1.00, 95% CI = 1.00−1.01; p < 0.01) and bilirubin (HR = 2.46, 95% CI = 1.38−4.39; p < 0.01) were independent predictors of death. The results indicate that RDW, BUN and bilirubin are useful predictors of short-term death in dogs with acute pancreatitis.
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