Veterinary Diagnostics:

ScopioVet Cases of the Month: Moxie

Case History

A 1.5-year-old, F/S, mixed breed dog named Moxie was adopted from a rescue organisation two weeks prior to presentation. Moxie began to have hemorrhagic diarrhea and vomited once. CBC showed hematocrit of 35.7%, eosinophilia 3.17K, thrombocytopenia 130K. One blood smear with CBC data from the clinic hematology analyser was submitted.

Notes: CBC data with results from the day prior listed on the right side. Values “flagged” with an asterisk should be confirmed by blood smear and/or dot plot review.

Questions

Why might some of the results be flagged? Why should they be reviewed microscopically? Possible platelet clumps, which artifactually decrease the automated platelet count. Unusual leukocyte distribution or detection (eg. eosinophilia, basophilia, atypical cells). Cells that the analyser cannot accurately differentiate (eg. bands, atypical cells).

Microscopic Features

Feathered edge of the smear. This area is reviewed for platelet clumps, large cells, leukocytes pushed out to the end of the smear, etc. There is large structure at the arrow.

At higher magnification, this is a clump of keratinocytes from the skin, which is insignificant.

Leukocytes are often pushed to the feathered edge and it can be a good place to find leukocyte inclusions (eg. morula) or in this case, eosinophils adjacent to neutrophils for comparison. This initial finding supports reported eosinophilia, which will be confirmed with manual differential.

Is there something else near the clump of keratinocytes?

Is this debris? A gauze fiber? Fibrin? A worm? If this is “real,” what is it?!

Interpretation

  1. Microfilaremia
  2. Mild normocytic, normochromic, non-regenerative anemia
  3. Probable mild inflammatory leukogram with antigenic stimulation
  4. Mild-to-moderate eosinophilia and mild basophilia
  5. Mild thrombocytopenia

ClinPath Notes

Blood smear evaluation is of particular importance in veterinary species for a variety of reasons. In this case, the CBC data was confirmed and refined by a manual leukocyte differential and interpretation of the hematologic changes, but there was also a surprise finding of circulating microfilaria. Microfilaria are seen in patients with heartworm disease caused by Dirofilaria immitis, but microfilaria from Acanthocheilonema reconditum, which is non-pathogenic, can look very similar and should be differentiated by confirmatory testing.

Common hematologic abnormalities in dogs with heartworm are seen in this patient and include mild non-regenerative anemia, neutrophilia, thrombocytopenia, and eosinophilia with or without basophilia. These findings overlap with other parasitic infections and in a rescue dog with hemorrhagic diarrhea, these can also be due to gastrointestinal parasites, so it is important to exclude all potential underlying etiologies.

Patient information has been altered for client confidentiality.

Latest Veterinary Diagnostics News
Ground-breaking Veterinary Digital Pathology Service

Ground-breaking Veterinary Digital Pathology Service set to Revolutionise Pet Care Across Finland and other Nordic countries A ground-breaking service that enables vets to diagnose and…

Read More (about 'Ground-breaking Veterinary Digital Pathology Service')
The Veterinary Pathology Group form a Strategic Alliance with Woodley Veterinary Diagnostics to Provide a Complete Point of Care Testing Solution

The Veterinary Pathology Group (VPG), a member of SYNLAB, today announced that they have formed a strategic alliance with Woodley Veterinary Diagnostics to provide veterinary…

Read More (about 'The Veterinary Pathology Group form a Strategic Alliance with Woodley Veterinary Diagnostics to Provide a Complete Point of Care Testing Solution')
Webinar: The Art and Science of Veterinary Pathology

In the first event in our 20th anniversary series, Andy Torrance talked about how to diagnose canine and feline diseases using haematological and biochemical profiles,…

Read More (about 'Webinar: The Art and Science of Veterinary Pathology')
20th Anniversary Education Series

To celebrate our 20th anniversary and thank our customers and the wider veterinary community for their ongoing support, over the next month we will be hosting…

Read More (about '20th Anniversary Education Series')
Customer Centricity, People and Innovation: The Secret to VPG’s 20 Years’ Success

The Veterinary Pathology Group (VPG), a member of SYNLAB UK and Ireland today announced that it is celebrating its 20th anniversary. The company attributes its…

Read More (about 'Customer Centricity, People and Innovation: The Secret to VPG’s 20 Years’ Success')
Customers and Patients Reap the Benefits of ScopioVet

Last year we launched the first Digital Cytology System in the UK and Ireland, ScopioVet, through our exclusive partnership with ScopioLabs. The partnership allows us…

Read More (about 'Customers and Patients Reap the Benefits of ScopioVet')
VPG’s Dr Rand Wilson Recognised by the Royal College of Veterinary Surgeons

Dr Rand Wilson, Director of Pathology and a Boarded Clinical Pathologist at the Veterinary Pathology Group (VPG) has been recognised with Specialist Status in Veterinary…

Read More (about 'VPG’s Dr Rand Wilson Recognised by the Royal College of Veterinary Surgeons')