Feline Differential Leukocyte Count with ProCyte Dx: Frequency and Severity of a Neutrophil-Lymphocyte Error and How to Avoid It.

BACKGROUND: Erroneous neutrophil and lymphocyte counts from analysis of feline blood samples were transferred directly into the hospital information system from the ProCyte Dx hematology instrument in our after-hours laboratory. Errors usually were not detected by the users. HYPOTHESIS/OBJECTIVES: To quantify the frequency and severity of errors associated with the ProCyte Dx analyzer and to identify methods to avoid the errors. ANIMALS: One-hundred six EDTA blood samples routinely submitted from feline hospital patients were analyzed. METHODS: ProCyte differential leukocyte counts were compared to 2 reference methods: Advia 2120 hematology instrument and manual enumeration. Limits for unacceptable deviation from the reference methods were defined as 18 for % lymphocytes and 23 for % neutrophils. RESULTS: Fourteen of 106 samples had unacceptable errors for both lymphocytes and neutrophils compared to both reference methods. Median % lymphocytes in those 14 samples were 11.2, 15.0, and 53.0% for Advia, manual, and ProCyte, respectively. Median % neutrophils were 85.4, 81.5, and 34.2% for Advia, manual, and ProCyte, respectively. All errors were avoided by rejecting automated ProCyte differential leukocyte results whenever the dot plot appeared clearly incorrect, but only 9 of these 14 samples had a ProCyte WBC distribution error flag. CONCLUSIONS AND CLINICAL IMPORTANCE: Results reported by ProCyte had markedly falsely increased lymphocyte and decreased neutrophil counts in 13% of feline patient samples. Users must reject automated differential leukocyte count results when the WBC dot plot appears overtly incorrect. Rejection based only on ProCyte WBC error flag was insufficient.

Comparison of specific gravity analysis of feline and canine urine, using five refractometers, to pycnometric analysis and total solids by drying.

AIMS: To compare the performance of five refractometers for determination of urine specific gravity in cats and dogs, with reference to weight of total solids and pycnometer analysis. METHODS: Urine samples from 27 cats and 31 dogs submitted for routine urinalysis were included. Urine specific gravity was determined with five refractometers. Four were optical, hand-held refractometers with a temperature compensation method and one was a digital model. Urine was dried to determine the precise weight of total solids. The total solids (g/L) were converted to an estimated specific gravity by division with 2.33. Urine specific gravity of four feline and seven canine samples were analysed with a pycnometer. Limits of agreement analysis was used to evaluate the agreement between specific gravity (analysed as specific gravity minus 1) measured by the refractometers and estimated from dried total solids, or pycnometer results. RESULTS: The five refractometers reported clearly different results from each other. Proportional negative bias was noted for refractometer results compared to estimated specific gravity from total solids and a constant negative bias compared to pycnometer results. The two refractometers designed for cat urine reported similar and lowest specific gravity results with a mean negative bias of 0.007 and 0.008 units compared to estimated specific gravity from total solids, and a mean negative bias of 0.006 units compared to pycnometer results. CONCLUSIONS: Refractometer results did not increase consistently with increasing urine specific gravity compared to reference methods or to other refractometers. Two feline refractometers reported consistently lower specific gravity results than reference methods and other refractometers. CLINICAL RELEVANCE: Because of this imprecision, veterinarians should not use precise cut off values such as 1.030 or 1.035 for evaluation of renal concentrating ability in dogs and cats. Veterinarians should consider the variability of refractometric specific gravity results in their clinical assessment. Two feline refractometers appeared to report falsely low specific gravity results.