84,99 €
Mehr erfahren.
- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Low-Cost Veterinary Clinical Diagnostics A practical guide to maximizing the diagnostic value of in-house quick assessment tests (QATs) In Low-Cost Veterinary Clinical Diagnostics, the authors provide a hands-on resource designed to facilitate healthcare delivery across the spectrum of care. Historically, clinicians have been taught to apply the gold standard approach to the practice of medicine. However, recent advances in veterinary medical care and associated technologies have made practitioners question whether a one-size-fits-all approach is truly best. After all, when we perform diagnostic tests, are we testing out of the desire for completeness, to cover all bases for the good of the patient? Or are we testing because we are expected to? The reality is that gold standard care is not always advisable and not always possible. In clinical practice, veterinarians frequently encounter obstacles that limit their approaches to case management. Cost of care is a significant constraint that requires practitioners to rethink which diagnostic tests are essential. Not every patient requires a complete blood count (CBC), chemistry profile, urinalysis, and fecal analysis to obtain diagnostic value. This text suggests that the "best" approach to case management be determined by the situation, the context, the patient, and the client. While sophisticated panels of tests may remain the recommended approach to case management, Low-Cost Veterinary Clinical Diagnostics outlines entry-level, in-house diagnostic blood, urine, fecal, and body cavity fluid tests: how to perform them as well as the breadth and depth of patient-specific data that can be gleaned from quick assessment tests (QATs). Readers will also find: * A thorough introduction to patient care considerations, communication strategies that facilitate cost-conscious shared decision-making * Comprehensive explorations of quick assessment tests (QATs) in hematology, including packed cell volume (PCV), total solids (TS), buffy coat analysis, blood smears, blood glucose, blood urea nitrogen (BUN), saline agglutination tests, and activated clotting time. * Practical discussions of quick assessment tests (QATs) involving urine, including urine color, dipstick analysis, specific gravity (USG), and urine sediment analysis * Pragmatic evaluation of fecal analysis, including considerations surrounding fecal color, volume, consistency, and odor; saline smears or wet mounts, and fecal flotation. * Discussion on body cavity fluid analysis * Sample case vignettes, complete with question and answer (Q&A) Perfect for veterinary practitioners, veterinary technicians, veterinary and veterinary technician students, Low-Cost Veterinary Clinical Diagnostics offers a quick and easy reference guide to maximizing diagnostic value in those cases where care is cost-prohibitive.
Sie lesen das E-Book in den Legimi-Apps auf:
Seitenzahl: 778
Veröffentlichungsjahr: 2022
Ähnliche
Table of Contents
Cover
Title Page
Copyright Page
Dedication
About the Authors
About the Contributors
Preface
Acknowledgments
Coaches
Colleagues
Part 1: Patient Care Considerations
1 The Gold Standard, Standards of Care, and Spectrum of Care
1.1 Defining the Gold Standard
1.2 Limitations of the Gold Standard
1.3 Returning to the Case of the Cat with Stranguria: a Different Perspective on Standards of Care
1.4 Limitations to Standards of Care
1.5 Spectrum of Care
References
2 Consultation Room Communication Strategies that Facilitate Dialogue on the Diagnostic Approach to Patient Care
2.1 Emergence of Communication as a Clinically Relevant Skill in Human Health Care
2.2 The Evolution of Communication in Veterinary Health Care
2.3 Communication Skills That Are Essential to Diagnosis‐Making
2.4 Concepts of Health Literacy and Compliance
2.5 Using Easy‐to‐Understand (Nonmedical) Language
2.6 Checking in
2.7 Assessing the Client's Knowledge
2.8 Signposting
2.9 Addressing the Cost of Care
References
Part 2: Quick Assessment Tests (QATS) Involving Blood
3 Packed Cell Volume
3.1 Procedural Definition: What Is this Test About?
3.2 Procedural Purpose: Why Should I Perform this Test?
3.3 Equipment
3.4 Procedural Steps: How Do I Perform this Test?
3.5 Time Estimate to Perform Test
3.6 Procedural Tips and Troubleshooting
3.7 Interpreting Test Results
3.8 Clinical Case Example(s): Can We Link to the Cases in Chapter 5?
3.9 Add‐On Tests That You May Need to Consider and Their Additive Value
3.10 Key Takeaways
References
4 Total Protein as Measured by Refractometry
4.1 Procedural Definition: What Is This Test About?
4.2 Procedural Purpose: Why Should I Perform this Test?
4.3 Equipment
4.4 Procedural Steps: How Do I Perform this Test?
4.5 Time Estimate to Perform Test
4.6 Procedural Tips and Troubleshooting
4.7 Interpreting Test Result
4.8 Clinical Case Example(s)
4.9 Add‐On Tests That You May Need to Consider and Their Additive Values
4.10 Key Takeaways
Reference
Suggested References
5 Gross and Microscopic Evaluation of the Buffy Coat
5.1 Procedural Definition: What Is This Test About?
5.2 Procedural Purpose: Why Should I Perform this Test?
5.3 Equipment
5.4 Procedural Steps: How Do I Perform this Test?
5.5 Time Estimate to Perform Test
5.6 Procedural Tips and Troubleshooting
5.7 Interpreting Test Results
5.8 Clinical Case Example(s)
5.9 Add‐On Tests That You May Need to Consider and Their Additive Value
5.10 Key Takeaways
Reference
6 The Blood Film
6.1 Procedural Definition: What Is This Test About?
6.2 Procedural Purpose: Why Should I Perform This Test?
6.3 Equipment
6.4 Procedural Steps: Preparing the Blood Film How Do I Perform This Test?
6.5 Time Estimate to Perform Test
6.6 Procedural Tips and Troubleshooting
6.7 Interpreting Test Results
6.8 Clinical Case Example(s)
6.9 Add‐On Tests That You May Need to Consider and Their Additive Value
6.10 Key Takeaways
References
Suggested Bench‐Side Reference
7 Blood Glucose
7.1 Procedural Definition: What Is This Test About?
7.2 Procedural Purpose: Why Should I Perform This Test?
7.3 Equipment
7.4 Procedural Steps: How Do I Perform This Test?
7.5 A Note on Quality Control
7.6 Procedure for Patient Samples
7.7 Time Estimate to Perform Test
7.8 Procedural Tips and Troubleshooting
7.9 Interpreting Test Results
7.10 Clinical Case Example(s)
7.11 Add‐On Tests That you May Need to Consider and Their Additive Values
7.12 Key Takeaways
References
8 Blood Urea Nitrogen
8.1 Procedural Definition: What Is This Test About?
8.2 Procedural Purpose: Why Should I Perform This Test?
8.3 Equipment
8.4 Procedural Steps: How Do I Perform this Test?
8.5 Time Estimate to Perform Test
8.6 Procedural Tips and Troubleshooting
8.7 Interpreting Test Results
8.8 Clinical Case Example(s)
8.9 Add‐On Tests That You May Need to Consider and Their Additive Value
8.10 Key Takeaways
9 Whole Blood Lactate
9.1 Procedural Definition: What Is This Test About?
9.2 Procedural Purpose: Why Should I Perform This Test?
9.3 Equipment
9.4 Procedural Steps: How Do I Perform This Test?
9.5 A Note on Quality Control
9.6 Procedure for Patient Samples
9.7 Time Estimate to Perform Test
9.8 Procedural Tips and Troubleshooting
9.9 Interpreting Test Results
9.10 Clinical Case Example(s)
9.11 Add‐On Tests That You May Need to Consider and Their Additive Value
9.12 Key Takeaways
References
10 Saline Agglutination Test
10.1 Procedural Definition: What Is This Test About?
10.2 Procedural Purpose: Why Should I Perform This Test?
10.3 Equipment
10.4 Procedural Steps: How Do I Perform This Test?
10.5 Time Estimate to Perform Test
10.6 Procedural Tips and Troubleshooting
10.7 Interpreting Test Results
10.8 Clinical Case Example(s)
10.9 Add‐On Tests That You May Need to Consider and Their Additive Value
10.10 Key Takeaways
Reference
11 Activated Clotting Time
11.1 Procedural Definition: (“What Is This Test About?”)
11.2 Procedural Purpose: Why Should I Perform This Test?
11.3 Equipment
11.4 Procedural Steps: How Do I Perform This Test?
11.5 Time Estimate To Perform Test
11.6 Procedural Tips and Troubleshooting
11.7 Interpreting Test Results
11.8 Clinical Case Example(s)
11.9 Add‐On Tests That You May Need to Consider and Their Additive Value
11.10 Key Takeaways
Part 3: Quick Assessment Tests (QATS) Involving Urine
12 Assessing Urine's Physical Properties
12.1 Procedural Definition: What Is This Test About?
12.2 Procedural Purpose: Why Should I Perform This Test?
12.3 Equipment
12.4 Procedural Steps
12.5 Time Estimate to Perform Test
12.6 Procedural Tips and Troubleshooting
12.7 Interpreting Test Results
12.8 Clinical Case Example(s)
12.9 Add‐On Tests That You May Need to Consider and Their Additive Value
12.10 Key Takeaways
12.11 Clinical Pearls
References
13 Urine Specific Gravity
13.1 Procedural Definition: What Is This Test About?
13.2 Procedural Purpose: Why Should I Perform this Test?
13.3 Equipment
13.4 Procedural Steps
13.5 Time Estimate to Perform Test
13.6 Procedural Tips and Troubleshooting
13.7 Interpreting Test Results
13.8 Clinical Case Example(s)
13.9 Add‐On Tests That You May Need to Consider and Their Additive Value
13.10 Key Takeaways
13.11 Clinical Pearls
References
14 Chemical Evaluation of Urine
14.1 Procedural Definition: What Is This Test About?
14.2 Procedural Purpose: Why Should I Perform This Test?
14.3 Equipment
14.4 Procedural Steps
14.5 Time Estimate to Perform Test
14.6 Procedural Tips and Troubleshooting
14.7 Interpreting Test Results
14.8 Clinical Case Example(s)
14.9 Add‐On Tests That You May Need to Consider and Their Additive Value
14.10 Key Takeaways
14.11 Clinical Pearls
References
15 Urine Sediment Examination
15.1 Procedural Definition: What Is This Test About?
15.2 Procedural Purpose: Why Should I Perform This Test?
15.3 Equipment
15.4 Procedural Steps: How Do I Perform This Test?
15.5 Time Estimate to Perform Test
15.6 Procedural Tips and Troubleshooting
15.7 Interpreting Test Results
15.8 Clinical Case Example(s)
15.9 Add‐On Tests That You May Need to Consider and Their Additive Value
15.10 Key Takeaways
Reference
Suggested Bench‐Side References
Part 4: Quick Assessment Tests (QATS) Involving Feces
16 Assessing the Physical Properties of Fecal Matter
16.1 Procedural Definition: What Is This Test About?
16.2 Procedural Purpose: Why Should I Perform This Test?
16.3 Equipment
16.4 Procedural Steps
16.5 Time Estimate to Perform Test
16.6 Procedural Tips and Troubleshooting
16.7 Interpreting Test Results
16.8 Clinical Case Example(s)
16.9 Add‐On Tests That You May Need to Consider and Their Additive Value
16.10 Key Takeaways
16.11 Clinical Pearls
References
17 Direct Smears
17.1 Procedural Definition: What Is This Test About?
17.2 Procedural Purpose: Why Should I Perform This Test?
17.3 Equipment
17.4 Procedural Steps [1–5, 20, 30, 60–62]
17.5 Time Estimate to Perform Test
17.6 Procedural Tips and Troubleshooting
17.7 Interpreting Test Results
17.8 Clinical Case Example(s)
17.9 Add‐On Tests That You May Need to Consider and Their Additive Value
17.10 Key Takeaways
17.11 Clinical Pearls
References
18 Fecal Flotation
18.1 Procedural Definition: Whatis This Test About?
18.2 Procedural Purpose: Why Should I Perform This Test?
18.3 Options Available for Fecal Flotation
18.4 Equipment
18.5 Procedural Steps: Fecal Flotation with Fixed‐Angle Centrifuge[1–4, 8, 11, 22, 23, 28]
18.6 Time Estimate to Perform Fecal Flotation with Fixed‐Angle Centrifuge
18.7 Brief Consideration of the Procedural Steps in the Event a Swinging Bucket Centrifuge Is Used
18.8 Equipment
18.9 Procedural Steps
18.10 Time Estimate to Perform Passive Fecal Flotation
18.11 Procedural Tips and Troubleshooting for Fecal Flotation
18.12 Interpreting Test Results
18.13 Clinical Case Example(s)
18.14 Add‐On Tests That You May Need to Consider and Their Additive Value
18.15 Key Takeaways
18.16 Clinical Pearls
References
Part 5: Quick Assessment of Body Cavity Fluids
19 Body Cavity Fluid Analysis
19.1 Procedural Definition: What Is This Test About?
19.2 Procedural Purpose: Why Should I Perform This Test?
19.3 Equipment
19.4 Procedural Steps: How Do I Perform This Test?
19.5 Time Estimate to Perform Test
19.6 Procedural Tips and Troubleshooting
19.7 Interpreting Test Results
19.8 Clinical Case Example(s)
19.9 Add‐On Tests That You May Need to Consider and Their Additive Value
19.10 Key Takeaways
References
Suggested Bench‐Side References
Part 6: Clinical Cases
20 Clinical Cases
1 Case #1
2 Case #2
3 Case #3
4 Case #4
5 Case #5
6 Case #6
7 Case #7
8 Case #8
9 Case #9
10 Case #10
11 Case #11
12 Case #12
13 Case #13
14 Case #14
15 Case #15
References
Index
End User License Agreement
List of Tables
Chapter 6
Table 6.1 Standard protocol for reporting erythrocyte morphology (cells/100...
Chapter 12
Table 12.1 The many shades of urine in cats and dogs and what each may be i...
Table 12.2 Scents that may be associated with urine and what they may indic...
Chapter 15
Table 15.1 Reference intervals for urine sediment formed elements.
Chapter 16
Table 16.1 The many shades of feces in cats and dogs and what each may be i...
Chapter 19
Table 19.1 Categorization of body cavity fluids.
List of Illustrations
Chapter 2
Figure 2.1 The basic framework of the Calgary‐Cambridge Guides.
Figure 2.2 The expanded framework of the Calgary‐Cambridge Guides.
Figure 2.3 Intricacies of knowledge in the consultation room: a consideratio...
Chapter 3
Figure 3.1 Equipment needed to perform a PCV include whole blood in a blood ...
Figure 3.2 Blood tube can be mixed on a rocker (a) or manually (b).
Figure 3.3 Microhematocrit tube is filled by placing it into the blood colle...
Figure 3.4 Once filled, a finger is placed at the end of the microhematocrit...
Figure 3.5 Wipe off any excess blood on the exterior of the microhematocrit ...
Figure 3.6 Place the end of the microhematocrit in the clay sealant to seal ...
Figure 3.7 (a) To keep the sealant clay clean, the microhematocrit tube can ...
Figure 3.8 Microhematocrit tubes are placed in the centrifuge while ensuring...
Figure 3.9 Place and secure the interior lid on the centrifuge before closin...
Figure 3.10 (a) Microhematocrit tube is placed on the hematocrit reader by a...
Figure 3.11 Microhematocrit tubes on the left do not have any anticoagulant ...
Chapter 4
Figure 4.1 Equipment needed for determining total plasma protein by refracto...
Figure 4.2 (a) The features of the refractometer: (A) the cover over the pri...
Figure 4.3 (a) Open the prism cover to expose the clean surface of the prism...
Figure 4.4 Replace the prism cover to allow the distilled water to spread ou...
Figure 4.5 (a) Hold the refractometer up to a light and read the scale for u...
Figure 4.6 (a) Place a small screw driver in the calibration screw just behi...
Figure 4.7 The microhematocrit tube can be scored just above the buffy coat ...
Figure 4.8 Gently break the microhematocrit tube and discard the portion con...
Figure 4.9 (a) Platten cover is opened and drops of the plasma have been sha...
Figure 4.10 A small bulb has been placed onto the microhematocrit tube conta...
Figure 4.11 The interface line in this image indicates a plasma protein of 9...
Chapter 5
Figure 5.1 The equipment for preparing a buffy coat preparation includes who...
Figure 5.2 The buffy coat in this case is increased in size (greater than 1%...
Figure 5.3 The black line indicates where the hematocrit tube should be scor...
Figure 5.4 Discard the segment of the hematocrit tube containing the RBCs le...
Figure 5.5 Tap or expel the buffy coat on to a slide.
Figure 5.6 (a) A spreader slide is placed on the buffy coat drop and it is a...
Figure 5.7 Dip the slide in the first solution 5–7 times. This solution is a...
Figure 5.8 (a) Drain on the lip of the jar.(b) dip the slide in the seco...
Figure 5.9 (a) Drain on the lip of the jar.(b) dip the slide in the thir...
Figure 5.10 Rinse the slide briskly with distilled water to remove the stain...
Figure 5.11 Place the slide in the stain solution for 10 seconds. This stain...
Figure 5.12 Place the slide in the distilled water for 20 seconds without dr...
Figure 5.13 Rinse off the residual stain and allow the slide to air dry.
Figure 5.14 Air‐dried slides are placed in a staining tray. Staining trays a...
Figure 5.15 The slides are flooded with an alcohol fixative for one minute....
Figure 5.16 The fixative is tipped off and the slide is flooded with the sta...
Figure 5.17 The stain is tipped off and the slide is flooded with the buffer...
Figure 5.18 Finally, the slide is rinsed with distilled water.
Figure 5.19 (a) Wright–Giemsa stained buffy coat; (b) Diff–Quik stain.
Chapter 6
Figure 6.1 Equipment necessary for preparing a blood film include whole bloo...
Figure 6.2 (a) A microhematocrit tube is used to place a small drop in the g...
Figure 6.3 The slide used to spread the blood film should be held at a 45° a...
Figure 6.4 The angle of the spreader slide is greater than 45° in this image...
Figure 6.5 The angle of the spreader slide is smaller than 45° in this image...
Figure 6.6 (a) Allow the blood to spread out to the edge of the spreader sli...
Figure 6.7 This is an example of a well‐made blood film with a good‐feathere...
Figure 6.8 The blood film shows no streaks, breaks, or droplets and has an i...
Figure 6.9 The blood film in this image is from a sample with a plasma total...
Figure 6.10 The side on the left is from a sample from a dog with a PCV in t...
Figure 6.11 The blood film in this case was made with too much downward pres...
Figure 6.12 (a)
Dirofilaria immitus
microfilaria; (b) platelet clusters; (c)...
Figure 6.13 (a) Neutrophil with phagocytized
Histoplasma capsulatum
yeast fo...
Figure 6.14 (a) Low leukocyte density; (b) appropriate leukocyte density; (c...
Figure 6.15 (a) The electronic cell counters not only allow counting of indi...
Figure 6.16 (a) Burr cell; (b) keratocytes (*); (c) blister cells (*); (d) H...
Figure 6.17 The polychromatophilic cel are not a true blue but slightly mudd...
Figure 6.18 (a)
Mycoplasma hemofelis
(*); (b) Cytauxzoon felis (*); (c) Babe...
Figure 6.19 Canine distemper virus inclusion within an erythrocyte (*).
Figure 6.20 Döhle bodies in a canine neutrophil (*).
Figure 6.21 Note the large cell present in the center of the field. The cell...
Figure 6.22 Acute myeloproliferative disease in a dog. While these cells are...
Figure 6.23 (a) A morula of
Anaplasma phagocytophilum
is present in the cyto...
Figure 6.24 An eosinophilic canine distemper virus inclusion is present in t...
Figure 6.25 Too little blood is present on the slide at the top (*) and too ...
Figure 6.26 In this image, the spreader slide is in the wrong position. The ...
Figure 6.27 If blood is fragile or the blood film maker has a “heavy hand,” ...
Chapter 7
Figure 7.1 Place a small droplet of control product close to the sample port...
Figure 7.2 Equipment needed to perform this test include a glucometer, reage...
Figure 7.3 Note the expiration date (April 2022), the lot number (1121580), ...
Figure 7.4 Inserting the test strip will activate the screen. Remember to no...
Figure 7.5 Follow the instruction manual on how to enter the code for the te...
Figure 7.6 A 1 ml syringe is used to introduce the sample onto the sample po...
Figure 7.7 A microhematocrit tube is used to introduce the sample onto the s...
Figure 7.8 The instrument display will show the reading for the sample or co...
Figure 7.9 Excel sheets are commonly used for creating and maintaining proce...
Chapter 8
Figure 8.1 Equipment needed to perform this test includes: Azostix reagent s...
Figure 8.2 Use a pipette to place a large drop of blood on the reagent pad. ...
Figure 8.3 Completely cover the reagent pad as shown in this image. Incomple...
Figure 8.4 Using a steady stream of water, wash the blood from the reagent p...
Figure 8.5 Holding the reagent strip to the color chart, determine which col...
Figure 8.6 In this image, three samples are shown with three different BUN r...
Chapter 9
Figure 9.1 Equipment needed to perform this test includes a lactate meter, r...
Figure 9.2 Note the expiration date and the lot number. Insert the test stri...
Figure 9.3 Inserting the test strip will activate the screen.
Figure 9.4 A 1 ml syringe is used to introduce the sample onto the sample po...
Figure 9.5 A microhematocrit tube is used to introduce the sample onto the s...
Figure 9.6 Excel sheets commonly are used for creating and maintaining proce...
Chapter 10
Figure 10.1 Supplies necessary for a saline agglutination test include whole...
Figure 10.2 Using a small pipette place a drop of blood onto a glass slide....
Figure 10.3 Place 10 drops of 0.9% saline onto the slide. At least 10 drops ...
Figure 10.4 Gently rotate the slide to be sure the sample is adequately mixe...
Figure 10.5 A coverslip is placed on the slide to provide an even layer and ...
Figure 10.6 (a) Erythrocytes have remained in large aggregates indicating a ...
Chapter 11
Figure 11.1 Equipment and slides needed to perform the activated clotting ti...
Figure 11.2 If a tube heating block is not available, a beaker of water can ...
Figure 11.3 Using a vacutainer sleeve and a multi‐draw vacutainer needle, dr...
Figure 11.4 Change to the activated clotting time tube and allow the tube to...
Figure 11.5 When drawing the blood using a butterfly catheter, follow the sa...
Figure 11.6 Once the line and needle of the catheter has been cleared, chang...
Figure 11.7 The tube should be gently tilted just off of horizontal to obser...
Chapter 12
Figure 12.1 A 15 ml sterile polypropylene conical centrifuge tube with print...
Figure 12.2 Cat voiding in litter box. Note that if the cat were tolerant, t...
Figure 12.3 (a) An example of feline hemoglobinuria.(b) an example of fe...
Figure 12.4 Using text against a white background to differentiate turbidity...
Figure 12.5 Two urine samples in canine patients. The sample on the left is ...
Figure 12.6 The expected color (straw yellow) in a canine patient.
Figure 12.7 Yellow‐green urine.
Figure 12.8 Deep yellow urine in a canine patient.
Figure 12.9 Orange‐colored urine in a patient that had been prescribed rifam...
Figure 12.10 Peach‐colored urine in a feline patient with UTO.
Figure 12.11 Pink‐colored urine in a feline patient with UTO.
Figure 12.12 Red urine in a feline patient with UTO.
Figure 12.13 Rust‐brown colored urine in a canine patient with urolithiasis....
Figure 12.14 Brown urine in a cat that ingested acetaminophen.
Figure 12.15 Brown‐black urine in a veterinary patient.
Figure 12.16 Milky white urine due to pronounced pyuria.
Figure 12.17 Example of clear urine in a canine patient.
Figure 12.18 Example of cloudy urine in a feline patient with urinary tract...
Figure 12.19 Example of turbid urine in a canine patient. Urine culture disc...
Figure 12.20 Example of turbid urine in a dog with a prostatic abscess.
Figure 12.21 Example of urine from a clinically healthy rabbit. Note that th...
Figure 12.22 Example of feline house soiling.
Chapter 13
Figure 13.1 Three different samples of urine with varying degrees of concent...
Figure 13.2 Supplies for USG by Refractometry.
Figure 13.3 Refractometer prior to calibration. The stage cover is closed....
Figure 13.4 Refractometer ready for calibration. The stage cover has been li...
Figure 13.5 Applying a drop of distilled water to the stage for the purpose ...
Figure 13.6 Distilled water has been placed on the stage for the purpose of ...
Figure 13.7 The correct positioning of the examiner's eye relative to the re...
Figure 13.8 The correct reading for a properly calibrated refractometer.
Figure 13.9 Inserting the refractometer's screwdriver into the calibration s...
Figure 13.10 Drying the stage of the refractometer following calibration in ...
Figure 13.11 Preparing to load the patient's sample onto the stage of the re...
Figure 13.12 Loading the stage of the refractometer with the patient's sampl...
Figure 13.13 Loading the stage of the refractometer with the patient's sampl...
Figure 13.14 The stage cover has been closed, causing the patient sample to ...
Figure 13.15 Close‐up of the correct positioning of the examiner's eye relat...
Figure 13.16 Urine specific gravity reading for hyposthenuric urine.
Figure 13.17 Urine specific gravity reading for isosthenuric urine.
Figure 13.18 Urine specific gravity reading for midrange concentrated urine....
Figure 13.19 Urine specific gravity reading of 1.050, the highest measuremen...
Chapter 14
Figure 14.1 Example of reagent test strip that exclusively tests for urine k...
Figure 14.2 Example of reagent test strip that exclusively tests for urine g...
Figure 14.3 Example of a reagent test strip that assesses multiple chemical ...
Figure 14.4 Gathering supplies for urine dipstick analysis.
Figure 14.5 One individual Multistix® test strip.
Figure 14.6 Immersing the dipstick within the patient's urine sample so as t...
Figure 14.7 Removing excess sample from the reagent test pads immediately fo...
Figure 14.8 The label of the product contains the recommended times to read ...
Figure 14.9 Manually reading the urine dipstick.
Figure 14.10 Manually reading the urine dipstick.
Figure 14.11 This photograph demonstrates how you would read the test pad fo...
Figure 14.12 This photograph demonstrates how you would read the test pad fo...
Figure 14.13 This photograph demonstrates how you would read the test pad fo...
Figure 14.14 This photograph demonstrates how you would read the test pad fo...
Figure 14.15 Manually reading the urine dipstick. Note that the bilirubin te...
Figure 14.16 Pipetting urine droplets onto each test pad.
Figure 14.17 Urine has been successfully applied to all reagent test pads....
Figure 14.18 Close‐up of test strip after urine has been applied to all reag...
Figure 14.19 Checking the expiration date on a container of urine dipsticks....
Figure 14.20 Dipstick reading printout from an automated analyzer that evalu...
Figure 14.21 Dipstick reading printout from an automated analyzer that evalu...
Figure 14.22 Peri‐aural icterus in a feline patient with underlying hepatopa...
Chapter 15
Figure 15.1 Equipment needed for a urine sediment analysis includes a centri...
Figure 15.2 Calibrated conical centrifuge tubes are helpful in consistently ...
Figure 15.3 It is essential to balance the tubes by using the same type of t...
Figure 15.4 (a) The centrifuge is set for five minutes at 250 RCF, which, wi...
Figure 15.5 The supernatant can be poured off the sediment. It may be diffic...
Figure 15.6 Conversely, a pipette can be used to remove the sediment from th...
Figure 15.7 (a) Once the supernatant has been removed, the sediment can be r...
Figure 15.8 (a) A drop of the sediment is placed on the slide; (b) a 25 x 25...
Figure 15.9 Microscopes with an adjustable condenser have a knob below the s...
Figure 15.10 Using the same technique for making a blood film, draw the spre...
Figure 15.11 Push the spreader slide toward the end of the slide.
Figure 15.12 Abruptly lift the spreader slide when it reaches about two‐thir...
Figure 15.13 The formed elements will be concentrated to the area where the ...
Figure 15.14 This image of an active sediment reveals several erythrocytes (...
Figure 15.15 Several large squamous epithelial cells (*) and a few scattered...
Figure 15.16 While not common, spermatozoa can be incidental findings in the...
Figure 15.17 A single coarsely granular cast is present in this urine sedime...
Figure 15.18 Several small square “maltese cross” dihydrate calcium oxalate ...
Figure 15.19 Numerous struvite crystals are present along with a large amoun...
Figure 15.20 Numerous coccoid bacteria in variably sized chains are present ...
Figure 15.21 A large aggregate of rod‐shaped bacteria and scattered individu...
Figure 15.22 Large numbers of branching fungal hyphae, bacteria, amorphous d...
Figure 15.23 One bioperculate ova of
Pearsonema feliscati
in a urine cytolog...
Chapter 16
Figure 16.1 Example of loose canine feces prior to being sampled. Note that ...
Figure 16.2 Example of semi‐formed canine feces prior to being sampled. Note...
Figure 16.3 Example of formed feline feces prior to being sampled. Note that...
Figure 16.4 Example of diarrheic feces from a puppy. This gelatinous fecal m...
Figure 16.5 Example of a polyethylene fecal wand.
Figure 16.6 Fecal scoring system for dogs.
Figure 16.7 Assessing canine BCS using the Purina 9‐point system.
Figure 16.8 Assessing feline BCS using the Purina 9‐point system.
Figure 16.9 Example of house‐soiling in a dog with diarrhea. The patient dem...
Figure 16.10 Normal canine posture for defecation.
Figure 16.11 Tenesmus in a dog with hematochezia.
Figure 16.12 Normal posture for urination in a female cat.
Figure 16.13 Normal feline posture for defecation.
Figure 16.14 Canine sample with a fecal score of 1.
Figure 16.15 Left lateral radiograph of a cat with megacolon. Note the signi...
Figure 16.16 Feline sample with a fecal score of 4. The stool is moist and s...
Figure 16.17 Feline sample with a fecal score of 6. The stool has texture bu...
Figure 16.18 Canine sample with a fecal score of 7. The stool is watery and ...
Figure 16.19 Canine fecal sample demonstrating normal color (brown).
Figure 16.20 The color of this fecal sample (white) is attributed to the fac...
Figure 16.21 Acholic feces in a canine patient.
Figure 16.22 The color of this fecal sample is abnormal. The feces are yello...
Figure 16.23 Orange feces in a canine patient.
Figure 16.24 Deep orange diarrhea in a canine patient.
Figure 16.25 Stool from a horse to emphasize that the chlorophyll from a fol...
Figure 16.26 Green stool from a canine patient that ate excessive amounts of...
Figure 16.27 Green stool from a canine patient that ingested rodenticide....
Figure 16.28 Turquoise vomit from a canine patient that had ingested rodenti...
Figure 16.29 Stool of pudding‐like consistency dotted with proglottid segmen...
Figure 16.30 Solid, formed stool that contains a ribbon of proglottid segmen...
Figure 16.31 Proglottid segment adhered to the fur near the perineum of a fe...
Figure 16.32 Example of melena produced by a canine patient. This stool is s...
Figure 16.33 Example of melena produced by a canine patient.
Figure 16.34 Example of melena that has just been passed by a laterally recu...
Figure 16.35 Example of canine diarrhea. Note the presence of a few fresh dr...
Figure 16.36 Example of hematochezia from a feline patient.
Figure 16.37 Example of hematochezia from a canine patient. Note that the st...
Figure 16.38 A sample from a canine patient with hemorrhagic gastroenteritis...
Figure 16.39 A sample from a canine patient with hemorrhagic gastroenteritis...
Figure 16.40 A sample from a canine patient with hemorrhagic gastroenteritis...
Figure 16.41 Canine feces with a slime‐like coating of mucus.
Figure 16.42 A sample of fecal mucus from a feline patient. This mucus is ti...
Figure 16.43 Appreciable mucus coating a canine fecal sample.
Figure 16.44
Dipylidium caninum
egg packet, 20×.
Figure 16.45
Dipylidium caninum
proglottid, grossly visible to the naked eye...
Figure 16.46
Dipylidium caninum
proglottid.
Figure 16.47
Dipylidium caninum
proglottids.
Figure 16.48 Adult
Toxocara cati
in a stool sample.
Figure 16.49 Adult roundworm in vomitus.
Figure 16.50 Bloody diarrhea from a patient with presumptive parvovirus.
Figure 16.51 Performing an in‐house parvovirus fecal ELISA antigen test.
Figure 16.52 A negative in‐house parvovirus fecal ELISA antigen test. The bl...
Figure 16.53 A negative in‐house parvovirus fecal ELISA antigen test.Not...
Figure 16.54 A faint‐positive in‐house parvovirus fecal ELISA antigen test. ...
Figure 16.55 A positive in‐house parvovirus fecal ELISA antigen test. Note t...
Figure 16.56 A positive in‐house parvovirus fecal ELISA antigen test. The bl...
Figure 16.57 Appreciable flea dirt in a seven‐month‐old kitten.
Figure 16.58 Pale oral mucosa in a seven‐month‐old kitten with severe flea i...
Figure 16.59 Pale conjunctiva in a seven‐month‐old kitten with severe flea i...
Figure 16.60 Dissected fecal matter. Note that this sample contains an appre...
Figure 16.61 This rope toy was extracted from a fecal sample. The presence o...
Chapter 17
Figure 17.1
Demodex gatoi
, 40x, as observed on routine fecal analysis from a...
Figure 17.2
Giardia
cysts in a feline patient, 40x. Concentrated from feces ...
Figure 17.3 Perianal irritation.
Figure 17.4 Rectal prolapse in a cat.
Figure 17.5 Supplies for direct smear.
Figure 17.6 Using a wooden applicator stick to apply the patient's fecal sam...
Figure 17.7 The patient's sample has been added to a microscope slide.
Figure 17.8 Adding one drop of 0.9% saline to the slide that contains the fe...
Figure 17.9 Getting ready to use a wooden applicator stick to mix the saline...
Figure 17.10 Using a wooden applicator stick to mix the saline and fecal sam...
Figure 17.11 Placing the slide against written text to check the slurry's th...
Figure 17.12 Placing a coverslip over the slurry in preparation for viewing ...
Figure 17.13
Giardia
cysts as seen on direct smear.
Figure 17.14
Giardia
cyst magnified and stained with iodine, direct smear....
Figure 17.15
Giardia
trophozoite as seen on direct smear.
Figure 17.16
Giardia
trophozoite as seen on direct smear.
Figure 17.17 Sideview of
Giardia
trophozoite, magnified, as seen on direct s...
Figure 17.18
Giardia
trophozoite, magnified, as seen on direct smear.
Figure 17.19 Tear‐drop shape of
Giardia
trophozoite, magnified, as seen on d...
Figure 17.20
Giardia
trophozoite, magnified and stained with iodine, as seen...
Figure 17.21
Giardia
trophozoite, magnified and stained with Giemsa, as seen...
Figure 17.22
Giardia
trophozoite, magnified and stained with Giemsa, as seen...
Figure 17.23
Tritrichomonas
trophozoite as seen on direct smear.
Figure 17.24 Two
Tritrichomonas
trophozoites as seen on direct smear.
Figure 17.25
Tritrichomonas
trophozoite as seen on direct smear.
Figure 17.26 Scanning slide for bacteria, as seen on direct smear.
Figure 17.27 Scanning slide for bacteria, as seen on direct smear.
Figure 17.28 Scanning slide for bacteria, as seen on direct smear. Iodine ha...
Figure 17.29 Scanning slide for bacteria, as seen on direct smear. Iodine ha...
Figure 17.30
Campylobacter
‐like organisms on fecal examination. Note the cha...
Figure 17.31 A negative in‐house
Giardia
ELISA antigen test. The blue dot at...
Figure 17.32 A positive in‐house
Giardia
ELISA antigen test. The blue dot at...
Figure 17.33 A negative in‐house
Giardia
ELISA antigen test.Note the abs...
Figure 17.34 A faint‐positive in‐house
Giardia
ELISA antigen test. Note the ...
Figure 17.35 In Pouch ™ TF Feline in‐house test for
Tritrichomonas foetus,
p...
Chapter 18
Figure 18.1 Oil mixed with water. Note that the oil is less dense than water...
Figure 18.2 Ice added to a cup of water. The ice is less dense than water, s...
Figure 18.3 One commercially available brand of Sheather's sugar solution....
Figure 18.4 One commercially available brand of zinc sulfate solution.
Figure 18.5 One commercially available brand of sodium nitrate solution.
Figure 18.6 Passive (gravitational) fecal flotation.
Figure 18.7 Centrifugal fecal flotation.
Figure 18.8 Centrifuge model that reflects the swinging bucket style. This s...
Figure 18.9 Centrifuge model that reflects the fixed‐angle rotor style. Note...
Figure 18.10 Appropriate sample size for centrifugal fecal flotation. For re...
Figure 18.11 Adding flotation solution to cup containing fecal sample.
Figure 18.12 Mixing fecal sample and flotation solution.
Figure 18.13 Filtering the mixture of feces and fecal flotation solution thr...
Figure 18.14 Agitating the mixture of feces and fecal flotation solution as ...
Figure 18.15 Pouring filtrate into a conical tube.
Figure 18.16 Capping the conical tube and placing it in the tube rack prior ...
Figure 18.17 Placing conical tubes in centrifuge prior to centrifugation. No...
Figure 18.18 Conical tubes following centrifugation. Note the supernatant an...
Figure 18.19 Conical tube post‐centrifugation, filled with fresh flotation s...
Figure 18.20 Coverslip placed on top of meniscus.
Figure 18.21 Creating one slide from a single sample.
Figure 18.22 Creating one slide from two samples.
Figure 18.23 Materials needed for passive fecal flotation.
Figure 18.24 Profile view of disposable fecal diagnostic kit, ready to be fi...
Figure 18.25 Aerial view of disposable fecal diagnostic kit, ready to be fil...
Figure 18.26 Appropriate sample size for passive fecal flotation.
Figure 18.27 Disposable fecal diagnostic kit, to which feces have been added...
Figure 18.28 Profile view of adding flotation solution to the disposable fec...
Figure 18.29 Close‐up view of adding flotation solution to the disposable fe...
Figure 18.30 Mixing the sample of feces and flotation solution by rotating t...
Figure 18.31 Close‐up view of the appropriately mixed slurry.
Figure 18.32 Filling the disposable fecal diagnostic kit to achieve a slight...
Figure 18.33 Slight meniscus has been achieved.
Figure 18.34 Profile view of slight meniscus.
Figure 18.35 Coverslip has been placed on top of the meniscus.
Figure 18.36 Alternate view of coverslip in place over meniscus.
Figure 18.37 Crystal artifact as seen under the microscope after delaying re...
Figure 18.38
Toxocara canis
egg on fecal examination, using light microscopy...
Figure 18.39
Toxocara cati
egg on fecal examination, using light microscopy....
Figure 18.40 Adult
Toxocara cati
in a stool sample.
Figure 18.41 Adult
Toxocara cati
in sample of vomitus.
Figure 18.42
Uncinaria
egg on fecal examination, using light microscopy.
Figure 18.43
Ancylostoma
egg on fecal examination, using light microscopy....
Figure 18.44
Dipylidium caninum
proglottid.
Figure 18.45 Magnified
Dipylidium
segment.
Figure 18.46
Dipylidium caninum
egg packet, 20×.
Figure 18.47 Magnified
Taenia
segment.
Figure 18.48
Taenia
egg, 40×.
Figure 18.49 Whipworm eggs, low magnification.
Figure 18.50 Whipworm egg, higher magnification.
Figure 18.51
Isospora felis
.
Figure 18.52
Isospora rivolta
.
Figure 18.53
Isospora canis
.
Figure 18.54
Isospora ohioensis
.
Figure 18.55
Baylisascaris procyonis
ovum.
Chapter 19
Figure 19.1 Equipment and supplies needed for performing a body cavity fluid...
Figure 19.2 (a) Red, cloudy pericardial fluid from a dog; (b) clear, light y...
Figure 19.3 (a) High‐protein/protein‐rich effusion with low cellularity (tho...
Figure 19.4 Transudate from the thoracic cavity of a cat (sediment preparati...
Figure 19.5 Sediment preparation of peritoneal fluid from a dog. The fluid w...
Figure 19.6 Abdominal fluid from a cat, chronic suppurative exudate. Note th...
Figure 19.7 Thoracic fluid from a cat, pyogranulomatous exudate. Note the la...
Figure 19.8 (a) Hemorrhagic effusion. Pericardial fluid from a dog. Fluid PC...
Figure 19.9 Milky white fluid from the thorax of a cat consistent with chylo...
Figure 19.10 Thoracic fluid from a dog. Note the numerous small, normal‐appe...
Figure 19.11 Direct preparation of thoracic fluid from a dog with multiple p...
Chapter 20
Case Figure 1.1 Hematologic data. Absolute leukocyte values are based on WBC...
Case Figure 1.2 Hematocrit tube gross image.
Case Figure 1.3 Blood film (Diff–Quick, 100×).
Case Figure 1.4 Blood film (Diff–Quick, 200×).
Case Figure 1.5 Blood film (Diff–Quick, 500×).
Case Figure 1.6 Biochemistry and urinalysis data. Urinalysis sample by cysto...
Case Figure 2.1 Hematologic data. *Absolute leukocyte values are based on WB...
Case Figure 2.2 Blood film (Wrights–Giemsa, 200×).
Case Figure 2.3 Blood film (Wrights–Giemsa, 200×).
Case Figure 2.4 Blood film (Wrights–Giemsa, 500×).
Case Figure 2.5 Blood film (Wrights–Giemsa, 500×).
Case Figure 2.6 Blood film (Wrights–Giemsa, 500×).
Case Figure 2.7 Blood film (Wrights–Giemsa, 1000×).
Case Figure 2.8 Blood film (Wrights–Giemsa, 1000×).
Case Figure 2.9 Blood film (Wrights–Giemsa, 1000×).
Case Figure 2.10 Biochemistry and urinalysis data. Urinalysis sample by cyst...
Case Figure 3.1 Hematologic data. *Absolute leukocyte values are based on WB...
Case Figure 3.2 Blood film (Wrights–Giemsa, 100×).
Case Figure 3.3 Blood film (Wrights–Giemsa, 200×).
Case Figure 3.4 Blood film (Wrights–Giemsa, 500×).
Case Figure 3.5 Blood film (Wrights–Giemsa, 1000×).
Case Figure 3.6 Biochemistry and urinalysis data. Urinalysis sample by cysto...
Case Figure 3.7 Hematologic data four hours post presentation. *Absolute leu...
Case Figure 3.8 Blood film (Wrights–Giemsa, 200×).
Case Figure 3.9 Blood film (Wrights–Giemsa, 500×).
Case Figure 3.10 Blood film (Wrights–Giemsa, 500×).
Case Figure 3.11 Blood film (Wrights–Giemsa, 500×).
Case Figure 3.12 Blood film (Wrights–Giemsa, 1000×).
Case Figure 3.13 Biochemistry and urinalysis data. Urinalysis sample by cyst...
Case Figure 4.1 Hematologic data. *Absolute leukocyte values are based on WB...
Case Figure 4.2 Blood film (Wrights–Giemsa, 100×).
Case Figure 4.3 Blood film (Wrights–Giemsa, 200×).
Case Figure 4.4 Blood film (Wrights–Giemsa, 500×).
Case Figure 4.5 Blood film (Wrights–Giemsa, 500×).
Case Figure 4.6 Blood film (Wrights–Giemsa, 500×).
Case Figure 4.7 Fluid analysis data.
Case Figure 4.8 Biochemistry and urinalysis data. Urinalysis sample by cysto...
Case Figure 5.1 Hematologic data. *Absolute leukocyte values are based on WB...
Case Figure 5.2 Blood film (Wrights–Giemsa, 200×).
Case Figure 5.3 Blood film (Wrights–Giemsa, 200×).
Case Figure 5.4 Blood film (Wrights–Giemsa, 500×).
Case Figure 5.5 Blood film (Wrights–Giemsa, 500×).
Case Figure 5.6 Blood film (Wrights–Giemsa, 500×).
Case Figure 5.7 Biochemistry and urinalysis data. Urinalysis sample by cysto...
Case Figure 5.8 Fecal analysis data.
Case Figure 6.1 Rapid basic diagnostic results.
Case Figure 6.2 Blood film (Wrights–Giemsa, 100×).
Case Figure 6.3 Blood film (Wrights–Giemsa, 100×).
Case Figure 6.4 Blood film (Wrights–Giemsa, 200×).
Case Figure 7.1 Hematologic data. *Absolute leukocyte values are based on WB...
Case Figure 7.2 Gross urine appearance, precentrifugation.
Case Figure 7.3 Gross urine appearance, postcentrifugation.
Case Figure 7.4 Urine sediment, wet mount (unstained, 100×).
Case Figure 7.5 Urine sediment, wet mount (unstained, 100×).
Case Figure 7.6 Urine sediment, wet mount (unstained, 400×).
Case Figure 7.7 Urine sediment, dry mount(Wrights–Giemsa, 100×).
Case Figure 7.8 Urine sediment, dry mount(Wrights–Giemsa, 200×).
Case Figure 7.9 Urine sediment, dry mount (Wrights–Giemsa, 500×).
Case Figure 7.10 Urine sediment, dry mount(Wrights–Giemsa, 500×).
Case Figure 7.11 Urine sediment, dry mount (Wrights–Giemsa, 1000×).
Case Figure 7.12 Biochemistry and urinalysis data. Urinalysis sample by cyst...
Case Figure 8.1 Hematologic data. *Absolute leukocyte values are based on WB...
Case Figure 8.2 Blood film (Wrights–Giemsa, 200×).
Case Figure 8.3 Blood film (Wrights–Giemsa, 400×).
Case Figure 8.4 Blood film (Wrights–Giemsa, 800×).
Case Figure 8.5 Blood film (Wrights–Giemsa, 800×).
Case Figure 8.6 Blood film (Wrights–Giemsa, 1000×).
Case Figure 8.7 Biochemistry and urinalysis data. Urinalysis sample by cysto...
Case Figure 9.1 Hematologic data. *Absolute leukocyte values are based on WB...
Case Figure 9.2 Blood film (Wrights–Giemsa, 100×).
Case Figure 9.3 Blood film (Wrights–Giemsa, 200×).
Case Figure 9.4 Blood film (Wrights–Giemsa, 500×).
Case Figure 9.5 Blood film (Wrights–Giemsa, 500×).
Case Figure 9.6 Fluid analysis data.
Case Figure 9.7 Biochemistry and urinalysis data. Urinalysis sample by cysto...
Case Figure 10.1 Hematologic data. *Absolute leukocyte values are based on W...
Case Figure 10.2 Urine sediment, wet mount (unstained, 400×).
Case Figure 10.3 Biochemistry and urinalysis data. Urinalysis sample by cyst...
Case Figure 10.4 Fecal analysis.
Case Figure 11.1 Hematologic data.
Case Figure 11.2 Fecal direct smear (unstained, 1000×).
Case Figure 11.3 Fecal direct smear (unstained, 1000×).
Case Figure 11.4 Fecal analysis data.
Case Figure 12.1 Hematologic data. *Absolute leukocyte values are based on W...
Case Figure 12.2 Fecal flotation (Sheather's sugar solution, 100×).
Case Figure 12.3 Fecal direct smear (Sheather's sugar solution, 400×).
Case Figure 12.4 Fecal analysis data.
Case Figure 13.1 Hematologic data. *Absolute leukocyte values are based on W...
Case Figure 13.2 Blood film (Wrights–Giemsa, 200×).
Case Figure 13.3 Blood film (Wrights–Giemsa, 500×).
Case Figure 13.4 Blood film (Wrights–Giemsa, 1000×).
Case Figure 13.5 Fecal analysis data.
Case Figure 14.1 Cytologic preparation of previously excised mast cell tumor...
Case Figure 14.2 Hematologic data. *Absolute leukocyte values are based on W...
Case Figure 14.3 Blood film (Wrights–Giemsa, 200×).
Case Figure 14.4 Blood film (Wrights–Giemsa, 500×).
Case Figure 14.5 Blood film (Wrights–Giemsa, 500×).
Case Figure 14.6 Biochemistry and urinalysis data. Urinalysis sample by cyst...
Case Figure 15.1 Hematocrit tube gross image 1.
Case Figure 15.2 Hematocrit tube gross image 2.
Case Figure 15.3 Refractometry measurement of total plasma protein.
Case Figure 15.4 Hematologic data. *Absolute leukocyte values are based on W...
Case Figure 15.5 Blood film
Case Figure 15.6 Blood film
Case Figure 15.7 Blood film
Case Figure 15.8 Blood film
Case Figure 15.9 Gross urine appearance, postcentrifugation.
Case Figure 15.10 Biochemistry and urinalysis data. Urinalysis sample by cys...
Guide
Cover Page
Title Page
Copyright Page
Dedication Page
About the Authors
About the Authors
Preface
Acknowledgments
Table of Contents
Begin Reading
Index
20 Clinical Cases
WILEY END USER LICENSE AGREEMENT
Pages
iii
iv
v
vi
xiv
xv
xvi
xvii
xviii
xix
xx
xxi
xxiii
xxiv
xxv
xxvi
1
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
99
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
235
237
238
239
240
241
242
243
244
245
247
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
Low‐Cost Veterinary Clinical Diagnostics
Ryane E. Englar DVM, DABVP (Canine and Feline Practice)
Executive Director of Clinical and Professional Skills
&
Associate Professor of Practice
University of Arizona College of Veterinary Medicine
Oro Valley, Arizona, USA
Sharon M. Dial DVM, PhD, DACVP (Clinical and Anatomic Pathology)
Research Scientist
University of Arizona College of Veterinary Medicine
Oro Valley, Arizona, USA
This edition first published 2023© 2023 by John Wiley & Sons, Inc.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.
The right of Ryane E. Englar and Sharon M. Dial to be identified as the authors of this work has been asserted in accordance with law.
Registered OfficesJohn Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USAJohn Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
For details of our global editorial offices, customer services, and more information about Wiley products visit us at www.wiley.com.
Wiley also publishes its books in a variety of electronic formats and by print‐on‐demand. Some content that appears in standard print versions of this book may not be available in other formats.
Trademarks: Wiley and the Wiley logo are trademarks or registered trademarks of John Wiley & Sons, Inc. and/or its affiliates in the United States and other countries and may not be used without written permission. All other trademarks are the property of their respective owners. John Wiley & Sons, Inc. is not associated with any product or vendor mentioned in this book.
Limit of Liability/Disclaimer of WarrantyThe contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.
Library of Congress Cataloging‐in‐Publication Data applied forHardback: 9781119714507
Cover Design: WileyCover Images: Courtesy of Robert Eisemann, DVM; © Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
Dedication
Isaac Newton once shared that:
“If I have seen further, it is by standing on the shoulders of giants.”
He was correct in ways that I didn't even recognize the first and the second and the third time that I read his quote.
The veterinary profession is full of giants, but I'm not talking about the neurosurgeons, orthopedic surgeons, or internists.
I'm not talking about Louis J. Camuti, the first veterinarian to devote his entire practice to cats, or even Bernhard Lauritz Frederik Bang, the Danish veterinarian who discovered Brucella abortus.
When I speak of giants, I am recalling those individuals who are ever‐present, yet underrecognized both in clinical practice and throughout veterinary medical education.
These giants are none other than our veterinary technicians.
Technicians are veterinarians' shadows – literally and figuratively – although my hope in penning this dedication is that we can extract them from the shadows and into the light, where they belong.
After all, they are the reason I have survived veterinary practice. The reason I am a good veterinarian today is because I have been lifted on the shoulders of great technicians.
Technicians are all‐star people, colleagues, and friends.
In a profession where they do so much for so many, we often fail to see them for who they are and all they contribute to the team.
They are talented and motivating individuals who excel in ways that I could never hold a candle to.
They are the blood, sweat, and tears of veterinary practice.
They are skilled diagnosticians, managers, nurses, and criticalists who maintain the pace and keep us all on track.
They are our pulse in ways that we can't even begin to wrap our heads around until we've been standing knee‐deep in the trenches for hours, days, weeks, years, lifetimes only to discover that they never left our sides. Through thick and thin. Through emergency C‐sections and CPR codes. Through life and death. And in the aftermath of death, too, when everyone else has gone home. They’re still there, too, waiting with you, beside you.
They are the only ones dedicated enough, determined enough, bold enough, and brave enough to stand with us, from dawn to dusk and from dusk to dawn, over and over and over again, putting forth all that they are and all that they strive to be, despite being continuously overworked and underpaid.
In the years that they have stood beside me, they have supported me, encouraged me, nurtured me, and taught me.
They have placed intravenous catheters when I could not; they have reassured clients when I could not.
They are the last gentle souls that my patients see when they are induced with general anesthesia, and they are the first gentle spirits that my patients awake to in recovery.
They have held my patients to quiet their fears and to provide comfort and warmth.
They have known the answers when I did not and believed in me when I did not.
Together, we have hoped and grieved, celebrated, and cried.
And when I have felt too weak, too lost, too alone to carry on, they have wiped away my tears and offered a hand and helped me stand so that together we could try again.
Dominique Wilkins was once credited as saying:
“You are only as good as your team.”
I am going to paraphrase this quote when I write this most essential truth of all for the veterinary profession: veterinarians are only as good as their technicians.
Veterinary technicians are extraordinary. They make us exceptional. They complete us. They make us whole.
To all the veterinary technicians out there, I see you. I appreciate you. I support you. I stand beside you.
May I never forget the sacrifices you have made on behalf of me and my patients.
You pave the way so that I can be me. You give my patients life and hope.
Thank you for being the backbone of our profession and the footprints in the sand.
You walk the walk beside us, with us, for us. And because of you, we are never ever the same.
– Ryane E. Englar
Every life is a culmination of the support and encouragement of those surrounding them. I have been remarkably fortunate to have grown up in the field of pathology surrounded by amazing individuals. As I contemplated returning to Colorado State University (CSU) to start my residency and PhD, I was told that the three most important things to consider are
choosing your mentor
choosing your mentor
And, finally
choosing your mentor.
I was fortunate to have been given the opportunity to work with Dr. Mary Anna Thrall (MAT) and it was the most important decision I made as I took my first steps toward being a clinical pathologist. She challenged me and my fellow residents to have an opinion and engage in lively discussion. As a PhD advisor, she provided support when, as is often the case, the research did not always go as planned. The quote she handed me when there was a difficult and unexpected outcome in our study is one that I have kept at heart since:
The joy of research must be in the doing for the outcome is uncertain –
Theobald Smith.
She made sure her residents participated in annual conferences and introduced us to the remarkable people who shaped the discipline of clinical pathology. As a friend, she showed me how to enjoy life in the moment. Thank you, MAT!
– Sharon M. Dial
About the Authors
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice) graduated from Cornell University College of Veterinary Medicine in 2008. She practiced as an associate veterinarian in companion animal practice before transitioning into the educational circuit as an advocate for preclinical training in primary care. She debuted in academia as a Clinical Instructor of the Community Practice Service at Cornell University's Hospital for Animals. She then transitioned into the role of Assistant Professor as founding faculty at Midwestern University College of Veterinary Medicine. While at Midwestern University, she had the opportunity to teach the inaugural class of 2018, the class of 2019, and the class of 2020. While training these remarkable young professionals, Dr. Englar became a Diplomat of the American Board of Veterinary Practitioners (ABVP). She then joined the faculty at Kansas State University between May 2017 and January 2020 to launch the clinical skills curriculum.
In February 2020, Dr. Englar reprised her role of founding faculty when she returned “home” to Tucson to join the University of Arizona College of Veterinary Medicine. As a dual appointment, Associate Professor of Practice and the Executive Director of Clinical and Professional Skills, Dr. Englar currently plays a lead role in the development and delivery of the pre‐clinical curriculum.
Dr. Englar is passionate about advancing education for generalists by thinking outside of the box to develop new course materials for the hands‐on learner. This labor of love is preceded by five sole‐authored texts that collectively provide students, clinicians, and educators alike with functional, relatable, and practice‐friendly tools for success:
Performing the Small Animal Physical Examination
(John Wiley & Sons, Inc., 2017)
Writing Skills for Veterinarians
(5M Publishing, Ltd., 2019)
Common Clinical Presentations in Dogs and Cats
(John Wiley & Sons, Inc., 2019)
