Several acanthocytes (irregularly spiculated cells) are present in this blood smear from a dog with liver disease. There are also more regularly spiculated cells (echinocytes, E) and rare keratocytes (K), the latter indicating fragmentation injury (Wright’s stain). The cause of acanthocyte formation in liver disease is unknown but is attributed to alterations in lipoprotein metabolism. Cats with liver disease frequently have acanthocytes but this RBC change is rare in other species and not definitively associated with liver disease.
