Feb 012018
 

Peripheral blood and pleural fluid from a dog

Case information

A 6.5 year old female spayed Cavalier King Charles Spaniel presented to the Cornell University Emergency Service for workup of an increased peripheral white blood cell count and pleural effusion detected by the primary veterinarian. Prior to presentation at Cornell, the primary veterinarian had removed approximately 300 mL of fluid from both sides of the chest. At presentation, the dog was quiet, alert, responsive, and tachypneic (44 bpm) with shallow breaths. Lung sounds were slightly decreased ventrally, compatible with an effusion. Thoracic radiographs confirmed a pleural effusion and revealed deviation of the trachea to the right with an enlarged mediastinal mass. The dog was placed into an oxygen cage due to low blood oxygen saturation (94%) on arterial blood-gas analysis and given intravenous fluid therapy at 1.5 times maintenance. Blood and pleural fluid were collected before treatment. Results are shown on the tables below.

Pertinent hematologic results
Test Result Units Reference interval
Hematocrit 40 % 41-58
Retic count 0.4 % 0.2-1.5
Absolute retic count 18.9 thou/μL 11.0-92.0
White blood cells 227.6 thou/μL 5.7-14.2
Seg neutrophils 4.6 thou/μL 2.7-9.4
Band neutrophils 2.3 thou/μL 0-0.1
Other leukocytes 211.7 thou/μL 0-0.1
Platelet count 108 thou/μL 186-545
MPV 17.5 fL 8.4-14.1
Mild toxic change in neutrophils

 

Pleural fluid 
Test Result Units
Volume 1.8 mL
Color Medium red
Turbidity Opaque
Total Protein (ref) <2.5 g/dL
Nucleated cells 16.0 thou/μL
Red blood cells 178.1 thou/μL

 

 

The “other cells” are shown on the representative photomicrographs of the blood and pleural fluid below. Based on the provided data, answer the following questions:

  1. What is the best interpretation for the leukocytosis?
  2. What additional diagnostic tests would you recommend for classification of the type of neoplasm? 

Figure 1. Peripheral blood from a dog. (Wright’s stain, 50x objective)

Figure 2. Peripheral blood from a dog. (Wright’s stain, 100x objective)

Figure 3. Pleural fluid from a dog. (Wright’s stain, 100x objective)

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