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 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.     

Evaluation of a point‐of‐care blood glucose monitor in healthy goats

Objective

To assess agreement between a point‐of‐care glucometer (POCG) and a laboratory chemistry analyzer for blood glucose measurements in goats.

Design

Prospective study.

Setting

University teaching hospital.

Animals

Eighteen healthy adult goats.

Investigations

Whole blood samples were obtained via jugular venipuncture prior to premedication with xylazine and butorphanol (T0), following premedication (T20), and after 1 hour of inhalant anesthesia (T60). Each sample was tested with a POCG and a laboratory analyzer (HITA). Agreement was assessed using concordance correlation coefficients and calculation of bias and 95% limits of agreement.

Measurements and Main Results

Mean blood glucose concentration at T0 was 3.9 ± 0.6 mmol/L (70 ± 10 mg/dL; POCG) and 2.9 ± 0.4 mmol/dL (53 ± 8 mg/dL; HITA). Glucose concentrations at T20 were 6.7 ± 2.4 mmol/L (121 ± 43 mg/dL) and 5.4 ± 2.1 mmol/L (97 ± 37 mg/dL) and at T60 were 5.7 ± 1.7 mmol/L (102 ± 31 mg/dL) and 4.7 ± 1.3 mmol/L (85 ± 24 mg/dL) when measured with the POCG and HITA, respectively. The POCG overestimated blood glucose compared to the HITA. The bias ± SD was 1.08 ± 0.53 mmol/L (19.4 ± 9.5 mg/dL) (95% LOA 0.04 to 2.11 mmol/L [0.7 to 38.0 mg/dL]) and the concordance correlation coefficient was 0.82. After correcting the results of the POCG using a mixed‐effects linear model, the bias was 0.0 ± 0.38 mmol/L (0.0 ± 6.8 mg/dL) (95% LOA ± 0.74 mmol/L [± 13.4 mg/dL]) and the concordance correlation coefficient was 0.98.

Conclusions

The POCG overestimated blood glucose concentrations in goats, compared to the HITA, but when the POCG concentrations were corrected, the agreement was excellent.     

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.     

Evaluation of a portable lactate analyzer (Lactate Scout) in dogs

BACKGROUND: Measurement of blood lactate concentration has become a common practice in canine medicine. However, the accuracy of portable lactate monitors has not been reported in dogs. OBJECTIVES: The aim of this study was to evaluate the accuracy and precision of a portable analyzer (Lactate-Scout) in measuring canine blood lactate concentration. METHODS: A preliminary study was performed to assess the effects of sample storage time and temperature on plasma lactate concentration. Blood samples obtained from 6 canine patients at our hospital were divided into 8 aliquots and stored at 4 degrees C and 20 degrees C; plasma lactate was measured in duplicate with a spectrophotometric system (Konelab) at 0, 30, 60, 120, and 240 minutes after the blood collection. Values were compared with those obtained immediately after blood collection. Lactate values obtained by the portable method also were compared with those obtained by the reference spectrophotometric analyzer on blood samples collected from 48 additional canine patients. RESULTS: There was no significant effect of storage time (P = .89) or temperature (P = .51) on plasma lactate levels. The correlation between lactate values measured with the Lactate-Scout and the Konelab method was r = .98 (slope = .81, 95% confidence interval = .73-.87; intercept = .20, 95% confidence interval = .13-.31). The level of agreement between the 2 methods was generally good for mean lactate concentrations <5 mmol/L. However, at higher lactate concentrations (5 of 48 samples), the values recorded by the Lactate-Scout analyzer were lower than those measured by the Konelab method. CONCLUSION: The Lactate-Scout analyzer is reliably comparable to a reference method for measuring whole blood lactate concentration in dogs; however, caution should be used when interpreting lactate values of 5 mmol/L and higher.     

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.     

Comparison of canine capillary and jugular venous blood lactate concentrations determined by use of an enzymatic-amperometric bedside system

OBJECTIVE: To evaluate the analytical agreement between blood lactate concentrations determined by use of an enzymatic-amperometric bedside system in capillary blood samples from the pinna and in jugular venous blood samples from dogs. ANIMALS: 53 dogs. PROCEDURES: For each dog, venous and capillary blood samples were obtained from a jugular vein and from the ear pinna (by use of a lancing device), respectively, following a randomized sequence of collection. Lactate concentrations in both types of samples were analyzed by use of an enzymatic-amperometric bedside system intended for lactate detection in capillary blood samples from humans that was previously validated in dogs. The Passing-Bablock regression analysis was used to compare venous and capillary blood lactate concentrations; the level of agreement was calculated by use of the Bland-Altman method. RESULTS: Jugular venous blood samples were collected without difficulty from all 53 dogs. A capillary blood sample was obtained from only 47 dogs. The correlation coefficient between lactate concentrations measured in venous and capillary blood samples was 0.58 (slope, 2.0 [95% confidence interval, 1.5 to 3.0]; intercept, -1.2 [95% confidence interval, -3.1 to 0.4]). The mean difference between methods was 0.72 mmol/L (95% confidence interval, 0.38 to 1.06) with limits of agreement of -1.55 to 2.99 mmol/L. CONCLUSIONS AND CLINICAL RELEVANCE: Because of the lack of agreement between lactate concentrations determined in capillary and jugular venous blood samples, measurement of capillary blood lactate concentration in dogs performed with the technique used in the study does not appear to be a reliable alternative to jugular venous blood measurements.     

Blood values of juvenile northern elephant seals (Mirounga angustirostris) obtained using a portable clinical analyzer

Background — Sick, injured, or orphaned juvenile northern elephant seals ( Mirounga angustisrostris ) treated at rehabilitation centers frequently present with abnormalities in blood sodium, potassium, chloride, BUN, and glucose concentrations, and HCT. These abnormalities could be detected rapidly using a portable blood analyzer, but the results with this analysis method do not necessarily equate with those obtained using other techniques.
Objective — The objective of this study was to better assess the clinical relevance of blood values obtained from a portable analyzer and to compare the results with values obtained using more common methods of analysis.
Methods — Heparinized whole blood samples were collected from 20 rehabilitated juvenile northern elephant seals. A portable clinical analyzer (i-STAT, i-STAT Corp, East Windsor, NJ, USA) was used to establish baseline values. Serum biochemical values were obtained using an automated chemistry analyzer (Olympus AU5200, Olympus America, Melville, NY, USA). HCT was determined using EDTA whole blood and a cell counter.
Results — Using the portable analyzer, mean (minimum-maximum) values were obtained for sodium, 143 (132–146) mmol/L; potassium, 4.4 (3.9–5.8) mmol/L; chloride, 106 (101–109) mmol/L; BUN, 1.8 (1.1–2.4) mmol/L; glucose, 7.55 (5.99–8.49) mmol/L; and HCT, 0.55 (0.52–0.61) L/L. Average differences between methods were small for potassium (-0.45 mmol/L), BUN (0.1 mmol/L), and HCT (0.037 L/L) but were large for sodium (-6.8 mmol/L), chloride (-6.4 mmol/L), and glucose (-0.56 mmol/L).
Conclusions — These results suggest that the i-STAT portable analyzer could be useful for clinically assessing juvenile elephant seals. However, when making medical decisions, the clinician should be aware of differences associated with various analyzers and sample types.     

Assessment of a point-of-care biochemical analyzer and comparison with a commercial laboratory for the measurement of total protein and albumin concentrations in psittacines

OBJECTIVE: To determine agreement for total protein (TP) and albumin concentrations measured by a point-of-care biochemical analyzer in heparinized whole blood and plasma samples obtained from psittacines and compare results with those from a commercial laboratory. SAMPLE POPULATION: Hematologic samples from 92 healthy birds. PROCEDURES: Duplicate samples of heparinized whole blood and plasma were obtained. A point-of-care biochemical analyzer was used to determine TP and albumin concentrations. To assess precision, intraclass correlation coefficient (r(i)) and Bland-Altman measures of agreement were used. These results were compared by use of Bland-Altman plots with those obtained from a commercial laboratory that used a biuret method for TP concentration and electrophoresis for albumin concentration. RESULTS: For the analyzer, there was excellent agreement (r(i) = 0.91) between heparinized whole blood and plasma samples for TP and albumin concentrations. Relative error was 0.9% for TP and 0.7% for albumin. Analyzer results correlated well with commercial laboratory results, with a downward bias of 0.6 for TP and 0.3 for albumin. CONCLUSIONS AND CLINICAL RELEVANCE: The analyzer had excellent precision for analysis of heparinized whole blood or plasma samples for TP or albumin concentrations; analyzer values had good agreement with those from a commercial laboratory. The analyzer could be a valid method to measure plasma TP concentrations and provide point-of-care testing in apparently healthy parrots. Biochemical analyzer results for plasma albumin concentration were not validated by results from a commercial laboratory, so conclusions cannot be drawn regarding use of the analyzer in measurement of albumin concentrations in psittacines.     

Evaluation of the Accutrend for lactate measurement in dogs

BACKGROUND: Lactate concentrations are increasingly quantified in dogs using point-of-care instruments, but often without canine-specific method evaluation and instrument-specific reference intervals. OBJECTIVES: The objectives of this study were to 1) determine the precision of the Accutrend (Roche Diagnostics) for lactate determination in dogs, 2) determine the accuracy of the Accutrend using the Rapidlab 865 (Bayer Diagnostics) as the reference method, and 3) establish and compare reference intervals for lactate concentration in clinically healthy dogs for both instruments. METHODS: Precision was evaluated using low and high control materials, and variable (1 drop) and fixed (25 microL) sample volumes. Accuracy was determined by comparing lactate concentrations obtained with the Accutrend with those from the Rapidlab 865 in 273 heparinized canine jugular venous blood samples from 100 clinically healthy dogs and 107 systemically ill dogs (173 samples). Lactate reference intervals were established for both analyzers using data from the 100 clinically healthy dogs. RESULTS: The precision of the Accutrend was good (coefficients of variation, < or = 5.3%) for 25-microL samples but not when a drop was used. Lactate concentrations obtained on the Accutrend correlated poorly with those from the Rapidlab 865 (r = 0.864, mean bias = 0.66 mmol/L, 95% confidence interval [CI] = 0.57-0.76 with 95% limits of agreement = -0.87 (lower limit, 95% CI = -1.03 to -0.71) and 2.20 (upper limit, 95% CI = 2.04 to 2.36). The reference interval for canine lactate concentration on the Accutrend was 1.2-3.1 mmol/L compared with 0.46-2.31 mmol/L on the Rapidlab. CONCLUSION: Although precision was good with fixed sample volumes, blood lactate concentrations obtained on the Accutrend were significantly different than those on the Rapidlab 865, with systematic and random errors resulting in a positive bias. Further evaluation of the Accutrend is required before its use in dogs can be recommended.     

I plasma concentrations of adrenocorticotrophic hormone and alpha-melanocyte-stimulating hormone in ferrets (Mustela putorius furo) with hyperadrenocorticism

OBJECTIVE: To determine plasma concentrations of adrenocorticotrophic hormone (ACTH) and alpha-melanocyte stimulating-hormone (alpha-MSH) in healthy ferrets and ferrets with hyperadrenocorticism. ANIMALS: 16 healthy, neutered, privately owned ferrets, 28 healthy laboratory ferrets (21 sexually intact and 7 neutered), and 28 ferrets with hyperadrenocorticism. PROCEDURES: Healthy ferrets were used for determination of reference plasma concentrations of ACTH and a-MSH. Diagnosis of hyperadrenocorticism was made on the basis of history, clinical signs, urinary corticoid-to-creatinine ratios, ultrasonography of the adrenal glands, and macroscopic or microscopic evaluation of the adrenal glands. Blood samples were collected during isoflurane anesthesia. Plasma concentrations of ACTH and alpha-MSH were measured by radioimmunoassay. RESULTS: Plasma concentrations of ACTH in 23 healthy neutered ferrets during the breeding season ranged from 4 to 145 ng/L (median, 50 ng/L). Plasma concentrations of alpha-MSH in 44 healthy neutered or sexually intact ferrets during the breeding season ranged from < 5 to 617 ng/L (median, 37 ng/L). Reference values (the central 95% of the values) for ACTH and alpha-MSH were 13 to 100 ng/L and 8 to 180 ng/L, respectively. Plasma concentrations of ACTH and alpha-MSH in ferrets with hyperadrenocorticism ranged from 1 to 265 ng/L (median, 45 ng/L) and 10 to 148 ng/L (median, 46 ng/L), respectively. These values were not significantly different from those of healthy ferrets. Plasma ACTH concentrations of sexually intact female ferrets in estrus were significantly higher than those of neutered females. CONCLUSIONS AND CLINICAL RELEVANCE: Ferrets with hyperadrenocorticism did not have detectable abnormalities in plasma concentrations of ACTH or alpha-MSH. The findings suggest that hyperadrenocorticism in ferrets is an ACTH and alpha-MSH-independent condition.     

Evaluation of a Veterinary Glucometer for Use in Horses

Background: Glucose assessment and regulation are important factors in the treatment of hospitalized horses and foals. Hypothesis/Objectives: The purpose of this study was to compare glucose measurement by a veterinary glucometer, adjusted by code for use in horses and foals, to a reference chemistry analyzer. It was hypothesized that the veterinary glucometer and reference analyzer would yield similar results and that interpretation of glucose values obtained from a veterinary glucometer would result in clinically appropriate decisions. Animals: Fifty blood samples from adult horses and 50 blood samples from neonatal foals admitted to the Colorado State University Veterinary Hospital or Equine Reproduction Laboratory for evaluation. Methods: Glucose concentrations from fresh whole blood samples were evaluated in duplicate with a veterinary glucometer and these values were compared with those obtained with a reference plasma chemistry analyzer. The accuracy of glucometer measurement was evaluated with a Clarke error grid. Results: The veterinary glucometer accurately measured whole blood glucose concentrations in both horses and foals when compared with a reference plasma chemistry analyzer. Nearly 97% of the glucometer values obtained in this study would have resulted in appropriate clinical decisions based on the Clarke error grid analysis. Conclusions and Clinical Importance: The veterinary glucometer evaluated has potential utility for point‐of‐care whole blood glucose evaluation in both horses and foals.     

Comparison of the Accu-Chek Aviva point-of-care glucometer with blood gas and laboratory methods of analysis of glucose measurement in equine emergency patients

Background: More information is needed regarding accuracy of commonly used methods of glucose measurement in the critically ill horse.
Hypothesis: Glucometry will have good agreement with a laboratory standard. Glucometry with plasma will have better agreement than when performed with whole blood.
Animals: Fifty sequentially admitted equine emergency patients, aged >1year.
Methods: Venous blood was collected at admission and immediately analyzed by point-of-care glucometry on both whole blood (POC/WB) and plasma (POC/PL), a multielectrode blood gas analyzer with whole blood (BLG), and a standard laboratory method with plasma (CHEM). Paired data were compared using Lin's concordance correlation, Pearson's correlation, and robust regression. Bias and limits of agreement were tested by the Bland-Altman technique. Bivariate regression analysis was used to explore confounding factors.
Results: Concordance was significant for all comparisons, and was strongest for CHEM-POC/PL (0.977) and weakest for POC/WB-POC/PL (0.668). Pearson's correlation was excellent for all comparisons except those with POC/WB. All comparisons had excellent robust regression coefficients except those with POC/WB.
Conclusions and Clinical Importance: POC glucometry with plasma had excellent agreement with a laboratory standard, as did blood gas analysis. POC glucometry with whole blood correlated poorly with a laboratory standard. These differences may be clinically important, and could affect decisions based on glucose concentrations.     

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.     

Effect of bupivacaine liposome suspension administered as a local anesthetic block on indicators of pain and distress during and after surgical castration in dairy calves

Castration is a routine procedure performed on beef and dairy operations in the United States. All methods of castration cause behavioral, physiologic, and neuroendocrine changes associated with pain. The American Veterinary Medical Association and the American Association of Bovine Practitioners recommend that anesthesia and analgesia be administered during castration. The objective of this study was to evaluate the effectiveness of bupivacaine liposome suspension, a novel, long-acting, local anesthetic formulation administered as a nerve block at castration. The authors chose to investigate this novel formulation as an alternative to the current industry standards using lidocaine nerve blocks alone or in combination with meloxicam. Thirty male Holstein calves, 16 to 20 wk of age, were enrolled and randomly assigned to one of the four treatment groups prior to surgical castration: 1) bupivacaine liposome suspension block + oral placebo (BUP), 2) lidocaine block + oral placebo (LID), 3) lidocaine block + oral meloxicam (1 mg/kg) (LID + MEL), and 4) saline block + oral placebo (CON). Biomarkers were collected at −24 h and from 0 to 120 h post-castration and included infrared thermography, pressure mat gait analysis, chute defense and behavior scoring (pain and activity), and blood sampling for serum cortisol and prostaglandin E₂ metabolites (PGEMs). Responses were analyzed using repeated measures, with calf nested in treatment as a random effect, and treatment, time, and their interaction designated as fixed effects. The results from pressure mat gait analysis show that the CON had a shorter front limb stance time from baseline (−8.73%; 95% confidence interval [CI]: −24.84% to 7.37%) compared with BUP and LID + MEL (>5.70%; 95% CI: −22.91% to 23.79%) (P < 0.03). The CON tended to have an increase in front limb force from baseline (6.31%; 95% CI: −1.79% to 14.41%) compared with BUP, LID, and LID + MEL (<−5.06%; 95% CI: −14.22% to 0.95%) (P < 0.04). The CON displayed higher counts of hunched standing (2.00; 95% CI: 1.68 to 2.32) compared with LID + MEL (1.43; 95% CI: 1.13 to 1.72) (P = 0.05). The CON had higher cortisol concentrations at 24 h (7.70 ng/mL; 95% CI: 1.52 to 13.87 ng/mL) relative to BUP (3.11 ng/mL; 95% CI: −2.56 to 8.79 ng/mL) (P = 0.002). At 4 and 24 h, LID + MEL had lower PGEM concentrations from baseline (−32.42% and −47.84%; 95% CI: −78.45% to −1.80%) compared with CON (27.86% and 47.63%; 95% CI: 7.49% to 82.98%) (P < 0.02). The administration of bupivacaine liposome suspension as a local anesthetic block at the time of castration was as effective at controlling pain as a multimodal approach of lidocaine and meloxicam.     

Use of a point-of-care beta-hydroxybutyrate sensor for detection of ketonemia in dogs

The urine test strip is the most common test used to detect ketones in veterinary patients, but it can underestimate the degree of ketonuria and hence, ketonemia. Additionally, adequate urine samples for analysis may be difficult to obtain from dehydrated animals. The standard method used to detect and monitor ketonemia in human medicine is measurement of serum or whole blood beta-hydroxybutyrate (βHOB). A point-of-care (POC) analyzer has been validated for this purpose in humans. This study compared the accuracy of the POC device to an enzymatic reaction laboratory method for measurement of βHOB in dogs. Although the POC sensor tended to overestimate βHOB concentrations, there was good correlation (R(2) = 0.96) and good agreement between the 2 methods with a bias +/- precision of 0.0860 +/- 0.3410 mmol/L βHOB. The POC βHOB sensor can be useful for assessing ketonemia in dogs.     

Composition of cerebrospinal fluid in clinically normal adult ferrets

OBJECTIVE: To determine the protein and cellular composition of CSF in healthy adult ferrets. ANIMALS: 42 clinically normal adult ferrets. PROCEDURE: CSF samples were collected from the cerebellomedullary cistern of anesthetized ferrets by use of disposable 25-gauge, 1.6-cm-long hypodermic needles. Samples were processed within 20 minutes after collection. The number of WBCs and RBCs per microliter of CSF was counted by use of a hemacytometer. The total protein concentration was determined by use of an automated chemistry analyzer. RESULTS: Total WBC counts (range, 0 to 8 cells/microL; mean, 1.59 cells/microL) in CSF of ferrets were similar to reference range values obtained for CSF from other species. Twenty-seven CSF samples had <100 RBCs/microL (mean, 20.3 RBCs/microL). A small but significant effect of blood contamination on WBC counts was found between the 27 CSF samples with <100 RBCs/microL and the remaining samples. Protein concentrations in CSF of ferrets (range, 28.0 to 68.0 mg/dL; mean, 31.4 mg/dL) were higher than has been reported for the CSF of dogs and cats. A significant effect of blood contamination on the CSF protein concentration was not found. CONCLUSION AND CLINICAL RELEVANCE: We have established reference range values for WBC counts and protein concentrations in CSF from healthy adult ferrets that may be useful in the clinical investigation of CNS disease. Results of our study indicate that the WBC count is significantly affected by blood contamination of the CSF sample.     

CONGENITAL ABNORMALITIES OF THE VERTEBRAL COLUMN IN FERRETS

Vertebral column pathologies requiring surgical intervention have been described in pet ferrets, however little information is available on the normal vertebral formula and congenital variants in this species. The purpose of this retrospective study was to describe vertebral formulas and prevalence of congenital vertebral anomalies in a sample of pet ferrets. Radiographs of 172 pet ferrets (96 males and 76 females) were included in this retrospective study. In 143 ferrets (83.14%), five different formulas of the vertebral column were recorded with normal morphology of vertebrae (rib attachment included) but with a variable number of thoracic (Th), lumbar (L), and sacral (S) vertebrae. The number of cervical (C) vertebrae was constant in all examined animals. Observed vertebral formulas were C7/Th14/L6/S3 (51.74%), C7/Th14/L6/S4 (22.10%), C7/Th14/L7/S3 (6.98%), C7/Th15/L6/S3 (1.74%), and C7/Th15/L6/S4 (0.58%). Formula C7/Th14/L6/S4 was significantly more common in males than in females (P < 0.05). Congenital spinal abnormalities were found in 29 ferrets (16.86%), mostly localized in the thoracolumbar and lumbosacral regions. The cervical region was affected in only one case. Transitional vertebrae represented the most common congenital abnormalities (26 ferrets) in the thoracolumbar (13 ferrets) and lumbosacral regions (10 ferrets) or simultaneously in both regions (three ferrets). Other vertebral anomalies included block (two ferrets) and wedge vertebra (one ferret). Spina bifida was not detected. Findings from the current study indicated that vertebral formulas may vary in ferrets and congenital abnormalities are common. This should be taken into consideration for surgical planning.     

Point-of-care β-hydroxybutyrate measurement for the diagnosis of feline diabetic ketoacidaemia

Objectives : To evaluate accuracy and precision of a hand‐held ketone meter measuring β‐hydroxybutyrate and to determine its diagnostic performance to rule out ketoacidaemia in diabetic cats. Methods : The ketone meter was validated by calculating within‐day precision at different β‐hydroxybutyrate concentrations and by comparison with a laboratory method. To determine its diagnostic performance to diagnose ketoacidaemia, 217 sets of data (venous blood gas analysis and β‐hydroxybutyrate measurements) were retrospectively analysed. Sensitivities and specificities were calculated with the help of receiver‐operating characteristic curves. Results : The ketone meter reliably detected β‐hydroxybutyrate at concentrations >0·1 mmol/L and reproducibility was acceptable. Measurements highly correlated with laboratory results (r=0·97; P<0·001), but a significant negative bias was found at high concentrations. A β‐hydroxybutyrate concentration of >2·55 mmol/L had a sensitivity of 94% and a specificity of 68% for diagnosing ketoacidaemia. Many cats with high β‐hydroxybutyrate concentrations and normal blood pH had an elevated chloride gap suggestive of superimposed hypochloraemic metabolic alkalosis. Clinical Significance : The commercially available point‐of‐care ketone meter Precision Xtra is a valid tool to measure β‐hydroxybutyrate in diabetic cats. Concentration <2·55 mmol/L enable ketoacidaemia to be excluded and should lead to redirection of differential diagnoses.