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Today's VeTerinary PracTice | July/august 2015 | tvpjournal.com consider This case Peer reviewed 52 CASE REPORT 1: ANSwER The presence of nucleated red blood cells is causing an erroneously elevated total white blood cell count by the hematology analyzer (Table 1, page 50); Table 4 provides a corrected cBc. Without blood flm review, this patient would be erroneously diagnosed with an infammatory leukogram, with the signifcant numbers of metarubricytes unidentifed because they were interpreted as leukocytes by the analyzer. Ultimately, the cause of the metarubricytosis and nonregenerative anemia could not be identifed, but the patient responded to immunosuppression, with resolution of both anemia and metarubricytosis. CASE REPORT 2: ANSwER a neutrophil (arrow) and eosinophil (arrowhead) are characterized by Pelger- huët anomaly, a heritable disorder that results in hyposegmentation of granulocytes. The absence of toxic change helps distinguish this anomaly from a left shift associated with an infammatory leukogram. Pelger- huët anomaly is common in australian shepherds. note that the quantitative data are not impacted by this change, which is not detected by automated analyzers. CASE REPORT 3: ANSwER Two macroplatelets (arrows) are approximately the same size as erythrocytes. english toy spaniels are a breed affected by congenital macrothrombocytopenia, which is not associated with hemostatic abnormalities. Therefore, in breeds predisposed to congenital macrothrombocytopenia, this diagnosis should be considered in asymptomatic dogs with persistent macrothrombocytopenia. congenital macrothrombocytopenia must be distinguished from immune-mediated thrombocytopenia by repeated hematologic evaluation, monitoring for clinical signs, and/or genetic testing. in this patient, artifactual thrombocytopenia was excluded by evaluation of the tube and blood flm for evidence of platelet clumping. an Mri was completed and revealed no abnormalities leading to a fnal diagnosis of idiopathic vestibular ataxia. cBc = complete blood count; rBc = red blood cell; WBc = white blood cell; WnL = within normal limits Table 4. Corrected Complete Blood Count results VariaBLE rEsuLts rEFErEnCE rangE ConCLusion White blood cells (×10 3 /uL) 7.45 3.88–14.57 WNL Segmented neutrophils (×10 3 /uL) 5.89 2.1–11.2 WNL Lymphocytes (×10 3 /uL) 0.37 0.78–3.36 Decreased Monocytes (×10 3 /uL) 0.37 0–1.2 WNL Eosinophils (×10 3 /uL) 0.82 0–1.2 WNL Basophils (×10 3 /uL) 0 0–0.13 WNL Nucleated RBCs (/100 WBCs) 277 0–1 Increased