Heinz body-related interference with leukocyte and erythrocyte variables obtained by an automated hematology analyzer in cats.

Heinz bodies (HBs) are known to interfere with automated hematology in cats, particularly with the white blood cell (WBC) count. We evaluated the influence of feline HBs on the complete blood count (CBC) results obtained using a flow cytometry-based analyzer. We retrospectively selected cats with circulating HBs and reviewed the results of their CBCs, including red blood cell (RBC) indices, basophil/lobularity (Baso) WBC count (WBCB), peroxidase (Perox) WBC count (WBCP), and cytograms. Based on the presence or absence of HB-related artifacts in their Baso cytogram, cats were grouped into Baso-HBs and HBs groups, respectively, for comparison. The WBCB and WBCP were compared to manual counts of WBCs carried out on blood smears at 400× (MC-WBC). We included 32 cats in our study: 9 of 32 were in the Baso-HBs group, and 23 of 32 were in the HBs group. Baso-HBs cats had a significantly increased HB percentage (p < 0.001), WBCB (p < 0.001), difference between WBCB and WBCP (p < 0.001), lymphocyte count (p < 0.001), mean corpuscular hemoglobin concentration (p < 0.001), and difference between calculated and measured erythrocyte hemoglobin concentrations (p < 0.001) compared to HBs cats. In Baso-HBs cats, the WBCB was significantly higher than the WBCP (p = 0.02); no significant difference was detected between the WBCP and the MC-WBC (p = 0.88). Evaluation of automated CBC results raised the suspicion of HB-related interference when using a hematology analyzer in cats; hence, blood smear examination remains essential in routine practice.