Comparison of four different hematocrit assays and the effect of albumin on their measurements

Clinical decisions are influenced by hematocrit values. Centrifugation (reference standard), conductivity, optical and impedance methods are often used interchangeably to measure hematocrit. The effects of albumin, which are known to affect conductivity methods, have not been evaluated for limits of agreement (LOA) between hematocrit assays in small animals. Canine venous blood was collected from 74 clinical cases and measured by centrifugation (n = 72), conductivity (n = 73), impedance (n = 24) and optical (n = 50) methods. Bland-Altman analysis determined bias (± SD) and 95% LOA between methods. There was a statistically significant difference between centrifugation hematocrit values and values obtained via conductivity (p < 0.0001), optical (p < 0.0001), and impedance (p = 0.0082) methods. The conductivity method underestimated hematocrit by 2.1 ± 2.9% (95% LOA −3.54 to 7.88), the optical method by 3.1 ± 3.6% (95% LOA −4.0 to 10.2), and the impedance method by 2.3 ± 3.7% (95% LOA −5 to 9.6) when compared to centrifuged hematocrit values. The hematocrit difference between conductivity and centrifugation methods was statistically different for low (4%, 0–5%), within reference limits (3%, −5 to 8%), and high (2%, −2 to 5%) albumin values, respectively (p = 0.02), with post-hoc analysis demonstrating that the difference occurred between the low and high albumin groups. This study confirms that albumin values outside reference limits can affect the conductivity method and that hematocrit values obtained via conductivity, optical and impedance methods underestimate values obtained via centrifugation. Therefore, the hematocrit methods cannot be used interchangeably. The wide limits of agreement also demonstrates that care must be taken when making clinical decisions with different hematocrit methodologies.

The effects of oral administration of Yunnan Baiyao on blood coagulation in beagle dogs as measured by kaolin-activated thromboelastography and buccal mucosal bleeding times

We examined the effects of oral administration of Yunnan Baiyao (YB) on hemostasis by measuring buccal mucosal bleeding times (BMBTs) and doing citrated kaolin-activated whole-blood thromboelastography (TEG). In a randomized controlled crossover trial 8 beagle dogs were given either placebo or 1000 mg of YB orally every 12 h for 5 consecutive treatments. Blood was drawn 24 h before treatment and 2 and 24 h after the last treatment, and the BMBT was measured in each sample in duplicate. The TEG analysis was done in duplicate 60 ± 5 min after sample collection. There were no adverse effects of treatment and no significant differences between the control and treatment BMBTs or TEG parameters at any time point. Significant differences were found between baseline and 24 h after the last treatment within the treatment group for the TEG parameters LY30 and LY60 and within the control group for the TEG parameters MA, G, LY30, and LY60. Thus, at the dose and frequency of administration in this study YB did not appear to have any clinically significant effects on the measured coagulation parameters. The differences within the treatment group were likely due to analytic error since similar differences were seen in the control group. Further studies with a larger sample, as well as more direct measures of platelet function, are needed.

Effect of Dexamethasone on Resting Blood Lactate Concentrations in Horses

Background

Blood lactate concentration is a marker of tissue perfusion and helps guide therapeutic interventions in critically ill horses. In both humans and dogs, administration of corticosteroids can increase blood lactate concentration, leading to type B hyperlactatemia. This effect could be a consequence of the impact of corticosteroids on glucose metabolism.

Objectives

To investigate the effects of daily IM dexamethasone administration on blood lactate and glucose concentrations in horses.

Animals

Nine healthy adult horses.

Methods

A randomized, blinded, controlled, cross‐over study design was used. Horses were randomly assigned to 1 of 2 groups, either receiving 0.05 mg/kg of dexamethasone IM or an equivalent volume of saline, daily for 7 days. Blood was collected to determine lactate and glucose concentrations at baseline, 2 hours after the daily injections and 24 hours after the last injection.

Results

Dexamethasone treatment had a statistically significant effect on lactate (P = .006) and glucose (P = .033) concentrations. The least squares mean lactate concentration was 0.93 mmol/L (95% CI: 0.87–0.99) in the dexamethasone group compared to 0.71 mmol/L (95% CI: 0.70–0.73) for the saline group. A positive relationship between blood lactate and glucose concentrations was identified, with a 0.07 mmol/L (95% CI: 0.05–0.09) increase in lactate concentration per unit increase in glucose (P < .0001) concentration.

Conclusions and Clinical Importance

Dexamethasone induces statistically significant increases in blood lactate and glucose concentrations in healthy horses. Awareness of the potential for corticosteroids to induce type B hyperlactatemia might be important in the management of critically ill horses receiving dexamethasone.

Comparison of two methods for measurement of equine insulin

Diagnosis of equine hyperinsulinemia requires an accurate method for quantification of equine insulin concentrations. The objectives of the current study were to compare 2 commercially available techniques for measurement of equine insulin, the radioimmunoassay (RIA) and chemiluminescent immunoassay (CIA). Recovery was poor for both assays, but worse for the CIA. Serial dilution of a high endogenous insulin sample yielded better linearity for the RIA ( r2 = 0.99, P < 0.001) than the CIA ( r2 = 0.92, P = 0.009). Bland–Altman analysis indicated that the CIA was, on average, 91 pmol/l higher than the RIA, with wide limits of agreement (95% limits of agreement: –508 to 691 pmol/l). These findings suggest that results between the assays should not be considered interchangeable.