Split: Split: Nula (5yr old English Cocker Spaniel)

[Ruth]

Thank you all for your lovely replies! Linda, I hope you’re having a good time away and enjoying yourself! Now I’m really confused! Finally got round to listening to my mobile phone voicemail, I hadn’t realised but DWR called me later on Friday and apparently when they ran Nula’s blood through the machine (as opposed to the manual PCV check they’d done that morning which came back at 21) it came back as being 39, so according to that she had maintained her PCV from our last DWR appt. So how can the local vet and DWR manual tests come back so low, when the machine came back so high?! What is going on?? It would explain why her gums and energy levels haven’t changed if she’s actually higher PCV than first thought. But how can it be so wildly different results? Keeping her on the 30mg of prednisolone til our next DWR appt on Friday for a retest. I’m so confused!! I hope you and your babies are all doing well. Xxxxxx

[admin]

Hi Ruth

No wonder you are confused – so would I be! There are many errors that can be made with testing blood. No-one will deliberately do this, of course.

Cornell University has a lot of copyrighted information on blood tests & facts in relation to AIHA/IMHA. I can’t put it on here because of the copyright, but you can read through it using the links below. I was doing some research on some unusual blood results for another lady on here & read a Cornell article that says that automatic counting machines can sometimes mistake platelets for red blood cells. I like to back up what I’m telling you with the links to the scholarly articles. Sorry there are quite a few, but it might be useful to you & your vets.

This is the link to the first page – you can look right through every type of test on here by using the right arrow.
https://ahdc.vet.cornell.edu/sects/clinpath/modules/hemogram/hct.htm

The following article also mentions that this disease (AIHA ) can alter readings & it also depends on the type of machine used.
https://ahdc.vet.cornell.edu/sects/clinpath/modules/hemogram/rbc.htm

You can also see nucleated red blood cells & reticulocytes during the normal course of recovery (called regeneration) from anaemia – these can also mess up automatic counting. See
https://ahdc.vet.cornell.edu/clinpath/modules/hemogram/NRBC.HTM

Something as simple as not putting precisely the right amount of blood in the tube, mishandling of the sample or not using a fresh enough sample can make a big difference. Have a look at this
http://www.merckmanuals.com/vet/clinical_pathology_and_procedures/diagnostic_procedures_for_the_private_practice_laboratory/clinical_hematology.html
It is a bit complicated, but paragraph 4 does explain there are several reasons for inaccurate PCV.
http://www.vetstream.com/canis/Content/Lab_test/lab00113.asp – see errors at the bottom.

So basically someone could have made an error, either in the machine sample or the manual sample, or it could be the machines – who knows?

I would not get too worried about it unless these large variations are seen again – just do another test as soon as you can & that will put your mind at rest. Our local vets couldn’t do a reticulocyte count, so we often used the human lab 100 yards up the road. Would it be an option to use a human lab nearby as well? I know it’s not cheap, mind you. I would personally get both the local vets & DWR to do the next sample both manually & by machine & see what happens.

I hope I’ve not confused you even more! It’s certainly puzzling. Any questions you want to ask?

Let us know how things are going – it sounds like Nula’s doing really well in herself and that is so important – you are doing such a great job of looking after her & being right on the ball with everything. How’s your hip & back now? Hope they are not giving you too much pain – look after yourself & that beautiful girl
Love
Sheena & the boys

[admin]

Me again! Sorry – should have said remind them about taking sample from the same site – preferably the neck AND not to reduce the pred until your absolutely sure all is well.
Sheena xxx

[admin]

Hi Ruth

Yes, I’m confused too! But as Sheena so rightly said, errors are not uncommon in PCV testing for a variety of reasons. It is bizarre that both your local vet and and DWR got the lower reading and now this higher one though. Still, excellent that she is well in herself and I agree with your plan to maintain her prednisolone dose. I like Sheena’s idea of having her PCV tested both locally and at DWR, and both a manual and machine check (if available) at both.

Sheena mentioned a human lab. Just a heads up – Cambridge University has a vet school which might be able to do some testing for you, particularly as it’s such a rare illness. You could also consider the human labs at Addenbrooke’s or one of the other local hospitals (your vet may be able to suggest somewhere nearer to you, as it’s important samples don’t clot). Additionally, you could try the Animal Health Trust at Newmarket (10 mins from DWR), although they are another specialist vet centre so it may be that they don’t offer anything different.

Anyway, so glad she is still doing well and I hope you are too?

Mary and Mable x

[Vally]

Wow Ruth, that’s a huge difference and all the worrying. As the others said, yes don’t reduce anything until there are absolutely no doubts about the numbers. As you’re doing, watch her gums and if she’s acting good that’s always a good sign. Let us know how you go on Friday.

Regards, Vally & Bingo

[admin]

Hi Ruth. How is Nula today. I was away, but keeping up with your posts. The discrepancy in the numbers on the blood tests are crazy. I hope you didn’t pay or they give you are refund. You should change them for your trouble! I know things get messed up and most of the time it’s no ones fault, but this is a bit over the top. You were frantic! I would be too.

I have Sadie’s in-house PVC tested every 10 days (was weekly) and send out her blood for a CBC monthly. I still, wait with baited breath, each and every test. Crazy, paranoid club, for sure!

Being in England, I’m glad we have Mary, whom is so helpful for those of you in the UK. Her advice is always right on target and her post here gives you some options. Also, Sheena and Vally’s words of wisdom too, about the blood draw from the neck (Sheena) and not reducing the prednisone until you know for sure (Vally), are important too.

I do have Sadie tested in her front leg, but I know the neck is better, far less chance for error. The holistic vet that Sadie went to several times insisted it be taken from the neck. But, Sadie was not big on that and we’re back to the leg/paw, front even -she does not like the back leg/paw. So now, we go into the vet’s office and I just tell her, “Go, it’s okay” and she trots off with the tech and she’s back in a jiffy, looking quite proud of herself for the indulgence. I get the PCV results within five minutes and the CBC is sent out and back within a few days. I’m never good at waiting on these numbers, never. Goodness. :)

Please keep us posted. You are the best of fur moms. I hope you too, are hanging in there with your back.

Thinking of you both and sending our love, Linda and well behaved Sadie ;)

[admin]

Hi Ruth

Just a quick line to see how Nula’s doing & to wish you luck with the next tests. Hope all is well.

 

[Ruth]

Thank you all! That’s really handy info! Thank you! I’m going to ask a lot of those questions on Friday!! I am not going to agree to any medication adjustments until the numbers are sorted. In herself, Nula is actually doing really well. More energy, more playful and just seems happier. Less puddles too which is good for me! She’s got the hang of waking me up at night when she needs to go out. We’re just plodding on really. I hope you’re all well and your puppies are all well too! Xxxxxxx