Blood morphology results (red and white blood cell and platelet morphology) combined with quantitative results provide more information and greater clarity. They aid in early disease detection, monitoring treatment effectiveness, assessing overall health status, and predicting prognosis while guiding further diagnostic tests.

Early Disease Detection with Blood Morphology

As veterinary professionals, we know that our best chance of success (quality and quantity of life through efficient and effective treatment plans) is often when we detect disease early. Blood morphology results paired with a CBC can provide much more detail to our diagnostic picture. This applies to all three categories on our complete blood count: red blood cells, white blood cells, and platelets.

One of the most common triggers for assessment of a CBC is concern about anemia. If a veterinarian relies solely on the quantitative CBC value, so much more information could be missed without a morphology assessment. Specifically, when we talk about red blood cell characteristics, we can go from a general quantitative diagnosis of anemia to a much more detailed characterization of regenerative capability, hemoglobin concentration, suggestion of autoimmune disease, hemoparasitism, and even detection of one of the earliest indications of possible splenic neoplasia (through schistocytes). Not only can this help narrow down our differential list, but it can also help us focus on additional diagnostics and guide treatment options.

Similarly, practitioners might only assess white blood cell counts or look for a stress pattern on a leukogram. However, looking at white blood cell morphology can provide so much information. It can confirm quantitative leukogram results, but I find the most value in its ability to identify the most acute and early inflammatory changes in a patient—the presence of band neutrophils. Finding bands on a patient's blood morphology is like having a spotlight immediately put on the patient. These results suggest we quickly dive deeper to find the source of acute inflammation through additional testing.

Finally, we can't forget to evaluate our patient's platelets. We can use our hematology analyzers to identify certain variables, including breed type and clumping, but veterinarians still might want further confirmation. Utilizing a blood smear or digital cytology evaluation helps us validate our quantitative number and look for subtle decreases that can indicate the need to investigate infectious and rickettsial diseases. All of this morphology information leads towards one goal—earlier disease detection for a better potential outcome and prognosis.

Monitoring Treatment and Overall Health Status

A CBC with paired blood morphology results can also be valuable when assessing treatment efficacy for acute and chronic diseases. Pet owners have a lot invested in successful treatment of these patients. It helps when we can show them that treatment is working.

The wellness exam CBC and associated blood work also help assess overall health status and organ function, especially when the results are routine. When this happens, we can deliver good news! This can be a powerful message for a pet owner's peace of mind.

Finally, guiding a pet owner's expectations including prognosis isn't always quick and easy, but our role in exam room communication includes providing as much objective data as possible to help them make the most informed decisions. This means being able to share information that helped determine the severity of the patient's disease or condition, or other underlying causes that may be identified or point towards additional specific diagnostic testing.

The CBC is one of the most powerful diagnostic tests for illness and wellness exams. However, if we rely entirely on quantitative results we will miss critical details only visible through blood morphology results. A paired CBC with blood morphology results gives us the power to diagnose, monitor, and manage various animal health conditions and objectively help predict the patient's prognosis more accurately.

Tags: blood morphology,