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research-article2014
VDIXXX10.1177/1040638714546490Hematology as a diagnostic tool in bovine medicineRoland et al.

Review

Journal of Veterinary Diagnostic Investigation

Hematology as a diagnostic tool in 2014, Vol. 26(5) 592­–598


© 2014 The Author(s)
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DOI: 10.1177/1040638714546490
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Leonie Roland, Marc Drillich, Michael Iwersen1

Abstract. The objective of the current review is to provide the reader with an overview of the bovine hematological
profile. Sample collection, bovine reference ranges, and cattle-specific characteristics of erythrocyte, leukocyte, and platelet
parameters are reviewed. Furthermore, diseases associated with abnormalities in the complete blood cell count of cattle are
discussed.

Key words: Blood; cattle; complete blood cell count; hematology; hemogram.

Introduction EDTA/Na2 per ml of blood. Heparin is not recommended for


general hematological use in cattle because it results in devia-
Hematologic analysis is not only relevant for diagnosing dis- tions of leukocyte counts.13 Mixing should occur by carefully
orders of the hematologic system but also helpful in the diag- inverting the tube several times. The correct blood quantity
nosis of many organ and systemic diseases. Although the should be collected in the sample tube, because an inappropri-
diagnosis of a disease can only occasionally be based solely ate ratio of sample blood to anticoagulant might cause errone-
on a complete blood cell (CBC) count, the hemogram may ous results for red blood cell (RBC) parameters and indices.
contribute valuable information in the diagnosis, surveil- Samples can be stored up to 24 hr at 4°C. Platelet counts
lance, and formulation of a prognosis regarding the future should be conducted within 4 hr after venipuncture.22,39,47
progression of a disease in an individual. The objective of the
current review is to provide bovine clinicians and laboratory
technicians with an overview of the sample collection pro- Bovine hematological reference ranges
cess, bovine reference ranges, cattle-specific properties of The most appropriate reference range is generated from a
blood cells, and diseases associated with abnormalities in the group of healthy animals with environmental and physiolog-
hematological profile of cattle. Because automated cell ical characteristics as similar to the patient as possible. As in
counters have become more and more popular in veterinary all species, a certain amount of physiological variability is
practice, the focus of the present review is on abnormalities observed in hematologic profiles of cattle. Variables that
detectable by automated cell counters (i.e., abnormalities in contribute to the thresholds and width of reference intervals
the number, volume, and hemoglobin concentration of blood include age, sex, stress, diet, body condition, reproductive
cells rather than on abnormal morphology). However, if status, recent activity, hydration, ambient temperature, and
pathological or irregular results are discovered, or abnormal altitude.28,50 Reference intervals for bovine hematologic
morphology or blood cell function impairment is suspected, parameters from 3 sources are summarized in Table 1.
an additional microscopic blood smear evaluation is strongly Many commonly used hematology reference intervals
recommended. originate from research undertaken in the 1960s. A 2010
study16 compared reference intervals of healthy North Amer-
Blood sampling and storage ican cows from 1957 to 2006 to account for changes in the
The most accessible and commonly used vessels for blood
collection in cattle are the external jugular vein and the coc- From the Clinical Unit for Herd Health Management in Ruminants,
University Clinic for Ruminants, Department for Farm Animals and
cygeal vessels. If possible, animals should be calm to avoid
Veterinary Public Health, University of Veterinary Medicine Vienna,
stress-related changes of the hemogram.22,39 For hematologic Vienna, Austria.
analysis, samples must be collected in tubes coated with anti- 1
Corresponding Author: Michael Iwersen, Clinical Unit for Herd
coagulant agents, preferably potassium–ethylenediamine
Health Management in Ruminants, University Clinic for Ruminants,
tetra-acetic acid (EDTA/K3) with a concentration of 1.27 mg Department for Farm Animals and Veterinary Public Health, University
EDTA/K3 per ml of blood, or disodium–ethylenediamine of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria.
tetra-acetic acid (EDTA/Na2) with a concentration of 1.5 mg michael.iwersen@vetmeduni.ac.at
Hematology as a diagnostic tool in bovine medicine 593

Table 1.  Bovine hematology reference intervals according to 3 sources.*

Wood and Quiroz-Rocha Kraft and Dürr George et al.


Parameter Unit (2010)50† (2005)27‡ (2010)16§
Erythrocytes 106/μl 4.9–7.5 5–10 5.1–7.6
Hematocrit % 21–30 28–38 22–33
Hemoglobin g/dl 8.4–12.0 9–14 8.5–12.2
Mean corpuscular volume fl 36–50 46–65 38–50
Mean corpuscular hemoglobin pg 14–19 11–17 14–18
Mean corpuscular hemoglobin concentration g/dl 38–43 31–34 36–39
Red cell distribution width % 16–20 NA 15.5–19.7
Reticulocytes 103/μl 0 NA NA
Leukocytes 103/μl 5.1–13.3 5–10 4.9–12.0
Segmented neutrophils 103/μl 1.7–6.0 1.0–3.5 1.8–6.3
Band neutrophils 103/μl 0–0.2 0.0–0.2 Rare
Lymphocytes 103/μl 1.8–8.1 2.5–5.5 1.6–5.6
Monocytes 103/μl 0.1–0.7 0–0.3 0–0.8
Eosinophils 103/μl 0.1–1.2 0.3–1.5 0–0.9
Basophils 103/μl 0–0.2 0–0.1 0–0.3
Platelets 103/μl 160–650 300–800 193–637
Mean platelet volume fl 4.6–7.4 NA 4.5–7.5

* NA = not available
† Reference intervals for the ADVIA 120 hematology analyzer from 99 clinically healthy cows, 50% in first lactation, all milking for 30–150 days, from 10
farms in Ontario, Canada.
‡ Mainly based on several German original research papers.
§ Reference intervals for the ADVIA 120 hematology analyzer from 58 healthy adult dairy Holstein cows in mid-lactation (at least 18 weeks into lactation)
and producing 50–70 pounds of milk per day from 4 herds in California.

CBC count during the past 50 years. The main findings An RBC count typically includes the total number of
included a significant increase in reference ranges for neutro- RBCs, hematocrit (HCT), hemoglobin (HGB), erythrocyte
phil counts over the study period, whereas reference inter- indices, and occasionally the red cell distribution width
vals for lymphocyte, monocyte, and eosinophil counts as (RDW). Erythrocyte indices include mean corpuscular vol-
well as hemoglobin concentration had decreased. Genetic ume (MCV), mean corpuscular hemoglobin (MCH), and
selection and decreased prevalence of bovine virus diarrhea mean corpuscular hemoglobin concentration (MCHC).7
were suggested as possible reasons for higher neutrophil In general, beef cattle breeds have higher RBC counts than
counts.16 Animals persistently infected with Bovine viral dairy cattle, bulls have greater RBC counts than cows, and
diarrhea virus (BVDV) exhibit significant neutropenia,35 nonlactating cows have higher RBC counts than lactating
thus the absence of persistently infected animals in the study cows.50 In calves, HGB, MCH, and MCHC decrease during
might have contributed to increased neutrophil numbers. The the first month and then start to increase during the first 3
reduced eosinophil count was assumed to be caused by months of life.31 In young calves, RBC counts might be
decreased exposure to parasites due to modern husbandry higher, and MCV and MCHC might be lower than in adults.9,22
and parasite control programs. The authors recommended Common indications for RBC analysis are clinical ane-
that laboratories should establish their own reference ranges mia or hemorrhage. In absolute anemia, RBCs, HGB, and/or
to reflect current cattle populations.16 HCT are decreased. Relative anemia is caused by an increase
of plasma volume (e.g., during pregnancy or after fluid ther-
Red blood cell parameters and apy). Anemia can be categorized into regenerative and non-
regenerative anemia according to the bone marrow response,
their interpretation and can also be classified with regard to the cell size (normo-
Erythrocytes have an average diameter of 5–6 μm in cattle, cytic, macrocytic, and microcytic, indicating normal,
which is small compared to other species. The key function increased, and decreased MCV, respectively) and hemoglo-
of erythrocytes is the transport of oxygen, which is bound to bin concentration (normochromic, hypochromic, and hyper-
hemoglobin. Erythropoiesis, which takes approximately 5 chromic, indicating normal, decreased, and increased HGB,
days, is stimulated by erythropoietin and occurs in the bone respectively).7,27
marrow parenchyma. Bovine erythrocytes have a relatively Causes for regenerative anemia are hemorrhage or hemo-
long life span of 130–160 days.7,50 lysis. With acute blood loss, the RBC parameters are initially
594
Roland et al.

within the reference ranges because cells and plasma are lost under hypoxic conditions, which can be of physiological
in the same proportion. Diminished RBC count and HGB (e.g., high altitude) or pathological (e.g., pulmonary or car-
can be found only after several hours, when fluid in the blood diac disorders) origin. It is also observed with renal tumors
vessels is replaced and dilutes the blood. In cattle, regenera- and cysts.7,22,27 A bovine hereditary polycythemia is known
tion of erythrocytes begins after approximately 2 days, and in Jersey and Hereford cattle.19
takes weeks to be fully accomplished. In chronic hemor- The RDW is the coefficient of variation of the RBC vol-
rhage, RBC count, HCT, and HGB are decreased while retic- ume distribution and is a measure of anisocytosis.7 The RDW
ulocytes as well as MCV are increased. In ruminants, only a can be presented as a diagram with the cell volume on the
moderate rise in reticulocytes is observed in responding ane- x-axis and the number of cells on the y-axis. The presence of
mia. If regenerative capacity is depleted, chronic bleeding macrocytosis or microcytosis results in abnormal peaks and
anemia can become nonregenerative.7 Causes for hemor- a wider distribution. In healthy calves, MCV is decreased,
rhage include trauma, abomasal ulcers, hemorrhagic enteri- resulting in a wider RDW. Further examples of conditions
tis, vena cava syndrome, blood-sucking parasites (e.g., associated with an increased RDW include iron deficiency,
Haemonchus spp., lice, or ticks), hemostasis defects, and or other trace mineral deficiencies associated with macro-
vessel erosion or rupture. Hemolytic anemia is caused cytic or microcytic anemia.4,9,24,27
by blood parasites, toxins, electrolyte imbalances, hypoos- The small size of ruminant erythrocytes might cause
molality,7,19,22 or autoimmune reactions.40 In cattle, common falsely low results for RBC counts if automated analyzers are
causes for hemolysis include unsuitable food and toxic not calibrated correctly for cattle. Erroneous results for RBC
plants, such as cabbage (Brassica spp.), onions (Allium parameters and indices might also occur due to in vitro
cepa), rye grass (Lolium spp.), or red maple (Acer hemolysis or inadequate blood sample–to–anticoagulant
rubrum).2,7,19,21,50 Microorganisms infecting ruminant RBCs ratio, which might cause erythrocyte shrinkage or dilution.22
include rickettsia (Anaplasma marginale),1,20,26 protozoa
(Babesia spp., Theileria spp., Trypanosoma spp., and Sarco- White blood cell parameters and
cystis spp.),1,7,20,22,34,53 or bacteria (Mycoplasma wenyonii,
Leptospira spp., and Clostridium spp.).1,22,37 Further factors
their interpretation
are copper deficiency or chronic copper intoxication,22,30,50 White blood cells (WBCs) or leukocytes play an essential
hypophosphatemia (postparturient hemoglobinuria),7,19,29 role in immune defense, and include different subpopula-
and water intoxication.19,27,41 tions: neutrophil, eosinophil, and basophil granulocytes,
Nonregenerative anemia generally occurs in the follow- monocytes, and lymphocytes. Leukocytes are produced and
ing combinations: normochromic and normocytic, normo- mature in the bone marrow, and, in the case of lymphocytes,
chromic and macrocytic, or hypochromic and microcytic.7,27 in the lymphoid tissues. The number of leukocytes in the
Normochromic, normocytic anemia is seen in nonspecific blood constitutes only a small percentage of the total popula-
disease, especially during chronic inflammation. It is also tion and undergoes wide fluctuation. In the vasculature, a
observed in connection with erythropoietin deficiency due to marginal pool and a circulatory pool of neutrophils are dif-
chronic renal disease or endocrine disorders, as well as bone ferentiated. The marginal neutrophils are attached to the
marrow depression, certain drugs (e.g., estrogen, chloram- endothelial cells, but detach and join the circulatory pool if
phenicol, or cytotoxic cancer medication), toxins (e.g., lead blood pressure rises and the blood flow velocity increases.
poisoning), abscesses, and neoplasia.7,15,22 Normochromic, Therefore, every change in blood pressure can result in a
macrocytic anemia occurs with deficiencies in vitamin B12, change in the amount of leukocytes present in the blood.27,48
folic acid, or cobalt.7,19 It is also found in polled Hereford A complete WBC count is composed of the total number
dyserythropoietic anemia, a congenital anemia accompanied of leukocytes, the relative differential blood count, and the
by dyskeratosis and progressive alopecia.49 Hypochromic, absolute differential blood count. Usually, the different sub-
microcytic anemia is commonly caused by iron deficiency as populations, as well as band and segmented neutrophils can
observed during chronic hemorrhage or in calves raised be distinguished.27,50
solely on milk,19,22 but microcytes are also observed in cop- In cattle, the total number of WBCs decreases with age.19
per deficiency, pyridoxine deficiency, or lead toxicosis.7 Lymphocytes are the dominant subpopulation, but the lym-
The term polycythemia is used to describe increased RBC, phocyte proportion varies with age. The newborn calf has
HCT, and/or HGB. Relative and absolute polycythemia are more granulocytes than lymphocytes.22,50 During the first
differentiated. Relative polycythemia is triggered by a reduc- month of life, calves exhibit a decrease in the overall number
tion in plasma volume in dehydrated individuals or by splenic of WBCs, neutrophils, and lymphocytes, followed by an
contraction. Absolute polycythemia is caused by an increased increase thereafter.31 Within approximately 3 months, the
number of erythrocytes. Primary polycythemia or polycythe- lymphocyte percentage increases up to 80% of the total cir-
mia vera is a myeloproliferative disorder resulting from culating WBC population. In the adult, the lymphocyte con-
autonomous stem cell proliferation. Secondary polycythemia centration decreases progressively but remains the dominant
is triggered by increased erythropoietin production. It occurs cell type. The neutrophil-to-lymphocyte ratio in adult cattle
Hematology as a diagnostic tool in bovine medicine 595

is approximately 1:2, which is low compared to other domes- monly observed with acute purulent processes, such as endo-
tic animals.22,46,50 Eosinophils are below adult reference metritis or metritis, retained placenta, acute bacterial mastitis,
ranges after birth and increase with age.9,27,50 and foreign body peritonitis.19,46 Inflammatory neutrophilia
Compared with other species, cattle have a small bone is seen in viral, bacterial, protozoal, parasitic, and fungal
marrow reserve for granulocytes. This results initially in a infections.46,48 Additionally, neutrophilia is observed with
neutropenic rather than a neutrophilic reaction in an early noninfective inflammation (traumatic injuries, necrosis,
inflammatory process. Neutrophilia and a left shift might be infarction, burns, thrombosis, etc.), neoplasia, intoxication,
observed only after the speed of granulopoiesis is increased. endocrine disorders, hemorrhage, and hemolysis.27,48 In cat-
After 3–5 days, immature and mature neutrophils might tle, stress-induced neutrophilia is also associated with
rebound.19,22,46,50 Cattle neutrophil counts rarely exceed abomasal displacement, ketosis, indigestion, and dysto-
30,000 cells/μl.46,48 Neutrophil numbers decrease in the post- cia.48,51,52 Severe leukocytosis, exceeding 40,000 cells/μl and
partum period,18 and lactating cows have lower WBC counts sometimes even 100,000 cells/μl, based on a marked increase
than nonlactating cows.50 in neutrophils may be a sign of BLAD in Holstein Friesians.
Indications for a leukogram include diagnostics, general BLAD is usually diagnosed in calves, and most affected
health assessments, monitoring of a disease, or monitoring of calves die within 1 year of age.17,32,33,48
therapeutic actions. However, it is seldom possible to come to Neutropenia occurs in ruminants during the first 1 or 2
a definite diagnosis based solely on a WBC count.27 Sequen- days of severe, acute inflammation, including sepsis, masti-
tial leukograms can help establish a prognosis. The return of tis, peritonitis, metritis, enteritis, and pneumonia. It can be
the leukogram within normal limits together with clinical caused by viral (BVDV, Bluetongue virus, Border disease
improvement can be interpreted as a favorable sign, whereas virus),46 rickettsial (Anaplasma phagocytophilum,43,46
a rapid fall in leukocytes without clinical improvement is Ehrlichia ruminantium), protozoal (Theileria sp.),34,46 and
regarded as a grave prognostic sign. Guarded or poor progno- fungal infections, as well as bone marrow disease, toxins,
ses should be formulated with persisting neutropenia, a neoplasia, or idiosyncratic drug reactions.27,48
degenerative left shift, or severe persistent leukocytosis.19,22,48 Conditions commonly associated with eosinophilia
The mechanisms underlying leukocytosis include include type I (immediate)23,45 hypersensitivity reactions and
increased release from the bone marrow, decreased emigra- parasitic infection.22,27,46 Additional causes are neoplasia,
tion into the tissues, and a shift of cells from the marginal into infections, and drug reactions.48 Eosinopenia might also
the circulatory pool.48 Physiologic leukocytosis is seen in occur in the early phase of infectious diseases, uremia, and
association with stress, excitation, fear, exercise, or parturi- acute hemolysis.27 Extreme eosinopenia has been associated
tion. A stress leukogram is characterized by neutrophilia, with Theileria infections.34,46
lymphocytopenia, eosinopenia, and occasionally monocyto- Basophilia has been linked to hyperlipidemia and occasion-
sis. It is triggered by endogenous or exogenous corticosteroid ally to allergies, ulcerations,27 and parasitic infections (ticks).8,46
exposure.22,25,27,46 A short-term physiological leukocytosis is Basopenia is not commonly reported in the literature because
also observed after epinephrine release.22,46 Causes for patho- basophil reference intervals often include zero.46,48
logical leukocytosis include infectious diseases, endogenous Lymphocytosis can occur in the healing phase of infec-
or exogenous intoxication, endocrine conditions, central ner- tious diseases, during chronic antigenic stimulation due to
vous disorders, anaphylactic shock, leukemia, and bovine infectious agents, neoplasia, and hypoadrenocorticism.27,48
leukocyte adhesion deficiency (BLAD).27 Reactive lymphocytosis is observed during chronic purulent
Leukopenia is caused by decreased production, increased diseases, such as hepatitis, peritonitis, pericarditis, nephritis,
tissue demand, and consumption combined with marginal- mastitis, or bronchopneumonia.19 Bovine leukemia virus
ization. In general, it is observed in connection with viral (BLV) is the causative agent of enzootic bovine leukosis.
infections, circulatory shock, peracute inflammation, cyto- Infection with BLV results in a persistent lymphocytosis
toxic substances, as well as hematopoietic stem cell disor- driven by an increase in B cells with abnormal lymphocyte
ders and bone marrow atrophy.27 In cattle, leukopenia often morphology in up to 30% of affected cattle. Only a small
occurs with metabolic disorders, liver disease, and infectious percentage of animals with lymphocytosis develop bovine
diseases (e.g., mucosal disease, paratuberculosis, or salmo- lymphoma. In some cases, WBC counts may exceed 100,000
nellosis). Panleukopenia, a depression of all WBC subpopu- cells/μl.3,12,22
lations, is observed in viral disease (e.g., mucosal disease, Reasons for lymphocytopenia include acute stress, viral
infectious bovine rhinotracheitis), rickettsiosis, bacterial or bacterial infection, immune suppression, chronic renal
septicemia, and purulent splenitis.19 insufficiency, and application of corticosteroids.22,27 It is
The most common causes for neutrophilia are chronic also induced by loss of lymph and disruption of lymph node
inflammation and stress. Chronic inflammation has been architecture (e.g., in paratuberculosis, inflammation, or
reported among other infections of the udder, urogenital neoplasia).48
tract, gastrointestinal tract, liver, respiratory tract, heart, and Monocyte numbers are variable in cattle and are thus not
central nervous system. In bovines, neutrophilia is also com- a sensible indicator for a specific disease.22 Monocytosis has
596
Roland et al.

been observed during acute stress and in the healing phase of distribution disorders (e.g., splenomegaly).6,27,38,44 Exam-
acute as well as chronic infections. It is further caused by ples for infectious diseases causing thrombocytopenia
hemolysis, hemorrhage, exudative inflammation, necrosis, include salmonellosis, leptospirosis, babesiosis, theilerio-
ulceration, and corticosteroid therapy.27,48 Monocytosis was sis,34,44 anaplasmosis,43 and BVDV infection.6,10,36,44 Exam-
also found to be a successful marker of bacteremia and bac- ples for toxins leading to platelet destruction are bracken
terial endocarditis48 as well as puerperal infections.19 Mono- fern (Pteridium aquilinum), mycotoxins (trichothecene),
cytopenia may be associated with endotoxemia,46 viremia, black fly (Simuliidae spp.) toxin, and coumarin rodenti-
and inflammation,22 but has so far not been proven to have cides.19,44 Thrombocytopenia associated with leukopenia
much clinical relevance.48 and bone marrow depletion is observed in bovine neonatal
With automated cell counters, falsely low WBC counts pancytopenia, a hemorrhagic disease of newborn calves
might occur due to clumping of leukocytes, and falsely high observed since 2006, which is thought to be linked to an
WBC counts might be caused by nucleated red blood cells, inactivated vaccine against BVDV in dams.11,14
insufficient lysis of erythrocytes, excessive Heinz bodies, or Enlarged platelets are associated with accelerated produc-
clumping of platelets.48 tion as well as myeloproliferative disorders and hyperthy-
roidism.38 Decreased MPV or platelet fragments are observed
Platelet parameters and in iron-deficiency anemia, bone marrow failure, and immune-
mediated thrombocytopenia.6
their interpretation Automated cell counters should be calibrated adequately
Platelets are anuclear cytoplasmic fragments of megakaryo- to account for the small size of bovine platelets. Falsely ele-
cytes, and play an essential role in hemostasis.6,38 With an vated platelet counts might be flagged if fragmented RBCs
average mean platelet volume (MPV) of 4.0–4.8 femtoliters, or WBCs are erroneously counted as platelets by an auto-
bovine platelets are small compared to those of other spe- mated analyzer.42 Platelet clumping might be a reason for
cies.5 Up to 30–40% of platelets are sequestered in the spleen indication of thrombocytopenia in automated cell counters.
and enter circulation in response to epinephrine release. Platelet clumping can result from exposure to EDTA exceed-
Thrombocytes are also stored in the liver and bone mar- ing 4–6 hr or from use of heparin as an anticoagulant.22,44
row.6,38 Bovine platelets survive up to 10 days in peripheral Storage of blood in EDTA tubes over 4 hr at room tempera-
blood.50 In intact blood vessels, platelets circulate predomi- ture or refrigerated might cause platelet swelling, resulting in
nantly in the marginal pool.27 The total number of platelets is falsely increased MPV. Storage over 24 hr can result in frag-
influenced by the amount of production, consumption, mentation of platelets.6,38
sequestration, and loss.6,38
Platelet numbers increase significantly during the first 2
weeks of age and more slowly thereafter during the first 3 Conclusions
months. Platelet counts in calves might be within31 or above Physiological and pathological characteristics of the bovine
adult reference intervals.9 The following parameters can be hemogram were discussed. The results of a CBC count are
estimated: total number of platelets, MPV, thrombocrit or often helpful in the diagnosis, monitoring, and prognosis of
plateletcrit, and platelet distribution width.6,38 a disease. If automated cell counters are used to obtain a
In practice, a count of platelets might be indicated with CBC count, results should be interpreted with care to avoid
severe hemorrhage or increased bleeding tendency. This false-positive or false-negative outcomes. If in doubt, a
includes clinical signs such as petechia, ecchymosis, hema- manual microscopic evaluation of the blood sample should
turia, epistaxis, melena, hematemesis, and hyphema.38,44 be carried out. In cattle, changes in the CBC count, espe-
Thrombocytosis occurs physiologically as a consequence cially in the leukogram, might not be as pronounced as in
of epinephrine-induced splenic contraction. Essential or pri- other species even during severe illness. Therefore, a diag-
mary thrombocytosis is an uncommon myeloproliferative nosis or prognosis should not be based on hematologic
condition. Reactive or secondary thrombocytosis is triggered results solely, but should also take findings from the clinical
by cytokine release and is observed in connection with stress, examination or other diagnostic procedures into consider-
chronic blood loss, inflammation, neoplasia, or iron defi- ation.19
ciency. Enhanced thrombopoiesis is also seen with inherited
megakaryocyte disorders.6,42 An increased platelet count
Declaration of conflicting interests
might be associated with an increased risk for thrombosis.6,27
Thrombocytopenia is found in excessive consumption The author(s) declared no potential conflicts of interest with respect
(e.g., with blood loss, disseminated intravascular coagula- to the research, authorship, and/or publication of this article.
tion, or thrombocytopenic thrombotic purpura), decreased
platelet production (e.g., in myelophthisis or bone marrow Funding
hypoplasia linked to toxins), destruction (e.g., due to infec- The author(s) received no financial support for the research, author-
tions, toxins, drugs, neoplasia, or immune-mediated), or ship, and/or publication of this article.
Hematology as a diagnostic tool in bovine medicine 597

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