To differentiate between pituitary-dependent hyperadrenocorticism and adrenal-dependenthyperadrenocorticism in a dog confirmed to have hyperadrenocorticism (by LDDST or ACTH stimulationtest).
Sample required:
Serum (0.5 mL) or Clotted blood (1.5 mL)
Blood tube required:
Gel (gold top) or plain (red top).
Test use:
Protocol:
Following medical therapy for hyperadrenocorticism an ACTH stimulation test should be performed:
Trilostane
Mitotane
Sample required:
EDTA plasma (0.5 mL minimum) or serum ifcentrifuged and separated shortly afterclotting
Blood tube required:
EDTA plasma in a plain (non-additive) tube, orserum in a plain tube
For the diagnosis of aldosterone secreting tumours in cats, and less commonly in dogs. These animals are often (but not always) persistently hypokalaemic and are often hypertensive.
EDTA plasma
Serum
Sample required:
Clotted blood (3.0 mL)
Blood tube required:
Plain (red top) tube
Anti--Müllerian Hormone is a hormone involved in gender differentiation in the developing embryo. Insexually mature animals it is produced by the granulosa cells of ovarian follicles and the Sertoli cells of the testicles.
AMH levels markedly decline following neutering.
Sample required:
Serum or Plasma (0.5 mL)Whole Blood (1.5ml)
Blood tube required:
Gel (gold top) or plain (red top) tubes. LithiumHeparin (Green top) or EDTA (purple top) may also be used.
Test Use
Bile acids are produced in the liver, secreted into the biliary system and subsequently into the duodenum where they aid in digestion of fats. They are then reabsorbed and removed from the portal circulation by the liver for reuse.
Measured blood bile acids will be influenced by any process that affects any part of this recycling system. This may include biliary obstruction, reduced hepatic mass, loss of function with acute inflammatory or toxic insults, or when portal blood is shunted away from the liver.
Sample required:
EDTA blood (2.0 mL) and serum (2 ml) from the recipient and each donor
Blood tube required:
EDTA (purple top) tubePlain (red top) tube
Test Use
Cross-matching is used prior to a blood transfusion in order to determine if the donor’s blood is compatible with the blood of an intended recipient. An incompatible cross match usually indicates prior sensitisation (and hence antibody formation), except in the cat which has naturally occurring antibodies.
The major cross match tests erythrocytes of the donor against the serum or plasma of the recipient. This allows detection of antibodies in the recipient which will react with donor erythrocytes. Major cross match incompatibilities may result in life-threatening transfusion reactions if that blood is transfused into the recipient.
The minor cross match tests serum or plasma of the donor against erythrocytes of the recipient. This detects the presence of antibody in the donor blood which may react with the recipient erythrocytes. Minor cross-match incompatibilities are usually not life threatening due to marked dilution of the donor antibodies following transfusion.
Sample required:
A strict aseptic collection technique is critical. Contaminants from the animal’s skin or other externalsources may give misleading results or mask significant bacteria.
Sample required:
Clotted blood (1.0 mL) orSerum (0.5 mL)
Blood tube required:
Plain or Gel (Red or Gold top) tubes
Clinical Information and Applications
CRP is a major acute phase protein (APP) in canines and forms part of the acute phase inflammatory response. Any inflammatory reaction that cannot be contained locally will “spill over” and initiate a systemic response, resulting in hepatic synthesis and release of CRP into the circulation. In diseases that are predominantly inflammatory in nature, integrated measurement of the severity of inflammation may be superior to measurement of organ specific marker enzymes.
KEY BENEFITS OF C-REACTIVE PROTEIN (CRP) AS “THE SYSTEMIC INFLAMMATORY MARKER” IN DOGS:
For detection and monitoring of a systemic inflammatory response in dogs.
Sample required:
Free catch urine collected into a special preservative container
SAMPLEREQUIRED:
Blood, minimum 1mL
BLOOD TUBE REQUIRED:
EDTA
Results are reported in ng/mL, with general interpretive guidelines for both trough and peak concentrations.
SAMPLE REQUIRED:
Serum (0.5mL)or clotted blood (1.5mL)
BLOOD TUBE REQUIRED:
Gel (gold top) or plain (red top) tube
To assist in the diagnosis of pituitary pars intermedia dysfunction (PPID) (Cushings-like syndrome) in horses.
Sample required:
Serum (0.5 mL) or Clotted blood (1.5 mL)
Blood tube required:
Plain (red top) tube
Monitoring of serum digoxin concentration in dogs and cats being treated for congestive heart failure, atrial fibrillation or flutter, and supraventricular tachycardia.
Gel/serum separator tubes are not recommended as the gel may absorb some of the drug, artificially lowering the serum concentration.
SAMPLE REQUIRED:
EDTA plasma (preferable) (2 mL) or
EDTA whole blood (4mL)
BLOOD TUBE REQUIRED:
EDTA plasma in a plain (non-additive)tube, or
EDTAwhole blood(purpletop)
Test use:
To aid in the diagnosis of pituitary pars intermedia dysfunction (PPID; equine Cushing’s disease).
All equine abortions should be treated as infectious.
Sample collection:
Footnotes:
a = preferred sample is single dry swab of multiple sites across the placenta (amnion, umbilical cord between amnion and chorioallantois, chorioallantois near umbilical cord insertion). Alternative sample is fresh tissue (chorioallantois or pool of each of those sites).
b = amnion, umbilical cord between amnion and chorioallantois, chorioallantois near umbilical cord insertion, chorioallantois at cervical pole.
EHV-1 PCR, Chlamydia psittaci PCR
Submit individual tissues in separate sterile leak-proof pots. Label these pots e.g. “Fresh lung – PCR”. Duplicate sets of tissues are not required (i.e. the same piece of each tissue can be tested for both EHV-1 and Chlamydia).
Culture Additional bacterial cultures can be added (e.g. placenta, other tissues showing lesions).
Fungal culture can be added as required (e.g. placenta, lesions).
Histopathology Take one sample (1cm thick x 2-3 cm) of each tissue. All tissues can be submitted in one leak-proof pot, if adequate formalin. In addition to standard range of tissues, include any other lesion or tissue showing lesions.
Case will be billed based on number of tissues submitted.
Summary
Fresh placenta, lung, liver, spleen, thymus for EHV-1 PCR, Chlamydia psittaci PCR, +/- EHV-4 PCR - separate labelled sterile pots - OR for placenta, single dry swab (multiple sites across placenta)
Fresh stomach contents, fresh lung for Bacterial culture
Formalin-fixed placenta, lung, liver, spleen, thymus for Histopathology
Sample required:
Blood tube required:
To assess for insulin resistance.
Indications:
Cushings – like syndrome).
Protocol:
EMS is a complex syndrome. The diagnosis is based on a complete history, performing a thorough physical examination (including assessment of regional adiposity and body condition scoring), documented evidence of insulin resistance, and results of additional diagnostic tests (serum triglycerides, radiographs of the feet etc).
SAMPLEREQUIRED:
Body fluid minimum 0.5mL, or FNA sample
BLOOD TUBE REQUIRED:
EDTA or Plain sterile
Sample required:
Dry cotton swab in sterile container (no transport media)
Test use:
This test is based on PCR technology, designed to identify the presence or absence of these infectious agents. ThePCR test is the preferred test for these infections, with both good sensitivity and specificity. It is important to note however, that due to the nature of these organisms, false negative results are possible. To maximise the possibility of successful recovery of organisms, samples should be collected during the acute phase of infection and prior to any therapy. Chronicity of infection and therapy (especially for Chlamydia) will lead to a lowering of virus/Chlamydia particle production.
Sample required:
May be performed on blood, bone marrow, body cavity fluids, and aspirates of solid tissues placed into liquid media (see below).
General sample collection requirements:
Specific sample collection requirements:
Further investigation of an acute leukaemia or persistent lymphocytosis
Further investigation of a lymphocyte-rich body cavity effusion
Lymph node and other organ aspirates for flow cytometry
Flow cytometry is a versatile and powerful technique using laser-based technology that allows for qualitative and quantitative assessment of multiple parameters of individual cells and particles. It may be used for cell counting, cell sorting and cellular marker detection (i.e. immunophenotyping).Flow cytometers detect and analyse multiple physical characteristics of single particles (cells) as they flow in a fluid stream through a beam of light. The properties analysed include a particle's relative size, relative granularity or internal complexity and relative fluroescence intensity. Fluorescently labelled antibodies may also be applied to detect expression of specific cell markers, there by assisting with identification and quantification of specific cell types, cell subsets, and cells expressing aberrant antigens.
SAMPLE REQUIRED:
Serum (1.5 mL) Fresh or Frozen
BLOOD TUBE REQUIRED:
Plain (Red Top) Tube
Note Gel Tubes are NOT suitable
Further assessment of high or low serum total calcium concentration.
Serum should be harvested within one hour of blood collection. Delayed harvesting can lead to a falsely increased ionised calcium concentration.
As a guide, serum ionised calcium is stable for:
4 hours at 22C
7 days at 4C
6 weeks at -20C
If PTH is also required on the same serum sample, note the following points (see PTH protocol):
Note: Ionised calcium concentrations are very sensitive to changes in sample pH. It is therefore recommended that, wherever possible, ionised calcium concentrations are assessed immediately at the time of collection (e.g using an I-Stat). If this is not possible, the protocol below should be strictly followed.
Sample required:
Fresh / frozen / formalin fixed** tissuePreferably > 100 mg wet weight (preferred minimum 30 mg wet weight)
Tube required:
Plain (non-additive) tube/vial
Test use
Copper can accumulate in hepatocytes due to excessive dietary intake, cholestasis or altered hepatocyte metabolism preventing copper excretion. Excessive intracellular copper can result in cellular damage due to formation of oxygen free radicals.
Copper associated chronic hepatitis has been documented in Bedlington Terriers, Doberman pinschers, Cocker spaniels, West Highland white terriers, Standard poodles, Dalmatians, English Springer spaniels, Samoyeds, Cairn terriers, Skye terriers, Anatolian Shepherd dogs, Welsh Corgis, Keeshonds, Great Danes and Labrador retrievers. Inherited disorders preventing hepatic copper excretion have been proven in both the Bedlington terrier and Labrador retriever, although an inherited defect is suspected in many other breeds.
Fresh chilled liver is the preferred sample. Samples should be placed into containers suitable for the sample size and chilled as quickly as possible.
For samples collected at post mortem, a sample size of 5 - 10 g in a 50 mL plastic screw-top container is preferred.Fresh tissue samples should be frozen if shipment will be delayed more than 2-3 days. Frozen samples are stable for several months. Extensive autolysis of liver samples may result in reduced mineral concentrations in the tissue.
For biopsy samples, a minimum biopsy weight of 100 mg is requested. Smaller samples can still be processed; however, biopsy samples <30mg require a different assay method/QC and are approximately twice the price of routine assays.
Biopsy samples must be gently rinsed with saline and excess fluid/blood removed by gently blotting with lint-free tissue or gauze swabs. Place the sample into a 1.5 mL 'O’-ring sealed plastic vial/tube. The entire contents of the biopsy vial, including any water condensate from the biopsy, will be assumed to be liver; therefore, it is vital that clots and excess blood/fluid are removed from the initial sample.
**Formalin fixed tissue samples may also be used for copper estimation, provided samples are of sufficient size to allow trimming of all external tissue surfaces.
Sample required:
Serum (0.5 mL) or clotted blood (1.5 mL)
Blood tube required:
Gel (gold top) or plain (red top) tubes.
To assist in the diagnosis of hyperadrenocorticism (Cushing’s syndrome) in dogs. If results of pituitary - adrenal testing confirm hyperadrenocorticism, the LDDST results can also be used as an aid in discriminating between pituitary and adrenal dependant hyperadrenocorticism.
Sample required:
Serum (0.5 mL) or Clotted blood (1.5 mL)
Blood tube required:
Plain (red top) tube or Gel (yellow top) tube
To assist in the diagnosis of hyperadrenocorticism (Cushing’s disease) in cats.
Sample required:
Frozen serum, minimum 1.0mL
Blood tube required:
Serum tube, red top
Canine PTH can now be run at Vetnostics in Sydney. This assay has currently only been validated in dogs, and an interim reference interval has been established and may be refined over time.
Feline and equine samples are still sent overseas for analysis. Please call to discuss further if you would like to discuss the limitations of performing this test in these species.
Note that PTHrP testing is not currently available in Australia.
Investigation of unexplained hypercalcaemia or hypocalcaemia.
Interpretation:
Sample required:
Serum (0.5 mL) or Clotted blood (1.5 mL)
Blood tube required:
Plain (red top) tube
Monitoring of serum phenobarbital concentration in dogs and cats being managed for seizures.
Recommendations for when to assess phenobarbital concentration:
Sample required:
Serum (0.5 mL) or Clotted blood (1.5 mL)
Blood tube required:
Plain (red top) tube
Monitoring of serum potassium bromide concentration in dogs being managed for seizures.
Recommendations for when to assess potassium bromide concentration:
Sample required:
Serum (0.5 mL) or clotted blood (1.5 mL)
Blood tube required:
Gel (gold top) or plain (red top) tubes.
Diagnosis of hypothyroidism.
Monitoring thyroid replacement therapy.
General
Monitoring therapy
Review of thyroid status in a dog currently receiving thyroid hormone supplementation
Exogenous thyroid hormone can suppress TSH secretion resulting in thyroid gland atrophy, and thus a low serum total T4 could suggest hypothyroidism (even in a previously euthyroid dog). To obtain a valid baseline total T4 result, thyroid hormone supplementation must be discontinued for a period of time to allow the pituitary-thyroid axis sufficient time to regain normal function. That time interval depends on the duration of treatment, the dosage and frequency of administration thyroxine and individual animal variation. As a guide, thyroid hormone supplementation should be discontinued for a minimum of 4weeks, and preferably 6-8 weeks before re-evaluation of thyroid gland function.
To aid in the assessment of thyroid status in dogs. TSH production and secretion is controlled by negative feedback from the thyroid hormones T4 and T3, as well as by secretion of the hypothalamic hormone thyrotropin releasing hormone (TRH). Most cases of canine hypothyroidism are primary, due to impaired production of T4 and T3. Due to the loss of negative feedback, TSH is increased in many of these cases.
Sample required:
Serum (0.5 mL) or clotted blood (1.5 mL)
Blood tube required:
Gel (gold top) or plain (red top) tubes.
General
Monitoring therapy – Oral dosing
Monitoring therapy – Transdermal (PLO) dosing
Diagnosis of hyperthyroidism.
Monitoring treatment of hyperthyroidism.
Sample required:
Serum (0.5 mL) or Clotted Blood (1 mL)
Blood tube required:
Plain (red top) or Gel (yellow top) tube
Test use:
To assist in the diagnosis of exocrine pancreatic insufficiency (EPI) in dogs.
Sample required:
Urine, minimum 10mL, frozen
Blood tube required:
Sterile container, frozen
Interpretation:
The following results are reported:
For evaluation of adrenal masses where excessive catecholamine production is clinically suspected.
Sample required:
Urine (2.0ml)
Test Use:
Screening for hyperadrenocorticism should not be performed in unwell or significantly stressed animals, which may yield false positive results in adrenal function tests. In potentially hyperadrenocorticoid dogs with significant intercurrent disease such as diabetic ketoacidosis or pancreatitis, adrenal function testing should be delayed until intercurrent disease is controlled.
Any form of corticosteroid therapy may interfere with adrenal function tests, partly by affecting the pituitary/adrenal axis via suppression of ACTH production. As a guide, the minimum periods for which corticosteroid therapy should be withheld before adrenal function testing are:
Sample required:
Plasma (2.0 mL)
Blood tube required:
Sodium Citrate (blue top) tube for initial collection and then plasma transferred to plain (non-additive) tube and frozen
This test is used in the diagnosis of von Willebrand factor deficiency (von Willebrand’s disease) in dogs.
Animal Requirements:
Sample Requirements:
If a centrifuge is not available and a whole blood sample is being transported to the laboratory, the sample should be wrapped in cotton wool or newspaper and then placed in an esky with ice packs and transferred to the laboratory as soon as possible. Direct contact with the ice packs is to be avoided, as this may cause haemolysis. Do not freeze whole blood.
Submission of whole blood is discouraged as this may lead to sample haemolysis and von Willebrand factor deterioration/loss, affecting the validity of the result.