Brief Answer: Need to see hematologist, check kidney function Detailed Answer: Hi and thanks for the query, The MCV (mean corpuscular volume) of your red blood cells , and the MCH (mean corpuscular hemglobin concentration) are not within normal limits. These measures give an idea on the respective concentrations and nature of the amount of hemoglobin in the cells with respect to red blood cell size. The MCV is normally between 80-100. At 34.3 as in your case, this is extremely very low and deserves a carefu in depth evaluation. MCH values generally range between 26 to 34. At 34.4, this indicates a slightly raised value. I would however suggest that these tests be run again to actually confirm the results, preferably in another reference laboratory. Esinophils are however within very normal limits. The normal range generally is between 1 to 4% . Lymphocyte levels are actually low from your reading. The value you have is relative very low. Normal expected value should be between 30 to 74. Your kidney function has to be carefully evaluated for; since this substance is mainly produced at the level of the kidneys. It is very important in Calcium metabolism, and low levels could alter Calcium levels in blood, and low Calcium has serious adverse health consequences. I strongly believe the opinion of a hematologist (blood specialist), or an internist is highly required. These tests need to be run again, especially for blood parameters. Your medical and family histories, coupled with a complete carefully conducted clinical evaluation are sufficient to make correct, reasonable and scientifically sound diagnosis, and lanagement schemes. Screening for kidney function remains key, for the Vita,in D, 25 hydroxy is too low. I do suggest you book these appointments first. Thanks and hope this helps. please do feel free asking any follow up questions in case you got any specific concerns. Thanks and kind regards as I wish you the best of health. Dr Rogers

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Brief Answer: Too early to be too worried Detailed Answer: Hi and thanks for the updates. Raised EOS are generally seen mainly in allergic reactions and chronic parasitic infections. It might be important to know if you have any allergy to any substance, or if you have any chronic allergic disease (skin, allergic rhinitis, asthma etc). Parasitic infections like worms could raise blood EOS. It is not rare in some diseases like sarcoidosis and Lymphomas to observe raised EOS. However, all these require a careful observation and evaluation. Raised lymphocytes are seen in viral infections, bacterial infection s and some bone marrow diseases . It might be difficult to interpret these results without clinical findings. Also, other blood parameters like the hemoglobin level are important to be known (anemic or not). Note also that stress and inflammatory reactions can simply raise cell counts, not actually meaning there is something that serious. A thick and thin blood film would also be necessary for a correct interpretation,. The sizes of the cells, the coloration and the shapes, with other aspects are all important to be considered. I still belief you consult a hematologist, for a timely and appropriate diagnosis and management. Doing the tests all over could be an option in some cases. I do not think you really need to bother much at this point in time. thanks and kind regards as I wish you the best of health. Dr Rogers

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Brief Answer: Get IgE test. Detailed Answer: Hi and thanks for the query, I do think sinus infection and the puppy are all risk factors for allergic reactions in the body, which could of course explain raised EOS. A consultation with your doctor would lead to the specific test for allergies, which is the Immunoglobulin E levels (IgE). I think a proper evaluation by the doctor is very necessary. You could do the IGE test to be quite very pretty sure it is an allergy to something. However, any worries still demand the opinion of the hematologist. Please, do do the IgE test and see a doctor. Thanks and kind regards as I wish you the best of health. Kind regards Dr Rogers

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