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| ===Platelet Number=== | | ===Platelet Number=== |
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− | Platelet numbers may be rapidly estimated by examination of a stained bloof smear, of quatnifies by manual counting techniques or automated haematology analysers. To estimate the platlet number using a blood smear, the average number of platelets in twn oil-immersion fields should be counted and the mean multiplied by 15. | + | A platelet count can give valuable information in all critically ill animals and is an essential laboratory tests for patients with bleeding concerns. Platelet numbers may be rapidly estimated by examination of a stained blood smear, of quantified by manual or automated counting techniques. To estimate the platlet number using a blood smear, the slide should first be scanned for evidence of clumping that would artificially reduce the count. The average number of platelets in ten oil-immersion fields should be counted, and a mean calculated. Each platelet in a high-power field represents 15,000 platelets per microlitre<sup>2</sup>. A "normal" platelet count therefore gives aroung 10-15 platelets per oil-immersion field. |
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− | The reference range given for platelet number is usually around 200-500x10<sup>9</sup>/l, although this varies depending on the laboratory used. Clinical signs due to thrombocytopenia are not commonly encountered until the platelet count drops below 50X10<sup>9</sup>/l, and spontaneous bleeding only occurs with counts lower than 20X10<sup>9</sup>/l. These cut-offs are lowered if platelet function is concurrently affected, for example by the use of non-steroidal anti-inflammatory drugs. | + | The reference range given for platelet number is usually around 200-500x10<sup>9</sup> per litre, although this varies depending on the laboratory used. Clinical signs due to thrombocytopenia are not commonly encountered until the platelet count drops below 50X10<sup>9</sup>/l, when increased bleeding times may be seen. Haemorrhage during surgery becomes a concern with counts lower than 20X10<sup>9</sup>/l, and spotaneous bleeding arises when platelets are fewer than 5X10<sup>9</sup>/l<sup>2</sup>. These cut-offs are lowered if platelet function is concurrently affected, for example by the use of non-steroidal anti-inflammatory drugs. |
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− | The platelet count is part of a routine coagulation profile or work-up for clotting abnormalities. It is also useful in the assessment of bleeding disorders occurind due to thrombocytopenia, uremia, liver disease or malignancies, and for monitoring the course of disease associated with bone marrow failure<sup>1</sup>.
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− | A platelet count is recommended in the evaluation of all critically ill animals and is vital for patients with bleeding
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− | concerns. A platelet count can be obtained from an automated machine but an estimate of the platelet count can
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− | be made at the bedside from a blood smear. The entire slide should first be scanned for evidence of platelet
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− | clumping that will artificially reduce the platelet count. The number of platelets in several high power fields should
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− | then be counted and an average calculated. There should be 10-15 platelets visible in one high power field (1000
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− | x magnification with oil immersion). One platelet per high power field represents approximately 15,000 platelets
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− | per microliter.
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− | A normal platelet count is considered to be in the range of 200 – 500,000 and less than 150,000 is generally
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− | considered as thrombocytopenia. Platelet counts less than 50,000 can be associated with increased bleeding
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− | times (see below), platelet counts less than 20,000 may cause clinically concerning bleeding for surgical
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− | procedures and platelet counts less than 5,000 are associated with spontaneous bleeding events. As a guideline
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− | if there are > 5 platelets present per high power field bleeding is most likely not due to thrombocytopenia alone.
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− | Platelet counts are susceptible to falsely low measurements as a result of blood collection and equipment error.
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− | For this reason the diagnosis of thrombocytopenia should always be confirmed prior to initiating major therapy.
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| ===Buccal Mucosal Bleeding Time=== | | ===Buccal Mucosal Bleeding Time=== |