Artifactual changes in canine blood following storage, detected using the ADVIA 120 hematology analyzer

BACKGROUND: Artifactual changes in blood may occur as a consequence of delayed analysis and may complicate interpretation of CBC data. OBJECTIVE: The aim of this study was to characterize artifactual changes in canine blood, due to storage, using the ADVIA 120 hematology analyzer. METHODS: Blood samples were collected into EDTA from 5 clinically healthy dogs. Within 1 hour after blood sample collection and at 12, 24, 36 and 48 hours after storage of the samples at either 4 degrees C or room temperature (approximately 24 degrees C), a CBC was done using the ADVIA 120 and multispecies software. A linear mixed model was used to statistically evaluate significant differences in values over time, compared with initial values. RESULTS: The HCT and MCV were increased significantly after 12 hours of collection at both 4 degrees C and 24 degrees C, and continued to increase through 48 hours. The MCHC initially decreased significantly at 12-24 hours and then continued to decrease through 48 hours at both temperatures. Changes in HCT, MCV, and MCHC were greater at 24 degrees C than at 4 degrees C at all time points. A significant increase in MPV and a decrease in mean platelet component concentration were observed at all time points at 24 degrees C. Samples stored at 24 degrees C for 48 hours had significantly higher percentages of normocytic-hypochromic RBCs, and macrocytic-normochromic RBCs, and lower platelet and total WBC counts. CONCLUSIONS: Delayed analysis of canine blood samples produces artifactual changes in CBC results, mainly in RBC morphology and platelet parameters, that are readily detected using the ADVIA 120. Refrigeration of specimens, even after 24 hours of storage at room temperature, is recommended to improve the accuracy of CBC results for canine blood samples.     

Artifactual changes in equine blood following storage,detected using the Advia 120 hematology analyzer

Background — Delayed analysis of blood samples may be caused by restricted access to laboratories. Artifactual changes may occur in the measured analytes as a consequence of delayed analysis and may complicate interpretation of the data.
Objective — The purpose of this study was to characterize artifactual changes in equine blood, due to storage, using the Advia 120 hematology analyzer.
Methods — Samples of blood from 5 horses were analyzed using the Advia 120 soon after collection and again after 24 and 48 hours of storage at either 4°C or ambient laboratory temperature (∼24°C).
Results — Delayed analysis of equine blood samples resulted in increased numbers of normocytic hypochromic RBCs, increased numbers of macrocytic hypochromic RBCs, misclassification of granulocytes as mononuclear cells using the basophil reagent method, and pseudothrombocytosis, due to misclassification of ghost RBCs as platelets. The latter artifact was corrected by an amended version of the software. Many of the artifactual changes were identified by morphology flags.
Conclusion — Characteristic changes in cytograms produced by the Advia 120 allowed recognition of artifactual changes in stored equine blood samples. These changes were less pronounced in samples stored at 24°C than at 4°C.     

Evaluation of a hematology analyzer with canine and feline blood

A semiautomatic electronic blood cell counter (Sysmex F-800:Toa Medical Electronics Europa Gmbh, Hamburg, Germany) was evaluated using canine and feline blood, following the International Committee for Standardization in Hematology protocol (ICSH, 1984). Precision and overall reproducibility were acceptable for all the parameters studied except for the feline platelet count, in which overlapping of erythrocyte and platelet populations prohibited determination of an accurate platelet count. Since carry-over from canine hematocrit values and platelet counts and from feline hematocrit values was unsatisfactory, the use of a blank diluent sample between different analyses was necessary. Linearity of the analyzer was acceptable in the studied range. Thirty canine and feline blood samples were analyzed using the Sysmex F-800 and a manual method. Correlations between both methods were acceptable for all the parameters, except for feline platelet count and erythrocyte indices for both species. In the storage study, red blood cell count and hemoglobin concentration were the parameters with the longest stability (72 hours at 4 degrees C and 25 degrees C) in both species. A statistically significant increase in MCV was obtained at 12 hours post-extraction in canine samples stored at 25 degrees C and at 24 hours in refrigerated samples. Feline leucocyte counts showed a downward trend at 12 hours post-extraction at both temperatures. Canine platelet count decreased significantly at 6 hours post-extraction in samples stored at 4 degrees C. During the evaluation period, Sysmex F-800 was user friendly and appeared well suited for routine canine and feline blood cell analysis.     

Neutrophil adherence,phagocytic-nitroblue tetrazolium reduction and chemiluminescence in canine whole blood

Methods for measuring neutrophil adherence, phagocytic-nitroblue tetrazolium (NBT) reducing activity and chemiluminescence were applied to canine whole blood as means for routine assessment of neutrophil functions. The phagocytic-NBT reduction test appeared to be useful for monitoring the NBT reducing activity of phagocytic cells associated with phagocytic functions. Ethylene diamine tetraacetic acid suppressed both the adherence and the phagocytic-NBT reducing activity of neutrophils. Increased phagocytic-NBT reduction and an enhanced chemiluminescence response were observed in dogs with neutrophilia. These methods provide a rapid and practical screening procedure for measuring selected phagocytic functions in canine whole blood.     

Validation of the Coulter AcT Diff hematology analyzer for analysis of blood of common domestic animals

Abstract: The objective of this study was to compare and assess the agreement between the Coulter AcT Diff hematology analyzer (CAD) and the Bayer Technicon H1 (H1) using blood samples from 391 animals of 4 species. The H1 has been used in veterinary laboratories for many years. Recently, Coulter modified the CAD and added veterinary software for hematologic analysis of feline, canine, and equine samples. A comparison of hemograms from dogs, cats, horses, and cattle was made using EDTA-anticoagulated blood samples. Both instruments were calibrated using human blood products. Performance characteristics were excellent for most values. The exceptions were MCV in canine samples (concordance correlation of .710), platelet counts for feline and equine samples (.258 and .740, respectively), feline and bovine WBC counts (.863 and .857, respectively), and bovine hemoglobin (.876).     

Automated flow cytometric cell count and differentiation of canine cerebrospinal fluid cells using the ADVIA 2120

Background: Microscopic cell counts in cerebrospinal fluid (CSF) are time-consuming and prone to imprecision. The recently introduced automated hematology analyzer ADVIA 2120 offers an automated cell count and differential for CSF in the veterinary software mode based on laser light scatter and absorbance measurements. Objectives: The purpose of this study was to evaluate the precision, linearity, and accuracy of the ADVIA 2120 CSF assay. Methods: Sixty-seven CSF samples were analyzed on the ADVIA 2120 and total nucleated cell counts (TNCC) and RBC counts were compared with the hemocytometer results. In 21 samples with TNCC >5/muL, ADVIA 2120 results were compared with 100-300 cell manual differentials performed on cytocentrifuged preparations. Statistical analysis included Spearman's rank correlation, Passing-Bablok regression, and Bland-Altman analysis. Results: Repeatability (intra-assay) coefficients of variation (CVs) ranged from 4.19% to 25.94%. Interassay CVs ranged from 2.56% to 28.67%. Accurate results within 30% were achieved for TNCC up to 4000/muL. Except for low TNCC, deviation from the expected value was higher (TNCC of 8/muL instead of 4/muL). The following correlation coefficients (r) and biases were achieved compared with the reference method: r=.90 and bias 2.3/muL for TNCC; r=.88 and bias 32.0/muL for RBC counts; r=.86 and bias +/-13.4% for mononuclear and polymorphonuclear cell percentages; r=.88 and bias -6.1% for lymphocyte percentage; r=.56 and bias 19.4% for monocyte percentage; and r=.75 and bias -9.7% for neutrophil percentage. Conclusion: Our results demonstrated that the automated ADVIA 2120 CSF assay generally compares well with reference methods although there are some limitations for the automated monocyte count and for samples with only mild pleocytosis.     

Clinical evaluation of the CA530-VET hematology analyzer for use in veterinary practice

BACKGROUND: The CA530-VET is a completely automated impedance cell hematology analyzer, which yields a 16-parameter blood count including a 3-part leukocyte differential. OBJECTIVES: The aim of this study was to examine the operational potential of the CA530-VET and its value for use in veterinary practice. METHODS: The analyzer was tested for blood carry-over, precision, and accuracy. Comparison methods included the CELL-DYN 3500, microhematocrit centrifugation, manual platelet (PLT) counting for feline and equine species, and a 100-cell manual WBC differential. Blood samples for comparison of the methods were obtained from 242 dogs, 166 cats, and 144 horses. RESULTS: The carry-over ratio (K) was 0.28% for RBC, 0.59% for PLT, 0.32% for WBC, and 0.18% for hemoglobin (HGB) concentration. Coefficients of variation (CVs) for within-batch precision and duplicate measurement of blood samples were clearly within the required limits, except for duplicate platelet counts in cats (8.7%) and horses (9.5%). The WBC count was in excellent agreement for dogs and horses and RBC count was in excellent agreement for horses. The accuracy of feline WBC counts was not acceptable, with the exception of values at the high end of the range. RBC counts in dogs and cats, and HGB concentration and MCV in all 3 species were sufficiently accurate. The CA530-VET HCT results were in excellent agreement with microhematocrit results in horses but exceeded the maximum allowed inaccuracy for cats and dogs. In all species, PLT counts established mechanically and manually were not in adequate agreement. Large differences were found between the CA530-VET and the manual differential percentage for lymphocytes and "mid-sized cells" (monocytes and basophilic granulocytes). CONCLUSIONS: The CA530-VET can be considered useful for routine canine, feline, and equine blood cell analyses. It should not be considered accurate, however, for PLT counts, feline total WBC counts in the subnormal and normal range, and leukocyte differentials, except for granulocytes.     

Effects of syringe material and temperature and duration of storage on the stability of equine arterial blood gas variables

OBJECTIVES: To evaluate the consistency of partial pressures (P) of arterial oxygen (aO(2)), arterial carbon dioxide (aCO(2)) and pH measurements in equine carotid arterial blood samples taken into syringes made from three different materials and stored at room temperature or placed in iced water for measurement at three different times. STUDY DESIGN: Prospective observational study over 19 days. ANIMALS: Four clinically normal Thoroughbred or Thoroughbred-cross horses (three geldings, one mare, mean age 6.25 years, range 5-7 years). METHODS: Identical blood samples were taken on two separate occasions from the carotid arteries of the four horses into syringes made of glass, plastic and polypropylene. PaO(2), PaCO(2) and pH determinations were performed on blood from each syringe type at 10, 60 and 120 minutes post-sampling with samples stored at room temperature (approximately 20 degrees C) or in iced water (approximately 0 degrees C). Data were analysed by anova and a split plot model fitting syringe within horse X pair and time within temperature within syringe. RESULTS: Syringe material, storage temperature and time before analysis all had significant effects on PaO(2) (p < 0.001). PaCO(2) was unaffected by syringe material or storage temperature. However, over 120 minutes, storage duration significantly (p = 0.002) affected values. Temperature of storage and duration prior to analysis both significantly affected pH values (p = 0.005 and p < 0.001, respectively), but syringe material did not. Several significant interactions between these variables were noted. CONCLUSIONS: Equine arterial blood gas determination has a different sensitivity to storage conditions compared to other veterinary species. CLINICAL RELEVANCE: For accurate equine arterial blood analysis, PaO(2) samples need to be analysed within 10 minutes or taken into glass syringes, stored on ice and analysed at 2 hours post-sampling. PaCO(2) and pH measurements can be performed on samples stored in glass, plastic or polypropylene syringes at room temperature for up to 1 hour post-sampling.     

Comparison of white blood cell differential percentages determined by the in-house LaserCyte hematology analyzer and a manual method

BACKGROUND: The LaserCyte hematology analyzer (IDEXX Laboratories, Chalfont St. Peter, Bucks, UK) is the first in-house laser-based single channel flow cytometer designed specifically for veterinary practice. The instrument provides a full hematologic analysis including a 5-part WBC differential (LC-diff%). We are unaware of published studies comparing LC-diff% results to those determined by other methods used in practice. OBJECTIVE: To compare LC-diff% results to those obtained by a manual differential cell count (M-diff%). METHODS: Eighty-six venous blood samples from 44 dogs and 42 cats were collected into EDTA tubes at the Forest Veterinary Centre (Epping, UK). Samples were analyzed using the LaserCyte within 1 hour of collection. Unstained blood smears were then posted to Langford Veterinary Diagnostics, University of Bristol, and stained with modified Wright's stain. One hundred-cell manual differential counts were performed by 2 technicians and the mean percentage was calculated for each cell type. Data (LC-diff% vs M-diff%) were analyzed using Wilcoxon signed rank tests, Deming regression, and Bland-Altman difference plots. RESULTS: Significant differences between methods were found for neutrophil and monocyte percentages in samples from dogs and cats and for eosinophil percentage in samples from cats. Correlations (r) (canine/feline) were .55/.72 for neutrophils, .76/.69 for lymphocytes, .05/.29 for monocytes and .60/.82 for eosinophils. Agreement between LC-diff% and Mdiff% results was poor in samples from both species. Bland-Altman plots revealed outliers in samples with atypical WBCs (1 cat), leukocytosis (2 dogs, 9 cats), and leukopenia (16 dogs, 11 cats). The LaserCyte generated error flags in 28 of 86 (32.6%) samples, included 7 with leukopenia, 8 with lymphopenia, 7 with leukocytosis, 1 with anemia, and 1 with erythrocytosis. When results from these 28 samples were excluded, correlations from the remaining nonflagged results (canine/feline) were .63/.65 for neutrophils, .67/.65 for lymphocytes, .11/.33 for monocytes, and .63/.82 for eosinophils. CONCLUSION: Although use of a 100-cell (vs 200-cell) M-diff% may be a limitation of our study, good correlation between WBC differentials obtained using the LaserCyte and the manual method was achieved only for feline eosinophils.