MAY / JUNE 2007 A NEWSLETTER FOR THE VETERINARY COMMUNITY MAY / JUNE HIGHLIGHTS Welcome Letter Special Look: Pet Food Recall The importance of a wellness testing program VetScan and Critical Care Profile Case Study Sasha had been eating one of the foods on the recall list. 2007 Medical Design Excellence Award Piccolo Xpress, Abaxis' Medical Chemistry Blood Analyzer WINS! Case Study: Three Case Studies Featuring the entire Vetscan Family and the Prep Profile II Product Spotlight: Equine Profile Plus Rotor utilization guide The VetScan Family at Work Southwest Foundation for Biomedical Research Get to Know Our Technical Support Staff This issue features Jimmy Bui Authorized Distributors Conference Calendar About Abaxis Contact Us WELCOME Welcome to VetCom, a newsletter for the Veterinary Community around the world. Protect animals and benefit people: If you are involved with animal health or research, the Abaxis VetCom printed version and our VetCom online edition has comprehensive information addressing your needs. Visit our website at www.abaxis.com/veterinary/ and sign-up today. Dogs, cats and horses are human companions, and the part they play as they accompany us through life is growing in significance. We have an obligation to our animal companions to keep this close relationship healthy. Increasingly, animal lovers expect the same equality of health care as for themselves. The demands placed on animal health and medical care are rising. At Abaxis we respond to those demands with new and more innovative products that meet the clinicians needs with ease of use, and cost effectiveness. In light of the caring nature of our pet owners and the on-going pet food recall, Abaxis recently offered a community outreach program to concerned pet owners in the East Bay area of California. Please see page 2 for more information on the event. For copies of VetCom back issues, please visit our website at www.abaxis.com or contact me directly. Valerie Goodwin Director Marketing, Veterinary Medicine valeriegoodwin@abaxis.com (510) 675-6604 ABOUT ABAXIS, INC. Abaxis is a leader in the development and commercialization of leading-edge innovative technology, tools and services that support best medical practices, enabling practitioners to respond to the health needs of their patients, while operating economical and profitable practices, at the point of care. Abaxis develops, manufactures and markets portable blood analysis systems for use in any veterinary or human patient care setting to provide clinicians with rapid blood constituent measurements. The system consists of a compact, 6.9-kilogram (10.5 pounds) portable analyzer and a series of single use plastic discs, called reagent rotors, that contain all the chemicals required to perform 23 different assays and 8 different profiles. The veterinary business system, which consists of the VetScan VS2, the next generation, electrolyte, immunoassay, blood gas analyzer, and the VetScan HM2 Hematology instrument, can be operated with minimal training and performs multiple routine tests on whole blood, serum or plasma samples. The system provides test results in minutes with superior precision and accuracy equivalent to a clinical laboratory analyzer. Abaxis, Inc. 3240 Whipple Road Union City, CA 94587 Tel. 800-822-2947 Fax 510-441-6150 www.abaxis.com 888-9300 Rev I MAY / JUNE 2007 1
DISTRIBUTORS SPECIAL LOOK United States AniSol Veterinary Distributor 877-426-4765 American Veterinary Supply (AVSC) 800-869-2510 PET FOOD RECALL: WELLNESS TESTING PROGRAMS BY VALERIE GOODWIN, DIRECTOR MARKETING, VETERINARY MEDICINE DVM Resources 877-828-1026 Hawaii Mega-Cor, Inc. 800-369-7711 Iowa Veterinary Supply (IVESCO) 800-831-4828 Merritt Veterinary Supply 800-845-0411 Miller Veterinary Supply 800-880-1920 Nelson Laboratories 800-203-4268 North East Veterinary Supply Co. (NEVSCO) 866-638-7265 Penn Vet Supply 800-233-0210 TW Medical 888-787-4483 Western Medical Supply 800-242-4415 Canada CDMV 800-668-CDMV MidWest Drug 204-233-8155 VetNovations 866-382-6937 Vet Purchasing 519-284-1371 Western Drug & Distribution 877-329-9332 Vie et Sante (Quebec) 418-650-7888 On Saturday, March 31, 2007 Abaxis, head-quartered in Union City, California, set-up a one day free Wellness Testing Program for low income families and concerned pet owners in the East Bay area of California to bring their pets for health screening at no-charge. Utilizing Abaxis' Comprehensive Diagnostic Profile and the company's state-of-the-art VetScan blood analyzer, pet owners were handed results in less than 15 minutes. This process only requires a few drops of blood taken from the cat or dog and tests all the necessary blood constituents to assure proper kidney function. Additionally, the profile tests for liver disease and can diagnose a wide range of illnesses often before the animal begins showing signs of clinical disease. Pet owners for which Abaxis uncovered underlying diseases were referred to a local veterinarian, taking along with them the full blood chemistry report. For those without a regular veterinarian, Abaxis referred them to local clinics. Fifty-two animals were presented for blood testing during the Abaxis community service health screening event. There were 20 cats and 32 dogs tested. It is interesting to evaluate the results of those screenings. It must be noted that these patients were presented only for blood draw. There was no history recorded, and physical examinations were not performed by a veterinarian. Therefore, we cannot truly classify these patients as either apparently healthy or ill. However, this small sampling may give you a good understanding of the potential value of blood screening in your patients. A review of the results by our Director of Professional Services, Dr. Craig Tockman, indicated the following: Three patients (5.8%) had clinically significant elevations in both BUN and Creatinine consistent with renal disease. All three of the patients were feline, and all three also had elevated amylase. One of these patients had mildly depressed potassium. Overall, 14 patients (27%) had some elevation in the BUN while a total of 4 patients (8%) had an elevated Creatinine. All the remaining patients with elevated BUN had a mild elevation (26-36mg/dL) and the cause was not determined. In addition, no baseline values were available. COMPREHENSIVE DIAGNOSTIC PROFILE 14 tests per rotor This rotor provides the following parameters: ALB, ALP, ALT, AMY, BUN, CA, CRE, GLOB, GLU, K+, NA+, PHOS, TBIL, TP. Pet Food Recall article continues on page 3 MAY / JUNE 2007 2
2007 CONFERENCES SPECIAL LOOK Jun. 3-6 Jun. 6-7 Jun. 9-13 Jun. 13-17 Jun. 21-24 Jun. 28-30 Jun. 28 - Jul. 1 Jun. 28 - Jul. 1 Jul. 14-18 Jul. 20-22 Aug. 1-3 Aug. 16-19 Aug. 23-26 KSUCVM Conf. Manhattan, KS www.vet.ksu.edu ACVIM Washington State Conv. & Trade Ctr. Seattle, WA Jackson Hole Vet. Rendezvous 2007 Jackson Hole, WY Southeast Vet. Conf. Springmaid Beach Resort & Conf. Ctr. Mrytle Beach, SC Pacific Vet. Conf. Anahiem, CA www.pacvet.net Louisiana VMA Beau Rivage Casino Hotel Biloxi, MS www.lvma.org NC VMA Conf. Grove Park Inn Asheville, NC Appalachian Mtn. Vet. Conf. Grove Park Inn Asheville, NC AVMA Washington DC Conv. Ctr. Washington, DC UC Davis Neurology Symposium Davis, CA ND VMA Doublewood Inn Bismarck, ND www.ndvma.com Pennsylvania VMA Hershey Lodge Conv. Ctr. Hershey, PA www.pavma.org Southwest Vet. Conference Fort Worth, TX Pet Food Recall article continued One canine patient had blood glucose of 590, likely a diabetic. This patient also had a clinically significant elevation of Alkaline Phosphatase (790) and a mild elevation of Total Bilirubin (0.8). Additionally, there were 4 patients with potentially significant elevations of ALT and/or ALP. Overall, 12% of the patients had some elevation in ALP and 15% had elevated ALT, but not all to an apparently clinically significant level. There was one other cat with a below normal potassium level. DR. CRAIG TOCKMAN OFFERS ADVICE ON PET FOOD RECALL: From what I read on VIN and see in the news reports, my impression is that very few veterinarians did not see at least one patient related to the food recall. Our practice saw at least 4 suspected cases. In addition, we lost one 18 month old cat that did not respond to treatment. So, what does all of this mean, and what can we (should we) learn from the pet food recall? Wellness Testing There were several web sites with recommendations for testing and treating the pet food recall patients that suggested that any suspect patient receive a blood chemistry profile and urinalysis. They also recommended that if the BUN or Creatinine were in the upper end of the normal range, that a second profile be performed shortly after to ensure that this was in fact a normal baseline for that patient. These articles state that this would be unnecessary if there was recent wellness blood work available as a baseline to evaluate. Also in regards to wellness testing, take a look at the small but significant sample collected above. Eight out of 52 animals presented (15%) had blood work consistent with a significant clinical problem. An additional 11 patients had mild elevations in at least one chemistry value that would have made me recommend at least a recheck follow-up and/or additional monitoring. That is a total of 19 out 52 patients (36.5%) that would have benefited from this testing, while all the rest now have established normal baseline values. Point-of-Care Your client came in concerned about their pet eating one of the recalled diets. You have the ability to provide an answer in 10-15 minutes in an efficient and cost effective manner. Your client receives either immediate piece of mind or treatment is immediately instituted. If wellness testing was not previously performed and the values are on the high side, you have the ability to discuss - face to face - the need for additional testing and potential outcomes. You are offering the best customer service possible. This leads to happy, bonded customers and additional referrals. Pet Food Recall article continues on page 4 MAY / JUNE 2007 3
2007 CONFERENCES CONT. SPECIAL LOOK Sep. 9-11 Sep. 15-16 Sep. 15-18 Sep. 20-22 Sep. 26-30 Oct. 9-11 Oct. 10-14 Oct. 11-14 Oct. 14-18 Oct. 20-23 Nov. 1-3 Dec. 2-7 CO VMA Copper Mountain Conv. Ctr. San Diego VMA The Kona Kai Resort San Diego, CA www.sdcvma.org CVC Central Kansas City, MO AABP Vancouver Conv. Ctr. Vancouver, BC Canada IVECCS New Orleans Marriott New Orleans, LA Atlantic Coast Vet Conf. Atlantic City Conv. Ctr. Atlantic City, NJ www.acvc.org Wild West Vet. Conf. Grand Sierra Resort Reno, NV Wisconsin VMA Madison, WI www.wvma.org AALAS Charlotte Conv. Ctr. Charlotte, NC www.aalas.org CVC West San Diego, CA North Carolina VMA Sheraton Imperial Hotel Research Triangle Park, NC AAEP Orlando, FL Pet Food Recall article continued Utilization of the Entire Rotor Menu During the early phases on the pet food recall, the ACVIM recommended that treatment of azotemic patients include IV fluid therapy to promote hydration and diuresis. This was also to flush the crystals supposedly associated with the aminopterin toxicity from the renal tubules. In addition, they recommended alkalinizing the urine (ph >7) to prevent the crystal formation. They suggested alkalinizing agents such as sodium bicarbonate IV to accomplish this. The availability of Carbon Dioxide (CO2) on the Critical Care Plus Rotor not only made this possible, but safe. The critical care rotor, used at least once daily provides BUN and Creatinine to monitor renal function, electrolytes including potassium as well as carbon dioxide. This allows us to not only identify an acidotic patient, but to also monitor carbon dioxide while correcting acidosis safely. Please see the associated case study for further details. Part of our responsibility as pet care providers is to learn from our successes, mistakes and from difficult situations. We should learn from this pet food crisis that we should utilize all the tools available to promote patient health and return the ill patient to health when needed. The availability of baseline values, point-of-care results and the ability to properly monitor our patients is available every day with the VetScan family of analyzers. PET FOOD RECALL CASE STUDY: VETSCAN AND CRITICAL CARE PLUS PROFILE BY DR. CRAIG TOCKMAN Sasha presented on March 20, 2007 with a history of vomiting 3 times in the previous 2 days and had been eating one of the foods on the recall list prior to the onset of symptoms. The patient was fractious and aggressive, but showed no obvious physical abnormalities. Abnormalities in the Complete Blood Count (elevated RBC, Hgb and HCT) were consistent with dehydration. The remainder of the CBC was normal. Abnormal chemistry values were as follows: Albumin: 4.7 (Normal 2.2-4.4) BUN: > 180 (Normal 10-30) CA++: 12.8 (Normal 8-11.8) PHOS: 17.1 (Normal 3.4-8.5) CRE: 13 (Normal 0.3-2.1) TP: 8.5 (Normal 5.4-8.2) Wellness testing the previous November showed a BUN of 16 and Creatinine of 1.0. Pet Food Recall case study continues on page 5 MAY / JUNE 2007 4
CONTACT ABAXIS, INC. 1-800-822-2947 VetCom Issues Valerie Goodwin, Editor Direct: 510-675-6604 Director, Marketing ValerieGoodwin@abaxis.com subscribe, unsubscribe, questions and comments Technical Support 1-800-822-2947 technical questions, rotor credits, software queries North American Sales Randy Knick, ext. 1509 Central Area Sales Director randyknick@abaxis.com Bill Wilson, ext. 1455 Mid-Atlantic Area Sales Director billwilson@abaxis.com Frank Pickard, ext. 1499 Southwest Area Sales Director frankpickard@abaxis.com Andy Koupas, ext. 1424 Western Area Sales Director andykoupas@abaxis.com John Therrien, ext 1476 Area Sales Manager, Mid-West johntherrien@abaxis.com Gerard Cabrera, ext. 1448 Area Sales Manager, Northeast gerardcabrera@abaxis.com Customer Service Gay Skubec, ext. 6578 Supervisor, Customer Service SPECIAL LOOK Pet Food Recall case study continued Free catch urinalysis abnormal results were as follows: 4-10 WBC/hpf ph 6.0 Hemolyzed trace blood Specific Gravity 1.008 The abnormalities were consistent with renal failure and dehydration. IV fluid therapy with 0.9% NaCl at 2 times maintenance was started as well as ampicillin and cimetidine. A Critical Care Plus Profile was performed the following morning. CRE had increased to 10.0, BUN was still >180 and CO2 was 14 (Normal 15-24). The attending veterinarian decided that no treatment for the low CO2 was necessary at that time. This level was unchanged the following day, so the patient began receiving sodium bicarbonate in the fluids in an effort to raise the blood CO2 as well as the urine ph based on recommendations from the ACVIM. After 2 days of bicarbonate therapy, the CO2 was 19, BUN had reduced to 112, Creatinine was 8.7 and Phos was 13.4. All other values were normal. Unfortunately, the patient began deteriorating again 2 days later and expired after 9 days of therapy. CRITICAL CARE PLUS THE ELECTROLYTE ROTOR 8 tests per rotor This rotor provides the following parameters: ALT, BUN, CL, CRE, GLU, K+, NA+, tco 2. 2007 MEDICAL DESIGN EXCELLENCE AWARD: THE PICCOLO XPRESS BY VALERIE GOODWIN, MARKETING DIRECTOR, VETERINARY MEDICINE Abaxis has received a 2007 Medical Design Excellence Award for Piccolo Xpress, the sister product to the VetScan VS2. The MDEA is the only awards program in the US that exclusively recognizes advances in design of medical products. The Piccolo Xpress Chemistry Analyzer by Abaxis enables healthcare providers to measure 14 different blood chemistry values simultaneously from just 100 µl of whole blood. It is so simple to use that 16 analytes have been granted CLIA waiver status from the US FDA, and its flexible enough to be used in doctors offices, hospital emergency rooms, surgical suites, and battlefields. This MDEA Award not only validates the design but also shows that with the new Piccolo Xpress system, the Abaxis platform including the VetScan VS2 will remain distinguished by their advanced design, performance and ease-of-use for routine blood testing. We were featured, with the other winners, in the April issue of Medical Device and Diagnostics Industry Magazine (MDDI). MAY / JUNE 2007 5
Utilization of the Equine Profile Plus rotor for the VS2 provides improved patient care, diagnostics, therapeutics, and profitability. Practice profits are often siphoned away by commercial labs that charge considerably more for an equine chemistry profile that often takes more than twenty-four hours for complete results. Competitive pricing of the Equine Profile Plus and its rapid turn-around time adds value to lab results making the services more attractive to an increasingly savvy client base. In-house lab services as an extension of the physical exam provides the important next level of diagnostic information. The information that is just beyond the reach of rectal palpation or the resolution of the ultrasound is at the tip of your fingers and can help you avoid the pitfall of offering blood work to only your sickest patients. o Even the most common clinical case can benefit from the added insight in-house lab testing can provide. The importance of accurate diagnosis, prognosis and therapeutic choices should be independent of likely case outcomes. o With lower costs and immediate results, lab testing can be offered to a broader range of patients and improve the delivery of veterinary care. o Clients are increasingly aware of lab testing options and are willing to pay for lab services. o When the results are reported promptly in a context that describes their importance in the diagnostic and therapeutic management of their horse, clients consistently find value and are willing to pay for lab services. Make a habit of collecting blood from every horse you are asked to examine. Owners usually will ask why you are taking the sample. An excellent reply should address the importance of diagnostics and/or obtaining baselines, such as I am taking this blood sample now, at the beginning of the exam, before your horse has become excited or agitated, so that when I am done I will have a good starting point for lab testing if I need it. o Owners ponder this proposition quietly and ask the doctor if the lab work is needed at the conclusion of the exam. o In this way the service has been passively marketed without any sales pitch and the owner has decided that if the doctor thinks the blood work is indicated, they will accept the charges. Pre-anesthetic testing has become the standard of care in both human and small animal veterinary medicine. Veterinarians practice in an increasingly litigious society and failure to offer pre-anesthetic testing prior to general anesthesia of any type is a serious legal liability. Pre-anesthetic screening must be offered to manage this growing risk. o A fresh pre-anesthetic sample allows accurate assessment of liver and kidney function and provides a snapshot of general health that might be critical in the event of complications. Chronic use of NSAIDs and bioactive nutritional supplements make periodic blood chemistry evaluation of liver enzymes prudent. Intensively managed geriatric horses have becoming increasingly common patients in many practices. Use of NSAIDs for periods exceeding two weeks should include periodic evaluation of liver enzymes before refills are filled. Add a line item to your pre-purchase exam form that requires the buyer to initial that they have been offered a CBC/chemistry as part of the exam and have accepted/declined the testing. No doctor would consider completing an equine purchase examination without a negative Coggins test, a screen for only one disease. The Equine Profile Plus screens for dozens of diseases in minutes and provides a level of completeness and professionalism your competitors have likely overlooked. Increases in muscle enzymes may give clues as to the horse s fitness, propensity for muscle diseases, and recent intramuscular injections. Increases in inducible liver enzymes may suggest the need for a drug screen of more extensive examination of the medical history. The growing population of aging horses who are prone to geriatric diseases lends itself to the development of comprehensive wellness programs that provide a package of services that addresses the special needs of the older horse. o Develop annual wellness programs for the varied horse populations in your practice and include an annual CBC and an Equine Profile Plus for every enrolled horse. o As horse populations age, the profession must be prepared to meet their changing needs, provide excellent preventive care, and prevent the special needs of these patients from being overlooked. o Comprehensive wellness programs provide the framework for the delivery of service and should include: Extensive physical examination Dental examination and care CBC, Equine Profile Plus, Fecal Floatation Appropriate vaccinations De-worming plan tailored to specific needs, housing and cohorts Nutritional consultation and monitoring MAY / JUNE 2007 6
Proactive management of the changing needs of geriatric horses and their owners allows better patient care, reduces crisis situations where it is too late for medical intervention, and ultimately improves client relations and practice profitability. IN-OFFICE UTILIZATION CASE STUDY Presentation Thunder, a 9 year old, Appaloosa Gelding. Presenting complaint: depression and weakness. The horse was in good body condition and was purchased from a local barn. Thunder was dewormed and vaccinated by the owner upon arrival. No health problems have been noted and no prior history was available. Retrospectively, the owner reported that Thunder may have been off for 2-3 days, but appetite had been good, though it was clear actual intake of both hay and grain was reduced. T99.5, HR 55, crt 3 sec, mucus membranes icteric, gut sounds were significantly decreased, no reflux when tubed, scant feces on rectal palpation but no palpable abnormalities were noted. No classic signs attributable to colic were reported by the owner or noted at the time of the exam. Thunder was alert and responsive to stimuli, but seemed to have short periods of disorientation and somnolence. Appetite was normal when tested with a handful of hay. A CBC and an Equine Profile Plus were included in the initial work-up in an effort to narrow the rule out list and gain a better understanding of this horse s condition. Plasma obtained from Thunder was grossly icteric but was within the visible range expected for a horse with the clinical presentation described. The icterus was profound as determined by the Vetscan VS2 and caused considerable interference with the analysis of several analytes: Na+ 143 126-146 mmol/l WBC 10.11 10^9l 5.4-14.3 K+ ICT 2.5-5.2 mmol/l LYM 1.76 1.5-7.7 tco2 ICT 20-33 mmol/l MON 0.80 0.0-1.5 CK 232 120-470 U/L GRA 7.55 2.3-9.5 Glu 62* 65-110 mg/dl LY% 17.4% 17-68% CA++ 10.7* 11.5-14.2 mg/dl MO% 8.0% 0-14% BUN 4* 7-25 mg/dl GRA% 74.6% 22-80% CRE ICT 0.6-2.2 mg/dl AST ICT 175-340 U/L RBC 12.41 10^12/l 6.8-12.9 TBIL 20.9* 0.5-2.3 mg/dl HGB 22.2* g/dl 11-19 GGT 114* 5-24 U/L HCT 63.15* 32-53 ALB ICT 2.2-3.7 g/dl MCV 51 fl 37-59 TP ICT 5.7-8.0 g/dl MCH 17.9 pg 12.3-19.7 GLOB ~~~ 2.7-5.0 g/dl MCHC 35.1 g/dl 31-39 RDWc 20.8 PLT 77-10^9/l 100-400 PCT 0.06 MPV 8.4 PDWc 34.5 Thunder s clinical presentation suggested an underlying disease process that was potentially very serious, yet clinically he was not the sickest of patients. In fact, the owner had been reluctant to call for an exam because of the good appetite and bright attitude the horse seemed to have most of the time. The results above are so severe that they approach the dynamic limits of a chemistry analyzer with the widest dynamic limits in the industry and cause suppression of several values due to the iqc on-board calibration and control system of the VetScan. The balance of results support liver disease and damage of a severe nature. The ability to understand the diagnosis, very poor prognosis and the relationship of the lab findings to the unusual clinical presentation helped to prepare the owner for a poor outcome and the potential for very rapid deterioration that would necessitate the eventual euthanasia of the horse. In further follow-up discussions with the owner, it was determined that the tetanus vaccine given was actually tetanus antitoxin purchased from a local feed store. Acute liver disease associated with the use of equine origin biological products is described as Theiler s Disease. A causative agent has never been isolated and exposure to biologics is not a consistent historical in every case. The strategies described above are keys to improving the profitability of any veterinary practice. By increasing the depth of services delivered to each patient, doctors can improve the quality of patient care by offering more complete comprehensive care to a smaller number of patients. By increasing the dollar density of service provided per veterinarian hour, veterinarians can begin to take control of their professional lives in a way that reduces the pervasive lifestyle issues that reduce quality of life for veterinarians. MAY / JUNE 2007 7
CUSTOMER SAMPLING CASE STUDY MEDICAL & RESEARCH SUBMIT A CASE STUDY Submit a case study where your Abaxis VetScan VS2 saved a life and we'll send you a FREE Sample Pack (MLP, T4, Critical Care). E-mail your comprehensive case study to Valerie Goodwin at valeriegoodwin@abaxis.com THREE CASE STUDIES: FEATURING CDP, PREP PROFILE II, AND VETSCAN HM2 BY DR. JEANNE TRAVIS, MERCY HOSPITAL, 1611 SATELLITE BLVD., DULUTH, GA UNIVERSITIES When I worked at another hospital, we had a hematology unit for six years. The results were so questionable that we either read our own slides as back-up or sent another sample to a local laboratory. We ran a CBC with each prep or diagnostic profile, but everyone regarded the results with skepticism. I was certain that I wanted a VetScan blood chemistry unit in my own hospital and knew I would need a reliable hematology unit, so I contacted Abaxis for a demo. After some convincing, we did decide on the whole VetScan system, including the VetScan Hematology unit. We have been open for a very short period now, but we have used the VetScan unit on every sick patient and on all of our pre-anesthetic patients. Calvin, an 11-year-old domestic short hair, was presented for not being himself. The owner reported no other clinical signs. The profile on the VetScan was within normal limits, but the WBC was 30,160. His body temperature was 101.7, and the physical exam was unremarkable. I questioned the high WBC, but when I read my own smear, I agreed with the count and found degenerative neutrophils and Dohle bodies. The urine was turbid, and had TNTC WBC, TNTC red blood cells and rod bacteria. Because of the high WBC, I gave Calvin an injection of Tobramycin until culture results were available the next day. The culture and sensitivity gave an alternative and preferable choice, so he was treated with azithromycin for 14 days. On recheck the cat was feeling better, but the culture grew a gram positive organism resistant to azithromycin. He was placed on 14 days of Clavamox. I will recheck urine, culture, and WBC four days after Clavamox is finished. Riley is a four year old neutered male schnauzer who came in because of five days of vomiting that had become progressively worse each day. When Riley came in, he was assessed to be 7-10% dehydrated, normal body temperature, and painful in the cranial abdomen. We ran a VetScan CBC and diagnostic profile. Other than a low phosphorous, the chemistries were within normal limits. The CBC showed a WBC of 33,010. The HCT was 59.96 percent. Because of the WBC, and cranial abdominal pain, he was placed on four quadrant antibiotic therapy. His urine was unremarkable, and highly concentrated. He was placed on an I.V. drip of LRS, and was given Anzemet, buprenophine, Baytril, and ampicillin all intravenously. He stayed overnight on a regulated drip. My plan for him Case Study continues on page 9 MAY / JUNE 2007 8
ROTOR PROFILE USE THE CDP ROTOR AND GET THE WHOLE PICTURE In fact, for the amount of information, the CDP costs LESS per test than the Prep Profile at only $1.34 per test! Below are additional tests you receive when using the CDP over the Prep Profile: 1. Total Bilirubin important value if there is elevation of ALT or ALP, clinical jaundice, bilirubinuria or if there is anemia to determine hemolysis. 2. While high levels of amylase can indicate pancreatitis, mild elevations are seen with upper intestinal inflammation, liver disease or renal disease. 3. Calcium is important in many disease states, and baseline values in wellness/pre-anesthetic testing are equally as important. Malignancy, hyperparathyroidism, chronic renal disease and hypoadrenocorticism are examples of disease states causing changes in the body CA. 4. Phosphorus should always be evaluated along with calcium levels and is often affected by similar processes. It is also affected by such things as renal disease, vitamin D toxicosis, malignancy and hypoparathyroidism. 5. Sodium should be evaluated in every ill patient. It is a very important value for determining fluid therapy and as part of a pre-anesthetic evaluation and also assists with determination of osmolality. 6. Potassium should be evaluated in all ill cats. It is also vital in determining fluid therapy and preanesthetic fluid requirements. Renal disease and diabetes can greatly affect potassium and should be monitored closely in these patients. 7. Albumin is the primary body protein. It should be evaluated in all disease states and baseline values. Globulin needs to be evaluated for conditions such as inflammatory disease, parasitism, neoplasia and immunemediated disease. CASE STUDY Case Study continued was to take abdominal films and/or perform an abdominal ultrasound if no improvement. By morning, Riley was bright, alert and no longer painful in the abdomen. He was hungry and ate with no vomiting. I sent him home that day on oral Baytril with presumptive gastroenteritis or pancreatitis. He has done well at home since that time (two weeks ago). I would have rehydrated Riley regardless of WBC, but I used broader spectrum antibiotic coverage because of it. Sundance was a 12 year old male castrated golden retriever who came in from the local emergency clinic with a diagnosis of splenic rupture secondary to a splenic mass. Only a PCV, T.S. was performed at the emergency clinic. The owner elected emergency surgery to remove the spleen so VetScan blood tests were performed prior to surgery. The albumin was low at 2.9; calcium was low at 8.2; total protein was low at 4.8 but the other chemistries were within normal limits. The CBC showed WBC of 16,940 which was expected. The hematocrit was 24% and the platelets were low at 152,000. The results were consistent with blood loss, inflammation, and the PCV was correlative with the values obtained at the emergency clinic. The exploratory did reveal a large amount of abdominal bleeding secondary to splenic rupture. The histopath diagnosis was aggressive hemangiosarcoma, the dog was euthanized three days following the surgery. The hematology unit gave results that were expected for the dog s presentation. The routine pre-operative CBCs were consistent with healthy pets undergoing routine procedures. Blood work is integrated in all of our surgical estimates. While there is profitability in performing routine blood tests, the value to me and the patient exceeds the monetary profit. The VetScan HM2, hematology unit has shown to be reliable. COMPREHENSIVE DIAGNOSTIC PROFILE 14 tests per rotor Provides a comprehensive diagnostic analysis, this rotor provides the following parameters: ALB, ALP, ALT, AMY, BUN, CA, CRE, GLOB, GLU, K+, NA+, PHOS, TBIL, TP. STOP BY AND SEE US AT YOUR NEXT TRADESHOW! Bring this coupon and receive a Complimentary Abaxis Promotional Sample Pack (MLP, T4, Critical Care Plus) a $200.00 dollar value! Take advantage of this special offer by bringing this coupon by our booth at one of the veterinary tradeshows listed on page 3. Promotion good through Sept. 30, 2007. MAY / JUNE 2007 9
EDITORIAL STAFF Valerie Goodwin Director, Marketing Veterinary Medicine VetCom Editor 510-675-6604 valeriegoodwin@abaxis.com Craig M. Tockman, DVM Director of Professional Services, Abaxis, Inc. Veterinary Care Center, St. Louis, MO 800-822-2947, ext. 1422 craigtockman@abaxis.com Baerbel Koehler Abaxis Sales and Marketing Manager for Europe, Africa and the Middle East Heidelberger Landstrasse 230, D-64297 Darmstadt, Germany +49 6151 350 79 0 baerbelkoehler@abaxis.de Kent Adams, DVM Abaxis Advisory Board Member Equine/Large Animal Practitioner kentadams@abaxis.com Don J. Harris, DVM Abaxis Advisory Board Member Avian/Exotic Practitioner donharris@abaxis.com PRODUCT SPOTLIGHT THE VETSCAN FAMILY AT WORK: SOUTHWEST FOUNDATION FOR BIOMEDICAL RESEARCH BY STACEY PEREZ, SUPERVISOR In our animal laboratory here we currently use the Abaxis HM2 and the Abaxis Vetscan VS2. We have also purchased an additional set of instruments, both hematology and chemistry, for use in our new laboratory. Before purchasing our Abaxis equipment we looked into all of the other bench top analyzers and decided that the HM2 and the VS2 were best for our facility. We have found our machines to be dependable, accurate and essential for our research. The Abaxis machines are definitely an asset to our research. Some of the features that benefit us most is that it does not take much blood to perform diagnostic tests and that the machines are extremely user friendly. Our facility works with very small animals that are often very difficult to collect samples from. We are able to run complete chemistry panels and CBC on minimal amounts of blood. The HM2 allows us to simply introduce a sample and seconds later the CBC is ready for the doctor s review. The VS2 allows us to run complete chemistry panels on blood without having to centrifuge samples saving us valuable time. The rotors for the VS2 provide all essential chemistries and electrolytes for the doctors to determine the animal's health. While working in the lab we have time restraints. The HM2 and the VS2 provide us with results in minutes allowing us to complete our work on time. It is also beneficial that the machines communicate with each other allowing us to print out all of the results on the same letter size sheet making it easy to incorporate into the animal s record. These machines are compact and do not take up much space, allowing us to move them around our facility as needed. GET TO KNOW OUR TECHNICAL SUPPORT STAFF: FEATURING JIMMY BUI In this Issue of VetCom, Jimmy Bui brings his dancing feet to the phones. Jimmy has a BS degree in Biology from San Jose State University, is a Certified RT (radiological technologist), and has done extensive work in immunology. Jimmy brings his educational background and scientific experience to the Abaxis technical service department with enthusiasm. In Jimmy's free time, he is the President of Salsagang.com, an organization that connects the salsa community together, and is a dance instructor for Jsmoothsalsa.com at his dance studio. Jimmy has brought his expertise in troubleshooting urgent issues and providing valuable information to our customers with a smile on his face. Call: 1-800-822-2947 for Tech Support. MAY / JUNE 2007 10
My primary supplier never told me how efficient the VetScan laboratory system is. Actually, they never told me about VetScan products period. Paul Nolan, DVM. Post Road Veterinary Clinic. Wells, Maine. Last fall a colleague asked if I d ever seen the VetScan Laboratory System. I called my rep to request a demo, but when he arrived he brought the same analyzers he d been showing me for years. I called Abaxis myself and got a first-hand look at what makes VetScan the most efficient laboratory system on the market: minimal bench space, no sample preparation and small sample size; reference lab quality results in under 12 minutes. You owe it to yourself to take a closer look at the VetScan Laboratory System. It s your business. It s your call. Call Abaxis at 800-822-2947 for a list of Abaxis VetScan authorized distributors.
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