Clinical utility of Erythrocyte Sedimentation Rate Test (ESR Test) in Veterinary practices

Hey pet docs I hope you all are doing fine!! Today I‘m going to talk over untouched part in veterinary hematology i.e. ESR. All vets recommend plenty of tests but ESR is still not given that much preference as given in human medical field. We all studied about ESR in our B.V.Sc. after that where is it gone? No one recommended that test after that. Somehow we occasionally see our doctors recommending this test but why don’t vets recommend? So I’m going to talk over all these issues. So let’s roll!!

What is ESR??

ESR also called as sedimentation rate test or sed rate test. is the rate at which settlement of the erythrocytes in a standardized tube over a period of one hour  placed in an absolutely vertical position.

ESR is done by Wintrobe method as well as with the capillary method and is inversely related to the packed cell volume (PCV), i.e., the lower the PCV, the higher the ESR.

ESR is really important diagnostic test which helps us to pinpoint or monitor anything wrong going inside body. It can detect the presence of inflammation caused by one or more conditions such as infections, tumors or autoimmune diseases. Helps diagnose and monitor specific conditions such as arteritis, systemic vasculitis, or rheumatoid arthritis.

Increased ESR seen in:

·         Infectious Disease such as bacterial infections(Leptospirosis, TB), Infectious hepatitis, Atypical pneumonia, Systemic Fungal Infection

·         Hematologic and Neoplastic Disease such as Severe anemia or macrocytosis, leukemia, lymphoma, metastatic tumor, chronic granulomatous disease, Increased fibrinogen level

·         Gastrointestinal Disease e.g. acute pancreatitis, hepatitis, cholecystitis, Peritonitis

·         Collagen Vascular Disease e.g. Rheumatoid arthritis, Systemic Lupus Erythematous (SLE), Systemic Vasculitis

·         Renal disease e.g. Acute and Chronic glomerulonephritis, renal failure, nephrosis, pyelonephritis

·         Miscellaneous disorders such as Hypothyroidism, thyroiditis, sarcoidosis, trauma from surgery or burn injury, Drug Hypersensitivity reaction

·         Miscellaneous factors such as older age (increased fibrinogen level), female, Pregnancy and Lab error (e.g. dilution error, tube tilted during measurement, increased temperature of specimen)

Falsely decreased ESR (interfere with rouleaux formation)                 

·         Severe leukocytosis

·         RBC abnormalities such as acanthocytosis, poikilocytosis, anisocytosis, spherocytosis, microcytosis (e.g. Iron deficiency anemia), Polycythemia

·         Protein abnormalities such as hypofibrinogenemia, hypogammaglobulinemia, macroglobulinemia or other dysproteinemia

·         Lab error e.g. clotted blood sample, tube vibration during measurement, short tube, inadequate mixing of sample and dilution problem

Reasons why ESR is not used much in veterinary practice?

• It's nonspecific test
• It can only suggest the ongoing inflammation inside animal body, but does not indicate where or why?

But ESR can be used in combination with other tests for better understanding of clinical problems. It is easy to perform and can be done where much new techniques are not available.

There are few risks associated with this ESR test and there are no contraindications. ESR can be done easily along with other erythrocytic tests

ESR should be determined soon after sampling, if not possible then the blood should be stored at 4°C and the test conducted within 6 hours.

    

NORMAL ESR VALUE IN DIFFERENT ANIMAL SPECIES
Cattle	0-3 / 8 hrs
Goat	2-3 / 24 hrs
Dog	6-10 / hr
Horse	15-38/ 20 min
Pig	0-6 / 30 min & 1-14 /hr
Cat	7-27 / Hr

I hope that this information is useful for you.

Stay safe.

Stay healthy..