GRH Clinical Pathology

Point-of-Care: the need for speed - racing through rapid tests

• Recognise and understand the different methodologies used in rapid POC test
• Discuss most common applications of rapid POC tests
• Identify the limitations of rapid POC tests

Point-of-Care: the need for speed - they are quick, but are we done and dusted?

• Review basic concepts of specificity and sensitivity and how this impacts interpretation of POC tests
• Examine what confirmatory tests are available
• Evaluate what the most appropriate next step may be

In-house urinalysis

• Review best practices for urinalysis
• Discuss possible pitfalls
• Integrate urinalysis results with other laboratory data

Urinary sediment cytology

• Describe how to prepare urinary sediment for cytological analysis
• Demonstrate how to read and interpret urinary sediment
• Revise ancillary tests available

 Tania Nunes Rodrigues, a European and RCVS specialist in veterinary dermatology at Willows Veterinary Centre and Referral Service focuses on cytology procedures in veterinary dermatology.

Which tests to do and in what order? The presence of anaemia may be harder to detect in cats compared to dogs, as their mucous membranes are typically slightly paler than those of dogs, and clinical signs such as exercise intolerance and weakness may manifest as sleeping more in cats, and therefore may go unnoticed by the owner. As a result, cats may be more severely affected by the time investigations are undertaken. Clinical assessment of cardio-vascular stability is therefore important before proceeding to performing diagnostic testing. The minimum volume of blood should be obtained, but it is also important to think in advance what tests might be required to reduce the number of blood draws that have to be performed. For cats that are cardio-vascularly compromised, stabilisation may be required before full diagnostic investigations can be undertaken, whereas for mild to moderate anaemia the aim should be to identify the cause. The use of in-house automated haematology analysers has facilitated rapid diagnosis of the presence of anaemia, but the limitations of these machines must be borne in mind. Further in-house tests can increase the information given from the automated analyser, namely assessing PCV and total solids, blood smear evaluation and auto-agglutination, before submitting samples to external labs for further testing.

Blood transfusion: Currently there is no UK feline blood bank, so in-house feline blood donations are sometimes required as a life-saving therapy. This session looks at the requirements of a feline blood donor and how to make this a safe and stress-free procedure. The post-donation care of feline donors differs to canine donors, and this session reviews the current recommendations of feline donor care. There are also a number of nursing considerations which RVNs should be able to add to the care plan of the recipient cat including pre, during and post transfusion.

The recognition and diagnosis of hepatobiliary diseases can be challenging. The associated clinical signs are varied and often quite vague and non-specific, and while there is a wide range of laboratory tests of both hepatic damage and function, there is rarely a single test that definitively identifies the disease. This chapter considers the disgnostic approach to liver disease, serum biochemistry, routine haematology, urinalysis, liver function tests, genetic testing, liver biopsy, pattern recognition in liver disease and prognostic indices. Case examples are included.

The function of the kidneys is to regulate the volume and composition of extracellular fluid. This is achieved by the initial formation of an ultrafiltrate of plasma by the passage of solutes, small proteins and other non-scellular constituents of the blood across the glomerular filtration barrier. The chapter deals with glomerular filtration, laboratory abnormalities in patients with kidney disease, staging chronic kidney disease, acute kidney injury, glomerular barrier function and tubular function. This chapter includes case examples.