Correlation between manual and automatized values of reticulocyte count in anemic feline samples

O objetivo do presente estudo foi correlacionar os valores de reticulócitos pontilhados e agregados obtidos por metodologia manual com a metodologia automática de contagem de reticulócitos totais em amostras de sangue de gatos anêmicos, analisados em um contador hematológico com citometria de fluxo. Para isso, 40 amostras de sangue de pacientes felinos anêmicos, independentemente de idade e sexo, foram utilizadas para a determinação das contagens absolutas de reticulócitos totais pela metodologia automatizada por citometria de fluxo fluorescente e pela técnica manual com corante supravital, em duplicata. Na contagem manual, houve a discriminação entre reticulócitos pontilhados e agregados. Para a correlação entre os métodos, foi realizada a análise de regressão de Passing-Bablok. A média do hematócrito dos gatos foi de 15,25%, tendo a maioria dos gatos (32,5%) apresentado anemia moderada (hematócrito = 17,81%). Como resultados, a análise de regressão demonstrou que a correlação entre a contagem absoluta total automática foi superior à contagem manual de reticulócitos agregados (rho= 0,71; P<0,001) do que a contagem absoluta de reticulócitos pontilhados (rho= 0,68; P<0,001). Os resultados apresentados sugerem que a contagem de reticulócitos total absoluta realizada pelo analisador hematológico ProCyte Dx em gatos anêmicos se refere à contagem absoluta de reticulócitos. Dessa maneira, recomenda-se que os valores possam ser utilizados para a avaliação imediata da condição hematológica de gatos anêmicos.The aim of this study was to correlate the punctate and aggregated reticulocytes values obtained by manual methodology and the automatic reticulocyte count in 40 blood samples from anemic cats. Total reticulocyte absolute counts were determined by automated fluorescence flow cytometry and manual methods in 40 blood samples obtained from anemic cats. The manual count was obtained by supravital stain in duplicate to each sample and the reticulocyte morphology were discriminated between punctate and aggregates reticulocytes. Passing-Bablok regression analysis was utilized to compare the methods. Most samples were from anemic cat (15,25%) and the hematocrit mean was 17,81%. Regression analysis showed that the correlation between the absolute total automatic counts is higher with aggregated reticulocytes (rho= 0,71; P< 0,001) than with absolute punctate reticulocytes counts (rho= 0, 68, P< 0.001). Results suggest that the ProCyte Dx reticulocytes count in anemic cats is correlated with aggregate reticulocyte count. Thus, the greater amount of RNA and organelles in aggregate reticulocytes generates a cellular complexity and, therefore, greater impregnation of the dye in an automatic count. Thus, the values obtained by the hematologic instrument can be used for the immediate evaluation of the hematological condition in anemic cats

He-matological and biochemical profile of capuchin monkeys (Cebus spp.) kept in captivity

O trabalho foi desenvolvido com o objetivo de montar um perfil hematológico e bioquímico, estabelecendo possíveis diferenças entre sexo e idade, de macacos-prego (Cebus spp.) mantidos em cativeiros, clinicamente saudáveis. Foram determinados valores hematológicos e mensurados valores bioquímicos para determinação do perfil hepático (ALT, AST, FA, GGT), perfil renal (CREAT e ureia), perfil lipídico (COL e TRIG), perfil proteico (ALB e PT), minerais (CA e P), CK-Total e frutosamina. Foram coletadas amostras de sangue de 20 animais (10 machos e 10 fêmeas) mantidos no Zoológico da Universidade de Passo Fundo. A análise estatística empregada foi a descritiva para obtenção da média, do desvio padrão, e de valores mínimos e máximos com 95% de confiança. Não foi encontrada diferenças significativas nos valores hematológicos e bioquímicos, para ambos os sexos e faixas etárias estudadas, de macacos-prego. Desse modo, tais valores encontrados corroboram com a literatura existente e aumentam o número de informações disponíveis aos clínicos de animais selvagens.The study was conducted with the aim to mount a hematological and biochemical profile, establishing possible differences between sex and age, capuchin monkeys (Cebus spp) kept in captivity, clinically healthy. Hematological values were determined as well as biochemical tests to avaliate the liver profile (ALT, AST, ALP and GGT), renal profile (CREAT and urea), lipids profile (COL and TRIG), protein profile (ALB and TP), minerals (CA and P), apart from CK-Total and fructosamine. Blood samples were collected from 20 animals (10 males and 10 females) kept in the Zoo at the University of Passo Fundo. It was employed one statistical descriptive, obtaining the mean, standard deviation, and minimum and maximum values with 95% confidence. There was no significant difference in hematological and biochemical values for both sexes and age groups of capuchin monkeys. Therefore, these results corroborate with the present literature, increasing the quantity of information available to Wildlife clinical

Clinical and laboratorial findings in cats naturally infected with feline leukemia virus (FeLV) and their correlations with viral and proviral loads

O vírus da leucemia viral felina (FeLV) é um dos patógenos que mais causa óbito em gatos, tendo ampla distribuição mundial. Os achados mais frequentes no hemograma incluem citopenias diversas decorrentes ou não de distúrbios mieloproliferativos, uma vez que os felinos com infecção progressiva possuem maior risco para desenvolver leucemia ou linfoma. O objetivo do presente trabalho foi identificar as alterações clínicas e laboratoriais na infecção natural pelo FeLV, através da avaliação hematológica, bioquímica e de medula óssea, além de quantificar a carga viral e proviral através da PCR em tempo real (qPCR) de gatos na cidade de Porto Alegre. Foram amostrados 44 gatos domésticos, distribuídos em cinco grupos conforme a antigenemia, achados clínicos e/ou laboratoriais e cargas viral e proviral em: progressivos sintomáticos, progressivos assintomáticos, regressivos, não classificados e saudáveis (grupo controle). As variáveis foram comparadas entre os grupos e correlacionadas com a carga viral e proviral. Dos 44 gatos amostrados, 21 foram positivos no teste de ELISA (47,73%) e 23 foram negativos (52,27%). Dos negativos, 9 gatos (20,45%) apresentaram apenas baixa carga proviral na medula óssea e foram classificados como regressivos. O grupo progressivo sintomático apresentou elevada carga viral e proviral, além de alterações no eritrograma, com diferença significativa dos demais grupos. Também foram observadas variações no mielograma, sobretudo na linhagem mieloide imatura, com diversas alterações displásicas e na contagem celular dos gatos infectados. Correlações moderadas puderam ser observadas entre a carga viral no soro e na medula óssea, e entre a carga viral e proviral na medula óssea. A quantificação das cargas virais e proviral através da qPCR demonstrou ser fundamental para classificação da infecção de acordo com as categorias. Também foi possível identificar um número significativo de animais apenas com carga proviral na medula óssea, demonstrando a importância da investigação de infecção regressiva, principalmente em gatos assintomáticos. Os achados sugerem que elevadas cargas virais e proviral estão relacionadas a alterações clínicas e hematológicas e à gravidade da doença.Feline leukemia virus (FeLV) is one of the deadliest pathogens of cats, with a worldwide distribution. The most frequent finding on complete blood count (CBC) include cytopenia, resulting or not from myeloproliferative disorders, since cats with progressive infections have a higher risk of developing leukemia or lymphoma. The aim of the present study was to identify clinical and laboratorial changes in natural FeLV-infected cats through hematological, biochemical and bone marrow evaluation, as well as to quantify viral and proviral load by real-time polymerase chain reaction (qPCR) in Porto Alegre city. Forty-four domestic cats were sampled and classified into five groups according to antigenemia, clinical and/or laboratory findings and viral/proviral loads: symptomatic progressives, asymptomatic progressives, regressive, unclassified, and healthy (control group). Variables were compared between groups and correlated with viral and proviral loads. Of the 44 cats sampled, 21 were ELISA positive (47.73%) and 23 were negative (52.27%). On the negatives, 9 (20.45%) had only low bone marrow proviral load and were classified as regressive. The symptomatic progressive group presented a higher viral and proviral load, besides alterations on the erythrogram, with significant difference from the other groups. Also, it was detected some variation on the myelogram, above all on the immature myeloid lineage, with several alterations on cellular counting and dysplasia on the infected cats. Moderate correlation could be observed between serum and bone marrow viral loads and between bone marrow viral and proviral loads. The quantification of viral and proviral loads by qPCR proved to be fundamental for the classification of the infection according to the categories. It was also possible to identify a significant number of animals with only bone marrow proviral load, demonstrating the importance of investigating regressive infection, especially in asymptomatic cats. These findings suggest that higher viral and proviral loads are related to clinical and hematological disorders and disease severity

Hematologic, biochemical and hemostatic abnormalities of paraneoplastic origin in female dogs with mammary Neoplasms

As anormalidades hematológicas de origem paraneoplásica são identificadas em diversos tipos de neoplasias que acometem cães e gatos. Nas neoplasias mamárias em cadelas, já foram identificadas anormalidades relacionadas com a coagulação, onde verificou-se que a coagulação intravascular disseminada (CID) clínica e subclínica pode estar presente em 83% das cadelas com carcinoma mamário. Na medicina humana, é dada relevância à investigação de tais alterações uma vez que são fatores indicadores de prognóstico do câncer. Enquanto isso, na medicina veterinária, são escassos os estudos que relacionam as alterações hematológicas com o tipo tumoral, estadiamento e determinação de prognóstico. O objetivo do presente estudo foi realizar a avaliação hematológica, bioquímica e da hemostasia de cadelas acometidas por neoplasia mamária para identificar a alteração mais frequente, além de relacionar as anormalidades com o estadiamento tumoral. Para isso, foram utilizadas 25 cadelas atendidas pelo Grupo de Estudos em Oncologia em pequenos animais (ONCOVET) do Hospital de Clínicas Veterinárias da UFRGS (HCV-UFRGS) durante o período de 4 meses. Foi realizado coleta de sangue para hemograma, contagem de plaquetas, bioquímica sérica (albumina, ALT, cálcio, creatinina, FA, glicose, ureia) e teste de coagulação que constou de TP (tempo de protrombina), TTPa (tempo de tromboplastina parcial ativada), TT (tempo de trombina), fibrinogênio e mensuração do dímero-D. O estadiamento tumoral foi obtido através do exame físico e do resultado da biopsia das mamas. As anormalidades encontradas incluíram anemia, leucocitose neutrofílica, monocitose, eosinofilia, trombocitose, hipoalbuminemia, hipocalcemia, hipoglicemia e diminuição dos níveis de ureia sanguínea. Entretanto, essas alterações não foram relacionadas diretamente com a progressão tumoral, uma vez que não houve diferença entre os grupos avaliados. Apenas as variáveis RDW e ALT apresentaram relação significativa entre os grupos, contudo, sem relevância clínica. No teste de coagulação, houve diferença significativa entre os grupos apenas no TT e fibrinogênio, que foi relacionado com o estadiamento tumoral.Hematological abnormalities of paraneoplastic origin are identified in several types of cancers that affect dogs and cats. In dogs with mammary neoplasms, abnormalities associated with coagulation have been identified, and verified that disseminated intravascular coagulation (DIC) clinical and subclinical may be present in 83% of dogs with mammary carcinoma. In human medicine, research in this field has been relevant since those factors are indicators of cancer prognosis. Meanwhile, in veterinary medicine, there are few studies that relate hematological changes with tumor type, staging and determination of prognosis. The aim of this study was to evaluate the hematological, biochemical and hemostathic abnormalities in bitches affected by mammary cancer to identify the most frequent alteration and associate with tumor staging. For this, 25 bitches attended by the Oncology Study Group in small animals (ONCOVET) of the Veterinary Hospital of UFRGS (HCV-UFRGS) for the period of 4 months were used. Blood collection for complete blood count, platelet count, serum biochemistry (albumin, ALT, calcium, creatinine, ALP, glucose, urea) and coagulation test that consisted of PT (prothrombin time), aPTT (activated partial thromboplastin time), TT (thrombin time), fibrinogen and D-dimer measurement were performed. Tumor staging was obtained by physical examination and the results of the biopsy of the breast. The abnormalities found included anemia, neutrophilic leukocytosis, monocytosis, eosinophilia, thrombocytosis, hypoalbuminemia, hypocalcemia, hypoglycemia and decreased levels of urea. However, these changes were not associated directly with tumor progression, since there was no difference among the groups. Only the RDW and ALT variables was associated significantly between the groups, however, with no clinical relevance. In the coagulation test, there was significant difference between the groups only in TT and fibrinogen, which was associated with tumor staging

Clinical and laboratorial findings in cats naturally infected with feline leukemia virus (FeLV) and their correlations with viral and proviral loads

O vírus da leucemia viral felina (FeLV) é um dos patógenos que mais causa óbito em gatos, tendo ampla distribuição mundial. Os achados mais frequentes no hemograma incluem citopenias diversas decorrentes ou não de distúrbios mieloproliferativos, uma vez que os felinos com infecção progressiva possuem maior risco para desenvolver leucemia ou linfoma. O objetivo do presente trabalho foi identificar as alterações clínicas e laboratoriais na infecção natural pelo FeLV, através da avaliação hematológica, bioquímica e de medula óssea, além de quantificar a carga viral e proviral através da PCR em tempo real (qPCR) de gatos na cidade de Porto Alegre. Foram amostrados 44 gatos domésticos, distribuídos em cinco grupos conforme a antigenemia, achados clínicos e/ou laboratoriais e cargas viral e proviral em: progressivos sintomáticos, progressivos assintomáticos, regressivos, não classificados e saudáveis (grupo controle). As variáveis foram comparadas entre os grupos e correlacionadas com a carga viral e proviral. Dos 44 gatos amostrados, 21 foram positivos no teste de ELISA (47,73%) e 23 foram negativos (52,27%). Dos negativos, 9 gatos (20,45%) apresentaram apenas baixa carga proviral na medula óssea e foram classificados como regressivos. O grupo progressivo sintomático apresentou elevada carga viral e proviral, além de alterações no eritrograma, com diferença significativa dos demais grupos. Também foram observadas variações no mielograma, sobretudo na linhagem mieloide imatura, com diversas alterações displásicas e na contagem celular dos gatos infectados. Correlações moderadas puderam ser observadas entre a carga viral no soro e na medula óssea, e entre a carga viral e proviral na medula óssea. A quantificação das cargas virais e proviral através da qPCR demonstrou ser fundamental para classificação da infecção de acordo com as categorias. Também foi possível identificar um número significativo de animais apenas com carga proviral na medula óssea, demonstrando a importância da investigação de infecção regressiva, principalmente em gatos assintomáticos. Os achados sugerem que elevadas cargas virais e proviral estão relacionadas a alterações clínicas e hematológicas e à gravidade da doença.Feline leukemia virus (FeLV) is one of the deadliest pathogens of cats, with a worldwide distribution. The most frequent finding on complete blood count (CBC) include cytopenia, resulting or not from myeloproliferative disorders, since cats with progressive infections have a higher risk of developing leukemia or lymphoma. The aim of the present study was to identify clinical and laboratorial changes in natural FeLV-infected cats through hematological, biochemical and bone marrow evaluation, as well as to quantify viral and proviral load by real-time polymerase chain reaction (qPCR) in Porto Alegre city. Forty-four domestic cats were sampled and classified into five groups according to antigenemia, clinical and/or laboratory findings and viral/proviral loads: symptomatic progressives, asymptomatic progressives, regressive, unclassified, and healthy (control group). Variables were compared between groups and correlated with viral and proviral loads. Of the 44 cats sampled, 21 were ELISA positive (47.73%) and 23 were negative (52.27%). On the negatives, 9 (20.45%) had only low bone marrow proviral load and were classified as regressive. The symptomatic progressive group presented a higher viral and proviral load, besides alterations on the erythrogram, with significant difference from the other groups. Also, it was detected some variation on the myelogram, above all on the immature myeloid lineage, with several alterations on cellular counting and dysplasia on the infected cats. Moderate correlation could be observed between serum and bone marrow viral loads and between bone marrow viral and proviral loads. The quantification of viral and proviral loads by qPCR proved to be fundamental for the classification of the infection according to the categories. It was also possible to identify a significant number of animals with only bone marrow proviral load, demonstrating the importance of investigating regressive infection, especially in asymptomatic cats. These findings suggest that higher viral and proviral loads are related to clinical and hematological disorders and disease severity

Hematologic, biochemical and hemostatic abnormalities of paraneoplastic origin in female dogs with mammary Neoplasms

As anormalidades hematológicas de origem paraneoplásica são identificadas em diversos tipos de neoplasias que acometem cães e gatos. Nas neoplasias mamárias em cadelas, já foram identificadas anormalidades relacionadas com a coagulação, onde verificou-se que a coagulação intravascular disseminada (CID) clínica e subclínica pode estar presente em 83% das cadelas com carcinoma mamário. Na medicina humana, é dada relevância à investigação de tais alterações uma vez que são fatores indicadores de prognóstico do câncer. Enquanto isso, na medicina veterinária, são escassos os estudos que relacionam as alterações hematológicas com o tipo tumoral, estadiamento e determinação de prognóstico. O objetivo do presente estudo foi realizar a avaliação hematológica, bioquímica e da hemostasia de cadelas acometidas por neoplasia mamária para identificar a alteração mais frequente, além de relacionar as anormalidades com o estadiamento tumoral. Para isso, foram utilizadas 25 cadelas atendidas pelo Grupo de Estudos em Oncologia em pequenos animais (ONCOVET) do Hospital de Clínicas Veterinárias da UFRGS (HCV-UFRGS) durante o período de 4 meses. Foi realizado coleta de sangue para hemograma, contagem de plaquetas, bioquímica sérica (albumina, ALT, cálcio, creatinina, FA, glicose, ureia) e teste de coagulação que constou de TP (tempo de protrombina), TTPa (tempo de tromboplastina parcial ativada), TT (tempo de trombina), fibrinogênio e mensuração do dímero-D. O estadiamento tumoral foi obtido através do exame físico e do resultado da biopsia das mamas. As anormalidades encontradas incluíram anemia, leucocitose neutrofílica, monocitose, eosinofilia, trombocitose, hipoalbuminemia, hipocalcemia, hipoglicemia e diminuição dos níveis de ureia sanguínea. Entretanto, essas alterações não foram relacionadas diretamente com a progressão tumoral, uma vez que não houve diferença entre os grupos avaliados. Apenas as variáveis RDW e ALT apresentaram relação significativa entre os grupos, contudo, sem relevância clínica. No teste de coagulação, houve diferença significativa entre os grupos apenas no TT e fibrinogênio, que foi relacionado com o estadiamento tumoral.Hematological abnormalities of paraneoplastic origin are identified in several types of cancers that affect dogs and cats. In dogs with mammary neoplasms, abnormalities associated with coagulation have been identified, and verified that disseminated intravascular coagulation (DIC) clinical and subclinical may be present in 83% of dogs with mammary carcinoma. In human medicine, research in this field has been relevant since those factors are indicators of cancer prognosis. Meanwhile, in veterinary medicine, there are few studies that relate hematological changes with tumor type, staging and determination of prognosis. The aim of this study was to evaluate the hematological, biochemical and hemostathic abnormalities in bitches affected by mammary cancer to identify the most frequent alteration and associate with tumor staging. For this, 25 bitches attended by the Oncology Study Group in small animals (ONCOVET) of the Veterinary Hospital of UFRGS (HCV-UFRGS) for the period of 4 months were used. Blood collection for complete blood count, platelet count, serum biochemistry (albumin, ALT, calcium, creatinine, ALP, glucose, urea) and coagulation test that consisted of PT (prothrombin time), aPTT (activated partial thromboplastin time), TT (thrombin time), fibrinogen and D-dimer measurement were performed. Tumor staging was obtained by physical examination and the results of the biopsy of the breast. The abnormalities found included anemia, neutrophilic leukocytosis, monocytosis, eosinophilia, thrombocytosis, hypoalbuminemia, hypocalcemia, hypoglycemia and decreased levels of urea. However, these changes were not associated directly with tumor progression, since there was no difference among the groups. Only the RDW and ALT variables was associated significantly between the groups, however, with no clinical relevance. In the coagulation test, there was significant difference between the groups only in TT and fibrinogen, which was associated with tumor staging

Correlation between manual and automatized values of reticulocyte count in anemic feline samples

O objetivo do presente estudo foi correlacionar os valores de reticulócitos pontilhados e agregados obtidos por metodologia manual com a metodologia automática de contagem de reticulócitos totais em amostras de sangue de gatos anêmicos, analisados em um contador hematológico com citometria de fluxo. Para isso, 40 amostras de sangue de pacientes felinos anêmicos, independentemente de idade e sexo, foram utilizadas para a determinação das contagens absolutas de reticulócitos totais pela metodologia automatizada por citometria de fluxo fluorescente e pela técnica manual com corante supravital, em duplicata. Na contagem manual, houve a discriminação entre reticulócitos pontilhados e agregados. Para a correlação entre os métodos, foi realizada a análise de regressão de Passing-Bablok. A média do hematócrito dos gatos foi de 15,25%, tendo a maioria dos gatos (32,5%) apresentado anemia moderada (hematócrito = 17,81%). Como resultados, a análise de regressão demonstrou que a correlação entre a contagem absoluta total automática foi superior à contagem manual de reticulócitos agregados (rho= 0,71; P<0,001) do que a contagem absoluta de reticulócitos pontilhados (rho= 0,68; P<0,001). Os resultados apresentados sugerem que a contagem de reticulócitos total absoluta realizada pelo analisador hematológico ProCyte Dx em gatos anêmicos se refere à contagem absoluta de reticulócitos. Dessa maneira, recomenda-se que os valores possam ser utilizados para a avaliação imediata da condição hematológica de gatos anêmicos.The aim of this study was to correlate the punctate and aggregated reticulocytes values obtained by manual methodology and the automatic reticulocyte count in 40 blood samples from anemic cats. Total reticulocyte absolute counts were determined by automated fluorescence flow cytometry and manual methods in 40 blood samples obtained from anemic cats. The manual count was obtained by supravital stain in duplicate to each sample and the reticulocyte morphology were discriminated between punctate and aggregates reticulocytes. Passing-Bablok regression analysis was utilized to compare the methods. Most samples were from anemic cat (15,25%) and the hematocrit mean was 17,81%. Regression analysis showed that the correlation between the absolute total automatic counts is higher with aggregated reticulocytes (rho= 0,71; P< 0,001) than with absolute punctate reticulocytes counts (rho= 0, 68, P< 0.001). Results suggest that the ProCyte Dx reticulocytes count in anemic cats is correlated with aggregate reticulocyte count. Thus, the greater amount of RNA and organelles in aggregate reticulocytes generates a cellular complexity and, therefore, greater impregnation of the dye in an automatic count. Thus, the values obtained by the hematologic instrument can be used for the immediate evaluation of the hematological condition in anemic cats

Approach to Classification of Cavitary Effusion and Comparison between Manual and Automatic Methods for Total Nucleated Cell Count

Background: Two classifications are used to categorize cavitary effusions using total nucleated cell count (TNCC): protein concentration and pathophysiology of its formation. The aims of the present study were to evaluate the correlation between the TNCC values of cavitary effusions obtained in the automatic and the manual method, and also evaluating the classification methodology. Materials, Methods & Results: Cavitary effusions were analyzed for physical, chemical and cytological aspects, as well as manual and automatic cell counts for the correlation between the traditional methods and those suggested by Stockham & Scott. Bland-Altman regression and Spearman correlation analysis were performed. Of the total, 44 were abdominal effusions (73.3%), 15 thoracic (25%) and 1 pericardial (1.7%). According to the traditional classification, most of the effusions were classified as modified transudates (40%) and according to the classification of Stockham and Scott, as transudates poor in protein (31.7%). The correlation between cell counting techniques between pure, modified and exudate transudates was 0.94, 0.97 and 0.94, respectively, indicating an excellent correlation between the parameters (p = 0.95%).Discussion: Considering the concentration of proteins and CCNT, the effusions classified as modified transudate were mainly caused by neoplastic processes (carcinomas/adenocarcinomas), since there are several mechanisms of their formation, such as large variation of protein concentration. According to the Stockham & Scott classification a unique classification is considered for exfoliative neoplastic effusions, the variation of the protein concentration of the effusion does not alter its classification. In neoplastic effusions, classified as exudates, lymphomas were the most prevalent, and hypercellularity (approximately 150,000 cells / μL) allowed this classification. When considering low-protein transudates, the findings related to low concentrations did not differ much from the traditional classification. In the ruptures of viscera and vessels, the hemorrhagic ones were the most frequent, thus, the cytological diagnosis is essential, since it can give information about the contamination with blood during the collection. Most of these were due to neoplasia as the underlying cause. A case of chylotorax was diagnosed by comparing cholesterol and triglyceride values of effusion and serum. In cases of uroperitoneum, the presence of urine in the abdominal cavity promotes the dilution of the fluid from the cavity, being initially classified as pure transudate and, with its permanence in the cavity, increasing the CCNT, becomes an exudate. As in cases of exfoliative neoplastic effusions, the classification of the uroperitoneum, according to Stockham & Scott, is classified directly into effusion due to rupture of the viscera, giving a quick and clear diagnosis. According to Stockham & Scott, cases classified as nonseptic exudates (n = 3), two of which resulted from feline infectious peritonitis (PIF). The effusive form of PIF presents with accumulations of fluid in the abdomen, having an inflammatory character, but according to the traditional classification, they enter the category of modified transudates, because, despite containing protein concentrations close to or above the serum level, they present a CCNT lower than an exudate. Cavitary effusions were classified as septic exudates when intracellular bacteria were present and in the present study, two effusions were classified as such in two patients, one with septic peritonitis and in the other the final diagnosis was not found. The high values of Spearman correlation coefficients found when comparing the automatic counts with the manual demonstrate that there is an excellent correlation between the methods and, the Bland-Altman test showed significant agreement between them

Approach of cavitary effusion classification and comparison between manual and automatic methods for total nucleated cell count

Background: Two classifications are used to categorize cavitary effusions using total nucleated cell count (TNCC): protein concentration and pathophysiology of its formation. The aims of the present study were to evaluate the correlation between the TNCC values of cavitary effusions obtained in the automatic and the manual method, and also evaluating the classification methodology. Materials, Methods & Results: Cavitary effusions were analyzed for physical, chemical and cytological aspects, as well as manual and automatic cell counts for the correlation between the traditional methods and those suggested by Stockham & Scott. Bland-Altman regression and Spearman correlation analysis were performed. Of the total, 44 were abdominal effusions (73.3%), 15 thoracic (25%) and 1 pericardial (1.7%). According to the traditional classification, most of the effusions were classified as modified transudates (40%) and according to the classification of Stockham and Scott, as transudates poor in protein (31.7%). The correlation between cell counting techniques between pure, modified and exudate transudates was 0.94, 0.97 and 0.94, respectively, indicating an excellent correlation between the parameters (P = 0.95%). Discussion: Considering the concentration of proteins and CCNT, the effusions classified as modified transudate were mainly caused by neoplastic processes (carcinomas/adenocarcinomas), since there are several mechanisms of their formation, such as large variation of protein concentration. According to the Stockham & Scott classification a unique classification is considered for exfoliative neoplastic effusions, the variation of the protein concentration of the effusion does not alter its classification. In neoplastic effusions, classified as exudates, lymphomas were the most prevalent, and hypercellularity (approximately 150,000 cells / μL) allowed this classification When considering low-protein transudates, the findings related to low concentrations did not differ much from the traditional classification. In the ruptures of viscera and vessels, the hemorrhagic ones were the most frequent, thus, the cytological diagnosis is essential, since it can give information about the contamination with blood during the collection. Most of these were due to neoplasia as the underlying cause. A case of chylotorax was diagnosed by comparing cholesterol and triglyceride values of effusion and serum. In cases of uroperitoneum, the presence of urine in the abdominal cavity promotes the dilution of the fluid from the cavity, being initially classified as pure transudate and, with its permanence in the cavity, increasing the CCNT, becomes an exudate. As in cases of exfoliative neoplastic effusions, the classification of the uroperitoneum, according to Stockham & Scott, is classified directly into effusion due to rupture of the viscera, giving a quick and clear diagnosis. According to Stockham & Scott, cases classified as nonseptic exudates (n = 3), two of which resulted from feline infectious peritonitis (PIF) The effusive form of PIF presents with accumulations of fluid in the abdomen, having an inflammatory character, but according to the traditional classification, they enter the category of modified transudates, because, despite containing protein concentrations close to or above the serum level, they present a CCNT lower than an exudate. Cavitary effusions were classified as septic exudates when intracellular bacteria were present and in the present study, two effusions were classified as such in two patients, one with septic peritonitis and in the other the final diagnosis was not found. The high values of Spearman correlation coefficients found when comparing the automatic counts with the manual demonstrate that there is an excellent correlation between the methods and, the Bland-Altman test showed significant agreement between them