- Email: [email protected]
Toxic neutrophils in cats
PA G E 4
A D VA N C E S
neutropenia, anemia, hypokalemia, and hypocalcemia. The presence of toxic neutrophils was significantly more common in cats with shock, sepsis, panleukopenia, peritonitis, pneumonia, and upper respiratory tract diseases, and infectious (viral and bacterial) and metabolic disorders. In 43% of sick cats, toxic neutrophils were the only hematologic evidence of inflammation or infection. Time required in the hospital and treatment cost were significantly higher in cats with toxic neutrophils.
Author Conclusion Toxic neutrophils are associated with certain clinicopathologic abnormalities, and when present, may aid in the diagnosis, as well as the assessment of hospitalization duration and cost.
Inclusions Four figures, 7 tables, 27 references.
Editor Annotation
TOXIC NEUTROPHILS IN CATS Background Toxic neutrophils have certain specific morphologic abnormalities observed on examination of Romanowsky-stained peripheral blood smears. These changes occur during the maturation process in the bone marrow under some abnormal conditions or in association with certain diseases. Since toxic neutrophils may appear in the peripheral blood prior to changes in the leukogram, their presence may serve as an early sensitive indicator of disease. They may also aid in determining an accurate prognosis.
Objectives To investigate the association of toxic neutrophils with clinicopathologic characteristics, diseases, and prognosis in cats.
Procedure One hundred and fifty cats with toxic neutrophils were compared with 150 negative-control cats for clinicopathologic characteristics, diseases, and prognosis.
Results Cats with toxic neutrophils had significantly more instances of fever, icterus, vomiting, diarrhea, depression, dehydration, weakness, and cachexia. Cats with toxic neutrophils also had significantly more leukocytosis, neutrophils, left shift,
These researchers evaluated toxic neutrophilic changes in a large group of cats and compared the observations of clinical disease to a group of control cats with some interesting clinically relevant results. Their criteria for neutrophil toxicity included cytoplasmic granulation, basophilia, and vacuolization with the presence of Dohle bodies. Nuclear changes, including vacuolization, ring formation, hypersegmentation, karyorrhexis, and karyolysis were also evaluated. There was a higher prevalence of more severe disease in cats that demonstrated toxic neutrophilic changes, compared to controls with a particularly higher incidence of panleukopenia in the cats with toxic neutrophils. Interestingly and dissimilar to dogs, the mortality rates were not significantly different. The group of cats with toxic neutrophils was frequently more anemic and demonstrated high levels of metabolic disorders. There were fewer biochemical and hematologic abnormalities compared to dogs. There is a concern from some of their observations that toxic neutrophils in the cat are associated with earlier disease. The hospital stay of cats with toxic neutrophils was longer and required more expense than with the control cats. The most interesting observation was that cats (43%) with toxic neutrophils frequently demonstrated a combination of normal leucocyte and neutrophil counts with no left shift. Therefore, if neutrophil morphology was not evaluated
A D VA N C E S
in these cats, no evidence of inflammation would be identified. These observations confirm the importance of making certain that all cat blood smears are evaluated for neutrophilic abnormalities (toxicity). This can be done in-house or sent to a laboratory. All hemograms sent out to a laboratory should have a smear examined in clinic. This means that blood smears, even those sent to a laboratory, need to be made routinely at the time of blood collection. This practice reserves the morphology of the red blood cells and white blood cells. This is important for the practice of good clinical medicine. (LDM) Segev G, Klement E, Aroch I. Toxic neutrophils in cats: Clinical and clinicopathologic features and disease prevalence and outcome B retrospective case control study. J Vet Intern Med 2006;20:20-31.
PAG E 5
A D VA N C E S
neutropenia, anemia, hypokalemia, and hypocalcemia. The presence of toxic neutrophils was significantly more common in cats with shock, sepsis, panleukopenia, peritonitis, pneumonia, and upper respiratory tract diseases, and infectious (viral and bacterial) and metabolic disorders. In 43% of sick cats, toxic neutrophils were the only hematologic evidence of inflammation or infection. Time required in the hospital and treatment cost were significantly higher in cats with toxic neutrophils.
Author Conclusion Toxic neutrophils are associated with certain clinicopathologic abnormalities, and when present, may aid in the diagnosis, as well as the assessment of hospitalization duration and cost.
Inclusions Four figures, 7 tables, 27 references.
Editor Annotation
TOXIC NEUTROPHILS IN CATS Background Toxic neutrophils have certain specific morphologic abnormalities observed on examination of Romanowsky-stained peripheral blood smears. These changes occur during the maturation process in the bone marrow under some abnormal conditions or in association with certain diseases. Since toxic neutrophils may appear in the peripheral blood prior to changes in the leukogram, their presence may serve as an early sensitive indicator of disease. They may also aid in determining an accurate prognosis.
Objectives To investigate the association of toxic neutrophils with clinicopathologic characteristics, diseases, and prognosis in cats.
Procedure One hundred and fifty cats with toxic neutrophils were compared with 150 negative-control cats for clinicopathologic characteristics, diseases, and prognosis.
Results Cats with toxic neutrophils had significantly more instances of fever, icterus, vomiting, diarrhea, depression, dehydration, weakness, and cachexia. Cats with toxic neutrophils also had significantly more leukocytosis, neutrophils, left shift,
These researchers evaluated toxic neutrophilic changes in a large group of cats and compared the observations of clinical disease to a group of control cats with some interesting clinically relevant results. Their criteria for neutrophil toxicity included cytoplasmic granulation, basophilia, and vacuolization with the presence of Dohle bodies. Nuclear changes, including vacuolization, ring formation, hypersegmentation, karyorrhexis, and karyolysis were also evaluated. There was a higher prevalence of more severe disease in cats that demonstrated toxic neutrophilic changes, compared to controls with a particularly higher incidence of panleukopenia in the cats with toxic neutrophils. Interestingly and dissimilar to dogs, the mortality rates were not significantly different. The group of cats with toxic neutrophils was frequently more anemic and demonstrated high levels of metabolic disorders. There were fewer biochemical and hematologic abnormalities compared to dogs. There is a concern from some of their observations that toxic neutrophils in the cat are associated with earlier disease. The hospital stay of cats with toxic neutrophils was longer and required more expense than with the control cats. The most interesting observation was that cats (43%) with toxic neutrophils frequently demonstrated a combination of normal leucocyte and neutrophil counts with no left shift. Therefore, if neutrophil morphology was not evaluated
A D VA N C E S
in these cats, no evidence of inflammation would be identified. These observations confirm the importance of making certain that all cat blood smears are evaluated for neutrophilic abnormalities (toxicity). This can be done in-house or sent to a laboratory. All hemograms sent out to a laboratory should have a smear examined in clinic. This means that blood smears, even those sent to a laboratory, need to be made routinely at the time of blood collection. This practice reserves the morphology of the red blood cells and white blood cells. This is important for the practice of good clinical medicine. (LDM) Segev G, Klement E, Aroch I. Toxic neutrophils in cats: Clinical and clinicopathologic features and disease prevalence and outcome B retrospective case control study. J Vet Intern Med 2006;20:20-31.
PAG E 5