Hi Sherri
Looking at the first set of results versus the second, I think there has been a
good improvement.
The haematocrit went from 13 to 15.3 in just a few days on Winstrol. That is a
definitive improvement.
The haemoglobin went from 4.0 to 5.3. Moving in the right direction. The
haemoglobin is a molecule which sits on the red blood cells, and allows the red
blood cells to carry oxygen to the organs and cells. When haemoglobin is too
low, you will see symptoms of easy fatigue and being out of breath quickly.
Bogie is starting to move around more because she has more ability to oxygenate
her organs and tissues.
The MCH went from19.3 to above the upper limit of the reference range to 21.8.
Though this is above the normal reference range, I suspect this is a temporary
condition which represents the body compensating for low red cells and low
haemoglobin. The MCH is the Mean Cell Haemoglobin levels. It is not measured
directly by the haematology equipment, but rather, is a calculation of how much
haemoglobin the average red cell is carrying so it is the haemoglobin level
divided by the number of red cells. A high MCH suggests that the red cells are
currently larger than normal (macrocytic anemia) and is likely the body's
compensation mechanism to allow more oxygenation to occur with fewer red cells
available. Another explanation is there is a significant population of
reticulocytes (which the lab results confirms is correct) because this category
of immature red cells is slightly larger than the mature red cells. I also
think that this number may be erroneously elevated in circumstances where there
are nucleated red cells in circulation. (Remember that nucleated red cells are
immature red cells and are counted by the machine as white cells because the
instrument is designed to count anything with a nucleus and a particular size
as a white cell. Therefore, if there are a significant number of nucleated red
cells, then when the machine calculates MCH, it will be dividing the amount of
haemoglobin by a deceptively smaller number of red cells because the nucleated
ones are not included in the denominator, and the result will be a falsely
elevated MCH.) Either way, it is good news.
The first set of blood work shows that there are nucleated red cells in
circulation (NRBC). The number is 7 which is quite elevated, and shows that
Bogart was already trying to make new red cells and immature forms were found
in the circulation. Unfortunately, the first blood work did not include a
reticulocyte count (which is a different phase of immature red cells versus the
nucleated ones) and the second blood work did not include a NRBC count, so we
cannot see if there is an increase between first and second blood work when
looking separately at the populations of the nucleated red cells and
reticulocytes. However, as I mentioned in my earlier post, the reticulocyte
count in the second blood work shows a strong push towards creating new red
cells.
I agree with you that you must be cautious when comparing results from
different labs. If you aren't running the blood on the same instrument, there
will be a variation since the two machines will be calibrated differently.
However, it isn't correct to say that because the reference ranges change, then
the red blood cell count is lower in the second set of results. Reference
ranges have nothing to do with the actual results. They are usually calculated
by collecting a certain number of normal results (say 100) and establishing a
high and a low number from the normal bloods. Often the manufacturer of the lab
equipment will have done this work and will simply provide the range to the lab
running the blood work. Just because a reference range is higher or lower in
different labs doesn't mean that the actual result can be interpreted to be
higher or lower in different labs. For now, I would suggest cautious optimism
that there is a slight uptick in the red cell count between the first set and
the second set. However, there is no question that the difference can certainly
mean nothing more than lab variation. You will know more next time.
It is hard for me to tell what is happening in the white cell count because not
all the white blood cell parameters are listed in either blood work. Usually,
in addition to a total white cell count (WBC) the total is then broken down to
the different types of white cells and numbers are given both as a count of
cells seen but also as a percentage of overall white cells. In both sets of
blood work, I see no neutrophil count. In neither do I see percentages either.
What I do see is a rise in lymphocytes in the second blood work and that is
what made me think of the Doxycycine. Often in FeLV, there is an abnormal
increase of lymphocytes and the lymphocytes themselves are abnormal. (I do not
see a manual assessment of the blood work, on either day, so again, I cannot
tell if the lymphocytes are
