Qualitative evaluation of irregularly spiculated red blood cells in the dog

Irregularly speculated red blood cells (IS-RBC) were quantified on fresh blood fixed in glutaraldehyde and were compared to RBC shape changes observed on Wright's-stained blood smears, RBC histograms, and RBC distribution widths (RDW). IS-RBC were infrequently found in healthy control dogs. Twenty dogs with increased IS-RBC were evaluated. The most common clinical diagnoses were lymphosarcoma (seven cases), glomerulonephritis (two cases), hemangiosarcoma (two cases), and chronic liver disease (two cases). Five cases had evidence of disseminated intravascular coagulopathy. In 12 of the 20 cases, keratocytes, schizocytes, and/or acanthocytes were detected in the monolayer area of blood smears. In the other seven cases, keratocytes, schizocytes, and/or acanthocytes were found only in thick areas of the smears. Acanthocytes were the most frequent cell type seen, while schizocytes were absent or present only in low numbers. RBC histograms had a shoulder on the left side of the tracing in six of the 20 cases, suggesting the presence of RBC fragments; however, cases with evidence of platelet aggregation had similar shoulders in RBC histograms. Red cell distribution widths were increased in 12 of the 20 cases with IS-RBC; however, the increase in RDW did not correlate with the presence of schizocytes and was most likely the result of reticulocytosis. This study suggests that quantitative evaluation of RBC shape is a more sensitive method for detection of mild RBC fragmentation when compared to blood smear evaluation, RBC histograms, or RDW. Additionally, acanthocyte-type cells were the most frequent shape change seen in dogs with evidence of RBC fragmentation.