Are hematology innovations on your radar?

By Eric Morissette, DVM, DACVP

In the late '90s, veterinary diagnostic medicine was said to have taken on a broader meaning, leading to an entirely new perspective on viewing laboratory tests and interpreting results.¹ Naturally, technology evolves, but to say veterinary medicine has changed drastically since then would be an understatement—doing the industry's innovators a disservice.

Decades on, a wide range of diagnostic tools are available to leverage, boasting advanced technology, such as digital imaging and AI-driven blood tests–with hematology analyzers representing a significant leap in diagnostic accuracy and efficiency.

Evolving from manual blood counts to automated three-part and five-part analyzers, hematology and the complete blood count (CBC) have long been essential and established diagnostic tools in veterinary medicine.

Notably, recent technological advances have made in-house equipment more accessible and effective, setting a new benchmark for diagnostic precision. What's more, these innovations emerge as valuable instruments in the push to tackle the growing disparity between demand for veterinary services and limited staff availability.²

With the shift away from curative medicine and towards preventive practice, advancements in hematology better equip and empower the modern clinic–offering benefits across the board.

The present-day analyzer

When it comes to veterinary medicine, few tools are as important as diagnostic tests, with hematology a vital part of the diagnostic protocol.^3,4 Today's hematology analyzers typically have the capabilities for:

• Multi-parameter analysis
• Integrated software for data interpretation
• Reticulocyte counts
• Measurement of cell volume distributions
• Assessment of cell morphology

With the advent of more powerful hematology technology and its introduction into veterinary practices–and more specifically, its role in routine check-ups–we can elevate patient care, allowing veterinarians and veterinary technicians quicker access to CBC results, and enabling fast and accurate results. In turn, hematology has the potential to facilitate cost savings, convenience, and confidence in the clinic, giving practitioners more informed diagnoses with significantly less technical time and effort required.^4,5

Beyond addressing limited in-clinic time and resources, and improving patient care, advanced hematology capabilities can also have positive knock-on effects on staff well-being and customer satisfaction.

It's all in the data

Encompassing some of the most important–and commonly performed–tests in veterinary diagnostics, hematology analyzers are broadly categorized into two types: those offering quantitative data, and those delivering qualitative data. Both data types are important and can serve to significantly enhance the quality of care provided to animal patients; however, modern technology really shines when the two are paired together.

Quantitative data
Quantitative evaluation of the blood includes a CBC–classifying, enumerating, and differentiating the number of red blood cells (RBC), white blood cells (WBC), and platelets (PLT) in a sample.^6-8 This can be performed manually or with the preferred method of using an automated analyzer; the latter providing detailed numerical data on cell counts, indices, and graphical data.^7-8,11

Dependent on analyzer type, CBC parameters can include the following:

Put more simply, the quantitative results from these parameters offer us a clearer understanding of an animal's health, aiding in the assessment of disease severity and prognosis.

Additionally, and importantly, these results allow for real-time monitoring of a patient's health over time, showing changes in their condition.⁵

Qualitative data
While quantitative data is based on measurement and numerical analysis, qualitative data identifies non-numerical information observed or surveyed. When it comes to hematology, this involves identifying characteristics–morphological and functional features–of the blood cells. This allows for the detection of conditions that may not be evident through automated CBC counts alone (unusual cell shapes, inclusions, parasites). They can involve a manual examination of blood smears under a microscope, where a trained technician at a reference laboratory, or veterinarian, can observe and identify various cell types and abnormalities. More recently, automated analyzers have been developed to offer qualitative analysis in-house.

Often referred to as a blood smear or blood film evaluation, a qualitative assessment is crucial for validating automated quantitative results, such as WBC differentials and PLT counts, as well as for detecting morphological changes in blood cells. This can help assess stress, inflammation, neoplasia, or bone marrow issues; parameters to detect anemia and erythrocytosis; and PLT parameters determine thrombocytopenia or thrombocytosis.^9-10 It can also provide useful information such as the presence of a left shift or toxic change in neutrophils, abnormal blast cells, platelet clumps (leading to falsely low platelet counts) and red cell clumps, which give clues to causes of anemia such as spherocytes, Heinz bodies or red cell parasites.⁶

To help ensure reliable diagnostics, it is important to interpret CBC results in conjunction with a well-prepared blood smear. This complementary approach enables vet staff to confirm results and assure quality, while also providing additional insights to guide diagnosis and treatment.¹⁰

Preventative practice

The saying goes prevention is better than a cure–and this is true in the realm of pet healthcare. Preventive care gives animals a greater chance of living longer, healthier lives. There are three key aspects: primary prevention (avoiding development of disease); secondary prevention (early detection of disease) and tertiary prevention (reducing the impact of disease).¹¹ Involving a multi-faceted approach, preventive care can increase the likelihood of successful outcomes, while the cost of prevention is often fractional in comparison to the treatment of an advanced disease.¹²

Typically, this care has referred to vaccination programs and physical examinations, but integrating regular diagnostic testing can be an essential component–important for monitoring animal health (primary prevention) and catching and addressing disease as early as possible (secondary prevention).

Ultimately, this strategy can lead to an improved quality of life for patients. It is also a chance for veterinary businesses to ensure economic stability–establishing profitability, building client loyalty, and driving long-term success.¹³

Continual innovations in diagnostics mean we have more tools to make maintaining health easier.¹³ Including both quantitative and qualitative assessments within the hematology workup helps vets gain a much fuller picture of an animal's health.

Embracing new tech

Recent technological advancements have significantly enhanced the availability and efficiency of in-house automated analyzers in primary care settings, enabling veterinarians to swiftly access CBC results for informed clinical decision-making. Most of these analyzers utilize flow cytometry or electrical impedance methods, which generally provide reliable CBC data.⁴

Nevertheless, accurate interpretation requires caution, as factors such as lipemia, hemolysis, and the presence of atypical white blood cells can affect result accuracy. To ensure reliable diagnostics, it is important to interpret CBC results in conjunction with a well-prepared blood smear.³

What's more, increased connectivity in veterinary medicine, such as with practice management software, digital records, clinical details, virtual communication pathways with experts, and the advent of big data and AI, means we can access and analyze data sets in the tens or hundreds of thousands.13 With greater precision and speed than ever before, advanced analyzers can connect veterinarians with detailed AI-powered assessments and results, or even a board-certified expert for a second opinion – all from the comfort of their practice.

However, for clinics to retain a competitive edge and align with customer demand, there is a pressing need for standard diagnostic tools to integrate the latest advancements in technology–particularly AI and machine vision algorithms.

Yet, keeping pace with the rapid development of these technologies can, in some cases, require a significant investment of time and resources, particularly in implementing new workflows, meeting equipment maintenance requirements and if training is required. In a profession where time is already at a premium and workloads are heavy, fast processing and time-saving technologies are critical to smoothing the transition and maintaining high standards of patient care.

Communicating value

The increased humanization of pets and the strengthening human-animal bond means today's pet owners expect the same health care for their pets as they do for themselves, providing opportunity to further integrate valuable routine screenings.² The good news is that younger generations appear to be more open to a preventive approach, with millennials in the U.S. expressing a greater interest in preventive care products and services than older generations.¹³

That said, barriers to adoption are expected, with diagnostics ranking lower in importance to exams and vaccines in a 2022 study of pet owners in the U.S., the UK, Italy, and Australia.¹⁴ The rising cost of care is one such barrier,² leading some pet owners to express skepticism about which treatments are deemed a financial necessity.

Communicating the value of diagnostic screenings—particularly hematology assessments—is key for clinics looking to improve efficiency, patient outcomes and pet owner satisfaction. Analyzers providing fast and conclusive results not only save valuable time for veterinary teams, but for the pet owner, as well. With information available in minutes, abnormal readings are detected earlier than ever, and, in some cases, treatment can commence almost immediately.

By embracing the latest diagnostic technology, clinics can continue to provide the best possible care–even when challenged with workforce complexities and increased demand. Specifically, when looking to AI, we can expect to see its integration widen across various diagnostic tools, treatment planning systems, and routine veterinary procedures, enhancing the efficiency and quality of care. Notably, a survey of U.S. veterinarian professionals found of those who used AI technology, 46.1 percent considered increased efficiency in treatment and diagnosis to be a top perceived benefit of AI.¹⁵

Hematology analyzers that utilize machine learning and complex algorithms will be instrumental to the changing landscape of veterinary care. Those who adopt and embrace the latest technology help to alleviate shared challenges of the industry, position themselves as trusted innovators and, most importantly, enhance the lives of animals.

Eric Morissette, DVM, DACVP, has extensive expertise in assay development and clinical pathology consultation. He leads innovation at Zoetis Global Diagnostics, where he focuses on advanced AI applications within the Imagyst and other AI platforms, driving advancements in veterinary diagnostics and shaping the future of veterinary medicine. Dr. Morissette is a board-certified veterinary clinical pathologist.

References

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15. Global Pet Industry. 2023. Almost 40% of vets are using AI tools to gain a competitive edge. https://globalpetindustry.com/article/almost-40-of-vets-are-using-ai-tools-to-gain-a-competitive-edge