Snarveier


IDEXX Hematology

Interpreting dot plots

4 easy steps to interpret dot plots and take your CBC interpretation to the next level

Download the ProCyte Dx guide

Numerical results are only part of the story

Dot plots provide a critical snapshot of cellular morphology and are intended to enhance the numerical results. Normal dot plots provide confidence in normal numeric CBC results. Abnormal dot plots provide insight into abnormal results; when combined with normal numerical results, abnormal dot plots may be your only indication of underlying illness. When you’re reviewing your patient’s dot plots, follow these 4 steps to determine if the dot plot results are normal or abnormal:
 

Step 1: Compare the dot plot provided with your results to a normal dot plot

When reviewing dot plots, it’s helpful to review them alongside a normal dot plot, available in VetConnect PLUS. 

Tip: Want more normal examples than what’s shown here? The Interpreting IDEXX ProCyte Dx Hematology Analyzer Dot Plots guide is a great resource for both normal and abnormal examples of canine, feline, and equine dot plots.

Interpreting IDEXX ProCyte Dx Hematology Analyzer Dot Plots

To compare your dot plot to a normal dot plot in VetConnect PLUS:

Screenshot of patient record in VetConnect PLUS.
  1. Open the patient record, and if multiple dates are displayed, select the date for the ProCyte Dx result.
Screenshot of dot plot in VetConnect PLUS.
  1. Click the dot plot image (you may need to scroll).
  1. Click the i in the top right to see a normal dot plot for comparison.

Step 2: Look for separations in the cell populations

Crowded cell populations can be caused by sample quality issues (such 
as clumping or hemolysis) or morphologic changes in the cells.

Dot plots enable critical evaluation of the reported CBC, turning a laborious manual differential to a visual snapshot.

  1. Good separation of red blood cell and platelet populations. Clear divide between cell populations.
  2. Not a clear divide between monocytes and lymphocytes as well as lymphocytes and basophils.
RBC dot plots

Normal canine dot plot
 

Size →
Procyte Dx RBC dot plot showing normal separation of cell populations.

Fluorescence →

Sparky, 9-year-old, neutered male Yorkshire terrier mix

Size →

Fluorescence →

Red blood cells Platelets White blood cells
Reticulocytes RBC fragments
WBC dot plots

Normal canine dot plot
 

Fluorescence →

Procyte Dx WBC dot plot showing normal separation of cell populations. Granularity →

Sparky, 9-year-old, neutered male Yorkshire terrier mix

Fluorescence →

Granularity →

Neutrophils Monocytes uRBC
Lymphocytes Eosinophils Basophils

Step 3: Look for changes in the density of the cell populations

Are there changes in the quantity of reticulocytes and/or platelets? Are the different WBC populations increased or decreased? Are there clumped platelets?

  1. Decreased platelet density (may indicate thrombocytopenia). 
  2. No reticulocyte present. 
  3. Increased density of basophils. 
  4. Decreased density of eosinophils. 
  5. Presence of clumped platelets on the WBC dot plot may explain thrombocytopenia.
RBC dot plots

Normal canine dot plot
 

Size →
Procyte Dx RBC dot plot showing normal separation of cell populations.

Fluorescence →

Sparky, 9-year-old, neutered male Yorkshire terrier mix

Size →

Fluorescence →

Red blood cells Platelets White blood cells
Reticulocytes RBC fragments
WBC dot plots

Normal canine dot plot
 

Fluorescence →

Procyte Dx WBC dot plot showing normal separation of cell populations. Granularity →

Sparky, 9-year-old, neutered male Yorkshire terrier mix

Fluorescence →

Granularity →

Neutrophils Monocytes uRBC
Lymphocytes Eosinophils Basophils

Step 4: Look for changes in the shape and location of the cells

Changes in the shape and location of cell populations may indicate changes in cell morphology that might not be evident in the numeric results. Don't overlook important clues provided in the dot plots!

  1. Elongation in red blood cells population suggests wider variation in RBC size (anisocytosis). 
  2. Abnormal position of basophils population, where it is moving upward into the lymphocytes population.
RBC dot plots

Normal canine dot plot
 

Size →
Procyte Dx RBC dot plot showing normal separation of cell populations.

Fluorescence →

Sparky, 9-year-old, neutered male Yorkshire terrier mix

Size →

Fluorescence →

Red blood cells Platelets White blood cells
Reticulocytes RBC fragments
WBC dot plots

Normal canine dot plot
 

Fluorescence →

Procyte Dx WBC dot plot showing normal separation of cell populations. Granularity →

Sparky, 9-year-old, neutered male Yorkshire terrier mix

Fluorescence →

Granularity →

Neutrophils Monocytes uRBC
Lymphocytes Eosinophils Basophils

Dot plots assist in confirmation of the numerical values of the CBC and provide insight into, and the direct assessment of, blood morphology. In this case, Sparky was newly diagnosed with diabetes mellitus and pancreatitis. Dot plots from Sparky were critical to prompting a blood film review to understand the numerical CBC findings and clinical picture, which led to a quicker diagnosis and treatment.

4 easy steps to interpret dot plots and take your CBC interpretation to the next level

Download the ProCyte One guide

Numerical results are only part of the story

Dot plots provide a critical snapshot of cellular morphology and are intended to enhance the numerical results. Normal dot plots provide confidence in normal numeric CBC results. Abnormal dot plots provide insight into abnormal results; when combined with normal numerical results, abnormal dot plots may be your only indication of underlying illness. When you’re reviewing your patient’s dot plots, follow these 4 steps to determine if the dot plot results are normal or abnormal:

Step 1: Compare the dot plot provided with your results to a normal dot plot

When reviewing dot plots, it’s helpful to review them alongside a normal dot plot, available in VetConnect PLUS. 

Tip: Want more normal examples than what’s shown here? The interpretation guides, Interpreting ProCyte One Dot Plots and Interpreting ProCyte One Equine Dot Plots, that you received with your analyzer are great resources for both normal and abnormal examples of canine, feline, and equine dot plots.

Interpreting ProCyte One dot plots

Interpreting ProCyte One equine dot plots

To compare your dot plot to a normal dot plot in VetConnect PLUS:

Screenshot of patient record in VetConnect PLUS.
  1. Open the patient record, and if multiple dates are displayed, select the date for the ProCyte One result.
Screenshot of Procyte One dot plot in VetConnect PLUS patient record.
  1. Click the dot plot image (you may need to scroll).
Screenshot of VetConnect PLUS procyte one dot plot comparison.
  1. Click the i in the top right to see a normal dot plot for comparison.

Step 2: Look for separations in the cell populations

Crowded cell populations can be caused by sample quality issues (such as clumping or hemolysis) or morphologic changes in the cells.

Dot plots enable critical evaluation of the reported CBC, turning a laborious manual differential to a visual snapshot.

  1. Good separation of red blood cell and platelet populations.
  2. Mild crowding between monocyte and neutrophil populations 
(should inform interpretation of numerical results).
RBC dot plots

Normal canine dot plot
 

Size →

Fluorescence →

Skittle, 11-year-old, neutered male Yorkshire terrier

Size →

Fluorescence →

Red blood cells Platelets White blood cells
Reticulocytes RBC fragments
WBC dot plots

Normal canine dot plot
 

Fluorescence →

Granularity →

Skittle, 11-year-old, neutered male Yorkshire terrier

Fluorescence →

Granularity →

Neutrophils Monocytes Clumped platelets
Lymphocytes Eosinophils Basophils

Step 3: Look for changes in the density of the cell populations

Are there changes in the quantity of reticulocytes and/or platelets? Are the different WBC populations increased or decreased? Are there clumped platelets?

  1. Increased density of reticulocytes (indicates reticulocytosis). 
  2. Decreased platelet density (may indicate thrombocytopenia).
  3. Indication of the presence of clumped platelets. This may explain the 
apparent thrombocytopenia. 
  4. Increased density of monocytes (may indicate monocytosis). 
  5. Decreased density of lymphocytes (indicates lymphopenia and suggests inflammation or stress leukogram). 
RBC dot plots

Normal canine dot plot
 

Size →

Fluorescence →

Skittle, 11-year-old, neutered male Yorkshire terrier

Size →

Fluorescence →

Red blood cells Platelets White blood cells
Reticulocytes RBC fragments
WBC dot plots

Normal canine dot plot
 

Fluorescence →

Granularity →

Skittle, 11-year-old, neutered male Yorkshire terrier

Fluorescence →

Granularity →

Neutrophils Monocytes Clumped platelets
Lymphocytes Eosinophils Basophils

Step 4: Look for changes in the shape and location of the cells

Changes in the shape and location of cell populations may indicate changes in cell morphology that might not be evident in the numeric results. Don't overlook important clues provided in the dot plots!

  1. No change in shape or location of RBC populations.
  2. Neutrophil population shifted left (may indicate inflammation).
RBC dot plots

Normal canine dot plot
 

Size →

Fluorescence →

Skittle, 11-year-old, neutered male Yorkshire terrier

Size →

Fluorescence →

Red blood cells Platelets White blood cells
Reticulocytes RBC fragments
WBC dot plots

Normal canine dot plot
 

Fluorescence →

Granularity →

Skittle, 11-year-old, neutered male Yorkshire terrier

Fluorescence →

Granularity →

Neutrophils Monocytes Clumped platelets
Lymphocytes Eosinophils Basophils

Dot plots assist in confirmation of the numerical values of the CBC and provide insight into, and the direct assessment of, blood morphology. In this case, Skittle was under treatment for immune-mediated thrombocytopenia (ITP). Dot plots from Skittle were critical to prompting a blood film review to understand the numerical CBC findings and clinical picture, which led to a quicker diagnosis and treatment.