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What are the highest differential for this cbc ?
analyse_media
Reading File
Note: This is a veterinary CBC (canine/dog), not a human CBC. Here is a full breakdown of the values and the top differentials based on the abnormalities.
CBC Summary - MAX (Dog), Nihon Kohden, 24 Jul 2026
| Parameter | Value | Flag | Canine Reference Range |
|---|---|---|---|
| WBC | 9.86 | C* | 6-17 × 10³/µL |
| RBC | 4.65 | L | 5.5-8.5 × 10⁶/µL |
| HGB | 11.3 | L | 12-18 g/dL |
| HCT | 30.4 | L | 37-55% |
| MCV | 65.4 | Normal | 60-77 fL |
| MCH | 24.3 | Normal | 19.5-24.5 pg |
| MCHC | 37.2 | H | 32-36 g/dL |
| PLT | 13.3 | C* | 150-400 × 10³/µL |
| LY | 0.90 (9.1%) | L | 1.0-4.8 × 10³/µL |
| MO | 0.15 (1.5%) | L | 0.15-1.35 × 10³/µL |
| EO | 0.30 (3.0%) | Normal | - |
| GR (Neutrophils) | 8.51 (86.4%) | H% | 60-77% |
| RDW-CV | 12.9 | Normal | 12-15% |
"C" flag = suspect abnormal morphology requiring manual review
Key Abnormalities
- Normocytic normochromic anemia - RBC ↓, HGB ↓, HCT ↓ (30.4% = mild-moderate anemia), with normal MCV (65.4 fL) and normal RDW
- Severe thrombocytopenia - PLT 13.3 × 10³/µL (critically low; normal ≥150)
- Relative neutrophilia / lymphopenia - GR 86.4%H, LY 9.1%L - classic stress leukogram
- MCHC mildly elevated - may indicate artifact, lipemia, hemolysis, or true spherocytosis
Top Differentials
For the combined picture (anemia + severe thrombocytopenia):
| Priority | Differential | Why |
|---|---|---|
| #1 | Immune-Mediated Thrombocytopenia (IMT) ± IMHA | Most common cause of severe isolated thrombocytopenia in dogs; can co-occur with immune-mediated hemolytic anemia (Evans syndrome). MCHC elevation may suggest spherocytes. |
| #2 | Tick-borne disease (Ehrlichia canis, Anaplasma platys) | Both cause thrombocytopenia + anemia in dogs; Ehrlichia classically causes profound thrombocytopenia. Stress leukogram also fits. |
| #3 | Disseminated Intravascular Coagulation (DIC) | Consumes platelets + RBCs; would expect schistocytes on blood smear. Associated with sepsis, neoplasia, pancreatitis. |
| #4 | Bone marrow disease / aplasia | Pancytopenia pattern (low RBC, PLT, lymphopenia); could be drug-induced (chemotherapy, estrogen toxicity), or infiltrative neoplasia. |
| #5 | Neoplasia (lymphoma, hemangiosarcoma, mast cell tumor) | Hemangiosarcoma in particular causes thrombocytopenia via mechanical destruction + DIC; can cause anemia from blood loss or sequestration. |
| #6 | Chronic blood loss (GI parasitism, ulcers, hemorrhage) | Would typically show microcytosis/low MCV but MCV is normal here, making ongoing hemorrhage less likely as sole cause. |
| #7 | Rodenticide toxicity (anticoagulant) | Causes bleeding + thrombocytopenia; relevant if there was possible exposure. |
Recommended Next Steps
- Blood smear (manual diff) - look for spherocytes (IMHA), schistocytes (DIC), platelet clumping (rule out pseudothrombocytopenia), morulae (Ehrlichia)
- Coombs test - if IMHA suspected
- Tick-borne disease serology / PCR (Ehrlichia, Anaplasma, Babesia)
- Coagulation panel (PT/aPTT, fibrinogen, D-dimers) - rule out DIC/rodenticide
- Abdominal ultrasound - rule out splenic masses (hemangiosarcoma)
- Bone marrow aspirate - if cytopenias unexplained after above workup
- Platelet clump check - PLT of 13.3 with a "C" flag may partly represent clumping artifact
The most urgent concern is the critically low platelet count (13,300/µL) - bleeding risk is high below 20,000/µL. This patient needs prompt clinical evaluation regardless of etiology.
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