Interpretation of cerebrospinal fluid analysis from recumbent cows using different thresholds of red blood cell count

Abstract

Background Hemodilution of the cerebrospinal fluid (CSF) could confound interpretation of results. Accurately predicting total nucleated cells count (TNCC) and total protein concentration (TPC) attributable to hemodilution is difficult. Objective To determine the effects of hemodilution on TPC and TNCC in bovine CSF. Methods Retrospective review of CSF analysis results of downer dairy cows treated at Centre hospitalier universitaire vétérinaire between January 2006 and December 2014. Descriptive statistics were performed using 3 scenarios. Results Among the 235 samples included, red blood cell (RBC) count (RBCC) ranged from 0 to 869 220 RBC/μL (median = 6.6), TPC ranged from 0.04 to 6.51 g/L (median = 0.27), and TNCC ranged from 0 to 7500 cell/μL (median = 1.1). Among the 157 samples that had <30 RBC/μL (a threshold used in other species), TPC and TNCC varied between 0.13 and 1.06 g/L (median = 0.27) and between 0 and 31.4 cell/μL (median = 0.6), respectively. Eighty‐four samples had TPC <0.25 g/L and TNCC ≤4.5 cell/μL. Among those 84 samples, RBCC varied between 0 and 1290 RBC/μL (median = 4.7). In 20 samples, TNCC was 0 with a variation in RBCC between 0 and 840 RBC/μL (median = 3.9). No strong correlations between RBCC and TNCC and TPC were found. Conclusions A cutoff around 200 RBC/μL is proposed as clinically meaninful in bovine CSF. Results between 200 and 1290 RBC/μL are equivocal.

Comparison of atlantoaxial and lumbosacral cerebrospinal fluid centesis techniques in South American camelids

“…A normal CSF sample is free of red blood cells (RBC) 3 . The presence of RBC can indicate CNS trauma, but is more commonly caused by iatrogenic blood contamination 4,5 . The diagnostic usefulness of a CSF sample can be limited by blood contamination causing artifactual increases in the total protein concentration (TPC) and total nucleated cell counts (TNCC) 5,6 .…”

“… 3 The presence of RBC can indicate CNS trauma, but is more commonly caused by iatrogenic blood contamination. 4 , 5 The diagnostic usefulness of a CSF sample can be limited by blood contamination causing artifactual increases in the total protein concentration (TPC) and total nucleated cell counts (TNCC). 5 , 6 Currently, CSF centeses in South American camelids (SAC) and other farm animal species are performed either at the atlantooccipital (AO) space or the lumbosacral (LS) space.…”

“… 4 , 5 The diagnostic usefulness of a CSF sample can be limited by blood contamination causing artifactual increases in the total protein concentration (TPC) and total nucleated cell counts (TNCC). 5 , 6 Currently, CSF centeses in South American camelids (SAC) and other farm animal species are performed either at the atlantooccipital (AO) space or the lumbosacral (LS) space. 7 , 8 Centesis at the AO space has greater risks in comparison with LS centesis, because of needle placement close to the brainstem, requiring the animal to be under general anesthesia.…”