Evaluation of point-of-care tests for diagnosis of disseminated intravascular coagulation in dogs admitted to an intensive care unit.

OBJECTIVE: To evaluate the accuracy of point-of-care tests for the diagnosis of disseminated intravascular coagulation (DIC) in dogs and assess the correlation and agreement of results between point-of-care and laboratory tests in the evaluation of hemostatic function. DESIGN: Prospective case series. ANIMALS: 59 critically ill dogs (affected dogs) with clinical signs of diseases known to predispose to DIC and 52 clinically normal dogs. PROCEDURES: Accuracy of the point-of-care tests (activated clotting time [ACT], estimated platelet count and number of schizocytes from a blood smear, plasma total solids [TS] concentration, and the protamine sulfate test) was evaluated, using receiver operating characteristic curves and likelihood ratios. A strategy, using likelihood ratios to calculate a posttest probability of DIC, was tested with 65% used as a threshold for initiation of treatment. Results of laboratory tests (coagulogram and plasma antithrombin III activity) were used as the standard for comparison in each dog. RESULTS: ACT and estimated platelet count provided the best accuracy for detection of DIC. The plasma TS concentration, schizocyte number, and protamine sulfate test had poor accuracy. The strategy using post-test probability of DIC identified 12 of 16 affected dogs that had DIC. Estimated platelet count was correlated and had acceptable clinical agreement with automated platelet count (r = 0.70). The plasma TS (r = 0.28) concentration and serum albumin (r = 0.63) concentration were not accurate predictors of plasma antithrombin III activity. The ACT did not correlate with activated partial thromboplastin time (r = 0.28). CONCLUSIONS AND CLINICAL RELEVANCE: Strategic use of likelihood ratios from point-of-care tests can assist clinicians in making treatment decisions for dogs suspected to have DIC when immediate laboratory support is unavailable.     

Canine hematology and biochemistry reference values.

Reference hematology and biochemistry values for 53 variables are presented from 51 clinically healthy dogs, 26 female and 25 male, approximately six to 24 months of age and of mixed breed. These dogs were sampled because of their good health status and the opportunity to collect the volume of blood required to complete the variable analysis of interest. Collection of blood specimens and laboratory analysis was done in a standard described manner, the latter including a continuing quality control program. For each variable the data were examined for homogeneity and when present, outliers (n = 9) were excluded. Parametric analysis was used to calculate the reference interval for those variables which had a Gaussian distribution or could be changed to a Gaussian distribution by any of four transformations. For those variables in which Gaussian distribution was not present or attained, nonparametric analysis was used. Due to the small size of the population sample, the uncertainty of breed and the exact age of each dog, breed, age and sex effects were not examined. Reference values should be used to assist interpretation of observations obtained from an animal or animals of comparable origin, i.e. similar subpopulation, and only if the same laboratory techniques are followed. Until each laboratory is able to generate reference values using adequate sample size and current methodology for the numerous subpopulations of interest, reference intervals such as these are useful to clinicians and researchers.     

Laboratory diagnosis of malassimilation

In many instances, the cause for malassimilation can be determined with ease, but finding the cause sometimes can be elusive and require the use of sophisticated laboratory techniques not available to the general veterinary practitioner. In either case, the clinician, whether generalist or specialist, must make an informed decision based on the results of many different testing modalities, and not only on the results of the laboratory tests described here. A flow chart is provided to assist the diagnostician in selecting and applying the more clinically oriented laboratory tests useful in dealing with a patient with chronic diarrhea and weight loss.     

Hematology and biochemistry reference values for female Holstein cattle.

Reference intervals are presented for 14 hematology and 32 biochemistry variables from four age groups of female Holstein cattle (n = 172) selected randomly from six well managed farms. Each animal was examined by a clinician and with the history available considered to be clinically normal at the time of blood collection. The variable observations were examined for outliers and Gaussian distribution prior to parametric or where necessary, nonparametric analysis. Many differences were noted between age groups but few between farms.     

Relationship of serum total calcium to serum albumin in dogs, cats, horses and cattle

A retrospective study was performed in order to assess the relationship between serum calcium and serum albumin concentrations in domestic animals. Results of 9041 canine, 1564 feline, 2917 equine, and 613 bovine serum samples from hospitalized patients were examined by regression analysis. Subpopulations of cases with concurrent elevations in creatinine or that were less than six months of age were evaluated separately. Statistically significant linear relationships between calcium and albumin concentrations were established for each species (p <0.05). The coefficients of determination (r²) were 0.169 for dogs, 0.294 for cats, 0.222 for horses, and 0.032 for cattle. The correlation coefficients (r) computed were: dogs = 0.411, cats = 0.543, horses = 0.471, cattle = 0.182. Neither increases in creatinine concentration nor juvenile age appreciably influenced the relationship between calcium and albumin concentrations. Interspecies variation was marked, and a strong correlation between calcium and albumin concentrations was not established in any species.     

The influence of the swine major histocompatibility genes on antibody and cell-mediated immune responses to immunization with an aromatic-dependent mutant of Salmonella typhimurium.

Eighty-two major histocompatibility complex (MHC) swine leukocyte antigen (SLA) defined miniature pigs from 16 litters were examined for serum agglutinating antibody titer and O-polysaccharide (O-ps) specific peripheral blood lymphocyte blastogenesis following two parenteral vaccinations with 1 x 10(8) aromatic-dependent (aroA) Salmonella typhimurium and following oral challenge with 1 x 10(12) virulent parent S. typhimurium. Least mean squares analysis allowed separate determinations of the effects of MHC genotype, dam, sire and litter. In most cases only litter significantly influenced both lymphocyte blastogenesis and antibody titer before and after vaccination and following challenge. However, pig SLA haplotype significantly influenced the degree of O-ps specific lymphocyte proliferation six days after the second vaccination (p < 0.004). Lymphocyte proliferation and serum agglutinating antibody response six days after primary vaccination were negatively correlated (r2 = -0.68, p < 0.001). In most cases, "dd" and "gg" homozygous and "dg" heterozygous pigs, having the same MHC class II region, behaved immunologically as a group distinct from the other genotypes.     

Analyte comparisons on the Coulter Dacos and Kodak Ektachem DT-60 clinical chemistry analyzers

Eighteen analytes were compared using the Coulter Dacos and Kodak Ektachem DT-60 chemistry analyzers. All analytes were significantly linearly related. Correlations were excellent for fifteen analytes (r > 0.95); the correlations for sodium, chloride, and total protein were less than 0.95 but greater than 0.90. Several analytes had slopes significantly different from unity which was likely related to methodological differences. Regression equations are presented for the conversion of data generated using the Kodak Ektachem DT-60 to Coulter Dacos values so that, in the University of Guelph clinical pathology laboratory, one set of reference intervals serves both instruments. These data are directly applicable only in the laboratory in which they were developed. They should not be utilized directly in other laboratories, but can be used as general guidelines until confirmatory studies are done.