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What should fluid cytology samples be placed in? (3)
- EDTA tubes (for cell counts and examination)
- Clot tubes (for biochemical analysis)
- Sterile container [clot tubes] (for microbial culture)
What should CSF fluid be placed into?
Clot tubes
3 main ways that fluid is evaluated
- Total protein concentration
- Cell counts
- Cytological evaluation
What are the cells that line body cavities? (2)
- Mesothelial cells (thorax and abdomen)
- Synovial lining cells (joint cavities)
What should be considered if large numbers of mesothelial cells are present?
Mesothelioma
3 other cell types that synovial lining cells resemble
- Mesothelial cells
- Macrophages
- Immature lymphocytes
How are synovial lining cells often classified?
Just lumped in with macrophages and called large mononuclear cells
Why must caution be taken to diagnose neoplasia off a fluid cytology?
Cells in fluid that has been sitting out for a while can distort and resemble neoplastic cells
What biochemical value are you looking for when diagnosing a uroabdomen?
Creatinine
- Should be higher in fluid than serum
Two values you should measure when diagnosing a chylothorax or chyloabdomen
- Triglyceride levels (should be higher in fluid than in serum)
- Cholesterol (should be lower in fluid than in serum)
What value should you measure to diagnose a bile peritonitis?
Bilirubin
- Higher in fluid than in serum
What does a higher triglyceride content in fluid than serum indicate?
Chylous effusion
Which species normally has fluid present in its abdominal cavity?
Horses
Accumulation of fluid into a body cavity beyond th ability of the cavity to reabsorb the fluid (term)
Effusion
4 basic mechanisms of effusion
- Decreased plasma oncotic pressure
- Increased hydrostatic pressure in BV
- Lymphatic obstruction
- Inceased vascular permeability
Transudate (define)
Fluid with low protein and low nucleated cell counts
WBC levels in transudates
< 1,000 for dogs, cats, cattle

< 5,000 for horses
WBC levels in modified transudates
1,000 < X < 5,000 in dogs, cats, cattle

5,000 < X < 9,000 in horses
WBC levels in exudates
> 5,000 in dogs, cats, cattle

> 9,000 in horses
Total protein content in transudates
< 2.5 g/dL
Total protein content in modified transudates
2.5 < X < 3.0
Total protein content in exudates
> 3.0 g/dL
3 causes of transudates
- Hypoalbuminemia (most common cause)
- Increased system or localized blood pressure (portal hypertension is second most common cause)
- Lymphatic obstruction
Causes of modified transudates
- CHF
- Neoplasia
- Organ torsion (early)
- Uroabdomen
- FIP
- Non-specific causes

Not really a useful measure
Predominant cell type in exudates
Neutrophils
4 classifications of exudates based on inflammatory cell present
- Suppurative
- Mixed cell
- Lymphocytic
- Eosinophilic
Exudates are always inflammatory
Transudates are non-inflammatory
- Modified transudates can be either
4 causes of exudates
- Sepsis (common)
- GI rupture (common)
- Organ torsion
- FIP
Most common cause of exudates in horses (2)
- Ruptured gut
- Gut torsion
How do you differentiate a gut tap (enterocentesis) from a sucessful abdominocentesis in horses?
Enterocentesis fluid will be dark brown or green with very low protein and loads of bacteria
What's the most common lymphatic structure to rupture?
Thoracic duct
5 causes of chylous effusions
- Trauma
- Heart failure
- Neoplasia
- Obstruction
- Idiopathic disorders
Appearance of fluid from chylous effusions
Milky white that does not clear with centrifugation
4 nucleated cells seen in smears of fluid, and two most common
- Plasma cells (most common)
- Neutrophils (most common)
- Lymphocytes
- Large mononuclear cells
What type of animal are chylous effusions common in?
Small animals only
- Rare in large
What indicates blood contamination of an effusion?
Platelets
4 reasons to suspect hemorrhagic effusion
Presence of:
- Erythrophagocytosis
- Hematoidin
- Hemosiderin
- Large numbers of RBCs without indication of inflammation
What is the precipitation test that's used on CSF fluid and what does it indicate?
Pandy test
- Indicates how much immunoglobulins are in the CSF
What are cell counts for CSF done on?
Hemocytometers
What is an albuminocytologic dissociation characterized by?
Increased microprotein without a pleocytosis
What does an increased microprotein without a pleocytosis indicate?
Albuminocytologic dissociation
What does a pleocytosis indicate?
CSF inflammation
What is a pleocytosis indicated by?
Increased numbers of nucleated cells in CSF
What does an increased number of nucleated cells in CSF indicate?
Pleocytosis
4 processes to be considered when a pleocytosis is present
- Inflammation/infectious Dz
- Neoplasia
- Degenerative disorders
- Trauma
5 further classifications of pleocytosis based on predominant cell type
- Neutrophilic
- Eosinophilic
- Large mononuclear cell
- Mixed cell
- Lymphocytic
Color of normal synovial fluid
Clear, though often tinged red due to contamination during collection
Why is synovial fluid highly viscous?
Presence of hyaluronic acid
4 causes of decreased viscosity in synovial fluid
- Dilutional effect of hyaluronic acid due to fluid accumulation in joints
- Bacterial by-products degrading hyaluronic acid
- Inflammatory cell by-products degrading hyaluronic acid
- Production of abnormal hyaluronic acid
What is the qualitative assessment of hyaluronic acid in joint fluid?
Mucin clot test
What needs to be added when doing a total protein examination on synovial fluid?
Hyaluronidase to break up viscosity
Two things that an increased total protein in synovial fluid indicates
- Hemorrhage
- Inflammation
Amount of nucleated cells in a normal animal's synovial fluid, and what is the exception?
< 500 per uL

Dogs, which have < 3,000 per uL
What is the most critical clinical evaluation of abnormal synovial fluid?
WBC count
What does a mild elevation (1,000 to 10,000) of WBCs indicate? (2)
- Trauma
- Degenerative Dz
What does a marked elevation (> 15,000) of WBCs indicate? (2)
- Sepsis
- Immune mediated arthropathy
5 classifications of abnormal joint fluid, and two most common
- Neutrohpilic/suppurative inflammation (most common)
- Mononuclear cell inflammation (most common)
- Mixed cell inflammation
- Eosinophilic inflammation
- Hemarthrosis
3 causes of a neutrophilic/suppurative inflammation of the joints
- Sepsis
- Immune-mediated disease
- Trauma
What is a mononuclear cell inflammation of joints associated with?
DJD
What is a high count mixed cell inflammation of the joints indicative of?
Immune mediated joint disease
What is a low count mixed cell inflammation of the joints indicative of? (3)
- DJD
- Trauma
- Sepsis
Predominant cell type in a mixed cell inflammation of the joints
Mononuclear cells
Two things a hemarthritic joint is associated with
- Trauma
- Coagulopathy
Primary cell type in a hemarthrosis
RBCs