Evaluation of reticulocyte hemoglobin content (RET-He) in the diagnosis of iron-deficient erythropoiesis in dogs

Vet Clin Pathol. 2017 Dec;46(4):558-568. doi: 10.1111/vcp.12547. Epub 2017 Oct 9.

Abstract

Background: Reticulocyte hemoglobin content provided by the Siemens ADVIA (CHr) is an established marker of iron deficiency. The IDEXX ProCyte Dx hematology analyzer now provides a similar variable, reticulocyte hemoglobin equivalent (RET-He).

Objectives: The objective was to evaluate RET-He and its diagnostic utility in dogs, and to calculate a cutoff value for diagnosing iron-deficient erythropoiesis (IDE). Furthermore, the prevalence of RET-He values below this cutoff value was established.

Methods: One hundred and seventy-one CBCs of healthy dogs were used to establish a RI. Stability of RET-He was evaluated by repeated measurements over 48 hours (n = 10). The 25-run coefficient of variation (CV) was calculated, and correlation and bias between measurements of RET-He and CHr were assessed (n = 190). A cutoff value for diagnosing IDE was calculated. The utility of RET-He in the detection of IDE was evaluated in 123 dogs. The prevalence of low RET-He values was assessed retrospectively in a multicenter study (2012-2014) under participation of 7 veterinary clinics.

Results: Reticulocyte hemoglobin equivalent with an RI of 22.2 to 28.6 pg was statistically stable over 48 hours (P = .10). The CV was 1.8%. A fair correlation (ρ = 0.74) between RET-He and CHr with a small bias of -0.6 pg was found. The cutoff value for diagnosing IDE was 20.9 pg (sensitivity: 85%; specificity: 99%). The prevalence of RET-He values below 20.9 pg was 10.3% (1084/10,553 dogs).

Conclusions: RET-He on the ProCyte Dx is a precise screening tool in dogs to detect iron-deficient erythropoiesis.

Keywords: Canine; ProCyte Dx; hematology; prevalence; reference interval.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / diagnosis
  • Anemia, Iron-Deficiency / veterinary*
  • Animals
  • Dog Diseases / blood*
  • Dog Diseases / diagnosis
  • Dog Diseases / epidemiology
  • Dogs
  • Erythropoiesis*
  • Female
  • Hemoglobins / metabolism*
  • Iron / blood
  • Iron Deficiencies*
  • Male
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Reticulocytes / metabolism*
  • Retrospective Studies

Substances

  • Hemoglobins
  • Iron