Clinical hematology practices at veterinary teaching hospitals and private diagnostic laboratories

The clinical hematology practices utilized at veterinary teaching hospitals and private veterinary diagnostic laboratories were surveyed using a questionnaire. The hematology caseload at private diagnostic laboratories was larger, and comprised predominantly of canine and feline submissions. The Coulter S Plus IV and Serono Baker 9000 were the hematology analyzers used most frequently at veterinary medical laboratories. The Abbott Cell-Dyn 3500, a multispecies analyzer capable of leukocyte differential counting, was utilized more by private laboratories. Commercial hematology control reagents were used at all laboratories; teaching hospital laboratories more often used reagents supplied by the manufacturer of the analyzer. A greater percentage of private diagnostic laboratories participated in the external quality assurance programs offered by Veterinary Laboratory Association and College of American Pathologists. While private diagnostic laboratories retained the EDTA blood specimens longer after initial testing, the teaching hospital laboratories retained blood smears and complete blood count reports longer. The complete blood count reports at veterinary teaching laboratories more often included red blood cell volume distribution width, mean platelet volume, manual hematocrit, plasma protein, and leukocyte differentials as absolute concentrations. The laboratory practices utilized by these veterinary medical laboratories were generally similar, and differences were attributed to divergent emphasis on economic accountability and clinical investigation.     

Farrier services at veterinary teaching hospitals in the USA

Horse health is best served when farriers and veterinarians collaborate in the care of their patients. Veterinary Teaching Hospitals (VTHs) provide an environment that can nurture that collaboration. While VTH veterinary services are well known, VTH farrier activities are undocumented. To characterise farrier services at VTHs in the USA, 27 VTH Diplomates of the American College of Veterinary Surgeons and/or VTH farriers completed a multiple choice questionnaire characterising VTH farrier details, training, certification, remuneration method, and clinical, teaching and research responsibilities; and farrier service prevalence, facilities and financial viability. Questionnaire response rate was 81%. Eighteen of 22 (82%) responding VTHs had in‐house farrier services. Twenty‐one of 22 (95%) VTH farriers were male. Farriers' ages ranged from <30 years (n = 1, 5%) to >50 years (n = 7, 32%). At 11 (61%) VTHs the farriers were paid by the client and at 7 (39%) by the VTH. Five farriers (23%) received a VTH salary. Eighteen of 22 (82%) farriers had a professional certification. At 5 (28%) VTHs the farrier service made a profit and operational costs were met at 13 (72%). Fifteen (83%) farrier services provided professional education in clinical settings and 13 (72%) in lecture settings. Nine (41%) VTH farriers participated in research activities. In the USA, VTH farrier services vary considerably in both nature and extent. The farriers' potential contributions to VTH operations are often recognised but not consistently exploited. VTH farriers are a valuable resource who can contribute effectively toward VTH patient care, veterinary education and research.     

Characteristics of biosecurity and infection control programs at veterinary teaching hospitals

OBJECTIVE: To characterize biosecurity and infection control practices at veterinary teaching hospitals located at institutions accredited by the AVMA. DESIGN: Cross-sectional survey. POPULATION: 50 biosecurity experts at 38 veterinary teaching hospitals. PROCEDURES: Telephone interviews were conducted between July 2006 and July 2007, and questions were asked regarding policies for hygiene, surveillance, patient contact, education, and awareness. Respondents were also asked their opinion regarding the rigor of their programs. RESULTS: 31 of 38 (82%) hospitals reported outbreaks of nosocomial infection during the 5 years prior to the interview, 17 (45%) reported > 1 outbreak, 22 (58%) had restricted patient admissions to aid mitigation, and 12 (32%) had completely closed sections of the facility to control disease spread. Nineteen (50%) hospitals reported that zoonotic infections had occurred during the 2 years prior to the interview. Only 16 (42%) hospitals required personnel to complete a biosecurity training program, but 20 of the 50 (40%) respondents indicated that they believed their hospitals ranked among the top 10% in regard to rigor of infection control efforts. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that differences existed among infection control programs at these institutions. Perceptions of experts regarding program rigor appeared to be skewed, possibly because of a lack of published data characterizing programs at other institutions. Results may provide a stimulus for hospital administrators to better optimize biosecurity and infection control programs at their hospitals and thereby optimize patient care.     

Modification and evaluation of a multichannel blood cell counting system for blood analysis in veterinary hematology

A multichannel, semiautomated, blood cell counting system (Coulter Counter Model S550) was modified for use in veterinary hematology by increasing both the erythrocyte and leukocyte aperture currents to 225 V and 195 V, respectively, followed by calibration with human blood. It was evaluated by use of 350 samples from dogs, cats, horses, and cows. Values for leukocyte count, erythrocyte count, mean corpuscular volume, and hematocrit generated by the S550 were compared with values generated by an automated multichannel counter with histogram capability and other reference procedures when appropriate. Mean differences for values between S550 and reference values were less than calibration tolerance limits for the instrument. Correlation coefficients were excellent for all values of each species. To assess behavior of leukocytes of the different species with respect to the counting threshold, leukocyte size distribution histograms were generated for all samples analyzed on the S550. Means for mean leukocyte volumes in diluent and lysing reagents were 55.5, 56.6, 67.4, and 72.8 fl for dogs, cats, horses, and cows, respectively. Canine leukocyte counts, because of small leukocyte size, were an average of 14% less for 5 samples analyzed on the unmodified instrument, compared with analysis after increasing the leukocyte aperture current. Leukocyte threshold failures attributable to interfering particles, resulting in falsely high counts, were recognized in 14%, 10%, 8% and 0% of feline, bovine, canine, and equine samples, respectively. The magnitude of error in these samples averaged 5% for cows and dogs, but was considered not important. However, leukocyte counts of feline samples in this group averaged 44% falsely high.     

Guidelines for zoo and aquarium veterinary medical programs and veterinary hospitals

These guidelines for veterinary medical care and veterinary hospitals are written to conform with the requirements of the Animal Welfare Act, which states that programs of disease prevention and parasite control, euthanasia, and adequate veterinary care shall be established and maintained under the supervision of a veterinarian. Ideally the zoo and aquarium should be providing the best possible veterinary medical care for the animals in their collections. Many of these animals are rare and endangered and the institutions should endeavor both to provide for the long term health and well being of these animals and to advance the field of non-domestic animal medicine. It is hoped that this publication will aid in this process.     

Application of flow cytometric techniques to veterinary clinical hematology

Flow cytometry has emerged as a major new technology in veterinary clinical laboratories. Flow cytometers in current use include stand-alone instruments and cytometers incorporated into hematology analyzers. Flow cytometers offer rapid and quantitative analysis of a variety of cell types based on cell size, molecular complexity, and antigenic composition. Therefore, flow cytometry complements and extends the knowledge that can be obtained by light microscopy. Stand-alone instruments are very flexible, however, this flexibility opens the instrument to obtaining invalid or misleading results. The recent development of monoclonal antibodies specific for epitopes on blood cells of food and companion animals has greatly expanded the spectrum of tests with potential clinical application. Tests that appear to have the greatest potential for routine application include reticulocyte and reticulated platelet enumeration, detection of erythrocyte-bound immunoglobulin, immunophenotyping of leukemias and lymphomas, and bone marrow differential cell counting. This report will briefly review the technical aspects of flow cytometry and then focus on techniques with present or potential application to the veterinary clinical laboratory.     

Balancing veterinary students' and house officers' learning experiences in veterinary teaching hospitals

Veterinary students at two large veterinary referral teaching hospitals were surveyed on their perceptions of competition with interns and residents for learning experiences during clinical instruction. Their responses led to an additional survey of a cohort of clinical educators on how this competition might be managed, what impedes effective management, and how progress toward an improved clinical learning environment might be measured. This article describes the results of the survey and discusses the nature of the competition and factors affecting the competitive learning environment. The results of this study should be expanded to include a larger cohort of veterinary students and an assessment of house officers' and faculty members' perceptions.     

Epidemiology of feline infectious peritonitis among cats examined at veterinary medical teaching hospitals

OBJECTIVE: To determine proportions of cats in which feline infectious peritonitis (FIP) was diagnosed on an annual, monthly, and regional basis and identify unique characteristics of cats with FIP. DESIGN: Case-control study. SAMPLE POPULATION: Records of all feline accessions to veterinary medical teaching hospitals (VMTH) recorded in the Veterinary Medical Data Base between January 1986 and December 1995 and of all feline accessions for necropsy or histologic examination at 4 veterinary diagnostic laboratories. PROCEDURE: Proportions of total and new feline accessions for which a diagnosis of FIP was recorded were calculated. To identify characteristics of cats with FIP, cats with FIP were compared with the next cat examined at the same institution (control cats). RESULTS: Approximately 1 of every 200 new feline and 1 of every 300 total feline accessions at VMTH in North America and approximately 1 of every 100 accessions at the diagnostic laboratories represented cats with FIP. Cats with FIP were significantly more likely to be young, purebred, and sexually intact males and significantly less likely to be spayed females and discharged alive than were control cats. The proportion of new accessions for which a diagnosis of FIP was recorded did not vary significantly among years, months, or regions of the country. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that FIP continues to be a clinically important disease in North America and that sexually intact male cats may be at increased risk, and spayed females at reduced risk, for FIP. The high prevalence of FIP and lack of effective treatment emphasizes the importance of preventive programs, especially in catteries.     

Canine and feline hematology reference values for the ADVIA 120 hematology system

Background: The ADVIA 120 is a laser-based hematology analyzer with software applications for animal species. Accurate reference values would be useful for the assessment of new hematologic parameters and for interlaboratory comparisons.

Objective:

Objective: The goal of this study was to establish reference intervals for CBC results and new parameters for RBC morphology, reticulocytes, and platelets in healthy dogs and cats using the ADVIA 120 hematology system.

Methods:

Methods: The ADVIA 120, with multispecies software (version 1.107-MS), was used to analyze whole blood samples from clinically healthy dogs (n=46) and cats (n=61). Data distribution was determined and reference intervals were calculated as 2.5 to 97.5 percentiles and 25 to 75 percentiles.

Results:

Results: Most data showed Gaussian or log-normal distribution. The numbers of RBCs falling outside the normocyticnormochromic range were slightly higher in cats than in dogs. Both dogs and cats had reticulocytes with low, medium, and high absorbance. Mean numbers of large platelets and platelet clumps were higher in cats compared with dogs.

Conclusions:

Conclusions: Reference intervals obtained on the ADVIA 120 provide valuable baseline information for assessing new hematologic parameters and for interlaboratory comparisons. Differences compared with previously published reference values can be attributed largely to differences in methodology.     

动物医院环境细菌监测及影响因素分析

为了调查动物医院环境细菌污染情况并评估其风险因子,从而给动物医院环境管理和降低患病动物医源性感染提供参考数据。通过抽样调查分析北京地区3家动物医院环境细菌含量与其相关因素。从2013年3月至2014年4月采用空气沉降法和涂布法,分别对空气和物体表面进行采样,37℃恒温培养24 h后进行菌落计数。同时记录采样当日医院的病例量、通风情况以及消毒频率和方法。结果显示,3家动物医院的污染均较为严重,医院A、B、C的空气细菌含量合格率分别为:13.80%、15.40%、31.25%;而物体表面细菌含量合格率较高。空气中细菌含量与病例量存在显著相关性。研究表明,动物医院空气细菌污染较严重,应针对相关的因素,采取有效措施降低环境细菌污染。     

Buying and leasing real estate for veterinary hospitals.

The major factors to be considered in the real estate purchase decision are the interest rate, the depreciation schedule, the property appreciation, the income tax impact, and the impact of paying a principal payment as part of the real estate mortgage. All these factors must be compared with the costs of leasing.     

Clinical evaluation of the CA530-VET hematology analyzer for use in veterinary practice

BACKGROUND: The CA530-VET is a completely automated impedance cell hematology analyzer, which yields a 16-parameter blood count including a 3-part leukocyte differential. OBJECTIVES: The aim of this study was to examine the operational potential of the CA530-VET and its value for use in veterinary practice. METHODS: The analyzer was tested for blood carry-over, precision, and accuracy. Comparison methods included the CELL-DYN 3500, microhematocrit centrifugation, manual platelet (PLT) counting for feline and equine species, and a 100-cell manual WBC differential. Blood samples for comparison of the methods were obtained from 242 dogs, 166 cats, and 144 horses. RESULTS: The carry-over ratio (K) was 0.28% for RBC, 0.59% for PLT, 0.32% for WBC, and 0.18% for hemoglobin (HGB) concentration. Coefficients of variation (CVs) for within-batch precision and duplicate measurement of blood samples were clearly within the required limits, except for duplicate platelet counts in cats (8.7%) and horses (9.5%). The WBC count was in excellent agreement for dogs and horses and RBC count was in excellent agreement for horses. The accuracy of feline WBC counts was not acceptable, with the exception of values at the high end of the range. RBC counts in dogs and cats, and HGB concentration and MCV in all 3 species were sufficiently accurate. The CA530-VET HCT results were in excellent agreement with microhematocrit results in horses but exceeded the maximum allowed inaccuracy for cats and dogs. In all species, PLT counts established mechanically and manually were not in adequate agreement. Large differences were found between the CA530-VET and the manual differential percentage for lymphocytes and "mid-sized cells" (monocytes and basophilic granulocytes). CONCLUSIONS: The CA530-VET can be considered useful for routine canine, feline, and equine blood cell analyses. It should not be considered accurate, however, for PLT counts, feline total WBC counts in the subnormal and normal range, and leukocyte differentials, except for granulocytes.     

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.     

Relationships between demographic variables and lead toxicosis in cattle evaluated at North American veterinary teaching hospitals

OBJECTIVE: To determine associations between age, sex, breed, and month and year of admission and the diagnosis of lead toxicosis in cattle. DESIGN: Retrospective case-control study. Sample Population-Records of all cattle evaluated at North American veterinary teaching hospitals during the years 1963 to 2002, which were available through the Veterinary Medical Database. PROCEDURES: Logistic regression was used to evaluate the associations between postulated risk factors and the occurrence of lead toxicosis in cattle and predict the occurrence of the diagnosis of lead toxicosis in cattle. RESULTS: 413 cases of lead intoxication and 202,363 control cattle were identified and met the inclusion criteria. Cattle < 4 years of age were at increased risk for the diagnosis of lead intoxication relative to cattle > or = 4 years of age. Cattle > or = 2 months and < 6 months of age had the greatest risk for lead intoxication (odds ratio, 12.3). Angus cattle were at greater risk for toxicosis (odds ratio, 1.95), compared with other breeds. The risk of lead toxicosis was greater before 1985 (odds ratio, 1.94) than the risk thereafter. The risk of lead toxicosis diagnosis was greatest in the months of May, June, July, and August. CONCLUSIONS AND CLINICAL RELEVANCE: Lead toxicosis in cattle was associated with age < 4 years and the Angus breed. A seasonal pattern existed with peak occurrence in the late spring and summer. The occurrence of lead toxicosis has declined over time.