Education
Welcome to our education blog, where we share a wide range of topics designed to inspire and inform. Whether you’re a student, educator, or lifelong learner, you'll find valuable insights and resources to enhance your knowledge and skills. Join us on this journey of discovery as we share tips, strategies, and latest trends in the world of veterinary diagnostics. Let's learn and grow together!
Getting to Know Your Point of Care Machines to Improve Patient Care
By Bonnie Bragdon DVM, MS
In-House vs. Reference Lab Diagnostic Testing: The Great Debate
In the veterinary world, there is an ongoing debate between in-house and reference lab diagnostic testing. While certain tests must be submitted to a reference lab due to their complexity or unavailability at the point of care, veterinarians have many excellent options for running routine chemistry and hematology tests within their hospitals. Doing so ensures the best patient care and can also improve hospital profit.
Benefits of In-House Testing
Running routine and stat chemistry and hematology tests on in-house analyzers can increase the cost of labor, but it helps your technical and medical team become proficient in the use and maintenance of point of care analyzers, as well as test result interpretation. Becoming familiar with the tools of our trade makes us experts in their best use and limitations. As they say, practice makes perfect.
Considerations for Reference Lab Testing
Some clinics opt to submit routine tests to reference labs to save money and labor. This approach can be cost-effective and reduce the workload on in-house staff. However, it may result in longer turnaround times for test results, potentially delaying clinical decisions and patient care.
Finding the right point of care diagnostic lab solution helps mitigate the cost of labor to perform tests and reduces the cost to train teams. When considering lab equipment, choose a system that is not only accurate, but also reliable, easy to operate, low maintenance, and reasonable cost. The labor costs to perform lab work in house can be managed and may generate greater income as patients are diagnosed and treated sooner.
Conclusion
Both in-house and reference lab testing have their advantages and challenges. The key is to find the right balance that works for your practice, ensuring the best care for your patients while maintaining efficiency and profitability.
The Importance of Complete Blood Count (CBC)
By Bonnie Bragdon DVM, MS
The Complete Blood Count (CBC) is an essential diagnostic tool used to assess overall patient health and direct further testing for various disease processes. This comprehensive test measures multiple components of blood, providing valuable insights into a patient's condition.
Key Components of CBC:
-
Hematocrit: Measures the percentage of Red Blood Cells (RBCs) in the blood, indicating oxygen-carrying capacity.
-
Hemoglobin: The molecule in RBCs that binds oxygen. Low hemoglobin means less oxygen can be delivered to cells throughout the body for normal metabolism.
-
White Blood Cells (WBCs): Quantification and differentiation of WBCs into specific types, each with unique functions. WBCs are immune cells that are important in fighting infection. Knowledge of a patient’s WBC count is important to understand infectious, immune, and autoimmune disorders.
Differential:
-
Neutrophils: Largest volume of WBCs, responsible for destroying bacteria with enzymes.
-
Lymphocytes: Increase during chronic infections and viral responses, producing antibodies.
-
Monocytes: Engulf dead cells and bacteria.
-
Eosinophils: Elevated in allergic responses, kill cancer cells and parasites.
-
Basophils: Indicate parasites and release histamine in allergic reactions.
The AlphaCyte module of the AlphaION System produces a six-part differential to include measurement of immature WBCs, providing insights into the patient's response to infection or other insults.
Additional Parameters:
-
Cell Size: Indicates RBC production efficiency.
-
Hemoglobin Density: Assesses oxygen-carrying capacity.
-
Polychromasia: Reflects uneven hemoglobin packaging, potentially indicating bone marrow issues.
-
Reticulocyte Count: Evaluates bone marrow's response to blood loss or production issues.
Advances in Technology:
Historically, blood smears were examined manually under a microscope, a labor-intensive process with potential chemical hazards. Modern automated analyzers have revolutionized this process, enhancing speed and reducing variability. Technologies like flow cytometry and impedance measurements provide precise differentiation of blood cells. Automated CBC analyzers have improved lab operations but have not eliminated the need for inspection of manual smears. As innovative technologies enter the market, the need to perform a labor-intensive blood smear will continually be reduced. Follow us to learn about the latest updates!
Understanding Primary Hyperlipidemia in Dogs
By Bonnie Bragdon DVM, MS
Primary hyperlipidemia is a condition characterized by elevated levels of lipids in the blood, even after fasting. This condition can often be overlooked as some breeds, like the miniature Schnauzer, may appear clinically normal but still exhibit hyperlipidemia. Identifying and managing primary hyperlipidemia is crucial to prevent potential health issues before clinical signs become apparent.
What is Primary Hyperlipidemia?
Primary hyperlipidemia is a genetic disorder that leads to an abnormal accumulation of lipids in the blood. Unlike secondary hyperlipidemia, which can be caused by factors like diet, obesity, or underlying diseases, primary hyperlipidemia is inherent to the animal's genetic makeup.
Key Diagnostic Tests
To diagnose primary hyperlipidemia, veterinarians can perform several tests, including:
· Serum Triglyceride and Cholesterol Levels: Measuring these levels after a 12-hour fast can help identify hyperlipidemia.
· Complete Blood Count (CBC) and Chemistry Panel: These tests provide a comprehensive overview of your pet's health.
· Thyroid Function Test: Ensures the thyroid gland is functioning correctly.
· Cortisol Test: Checks for conditions like Cushing's disease.
· Imaging (Radiographs and Ultrasound): Visual assessment of internal organs to identify abnormalities.
Why Early Detection Matters
Detecting primary hyperlipidemia early is essential to manage and prevent potential health problems. Regular veterinary check-ups and additional diagnostic tests can help rule out this condition before any clinical signs appear.
Conclusion
Primary hyperlipidemia may be a silent condition, but with the right approach and timely diagnostics, veterinarians can ensure your pet stays healthy and happy. Always consult with your veterinarian if you notice any unusual signs in your pet or if you belong to a breed known to have this condition.
Interpreting Novel Platelet Indices in Veterinary Practice
By Bonnie Bragdon DVM, MS
In recent years, CBC (complete blood count) analyzers have advanced significantly, allowing veterinarians to access a series of platelet indices that are crucial in diagnosing conditions affecting platelet count, morphology, and activation. These novel platelet indices include Platelet Distribution Width (PDW), Platelet Large Cell Coefficient (P-LCC), Platelet Large Cell Ratio (P-LCR), and Plateletcrit (PLT).
Platelet Distribution Width (PDW)
PDW, like Red Cell Distribution Width (RDW), indicates an increase in platelet size and variability. An elevated PDW suggests a higher variability in platelet size, which may be indicative of an underlying condition affecting platelet production. Notably, PDW is believed to increase before mean platelet volume (MPV) increases, making it a valuable early indicator.
Platelet Large Cell Coefficient (P-LCC) and Platelet Large Cell Ratio (P-LCR)
P-LCC reports the number of platelets between 12fl and 30fl in size, providing insight into the presence of larger platelets within the bloodstream. On the other hand, P-LCR represents the percentage of large platelets in the blood and is calculated from the P-LCC and total platelet count. Both P-LCC and P-LCR are thought to be more sensitive indicators of bone marrow response in thrombocytopenic dogs than MPV.
Plateletcrit (PLT)
Like hematocrit, Plateletcrit measures the volume occupied by platelets in the blood. It is an essential parameter for assessing the overall platelet mass, particularly in conditions with altered platelet counts.
Clinical Applications
PDW and P-LCR are considered more sensitive indicators of bone marrow response in thrombocytopenic dogs compared to MPV. In a healthy dog, an appropriate response to decreased platelets would result in increased PDW and P-LCR. Conversely, in cases of immune-mediated thrombocytopenia, PDW is significantly lower due to the immune system's rapid destruction of platelets outpacing the bone marrow's production of new ones.
Conclusion
Understanding and interpreting these novel platelet indices can enhance veterinarians' diagnostic capabilities, leading to more accurate assessments of platelet-related conditions and improved patient care. Incorporating these indices into routine CBC analysis can provide valuable insights into platelet dynamics and the overall health status of veterinary patients.
The Future of Automated CBC Analysis
Digital Holographic Microscopy
By Bonnie Bragdon DVM, MS
Do you ever doubt the results from your CBC analyzer? While automated CBCs performed by point of care analyzers are efficient and accurate, they often provide limited information about cell morphology. Many indices are reported through indirect measurement methods or calculations. For ill patients and flagged or abnormal results from automated analyzers, a manual blood smear is typically indicated.
However, this need for manual smears is set to change with the advent of new methods for digital microscopy. With increased computing power and the integration of artificial intelligence, three-dimensional measurements of cells and their morphology can be made and interpreted, potentially replacing current methods for reporting a CBC. Expect new methods for assessing blood cell morphology to be available in your clinic in 2025.
What New Methods for Blood Cell Microscopy are in Development?
New methods for digital microscopy are in development and digital microscopy is an emerging technology that allows label-free cell imaging by capturing phase contrast images of cells. This method provides rich intracellular information due to subtle refractive index changes at internal structures.
Advantages of DHM
· Accuracy: Provides detailed three-dimensional measurements of cells and their morphology.
· Efficiency: Capable of high-throughput imaging without time-consuming procedures.
· Automation: Reduces the need for manual blood smears, streamlining the diagnostic process.
Clinical Implications
Veterinarians can expect more accurate and comprehensive automated CBC analyses, leading to better-informed clinical decisions and improved patient care. The integration of this technology into routine practice will enhance diagnostic capabilities and reduce the reliance on manual smears.
Conclusion
Digital holographic microscopy represents the future of automated CBC analysis. By leveraging advanced computing power and artificial intelligence, this technology promises to revolutionize the way we analyze blood samples, providing more detailed and accurate information about cell morphology.
Interpreting Intrasample Test Result Variance in Veterinary Practice
By Bonnie Bragdon DVM, MS
Lab results can sometimes show variance, even when the same sample is tested multiple times. This is called intrasample variability, and it is both expected and acceptable. Understanding this variance can help veterinarians make informed clinical decisions.
What is Intrasample Variability?
Intrasample variability refers to the differences in test results when the same sample is run multiple times on the same or different analyzers. This can happen due to factors like sample type or testing methods.
Example in Practice
Consider a diabetic dog undergoing a routine health check. Blood is collected and tested using a blood glucose meter (whole blood) and immediately processed for serum testing using an analyzer (serum). The glucose test results are likely to vary because of the different sample types and test methods used.
Clinical Implications
If the varying results are close enough to lead to the same clinical decision, the variability is likely insignificant. However, if the results differ so much that they would lead to different clinical decisions, additional testing may be needed.
Conclusion
Understanding and interpreting intrasample test result variance is crucial for accurate veterinary diagnosis and treatment planning. Veterinarians should be aware of this variability and consider it when making clinical decisions.
Drawbacks of Outsourcing Laboratory Testing
By Bonnie Bragdon DVM, MS
Laboratory testing is an essential part of health care, as it can help diagnose, monitor, and treat various diseases and conditions. Health care providers may have limited capacity, expertise, and equipment to perform even routine diagnostic testing causing delays in diagnosis and treatment. Health care providers may choose to send patient samples to a reference laboratory, that provides clinical pathology services to offset gaps in testing at the point of care. 1
Outsourcing Routine Laboratory Testing Delays Diagnosis
Delay and uncertainty: Outsourcing laboratory testing may result in longer turnaround times and increased uncertainty for the test results, as they depend on the transportation, processing, and reporting of the samples by the reference laboratory. This may affect the timeliness and effectiveness of patient care, especially for urgent or critical cases. 2 3
Error and variability: Outsourcing laboratory testing may introduce more sources of error and variability for the test results, as they involve different devices, operators, and environments than the original laboratory. Samples may degrade during transport and errors in processing can occur. These errors and variability may affect the accuracy and reliability of the test results, and may lead to misdiagnosis, inappropriate treatment, or adverse outcomes. 2 3 4
Cost and reimbursement: Outsourcing laboratory testing may incur additional costs and complications for the billing and reimbursement of the tests, as they involve different payers, contracts, and regulations than the original laboratory. These costs and complications may affect the financial viability and sustainability of the laboratory and may also impact the affordability and accessibility of the tests for the patients. 2 3
Communication and coordination: Outsourcing laboratory testing may require more communication and coordination between the clinic and the reference laboratory, as well as between the laboratory and the clinician, to ensure the quality and continuity of care for the patient. This may require more resources, time, and effort from the laboratory staff, and may also pose some challenges and risks for the data protection and confidentiality of the patient information. 2 3
Conclusion
Outsourcing laboratory testing is a common and convenient practice that can offer some benefits for the laboratory and the patient, such as access to a wider range of tests. However, outsourcing laboratory testing also has some drawbacks and challenges, such as delay and uncertainty, error and variability, cost and reimbursement, and communication and coordination. Clinicians should be cautious when deciding between completing tests at the point of care or sending samples to a reference lab.
1. Recent and Emerging Issues Related to Clinical Laboratory Testing and ...
2. Referred Laboratory Testing - HHSC
3. Reducing the occurrence of errors in a laboratory's specimen receiving ...
4. Limitations of Laboratory Testing | Laboratory Test Guide | Dept. of ...
Great Partnerships
Meet our Distributor Partners
"We are excited to announce our great partnership with Midwest Veterinary Supply and Patterson Veterinary. Together, we are committed providing exceptional products and services that enhance veterinary care and support animal health. This collaboration allows us to leverage our strengths and resources, ultimately benefiting our customers and their furry companions."
.png)
