Diagnostic accuracy of using erythrocyte indices and polychromasia to identify regenerative anemia in dogs

Joanne Hodges, Mary M Christopher

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objective-To determine diagnostic accuracy of using erythrocyte indices and polychromasia to identify regenerative anemia in dogs. Design-Retrospective and prospective cross-sectional study. Animals-4,521 anemic dogs. Procedures-CBC results obtained between July 2002 and July 2008 by use of an automated laser-based flow cytometric hematology analyzer from dogs with Hct values ≤ 35% were retrieved. Sensitivity, specificity, accuracy, and predictive values of using erythrocyte indices and polychromasia to identify regeneration were determined, with a reticulocyte count > 65,000 reticulocytes/μL considered the gold standard. Similarly, 134 blood samples from anemic dogs were analyzed prospectively with an in-house electrical impedance analyzer. Results-Of 4,387 dogs with samples analyzed retrospectively, 1,426 (32.5%) had regenerative anemia. Of these, 168 (11.8%) had macrocytic hypochromic anemia. High mean cell volume and low mean cell hemoglobin concentration had low sensitivity (11%), high specificity (98%), and moderate accuracy (70%) when used to identify regenerative anemia. Use of polychromasia alone had an accuracy of 77%, and use of polychromasia combined with a high RBC distribution width (RDW) had an accuracy of 79%. Results obtained with the in-house analyzer were similar. Conclusions and Clinical Relevance-Results suggested that most regenerative anemias in dogs were not macrocytic hypochromic. Polychromasia, with or without high RDW, was a more accurate indicator than other erythrocyte indices of regenerative anemia. To avoid a false diagnosis of nonregenerative anemia, a blood smear should be evaluated in anemic dogs when a reticulocyte count is not available.

Original languageEnglish (US)
Pages (from-to)1452-1458
Number of pages7
JournalJournal of the American Veterinary Medical Association
Volume238
Issue number11
DOIs
StatePublished - Jun 1 2011

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Erythrocyte Indices
anemia
Anemia
erythrocytes
Dogs
dogs
reticulocytes
Reticulocyte Count
Macrocytic Anemia
Hypochromic Anemia
Reticulocytes
blood
impedance
Hematology
hematology
Electric Impedance
cross-sectional studies
gold
lasers
Regeneration

ASJC Scopus subject areas

  • veterinary(all)

Cite this

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title = "Diagnostic accuracy of using erythrocyte indices and polychromasia to identify regenerative anemia in dogs",
abstract = "Objective-To determine diagnostic accuracy of using erythrocyte indices and polychromasia to identify regenerative anemia in dogs. Design-Retrospective and prospective cross-sectional study. Animals-4,521 anemic dogs. Procedures-CBC results obtained between July 2002 and July 2008 by use of an automated laser-based flow cytometric hematology analyzer from dogs with Hct values ≤ 35{\%} were retrieved. Sensitivity, specificity, accuracy, and predictive values of using erythrocyte indices and polychromasia to identify regeneration were determined, with a reticulocyte count > 65,000 reticulocytes/μL considered the gold standard. Similarly, 134 blood samples from anemic dogs were analyzed prospectively with an in-house electrical impedance analyzer. Results-Of 4,387 dogs with samples analyzed retrospectively, 1,426 (32.5{\%}) had regenerative anemia. Of these, 168 (11.8{\%}) had macrocytic hypochromic anemia. High mean cell volume and low mean cell hemoglobin concentration had low sensitivity (11{\%}), high specificity (98{\%}), and moderate accuracy (70{\%}) when used to identify regenerative anemia. Use of polychromasia alone had an accuracy of 77{\%}, and use of polychromasia combined with a high RBC distribution width (RDW) had an accuracy of 79{\%}. Results obtained with the in-house analyzer were similar. Conclusions and Clinical Relevance-Results suggested that most regenerative anemias in dogs were not macrocytic hypochromic. Polychromasia, with or without high RDW, was a more accurate indicator than other erythrocyte indices of regenerative anemia. To avoid a false diagnosis of nonregenerative anemia, a blood smear should be evaluated in anemic dogs when a reticulocyte count is not available.",
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