Blood smear help...

Re: Blood smear help...

Mark Frost — Wed, 16 Jan 2013 17:32:52 GMT

No problem, pain relief and fluids is helping as the cat is starting to eat with some fuss and encouragement, will update once the results come in but I suspect pancreatitis is most likely at this stage.

Re: Blood smear help...

Kate Richardson — Wed, 16 Jan 2013 15:43:07 GMT

I'd be interested to know what the lab says re the smear, from a self education point! Keep us posted

Re: Blood smear help...

Mark Frost — Wed, 16 Jan 2013 12:39:43 GMT

Thats really helpful thanks Kate.. buprenorphine has been started already, no indication of nausea other than anorexia at present so have held off with maropitant but is being considered if no improvement with pain relief & fluids, USG was 1.051. Can't measure lytes currently.

Re: Blood smear help...

Kate Richardson — Wed, 16 Jan 2013 12:05:05 GMT

I am no cytology expert, but I think there are crenated RBCs present and there is some anisocytosis and mild polychromasia; I think mycoplasmas tend to stain more densely? There may be some Howell-Jolly bodies present indicating immature red cells, but I really am no expert. The HCT is wnl, however there is evidence of possible dehydration shown by the urea elevation (what was the USG?), and globulin is also high normal (which could equally be inflammatory), so the cats actual HCT may be lower than shown, so definitely recheck once hydrated. You also have an mild neutrophilia which is likely inflammatory. Cats with haemolytic anaemia don't tend to become as icteric as dogs, so I would still be thinking cholangitis/pancreatitis but I think your plan of getting the haematology and smears assessed externally is a good one.

In the mean time, if you are able to, check electrolytes to see what potassium is doing as often low in anorectic cats, supplement iv fluids if necessary. If you don't have access to measure electrolytes then Hartmans or NaCL with K added (500mls + 13mmols KCl will do fine), add pain relief eg buprenorphine, in case of pancreatitis, possibly an anti-emetic such as maropitant if you have any suggestion of nausea, and no harm in adding doxycycline in the mean time until you have mycoplasma ruled in or out. I would assess response to this, and then investigate further as necessary with scans etc. Won't hurt to send a blood for PLI as well if finances permit.

Re: Blood smear help...

Andrew Kent — Wed, 16 Jan 2013 11:54:31 GMT

[quote user="Mark Frost"]

I thought you could see the intracellular inclusions from mycoplasma at 100x under oil immersion, and the external lab offer microscopic exam for mycoplasma - however I appreciate they would likely be using higher mag.

[/quote] Yes it's the inclusions that you look for which are visible under light.

Re: Blood smear help...

Mark Frost — Wed, 16 Jan 2013 11:53:34 GMT

Re: Blood smear help...

Mark Frost — Wed, 16 Jan 2013 11:52:03 GMT

Only eyeball PCV as we don't have the right kit for proper manual PCV at the moment (being rectified!!), 35 - 40% looks about right though.

Appreciate your help, no access to ultrasound at the moment unfortunately but will discuss with the owner possibility of a local referral for a scan depending on progress.

Re: Blood smear help...

Michael Woodhouse — Wed, 16 Jan 2013 11:45:01 GMT

Bacteria are small - mycoplasma 1/10 the size of bacteria. I don't believe they are visible with a light microscope.

Re: Blood smear help...

Andrew Kent — Wed, 16 Jan 2013 11:42:29 GMT

Have you done a manual PCV? With a HCT of 37.5% it is unlikely to be acutely haemolysing or it would be lower, unless this is a spurious machine reading. So I would still consider a post hepatic cause highly and would image the hepatobiliary system.

the pictures look very dark on my iPhone screen but I can't see any obvious red cell inclusions. Looks more like rouleaux on my small screen?

Andy