ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: VETERINARY BASICS: How to read a blood test! CBC & Haematology

This is going to be the absolute basics, how to read blood test results.

Hey guys, how's it going?

And welcome back to another video.

Last year, I filmed a video called Veterinary Basics, and it had some really basic information about what I think

was important to know before you go into a small animal clinic.

And that was received really well by you guys.

A lot of you really, really enjoyed that video.

So I thought I would film something kind of similar and make a little bit of a series out of it.

How to read blood test results.

In particular, a CBC, also known as a complete blood count, or a haematology report, which is basically the same thing.

We're not going to be doing serum biochemistry today.

A whole other aspect of a blood test that you can do that tells you proteins and electrolytes.

I'm going to teach you how to read CBC results today.

And I just thought it would be helpful because I know

when I first started out and a vet would give me blood test results and be like What do you think?

And we hadn't really learned it yet and I couldn't even give my two cents.

Now we've learned how to do it in class

and I thought I would tell you the basics on how to do it

so that you can do it too when you go into practice.

So I'm reading off my laptop in front of me so that I don't get anything wrong.

The blood test results that I'm going to be talking about are only for small animals.

This is just for cats and dogs.

Just general small animal medicine.

A CBC report is also known as a complete blood count or hematology report.

And it tells you about the cells in your blood, which include your red blood cells, your white blood cells, and platelets.

So red blood cells are also known technically as urethrocytes, and white blood cells are known as leukocytes.

There are five main types of leukocyte.

These are neutrophils, lymphocytes, eosinophils, monocytes, and basophils.

If you're in another country, you might do something slightly differently, or you might be pronouncing these words differently to what I am.

Ignore my New Zealand accent.

We're going to start off with the red blood cell portion, or the erythrocyte part of a hematology report.

So the first thing that is normally at the top of your report is HB, and this means hemoglobin.

And the report is telling you how much

or the amount of hemoglobin in one liter of whole blood from that particular animal.

Hemoglobin is the indicator of how much oxygen that your blood can carry.

Hemoglobin makes up a huge portion of the actual red blood cell itself.

PCV, which also can be written as HCT, means packed cell volume or hematocrit.

And this is the proportion of blood, like whole blood, that is made up of RBCs.

We then have RBCs, which tells you the number of urethrocytes per unit volume.

Then you have MCV, which is the size of the urethrocytes.

MCHC, which is the color of the urethrocytes.

You might get reticulocytes as well.

and reticular sites or absolute reticular sites are the immature red blood cells.

So say, say you're bleeding, for example, you may need to release more red blood cells into your system.

So you're more likely to see more immature red blood cells

because your bone marrow or spleen or whatever is just pumping out as much red blood cells as they possibly can.

So an increased number of red blood cells is known as urethrocytosis or polycythema.

Decreased number of red blood cells is simple and it is known as anemia.

In people we often refer to anemia as because you are iron deficient, but anemia can be as a result of a lot of different reasons other than just iron deficiency.

If you have urethrocytosis in an animal you will see increased red blood cells, increased hemoglobin, and increased PCV normally.

And this can be caused by numerous reasons.

Most often in animals, urethrocytosis is relative, so it's not actually real.

It can be due to something like dehydration.

So the fluid or the plasma in your blood goes down

because you haven't drunk enough water and

so it looks like there's more cells in your blood than there actually is

so it's like a false erythrocytosis you can also have a physiologic erythrocytosis which is

when the body rapidly increases your production of red blood cells

over a short period of time a disease process like bone marrow cancer

or something like that and you have to do more investigation to figure out

which one it is just on the side just a weird and wonderful fact greyhounds the breed greyhounds.

They're weird.

They have a higher PCV than normal animals.

So if you are sending away blood to a lab or you're doing a greyhound's blood test results in clinic,

you need to be aware that they have more red blood cells than the average dog.

Anemia is decreased red blood cells, hemoglobin and PCV.

It could be due to increased destruction.

It could be due to increased loss such as bleeding

or it could be decreased production of red blood cells or a combination of all of the above.

MCHC is the color of the cells.

We use chromic as the suffix to describe color.

If it's within the reference ranges, this is known as normochromic, so it's normal color.

If it's less than the reference range, the cells are hypochromic, and if the cells are above the reference range,

then they're hyperchromic, so they have more pigment.

Whereas MCV is the size of the red blood cells.

Say the red blood cells are within the reference range, they are normocytic, so they're normal-sized cells.

If they're on the lower end or if they're below the reference range, then they are microcytic, or they're small cells.

And if they're above the reference range, then they are macrocytic, so large cells.

So this can be really, really helpful when you're trying to classify by the type of anemia or erythrocytosis that you have.

So for example, if you have a macrocytic hypochromic anemia,

this is often due to a lot of reticulocytes being in the blood or immature red blood cells.

This is because they are larger and paler than your normal mature urethrocyte.

So if you have a lot of reticulocytes in the blood, meaning it is a regenerative anemia, so loss of red blood cells, is regenerating rapidly.

When you see them in the blood, then you can see a macrocytic hypochromic anemia.

If you don't see reticular sites, this doesn't mean that your anemia is non-regenerative.

It could be pre-regenerative because say if you have blood loss, it can take up to three to five days for these reticular sites to be in circulation.

If it's more than three to five days after blood loss, then you know it's non-regenerative and there's something else going on in the body

because your body's not producing red blood cells to replace the other ones.

So now we're going to move on to the white blood cell portion of a CBC.

So white blood cells are also known as leukocytes.

Leukocytosis is increased white blood cells and leukopenia is decreased white blood cells.

Neutrophils are the most common white blood cell that we see in small animals.

An increase in neutrophils is a neutrophilia and a decrease is in neutropenia.

Neutrophilia can be due to physiologic response like fear or excitement.

It can also be due to a steroid response or a stress response.

It's due to like high corticosteroids or cortisol in your blood.

You can also have inflammation.

Lots of inflammation will cause a neutrophilia in small animals.

It can also be caused by cancer but I'm not going to go into that.

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So neutropenia can be due to really severe inflammation

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when you're using up all your neutrophils to the point where you don't have any left in circulation.

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It can be also due to decreased production and increased destruction of neutrophils.

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They have a whole life cycle that they go through from the start of their generation to becoming a big full-grown neutrophil.

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But in the last two stages, they have names that we use.

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So they can be bands or segmented neutrophils.

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These can be both detected on blood smears and blood tests.

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Bands are the more immature version of a segmented neutrophil.

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When you see more bands, say, than segmented neutrophils or more bands than you normally would, this is called a neutrophilia with a left shift.

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So it's shifting to the left because it's going towards the more immature side of the cycle.

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Lymphocytes are the next white blood cell that I want to talk about, and they are involved in immunity and inflammation in the body and a bunch of other processes.

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An increase in lymphocytes is called a lymphocytosis, and this can be physiological, so like a fight or flight response,

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chronic inflammation or another weird disease process, and a lymphopenia or decreased lymphocytes can be seen with a stress response.

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It's most often seen with a stress or steroid response.

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Monocytes are the next white blood cell.

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They're really, really big and they do a bunch of other things around the body like phagocytosis.

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They eat up bad things in the body pretty much.

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So an increase in monocytes or monocytosis.

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You can see a pattern here.

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This will indicate inflammation, particularly chronic inflammation in small animals, and also high levels of corticosteroids or stress.

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A monocytopenia, or not many monocytes, has very little clinical significance, and we often ignore it when we see it on a CDC.

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Eosinophils, or eosinophils, or however you want to say it, are these weird little granulated cells increase in eosinophils

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or an eosinophilia is often seen with animals that have really bad allergies or a hypersensitivity reaction.

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They can also be seen when an animal has parasites like in their gut

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or on their skin like fleas and it can also be seen with inflammation and a couple other weird disease processes.

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Eosinopenia can be completely normal for that animal

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and might have no clinical significance but it can also be due to a stress response or acute inflammation.

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We also have basophils.

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These are quite rare leukocytes and you don't tend to see them very often.

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They are often seen when there's an allergic reaction going on and they tend to follow eosinophils.

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So if you see a lot of eosinophils, you're probably going to see some basophils as well.

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To kind of summarize, I feel like I said stress quite a lot.

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There is something called a stress leukogram that we see quite often with dogs and cats and it's like a set

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type of pattern that we see called a stress leukogram.

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This includes a mature neutrophilia, so lots of segmented neutrophils, a lymphopenia, and this can also be maybe accompanied by,

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not always, an eosinopenia and a monocytosis.

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And if you see those four things, you know that that animal is either really stressed

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or you've given them some steroids recently or they've got something else going on.

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So now that we've learned all of this, I want to put this into an example.

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I don't want to go into too many details because I'm not obviously an actual veterinarian yet, so I'm just teaching you the absolute basics.

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So here is what a basic normal looking reference chart looks like.

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We've got hemoglobin, PCV, red blood cells, MCV, MCHC, reticulocytes for the erythrocyte portion of the chart.

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And we also have total white blood cells or leukocytes, neutrophils, segmented, neutrophils, bands, lymphocytes, esinophils, monocytes, and platelets.

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We haven't talked about platelets, but platelets are the third type of blood cell that you'll see.

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If you need to clot your blood, basically platelets are your first line of resort for clotting your blood.

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If you have increased platelets, it's called thrombocytosis.

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And if you have decreased platelets, it's called thrombocytopenia.

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My leg's gone completely numb. So numb.

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I've been sitting cross-legged this whole time.

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These are the reference ranges we're given in class.

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They're slightly wrong.

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I'm really sorry.

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This is what I'm given by my lecturers.

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So here's an example.

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So we've got animal A.

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And animal A has come into the clinic.

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And you've done a blood test on them or a CBC see.

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And so you've got the results back and this is what you see.

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So I just want you to take a minute to look at this chart

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and I just want you to take note of what you see and try and describe it.

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Ideas in your head and now I'm going to talk through it.

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So I've gone through the chart and I've made the things blue

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that are lower than the reference range and made some things red

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that are higher than the reference range just to make it clearer to you.

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From the top down I'm going to describe it

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and you can say whether you agree or disagree with me if you've had enough time to look at it.

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So we can see that we have an anemia here.

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The first three things are below the reference range and this is indicative of an anemia.

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It is a normocytic, normochromic anemia.

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Both our MCV and our MCHC are within the normal reference range.

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We also have low reticulocytes.

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This could be a non-regenerative anemia or it could also be pre-regenerative.

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It hasn't been three to five days since the insult has occurred.

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Next we're going to move on to the leukocyte portion, so the white blood cells.

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So we can see we have a leukocytosis slightly above the reference range.

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And this is due to a mature neutrophilia because our segmented neutrophils are high.

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We can also see that we have a lymphopenia, an eosinopenia, and a monocytosis.

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And as I mentioned before, this is completely classic of a stress leukogram or corticosteroid response.

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So yeah, that is basically an example of a CBC.

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Lots of resources I'm going to leave linked in the description

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and probably up here as well for if you want a better teacher than me.

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Hopefully this has helped in giving you some more information

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so next time if you're a pre-vet student

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or a vet student like me or you're at high school

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or something and you're going to do work experience in a clinic, hopefully this will help when you go into a clinic

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and a vet shows you a blood test result for a CBC and you can tell them kind of what you're thinking.

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You won't be able to give them any answers, but I think it might help you open up a discussion with a vet.

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If your hematology reports or CBC reports are different around the world, or if you learn things differently, I would love to know down in the comment section below.

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Let me know what you think of this video, and if you are excited by the idea of a veterinary basics series type thing.

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This is not confirmed, and it's just me spitballing here, but if this is something that you guys like,

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I might create PDF documents of these like information type things and make them accessible to you somehow,

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maybe through a website or something else like that if it's something that interests you guys.

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Thank you very much for watching.

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Let me know if you have any questions, complaints or comments down below.

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Like if you liked and subscribe if you want to see more from me or if you like this type of content.

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Thank you so much for watching and I will see you next time.

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ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: VETERINARY BASICS: How to read a blood test! CBC & Haematology

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