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Extreme Veteran
Posts: 520
| I have two horses here that I just had blood panels done on and both are anemic. Everything else was normal. vet wanted me to treat with iron. She was not sure the cause, mentioned cancer which would be unlikely with two at the same time, lyme disease which I know the one had lyme disease a year ago (I have blood on the way to cornell to check his titers) the other was tested in the fall neg. And also mentioned possibly something in our soil that might be causing them to not be able to absorb enough nutrients. She was going to look into some more causes and call me back, so I'd like to have some more info about it to be able to talk to her about it. Just doing my own research online ulcers seems to be the number one cause for anemia and that treating with iron doesn't really do much as its very rare for horses to lack in iron even when anemic, and the cause needs to be addressed and the horse will build up its own red blood cells within 2-6 weeks.
The one was only slightly anemic at 6.1 (normal 6.8-12.9), I haven't had any blood panels done on him lately so have nothing to compare to so I don't know if this is a new thing or an improvement on what he had been. He has been treated for ulcers in January with a month and a half of omeprazole, saw a huge improvement in him. He had started to regress as soon as I started tapering him off. So had him on gastro plus and now currently on gi support and he has been doing really well. He was never off his feed, but was extremely grumpy, didn't want his sides touched and would bite and kick at me, pain at all the ulcer points. He has pssm which went unmanaged for a quite a while because our vets had no idea what was wrong with him, and had also went through two treatments for lyme disease before that, so I can easily see him having ulcers.
The other horse was 5.9 which was more concerning to me as he had been at 6.7 in January. He was also treated with omeprazole in january and I had seen no improvement in him. I have had this horse for 7 months and I honestly have no idea what is wrong with him, just treated him as I honestly have no clue whats going on with him and neither do the vets. He has had body and back pain pretty much since I have purchased him (yes he has gone though several vet exams, therapies, x-rays etc). Highly suspect pssm, but I don't have any tests back yet. I've had him on a similar diet to my other 2 horses that have pssm (yea I have 2, possibly now 3 cause I am lucky like that) and his body pain has gone, but still having back pain and he also does have pain around his girth area, why I thought maybe ulcers. I had briefly talked to our vet about the possibility of ulcers with him still while she was here yesterday before blood tests were done, but she thought it was unlikely because he has never been off feed, hasn't lost weight, coat looks great (which was the same with the other horse that responded to omeprazole).
I have heard some mixed things about omeprazole. Some saying it treats hindgut ulcers, some saying it may make them worse. So hindgut is still in my mind for the second horse.
Edited by Buckles 2017-03-22 6:07 AM
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Extreme Veteran
Posts: 520
| My husband and I had talked about the soil being the cause, which we are just going to get the soil tested. But also thought maybe we should just get a blood panel on our one horse that doesn't have pssm or any other apparent issues for comparison and to try to rule something like that out. | |
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 You get what you give
Posts: 13030
   
Location: Texas | hindgut ulcers are also known as right dorsal colitis, which is often correlated with NSAID use. Horses with hindgut ulcers typically have a thicken colonic wall on ultrasound, loose stools, and they usually look poor. Treating hindgut ulcers is multifocal and includes a high fiber diet, discontinue use of NSAIDs, and reduction of stressors. | |
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You get what you give
Posts: 13030
Location: Texas | OP it may be worth getting a chemistry panel done in addition to the CBC to see if theres any sign of systemic disease that may explain an anemia. | |
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Extreme Veteran
Posts: 520
| Chemistry was normal for both. They don't get NSAIDs. Neither looks poor or has loose stool. Both are good weight (well the one is fat), shiny coats, and look healthy. | |
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You get what you give
Posts: 13030
Location: Texas | So that makes me lean against hindgut ulcers.
The fact that both horses are anemic makes me think
A- its something environmental like pasture or feed or hay
B- maybe they should be retested in 30 days or with a different machine
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Member
Posts: 29
| The findings on your horses are very common, in my opinion. I've had clients ask this question dozens of times (vets too). True anemia in a horse is a problem. Mildly low RBC (red cell counts) in an otherwise normal horse are not usually "abnormal." Horses have a huge spleen, which acts as a filter and reservoir for the blood. Under relaxed conditions (e.g. not exercise or high stress), the spleen is full of blood. When the horse exercises or is very stressed, the spleen contracts, releasing extra blood to the horses bloodstream, allowing more efficient exercise. Sorry--that's a fairly crude explanation. Normal ranges include those horses that are under severe stress or being exercised, so that may "artificially" elevate the low, normal value. I hope that makes sense!
When blood is drawn while the horse is not stressed or exercising, the red cell count can appear low, but the horse is perfectly normal. I've had more than one friend call me, freaking out, because their veterinarian diagnosed anemia and prescribed hematinics like Red Cell or iron. Their horses were totally normal and they didn't need it. The changes you list are mild. In my opinion (that's all it is, albeit edumacated), unless your horses are showing other issues, they're totally normal. Those values wouldn't concern me in the least.
If you're concerned, your vet needs to also review the other parts of the CBC and not just the red cell count (maybe they did--it gives you huge clues as to the cause and the horses response). This includes the MCH (how much hemoglobin is in the red cell), MCV (the volume of the red cells), checking for reticulocytes (young red cells that indicate that the horse is fighting the anemia), packed cell volume etc.
If you use UC Davis' reference ranges, one of your horses is perfectly normal and one is very slightly low.
Also, if ulcers may be causing anemia, a simple fecal test for blood should be performed. It's cheap, accurate and easy.
If you're really curious, trot your horse for a couple minutes and then draw another sample. I would guess the results would be totally different. :-) Sorry so long. Evaluating blood work isn't just a black and white, normal/abnormal thing. Best of luck! | |
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The Advice Guru
Posts: 6419
| shepsrus - 2017-03-23 6:39 PM
The findings on your horses are very common, in my opinion. I've had clients ask this question dozens of times (vets too). True anemia in a horse is a problem. Mildly low RBC (red cell counts) in an otherwise normal horse are not usually "abnormal." Horses have a huge spleen, which acts as a filter and reservoir for the blood. Under relaxed conditions (e.g. not exercise or high stress), the spleen is full of blood. When the horse exercises or is very stressed, the spleen contracts, releasing extra blood to the horses bloodstream, allowing more efficient exercise. Sorry--that's a fairly crude explanation. Normal ranges include those horses that are under severe stress or being exercised, so that may "artificially" elevate the low, normal value. I hope that makes sense!
When blood is drawn while the horse is not stressed or exercising, the red cell count can appear low, but the horse is perfectly normal. I've had more than one friend call me, freaking out, because their veterinarian diagnosed anemia and prescribed hematinics like Red Cell or iron. Their horses were totally normal and they didn't need it. The changes you list are mild. In my opinion (that's all it is, albeit edumacated), unless your horses are showing other issues, they're totally normal. Those values wouldn't concern me in the least.
If you're concerned, your vet needs to also review the other parts of the CBC and not just the red cell count (maybe they did--it gives you huge clues as to the cause and the horses response). This includes the MCH (how much hemoglobin is in the red cell), MCV (the volume of the red cells), checking for reticulocytes (young red cells that indicate that the horse is fighting the anemia), packed cell volume etc.
If you use UC Davis' reference ranges, one of your horses is perfectly normal and one is very slightly low.
Also, if ulcers may be causing anemia, a simple fecal test for blood should be performed. It's cheap, accurate and easy.
If you're really curious, trot your horse for a couple minutes and then draw another sample. I would guess the results would be totally different. :-) Sorry so long. Evaluating blood work isn't just a black and white, normal/abnormal thing. Best of luck!
My vet also said that a CBC is not a reliable test as horses are more sensitive to the procedure and begin clotting immediately which can compromise the test.
It also depends on how the vet collected it? If he used a syringe then transferred it into the tube, you wasted your money.
If you are worried, I would test the stool for blood to see if there is a gi bleed.
Other then that I would go back to a balanced diet, if you want to increase the rbc, red cell is a good product. | |
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 It Goes On
Posts: 2262
Location: Muskogee, OK | sheprus had very good, accurate information! Agree in full. If they are otherwise normal (eating, drinking, looking fat and shiny as you mentioned)- I would have a hard time considering it significant. | |
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Extreme Veteran
Posts: 520
| shepsrus - 2017-03-23 6:39 PM
The findings on your horses are very common, in my opinion. I've had clients ask this question dozens of times (vets too). True anemia in a horse is a problem. Mildly low RBC (red cell counts) in an otherwise normal horse are not usually "abnormal." Horses have a huge spleen, which acts as a filter and reservoir for the blood. Under relaxed conditions (e.g. not exercise or high stress), the spleen is full of blood. When the horse exercises or is very stressed, the spleen contracts, releasing extra blood to the horses bloodstream, allowing more efficient exercise. Sorry--that's a fairly crude explanation. Normal ranges include those horses that are under severe stress or being exercised, so that may "artificially" elevate the low, normal value. I hope that makes sense!
When blood is drawn while the horse is not stressed or exercising, the red cell count can appear low, but the horse is perfectly normal. I've had more than one friend call me, freaking out, because their veterinarian diagnosed anemia and prescribed hematinics like Red Cell or iron. Their horses were totally normal and they didn't need it. The changes you list are mild. In my opinion (that's all it is, albeit edumacated), unless your horses are showing other issues, they're totally normal. Those values wouldn't concern me in the least.
If you're concerned, your vet needs to also review the other parts of the CBC and not just the red cell count (maybe they did--it gives you huge clues as to the cause and the horses response). This includes the MCH (how much hemoglobin is in the red cell), MCV (the volume of the red cells), checking for reticulocytes (young red cells that indicate that the horse is fighting the anemia), packed cell volume etc.
If you use UC Davis' reference ranges, one of your horses is perfectly normal and one is very slightly low.
Also, if ulcers may be causing anemia, a simple fecal test for blood should be performed. It's cheap, accurate and easy.
If you're really curious, trot your horse for a couple minutes and then draw another sample. I would guess the results would be totally different. :-) Sorry so long. Evaluating blood work isn't just a black and white, normal/abnormal thing. Best of luck!
Thank you so much for this! | |
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You get what you give
Posts: 13030
Location: Texas | Okay time out. I have to step in again. As an almost vet (graduate May 10) I can't help but point out a huge error.
Horses do NOT make reticulocytes. That's the reason why equine CBCs are harder to interpret, because they do not work the same way as other mammals. For dogs and cats, you can look at reticulocytes, but NOT horses.
Other factors that are ussed to evaluate the health of blood cells are their color and shape.
Things like Polychromasia and Anisocytosis can help classify an anemia as regenerative or non regenerative. Regenerative means the body is creating new RBCs and is responding appropriately to loss. Non regenerative anemia means the body is not responding and creating new red blood cells. With dogs, regenerative anemia is beautiful under the microscope- you really will have red cells that look pink, purple, and blueish, and they will be big and small. There's also classic signs blood cells can have like rouleaux formation- which is also NORMAL in a horse but ABNORMAL in other species.
That's just scraping the surface of interpreting CBCs. But I had to make a huge correction to some prior posts because horses absolutely do not make reticulocytes and the absence of them means nothing.
And one other thing- the parameters for "normal" on CBCs were all compiled with horses at rest, taking into account their large spleen. When people say a horse is anemic because the spleen is sequestering blood cells- that sounds like a good theory but it really isn't how it works. They aren't going to systemically be anemic at all times and then flush out a bunch of RBCs during stress of activity and go back to being anemic. They will be normal until they aren't normal, if that makes sense.
Edited by casualdust07 2017-03-23 9:54 PM
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Elite Veteran
Posts: 883
Location: Southern Indiana | I had a CBC ran on one of my horses last year and he came back slightly anemic. It's fairly common from what I understand. Oh and mine also had back/abdominal sensitivity to the touch. | |
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Member
Posts: 29
| To the upcoming grad (sorry, I can't quote you from my phone):
Horses do make and release punctate reticulocytes, and evaluation of reticulocyte numbers should be a part of ANY good CBC. A good read is "Equine Clinical Pathology" (Walton, I believe. My copy is at work). One of the issues is that they are difficult to detect, which is why pathologists didn't think horses made them. The Advia 120 is able to detect equine retics. This is the machine in my facility used to process CBCs. Maybe this article will help--just a quick Google... :-)
http://www.eclinpath.com/hematology/anemia/assessment-regeneration/
And according to the laboratory I've used every day for the fifteen years I've been at my current position, the reference ranges are established from ALL stages of exercise/rest. They used over 10,000 results to generate their reference ranges. And they do not track the disease status nor the activity level of the animal at the time of the draw. Coincidentally, the reference range stated by the OP is nearly identical to the lab I've used.
I've always said the day I don't learn something new is the day I should go in the ground. :-) Best of luck to you in your upcoming career--your education has yet to begin! I enjoy my career immensely!
DVM--25+ years, equine industry 40+ years, reviewing clinical pathology as part of my job 15+ years. | |
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Who Wants to Trade?
Posts: 4692
| shepsrus - 2017-03-24 3:36 PM
To the upcoming grad (sorry, I can't quote you from my phone ):
Horses do make and release punctate reticulocytes, and evaluation of reticulocyte numbers should be a part of ANY good CBC. A good read is "Equine Clinical Pathology" (Walton, I believe. My copy is at work ). One of the issues is that they are difficult to detect, which is why pathologists didn't think horses made them. The Advia 120 is able to detect equine retics. This is the machine in my facility used to process CBCs. Maybe this article will help--just a quick Google... :- )
http://www.eclinpath.com/hematology/anemia/assessment-regeneration/
And according to the laboratory I've used every day for the fifteen years I've been at my current position, the reference ranges are established from ALL stages of exercise/rest. They used over 10,000 results to generate their reference ranges. And they do not track the disease status nor the activity level of the animal at the time of the draw. Coincidentally, the reference range stated by the OP is nearly identical to the lab I've used.
I've always said the day I don't learn something new is the day I should go in the ground. :- ) Best of luck to you in your upcoming career--your education has yet to begin! I enjoy my career immensely!
DVM--25+ years, equine industry 40+ years, reviewing clinical pathology as part of my job 15+ years.
That article says equine are the exception to the rule? Or did I stopped reading too soon?
Equine species are an exception to this rule. Although they do release reticulocytes (punctate) in response to an anemia, there are usually too few of these cells to identify in peripheral blood reliably. Instead, they appear to retain immature RBC in the bone marrow until they lose most or all of their RNA and release larger cells (macrocytes) instead (see more below). | |
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Extreme Veteran
Posts: 516
| kuhlmann - 2017-03-24 4:48 PM
shepsrus - 2017-03-24 3:36 PM
To the upcoming grad (sorry, I can't quote you from my phone ):
Horses do make and release punctate reticulocytes, and evaluation of reticulocyte numbers should be a part of ANY good CBC. A good read is "Equine Clinical Pathology" (Walton, I believe. My copy is at work ). One of the issues is that they are difficult to detect, which is why pathologists didn't think horses made them. The Advia 120 is able to detect equine retics. This is the machine in my facility used to process CBCs. Maybe this article will help--just a quick Google... :- )
http://www.eclinpath.com/hematology/anemia/assessment-regeneration/
And according to the laboratory I've used every day for the fifteen years I've been at my current position, the reference ranges are established from ALL stages of exercise/rest. They used over 10,000 results to generate their reference ranges. And they do not track the disease status nor the activity level of the animal at the time of the draw. Coincidentally, the reference range stated by the OP is nearly identical to the lab I've used.
I've always said the day I don't learn something new is the day I should go in the ground. :- ) Best of luck to you in your upcoming career--your education has yet to begin! I enjoy my career immensely!
DVM--25+ years, equine industry 40+ years, reviewing clinical pathology as part of my job 15+ years.
Equine species are an exception to this rule. Although they do release reticulocytes (punctate) in response to an anemia, there are usually too few of these cells to identify in peripheral blood reliably. Instead, they appear to retain immature RBC in the bone marrow until they lose most or all of their RNA and release larger cells (macrocytes) instead (see more below).
Keep reading :) here's what it says below:
The equine bone marrow does not release many reticulocytes in health and polychromasia is not expected in horse blood smears in a regenerative anemia. Although reticulocytes can be counted in equine blood with newer fluorescent-based techniques (Cooper et al., 2005), the increase observed in regenerative anemia is too small to be detected clinically. In rare cases of very severe, peracute blood loss or hemolytic anemia, a few polychromatophilic RBC and nRBC can be found in blood.
And here is another excerpt about equine reticulocytes from Equine Clinical Pathology (Walton, 2013) that I think explains it a little better:
Until the advent of automated reticulocyte enumeration methods that evaluate more than 40 times the number of erythrocytes evaluated by manual methods, reticulocytosis was not thought to occur in equine blood. Using laser methodology (Advia 120), small numbers of circulating reticulocytes can be detected in healthy states. However, because of these low circulating numbers, the precision of reticulocyte counts in healthy horses is poor. Using automated methods, regenerative responses in reticulocytes can be detected in select situations such as hemolytic anemia with a high dose erythropoetin administration.
Edited by WiscoRacer 2017-03-24 6:04 PM
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You get what you give
Posts: 13030
Location: Texas | shepsrus - 2017-03-24 3:36 PM
To the upcoming grad (sorry, I can't quote you from my phone ):
Horses do make and release punctate reticulocytes, and evaluation of reticulocyte numbers should be a part of ANY good CBC. A good read is "Equine Clinical Pathology" (Walton, I believe. My copy is at work ). One of the issues is that they are difficult to detect, which is why pathologists didn't think horses made them. The Advia 120 is able to detect equine retics. This is the machine in my facility used to process CBCs. Maybe this article will help--just a quick Google... :- )
http://www.eclinpath.com/hematology/anemia/assessment-regeneration/
And according to the laboratory I've used every day for the fifteen years I've been at my current position, the reference ranges are established from ALL stages of exercise/rest. They used over 10,000 results to generate their reference ranges. And they do not track the disease status nor the activity level of the animal at the time of the draw. Coincidentally, the reference range stated by the OP is nearly identical to the lab I've used.
I've always said the day I don't learn something new is the day I should go in the ground. :- ) Best of luck to you in your upcoming career--your education has yet to begin! I enjoy my career immensely!
DVM--25+ years, equine industry 40+ years, reviewing clinical pathology as part of my job 15+ years.
Oh gosh you know, I try and keep all this simplified in my head and know better that they do have them because its part of the normal process of making RBCs... I've just been taught these last four years not to take them into account on CBCs of horses. That's neat that technology has caught up! | |
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