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. 2023 Mar;37(2):484-489.
doi: 10.1111/jvim.16641. Epub 2023 Feb 10.

Clinical utility of immature reticulocyte fraction for identifying early red blood cell regeneration in anemic dogs

Jae-Ha Jung  1   2 , Yeseul Yang  1 , Dansong Seo  1 , Soyeon Cho  1   2 , Goeun Choi  1 , Yongbaek Kim  1   3
Affiliations

Clinical utility of immature reticulocyte fraction for identifying early red blood cell regeneration in anemic dogs

Jae-Ha Jung et al. J Vet Intern Med. 2023 Mar.

Abstract

Background: Evaluating regeneration is essential for the classification and differential diagnosis of anemia in dogs. Early detection of regeneration is challenging in anemic dogs.

Objectives: This study assessed the value of immature reticulocyte fraction (IRF) in differentiating preregenerative anemia (PRA) from nonregenerative anemia (NRA) in dogs.

Animals: Ninety-four dogs: 49 controls and 45 with anemia.

Methods: Case-control study. Fractions of low-, medium- (MFR), and high-fluorescence reticulocytes (HFR), were measured using the ADVIA 2120i hematology analyzer. The IRF was calculated as the sum of percentages of MFR and HFR. Data from dogs with regenerative anemia (RA, n = 19), PRA (n = 11), and NRA (n = 15) were retrospectively analyzed. The value of IRF was compared with reticulocyte production index (RPI) using the receiver operating characteristic (ROC) curve.

Results: The median of IRF was significantly higher in dogs with RA (46.5%; range, 40.9-53.6%; P < .001) and PRA (40.6%; range, 27.7-47.1%; P = .01) than in controls (22.1%; range, 16.9-29.3%). The IRF in dogs with PRA showed no difference compared to dogs with RA (P > .99) but was higher than dogs with NRA (18.7%; range, 8.8-24%; P = .00). The area under the ROC curve of IRF was superior to that of RPI (0.897 vs 0.818, P = .00) in differentiating dogs with PRA from NRA.

Conclusions and clinical importance: The IRF is a reliable variable for detecting early regeneration in anemic dogs without reticulocytosis. The study suggests that the measurement of IRF could be useful in classifying anemic dogs.

Keywords: anemia; complete blood count; hematopoiesis; reticulocytes.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram of case enrollment in the study.
FIGURE 2
FIGURE 2
Box and whisker plot of (A) automated reticulocyte concentration (ARC) and (B) immature reticulocyte fraction (IRF) values in 49 healthy dogs (control) and 45 anemic dogs grouped by regeneration status: regenerative anemia (RA, n = 19), preregenerative anemia (PRA, n = 11), and nonregenerative anemia (NRA, n = 15). The data were analyzed by the first CBC results at the first time of presentation of anemia. The box represents the first and third quartiles, the middle line represents the median, and the whiskers represent the 5%‐95% range. Black crosses denote mean values. *P = .01; **P = .001; ***P < .001.
FIGURE 3
FIGURE 3
Receiver operating characteristic curve of the immature reticulocyte fraction (IRF) and reticulocyte production index (RPI) in differentiating dogs with preregenerative anemia from those with nonregenerative anemia.
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