Evaluation of a portable glucose meter for use in cattle and sheep

Background: In farm animal practice, determination of blood glucose concentration under field conditions is often necessary. Objective: As there is no portable glucose meter device developed for use in farm animals, the analytical accuracy of a portable glucometer designed for people was evaluated for its use in cattle and sheep. Methods: Blood samples from 90 cattle and 101 sheep were used in the study. Glucose concentration was determined in whole blood immediately after blood collection from the jugular vein with the One Touch Vita portable glucometer and in serum with an enzymatic colorimetric method. The agreement between methods was assessed by Passing and Bablok regression analysis. The precision and the accuracy of the measurements were determined using the concordance correlation coefficient. Results: There was a strong linear relationship between the glucose values obtained using the portable glucometer and those obtained by the bench method in both cattle and sheep. Precision was 95% for cattle and 88% for sheep, whereas accuracy was 92% and 99%, respectively. The mean glucose values obtained using the portable glucometer were significantly lower by 8.3% in cattle and 3.2% in sheep than those determined by the bench method. Conclusion: The One Touch Vita portable glucometer can be used in clinical practice to determine blood glucose concentrations in cattle and sheep, but reference intervals (RI) must be corrected to allow for negative bias. Based on these equations the RI for blood glucose in cattle and sheep using the portable glucometer were corrected to 1.84–4.17 and 2.41–4.35 mmol/L, respectively.     

Comparison of a portable blood glucose meter analyzer with a benchtop point-of-care chemistry analyzer for measurement of blood glucose concentration in client-owned ferrets (Mustela putorius furo)

BackgroundHypoglycemia is common in pet ferrets (Mustela putorius furo) because of the high prevalence of insulinoma in this species. The objectives of this study were to evaluate agreement of a portable blood glucose meter (PBGM) with a benchtop point-of-care (POC) chemistry analyzer for measurement of blood glucose concentration in ferrets, and to assess the clinical impact of using a PBGM for blood glucose measurement. The benchtop POC analyzer was used as the reference analyzer (modified hexokinase method).MethodsGlucose concentration was measured from 82 blood samples from client-owned ferrets with the benchtop POC chemistry analyzer and the PBGM. Agreement and bias between measurements were assessed using the Bland-Altman method and a Passing-Bablok regression analysis. A modified Clarke error grid analysis was modelized to evaluate the clinical effect if the PBGM was used rather than the benchtop POC chemistry analyzer.ResultsGlucose values obtained with the PBGM were not in agreement with the benchtop POC chemistry analyzer, and it underestimated blood glucose concentration in many cases. However, variation was unpredictable (mean bias, -3.97 mg/dL; range, -52.2 to 64.8 mg/dL), with wide 95% LOA (-47.3 to 38.5 mg/dL). A Passing-Bablok linear regression analysis had a slope of 1.13 (95% confidence interval: 1.00–1.36), and an intercept of -20.78 (95% confidence interval: -38.92 to -9.90), highlighting presence of a proportional and a constant bias. Important clinical error would have occurred in 1% of cases with the PBGM.ConclusionUnpredictable variation of glucose results obtained with the PBGM could have an important impact on clinical decision making. Thus, the use of a benchtop POC analyzer using hexokinase method for measurement of blood glucose concentration should be favored in ferrets for rapid onsite result obtention.     

Comparison of glucose concentrations in canine whole blood,plasma, and serum measured with a veterinary point-of-care glucometer

Previous studies have determined that, compared to whole blood, serum or plasma used in a portable blood glucometer (PBG) may provide more accurate results. We investigated the accuracy of a veterinary PBG (AlphaTRAK 2; Zoetis) for the measurement of glucose concentrations in serum, plasma, and whole blood compared to plasma glucose concentration measured by a biochemical analyzer. Blood samples from 53 client-owned dogs were collected. Lin concordance correlation coefficient (ρ_c) and Bland–Altman plots were used to determine correlation and agreement between the results obtained for the different sample types. Glucose concentration in whole blood measured by the veterinary PBG was more strongly correlated with the glucose concentration measured by the biochemical analyzer (ρ_c = 0.92) compared to plasma and serum glucose concentrations (ρ_c = 0.59 and 0.57, respectively). The mean differences between the glucose concentrations in whole blood, plasma, and serum measured by the veterinary PBG and the glucose concentration determined by the biochemical analyzer were 1.0, 6.3, and 6.7 mmol/L (18, 113, and 121 mg/dL), respectively. Our findings suggest that, when using this veterinary PBG, the accuracy of a glucose measurement obtained is higher when using whole blood compared to plasma or serum. Use of whole blood allows for more correct assessment and diagnosis, which are necessary for appropriate therapeutic intervention.     

Performance of the Ascensia ENTRUST glucose meter for determination of blood glucose concentration in rats

Background: The Ascensia ENTRUST blood glucose meter is intended for self‐monitoring of blood glucose by diabetic patients. Use of such a glucometer would minimize blood volume requirements for the measurement of glucose in small laboratory animals. Objective: The purpose of this study was to assess the performance of the Ascensia ENTRUST for measuring glucose in whole blood from Wistar rats by evaluating the effect of anticoagulant and sample processing delay and comparing normalized results with plasma glucose concentration. Methods: Blood samples were collected from the retroorbital sinus of 30 male Wistar rats with a wide range of blood glucose concentrations. Glucose concentration was measured with the Ascensia ENTRUST in nonheparinized (NH) and heparinized samples immediately after collection (Hep‐0) and in heparinized samples after a 15 min delay at 23–28°C (Hep‐15). Heparinized samples were centrifuged and glucose concentration was determined in plasma using an automated chemistry analyzer. Results were compared to assess the effect of anticoagulant (NH vs Hep‐0) and time (Hep 0 vs Hep 15), and to compare normalized Hep‐15 results with plasma glucose concentration. Results: Glucose concentration was not significantly different between NH and Hep‐0 samples. Glucose concentration was lower in Hep‐15 (77±36.9 mg/dL) than Hep‐0 (88±39.7 mg/dL) samples, but the difference was not significant. With normalization, Hep‐15 glucose concentration correlated well (r≥.98) with plasma glucose concentration but was lower by 6.0±16.7 mg/dL, with a positive bias at low glucose concentrations and a negative bias at high concentrations. Conclusion: The Ascensia ENTRUST may be adequate for repeated blood glucose measurements in rats, but its results do not accurately predict plasma glucose concentrations measured by an automated clinical chemistry analyzer.     

Comparison of 2 glucose analytical methodologies in immature Kemp’s ridley sea turtles: dry chemistry of plasma versus point-of-care glucometer analysis of whole blood

Blood glucose measurements provide important diagnostic information regarding stress, disease, and nutritional status. Glucose analytical methodologies include dry chemistry analysis (DCA) of plasma and point-of-care (POC) glucometer analysis of whole blood; however, these 2 methods differ in cost, required sample volume, and processing time. Because POC glucometers use built-in equations based on features of mammalian blood to convert whole blood measurements to plasma equivalent units, obtained glucose data must be compared and validated using gold-standard chemistry analytical methodology in reptiles. For in-water, trawl-captured, immature Kemp’s ridley sea turtles (Lepidochelys kempii) from Georgia, USA, we observed significant, positive agreement between the 2 glucose determination methods; however, the glucometer overestimated glucose concentrations by 1.4 mmol/L on average in comparison to DCA and produced a wider range of results. The discordance of these results suggests that POC glucometer glucose data should be interpreted in the context of methodology- and brand-specific reference intervals along with concurrent packed cell volume data.     

Assessment of five portable blood glucose meters, a point-of-care analyzer, and color test strips for measuring blood glucose concentration in dogs

OBJECTIVE: To compare blood glucose concentrations obtained using a point-of-care (POC) analyzer, 5 portable blood glucose meters (PBGM), and a color reagent test strip with concentrations obtained using a reference method, and to compare glucose concentrations obtained using fresh blood samples in the PBGM with concentrations obtained using blood anticoagulated with lithium heparin. DESIGN: Case series. SAMPLE POPULATION: 110 blood samples from 34 dogs; glucose concentration of the samples ranged from 41 to 596 mg/dl. PROCEDURE: Logistic regression was used to compare blood glucose concentrations obtained with the various devices with reference method concentrations. Ease of use was evaluated subjectively. Percentage of times a clinical decision would have been altered if results of each of these methods had been used, rather than results of the reference method, was calculated. RESULTS: For 3 of the PBGM, blood glucose concentrations obtained with fresh blood were not significantly different from concentrations obtained with blood samples anticoagulated with lithium heparin. None of the devices provided results statistically equivalent to results of the reference method, but the POC analyzer was more accurate than the others. For some samples, reliance on results of the PBGM or the color test strip would have resulted in erroneous clinical decisions. CONCLUSIONS AND CLINICAL RELEVANCE: Although commercially available PBGM and color test strips provided blood glucose concentrations reasonably close to those obtained with reference methods, some devices were more accurate than others. Use of results from these devices could lead to erroneous clinical decisions in some cases.     

Artifactual hypoglycemia associated with hemotrophic mycoplasma infection in a lamb

Background: A 35-day-old male lamb with Mycoplasma ovis infection (previously Eperyihrozoon avis ) was evaluated because of severe hypoglycemia (serum glucose 4 mg/dL, Hitachi 704 automated chemistry analyzer) inconsistent with the animal's condition. Whole blood glucose concentration measured with a glucometer was 74 mg/dL. Objective: The purpose of this study was to investigate this discrepancy through in vitro evaluation of the patient's blood.
Methods: Blood was incubated alone, with increasing concentrations of plasma, or with equine serum of known glucose concentration for 0,15, 30, and 60 minutes at room temperature; end-point glucose concentrations were compared with blood from a control sheep handled similarly.
Results: A rapid decline in glucose concentration was observed in heparinized or EDTA anticoagulated whole blood from the infected lamb incubated alone or with the equine serum. Glucose concentrations in incubated samples from a control sheep remained stable. Incubation of increasing concentrations of heparinized blood with autologous plasma resulted in decreased glucose concentrations in patient, but not control, blood. As parasitemia decreased after treatment, serum glucose concentration increased, serum lactate concentration decreased, and in vitro glucose concentration stabilized.
Conclusions: These findings are consistent with parasite-associated in vitro glucose consumption. An increase in the lamb's plasma glucose concentration associated with reduction of parasite load suggested excess glucose consumption also may have occurred in vivo.     

Evaluation of an in-house centrifugal hematology analyzer for use in veterinary practice

OBJECTIVE: To compare CBC results obtained by use of an in-house centrifugal analyzer with results of a reference method. DESIGN: Prospective study. SAMPLE POPULATION: Blood samples from 147 dogs, 42 cats, and 60 horses admitted to a veterinary teaching hospital and from 24 cows in a commercial dairy herd. PROCEDURE: Results obtained with the centrifugal analyzer were compared with results obtained with an electrical-impedance light-scatter hematology analyzer and manual differential cell counting (reference method). RESULTS: The centrifugal analyzer yielded error messages for 50 of 273 (18%) samples. Error messages were most common for samples with values outside established reference ranges. Correlation coefficients ranged from 0.80 to 0.99 for Hct, 0.55 to 0.90 for platelet count, 0.76 to 0.95 for total WBC count, and 0.63 (cattle) to 0.82 (cats) to 0.95 (dogs and horses) for granulocyte count. Coefficients for mononuclear cell (combined lymphocyte and monocyte) counts were 0.56, 0.65, 0.68, and 0.92 for cats, horses, dogs, and cattle, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that there was an excellent correlation between results of the centrifugal analyzer and results of the reference method only for Hct in feline, canine, and equine samples; WBC count in canine and equine samples; granulocyte count in canine and equine samples; and reticulocyte count in canine samples. However, an inability to identify abnormal cells, the high percentage of error messages, particularly for samples with abnormal WBC counts, and the wide confidence intervals precluded reliance on differential cell counts obtained with the centrifugal analyzer.     

Thromboelastography in equine medicine: Technique and use in clinical research

Thromboelastography (TEG) is a viscoelastic, whole blood‐based assay that integrates information from both the cellular and soluble components of coagulation, providing a global evaluation of the haemostatic system. This contrasts with the conventional coagulation assays (i.e. platelet count, prothrombin time [PT], activated partial thromboplastin time [aPTT] and fibrinogen concentration [FIB]), which only provide information about one component (e.g. clotting factors in the case of PT and aPTT) of the haemostatic process, requiring the combination of several assays for a complete evaluation of haemostasis. Thromboelastography is an old technology that has been used in human medicine for over 50 years. However, it is relatively new in veterinary medicine and has only been applied to horses in the last 5 years. Clinical applications in human medicine include diagnosis and monitoring of coagulopathies. Currently, extensive research is being carried out to expand the use of TEG in dogs and cats. Therefore, it is expected that the use of this technique will also further expand in horses in the near future. To date, the available studies in the equine species have evaluated TEG in healthy horses, horses with gastrointestinal disease, septic foals, horses with exercise‐induced pulmonary haemorrhage (EIPH) and a filly with Glanzmann's thrombasthenia. The main objective of this review is to introduce the TEG technique to equine clinicians, providing information on how the TEG functions, blood sample collection and processing, variables measured and their interpretations, normal reference values and areas of potential clinical application.     

Comparison of a human portable glucometer and an automated chemistry analyzer for measurement of blood glucose concentration in pet ferrets (Mustela putorius furo)

This study compared blood glucose concentrations measured with a portable blood glucometer and a validated laboratory analyzer in venous blood samples of 20 pet ferrets (Mustela putorius furo). Correlation and agreement were evaluated with a Bland-Altman plot method and Lin’s concordance correlation coefficient. Blood glucose concentrations measured with the laboratory analyzer and the glucometer ranged from 1.9 to 8.6 mmol/L and from 0.9 to 9.2 mmol/L, respectively. The glucometer had a poor agreement and correlation with the laboratory analyzer (bias, −0.13 mmol/L; level of agreement, −2.0 to 3.6 mmol/L, concordance correlation coefficient 0.665). The relative sensitivity and specificity of the portable blood glucometer for detection of hypoglycemia were 100% (95% CI: 66% to 100%) and 50% (95% CI: 20% to 80%), respectively. Positive and negative predictive values were 67% (95% CI: 39% to 87%) and 100% (95% CI: 46% to 100%), respectively. Based on these results, clinicians are advised to be cautious when considering the results from this handheld glucometer in pet ferrets, and blood glucose concentrations should be determined with a laboratory analyzer validated for this species.     

Evaluation of a point-of-care blood analyzer and determination of reference ranges for blood parameters in rockfish

OBJECTIVE: To compare values of blood parameters in rockfish obtained by use of a point-of-care portable blood analyzer with values determined by a veterinary diagnostic laboratory, calculate reference ranges for various blood parameters in black rockfish, and compare values of blood parameters in clinically normal fish with those of fish with clinical abnormalities. DESIGN: Prospective study. ANIMALS: 41 captive adult black rockfish (Sebastes melanops) and 4 captive adult blue rockfish (Sebastes mystinus). PROCEDURE: Rockfish were anesthetized with tricaine methanesulfonate for collection of blood samples. Heparinized blood samples were immediately analyzed with a point-of-care analyzer. Blood sodium, potassium, chloride, urea nitrogen, and glucose concentrations; Hct; pH; partial pressure of carbon dioxide; total carbon dioxide concentration; bicarbonate concentration; base excess; and hemoglobin concentration were determined. A microhematocrit technique was used to determine PCV, and a refractometer was used to estimate total plasma protein concentration. Paired heparinized blood samples were transported to a veterinary diagnostic laboratory for analyses. RESULTS: Data obtained with the point-of-care analyzer were reproducible; however, values for most blood parameters were significantly different from those obtained by the veterinary diagnostic laboratory. Fish with poor body condition had several blood parameter values that were lower than corresponding values in clinically normal fish. CONCLUSIONS AND CLINICAL RELEVANCE: Point-of-care blood analyses may prove useful in rockfish. Point-of-care data for a large number of clinically normal fish must be obtained for reference ranges to be calculated, and further assessments of clinically abnormal fish are necessary to determine the relevance of the data.     

Agreement between point-of-care glucometry, blood gas and laboratory-based measurement of glucose in an equine neonatal intensive care unit

Objective: To test the agreement between 3 common methods of glucose measurement in a population of critically ill foals presenting to a neonatal intensive care unit. Design: Prospective clinical study. Setting: University large animal hospital neonatal intensive care unit. Animals: Sequentially admitted critically ill neonatal foals <30 days of age. Interventions: Venous blood obtained from a jugular vein was used for determination of blood glucose concentration using point‐of‐care (POC) glucometry (GLU), a laboratory chemistry technique (CHEM) and a multi‐electrode blood gas analyzer (BG). Paired data were compared using Lin's concordance correlation, Pearson's correlation and robust regression. Bias and limits of agreement were investigated using the technique of Bland and Altman. Measurements and main results: Concordance was significant for all comparisons and was strongest for CHEM‐BG while weakest for GLU‐BG. Pearson's correlation was excellent for all comparisons: CHEM‐BG, 0.98; GLU‐BG, 0.94; GLU‐CHEM, 0.96. All comparisons had significant robust regression coefficients: CHEM‐BG, 0.99; GLU‐BG, 0.80; GLU‐CHEM, 0.79. For Bland–Altman analysis, mean differences (mean±SD, 95% limits of agreement) were: GLU‐BG (?33±18 mg/dL, ?68.6 to 1.5); GLU‐CHEM (?20±16 mg/dL, ?51.0 to 10.9); CHEM‐BG (13±11 mg/dL, ?8.7 to 34.7). Conclusions: This study demonstrates that glucometry has less than ideal agreement with a laboratory standard and another POC test, blood gas analysis. These differences may be clinically important and decisions regarding management of glucose concentrations in critically ill foals should be made with these differences in mind.     

Comparison of chemistry analytes between 2 portable, commercially available analyzers and a conventional laboratory analyzer in reptiles

Background: Advantages of handheld and small bench‐top biochemical analyzers include requirements for smaller sample volume and practicality for use in the field or in practices, but little has been published on the performance of these instruments compared with standard reference methods in analysis of reptilian blood. Objective: The aim of this study was to compare reptilian blood biochemical values obtained using the Abaxis VetScan Classic bench‐top analyzer and a Heska i‐STAT handheld analyzer with values obtained using a Roche Hitachi 911 chemical analyzer. Methods: Reptiles, including 14 bearded dragons (Pogona vitticeps), 4 blue‐tongued skinks (Tiliqua gigas), 8 Burmese star tortoises (Geochelone platynota), 10 Indian star tortoises (Geochelone elegans), 5 red‐tailed boas (Boa constrictor), and 5 Northern pine snakes (Pituophis melanoleucus melanoleucus), were manually restrained, and a single blood sample was obtained and divided for analysis. Results for concentrations of albumin, bile acids, calcium, glucose, phosphates, potassium, sodium, total protein, and uric acid and activities of aspartate aminotransferase and creatine kinase obtained from the VetScan Classic and Hitachi 911 were compared. Results for concentrations of chloride, glucose, potassium, and sodium obtained from the i‐STAT and Hitachi 911 were compared. Results: Compared with results from the Hitachi 911, those from the VetScan Classic and i‐STAT had variable correlations, and constant or proportional bias was found for many analytes. Bile acid data could not be evaluated because results for 44 of 45 samples fell below the lower linearity limit of the VetScan Classic. Conclusions: Although the 2 portable instruments might provide measurements with clinical utility, there were significant differences compared with the reference analyzer, and development of analyzer‐specific reference intervals is recommended.     

Evaluation of an automated tabletop blood biochemical analyzer for the veterinary clinical pathology laboratory

The importance of accurate quantitative blood biochemical analysis for the diagnosis and management of disease is recognized by most veterinarians. In recent years, several biochemical analyzers have become available for the veterinary market. One of these analyzers was evaluated for its suitability in measuring several biochemical variables--alkaline phosphatase, urea nitrogen, creatinine, glucose, alanine transaminase (dog and cat only), and aspartate transaminase (horse only)--in dogs, cats, and horses. Instrument within-day precision ranged from 1.0 to 7.1%, and between-day precision ranged from 1.6 to 7.4%. During the 6-month period of the study, the analyzer required recalibration for only 1 analyte (creatinine). Concentrations of individual analytes were similar when blood (collected in anticoagulant), plasma, and serum were assayed in parallel. The accuracy of the analyzer, as measured by correlation to a reference method, ranged from 0.861 for creatinine in horses to greater than 0.950 for each of the other analytes in the 3 species. Mean values for each analyte were similar, except for alkaline phosphatase, which had consistently lower values by use of the analyzer method. A data base was established for reference values in each species.     

Preliminary evaluation of hemostasis in neonatal foals using a viscoelastic coagulation and platelet function analyzer

Objectives – To compare coagulation and platelet function parameters measured using a viscoelastic analyzer in 3 groups: foals presenting to a neonatal intensive care unit with presumed sepsis, normal foals, and adult horses. Design – Preliminary prospective trial. Setting – Veterinary teaching hospital. Animals – Ten clinically healthy foals, 13 clinically healthy adult horses, and 17 foals sequentially admitted for suspected sepsis. Intervention – A single citrated (3.8%) blood sample collected at admission was submitted for coagulation evaluation using a viscoelastic analyzer. Measurements and Main Results – Time to initial clot formation (ACT), clot rate (CR), platelet function, and time to peak parameters were collected from the signature generated with the associated software. Peak clot strength was collected manually from signature tracings. Signalment, presenting complaint, blood culture results, clinical progression, and outcome were collected from the medical record. Kruskal‐Wallis testing was used to determine differences in coagulation parameters between groups, as well as to identify any associations between coagulation variables, foal variables, and outcome. Normal foals were more likely to have increased platelet function (P=0.04) compared with normal adult horses. Prolonged ACT (P=0.004) and decreased CR (P=0.03) were associated with foals with positive blood culture. There was a trend toward prolonged ACT and increased likelihood of death (P=0.06). Conclusions – Healthy foals differ in values measured by the viscoelastic coagulation and platelet function analyzer compared with healthy adult horses. ACT and CR abnormalities were more likely to be observed in foals with positive blood cultures. The viscoelastic coagulation and platelet function analyzer may be useful in identifying early hemostasic and platelet dysfunction in critically ill foals, particularly those that are septic.     

Concentrations of ionized and total magnesium and calcium in healthy horses: effects of age, pregnancy, lactation, pH and sample type

Magnesium (Mg) and calcium (Ca) are the main divalent cations in the body. The free ionized fraction is the physiologically active form of both Mg and Ca. As ion-selective-electrode (ISE) analyzers are becoming widely used in veterinary practice it will be useful to establish reference intervals for horses. In the present study, reference intervals were established for ionized, total and the ratio of the ionized to total Mg and Ca concentrations in four horse groups: adults, neonatal foals, and pregnant and lactating mares, as well as in three sample types, whole blood, plasma and serum, using an ISE-analyzer. Sample pH effect was assessed.Concentration differences in both total and ionized cations were recorded for some measures between horse groups and different sample types. The most significant differences were recorded between neonatal foals and other groups. These results demonstrate the need to use specific reference intervals for horses of different physiologic status and in specific sample types.     

Comparison of two dry chemistry analyzers and a wet chemistry analyzer using canine serum

Canine serum was used to compare seven chemistry analytes on two tabletop clinical dry chemistry analyzers, Boehringer's Reflotron and Kodak's Ektachem. Results were compared to those obtained on a wet chemistry reference analyzer, Roche Diagnostic's Cobas Mira. Analytes measured were urea nitrogen (BUN), creatinine, glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), cholesterol and bilirubin. Nine to 12 canine sera with values in the low, normal, and high range were evaluated. The correlations were acceptable for all comparisons with correlation coefficients greater than 0.98 for all analytes. Regression analysis resulted in significant differences for both tabletop analyzers when compared to the reference analyzer for cholesterol and bilirubin, and for glucose and AST on the Kodak Ektachem. Differences appeared to result from proportional systematic error occurring at high analyte concentrations.     

ASVCP guidelines: quality assurance for portable blood glucose meter (glucometer) use in veterinary medicine

Portable blood glucose meters (PBGM, glucometers) are a convenient, cost effective, and quick means to assess patient blood glucose concentration. The number of commercially available PBGM is constantly increasing, making it challenging to determine whether certain glucometers may have benefits over others for veterinary testing. The challenge in selection of an appropriate glucometer from a quality perspective is compounded by the variety of analytic methods used to quantify glucose concentrations and disparate statistical analysis in many published studies. These guidelines were developed as part of the ASVCP QALS committee response to establish recommendations to improve the quality of testing using point‐of‐care testing (POCT) handheld and benchtop devices in veterinary medicine. They are intended for clinical pathologists and laboratory professionals to provide them with background knowledge and specific recommendations for quality assurance (QA) and quality control (QC), and to serve as a resource to assist the provision of advice to veterinarians and technicians to improve the quality of results obtained when using PBGM. These guidelines are not intended to be all‐inclusive; rather they provide a minimum standard for management of PBGM in the veterinary setting.     

Investigations on the usefulness of the dry chemistry blood anaylsis system SPOTCHEM SP-4410in laboratory diagnosis of cattle

The usefulness of the dry-chemistry blood analyzer, SPOTCHEM SP-4410, for analysis of bovine blood chemistry was studied in a veterinary clinic. The control serum Precipath-U, Boehringer-Mannheim, was used to measure precision within each run and between days. The coefficients of variation (CV) ranged between 1.54% and 4.86%, with the exception of albumin and creatine phosphokinase showing a CV of 6.3% and 10.03% for between-day precision. For methodological comparison bovine serum samples were assayed with both the SPOTCHEM SP-4410 and the automated blood analyzer HITACHI 705, which served as a wet-chemistry reference system. The following analytes were measured: glucose, urea, creatinine, total protein, albumin, total bilirubin and the enzymes AST, CPK and gamma-GT. For hemoglobin, which was measured in heparinized whole blood, the CO oximeter 855, CIBA-CORNING, was used as a reference system. The comparative analysis showed very good correlation in eight of ten parameters and their correlation coefficients (r) ranged between 0.962 and 0.998. Only the correlation coefficients of the analysis of total bilirubin (r = 0.903) and albumin (r = 0.771) were less satisfactory. The recovery test was carried out with the two parameters glucose and blood urea. The recovery of glucose was 93.7% and of urea 98.8%. The SPOTCHEM SP-4410 is easy to use and proved to be reliable and accurate, and therefore it seems to be useful for analysis of bovine blood samples.     

Evaluation of five portable blood glucose meters for use in dogs

OBJECTIVE: To evaluate clinical and analytical accuracy of 5 portable blood glucose meters (PBGM) used to measure blood glucose concentrations in dogs and to determine potential sources of error. DESIGN: Prospective study. ANIMALS: 221 dogs. PROCEDURE: Venous blood samples were obtained, and results of the 5 PBGM were compared with results of a hexokinase reference method. Agreement among methods was determined by use of error grid analysis and statistical methods. RESULTS: Accuracy of the PBGM varied with glucose concentration of the sample. The largest differences between results of the PBGM and results of the reference method were obtained with samples with high glucose concentrations; 4 PBGM tended to underestimate and 1 PBGM tended to overestimate the true glucose concentration. Absolute differences between results of the PBGM and results of the reference method were small for samples with low glucose concentrations and samples with concentrations in the reference range. None of the PBGM yielded measurements that would result in clinically unacceptable errors. Within-run and between-day precision was good for all PBGM, and results were not affected by use of EDTA or heparin to anticoagulate blood. Readings of the PBGM were significantly higher for blood samples with low Hct than for samples with normal Hct. For 3 PBGM, samples < 3 microliters resulted in inaccurate measurements. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that currently available PBGM are sufficiently accurate for use in clinical practice to determine blood glucose concentrations in dogs.