My 13.5 year old dog has been slightly anemic for over a year... he used to have low blood platelets (2.5 years ago) and now high platelets ( from 9, to 51, to 400, to 575, then 875, 975, 375, now 687)
His current
RBC 3.8
HGB 9.1
HCT 26
MCV 69
MCH 23.9
MCHC 35
Reticulocyte Total 1.1
Absolute Reticulocytes 41800
Could you please explain the significance and difference in Reticulocyte Total and Absolute Reticulocytes to me?
Also, how serious is the anemia?
Thanks for your time
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Aloha! You're speaking to Dr. Michael Salkin
Bone marrow effective erythropoiesis (manufacture of red blood cells) is primarily judged by its release of reticulocytes - immature red blood cells without nuclei. Bone marrow function should respond normally in blood loss or hemolytic anemia, and reticulocyte production should be increased in proportion to the severity of the anemia. Anemia with appropriately increased erythropoiesis is classified as regenerative anemia. A nonregenerative anemia is indicated by finding clearly less than an expected reticulocyte response for the time after onset of an anemia and the severity of the anemia.
The 1.1 indicates that 1.1% of erythrocytes are reticulocytes and that's normal...but we don't want normal, we want to see a marked degree of stimulation (21-50%) - in other words ,we want to see that Ben can replace the red blood cells he's lacking. The percentage of reticulocytes can be misleading, however, because the percentage is a ratio of reticulocytes to mature RBCs. In anemia, the mature RBCs are variably reduced, thus the reticulocyte percentage overestimates the hematopoietic response. The absolute reticulocyte count is calculated by multiplying the reticulocyte percentage by the RBC count, so it adjusts the reticulocyte percentage for the severity of the anemia. Absolute reticulocyte count is the most consistent indicator of bone marrow production and is recommended as the best single indicator of regeneration in the dog.
41,800 is less than what's considered "no degree of regeneration" - 60,000. A marked degree of regeneration is >500,000.
Hence, Ben's anemia is nonregenerative - as seen with inflammatory diseases, chronic renal disease, chronic hepatic disease, hypothyroidism, hypoadrenocorticism, many bone marrow disorders - including malignancies, drug-induced hematologic dyscrasia, and various infections. His anemia is moderate - a normal HCT ranges between 35 and 52.
Please respond with further questions or concerns if you wish.
Thanks Dr Salkin.
His RBC , HGB and HCT have been this low before and have gone up to slightly below normal and now back down, this last blood test has been the only test that showed reticulocytes because the lab decided to add it on...
So the next blood test I will request reticulocytes... if Ben can start to get better, I should look for <60,000, correct ?
Also, the Antech Blood Test gave a reference range of 0-1% for normal and rated Ben as high at 1.1% Reticulocyte Total... this differs from your answer as normal and needing to be (21-50%) ...
Thanks so much for your detailed responses Dr Salkin. I very much appreciate your help!
With gratitude,
Sunny :-)
Hi Dr Salkin
Thank you so much for the follow up!
I am giving Ben a supplement called Prohemia ( usually for people, EPO-Canine is for dogs from the same company in case you want to google)... It seems to be helping because his gums and tongue are much pinker and he has more energy. I will keep you posted and will get another blood test in 2 weeks to see if he is getting better.
Thank you again for checking.
Sincerely,
Sunny :-)
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