NationWide Labs NEWS ISSUE 9 Exciting News SPRING 2014 Dates for your diary The Farm Animal price list for 2014 now has a separate Ovine section. 3rd-6th April 2014 Cost effective clinical biochemistry packages are available to suit all needs including ill-thrift, trace element, general FARM health, myopathy, nutritional and metabolic ANIMAL disease profiles as well as the opportunity PRICE LIST to select individual tests relevant to a particular case. A wide range of serology tests allow for investigation of numerous diseases from Johne’s to Fluke to Toxoplasma. The Enteritis section offers a comprehensive range of tests, Trust in excellence. including bacteriology, virology and Trust us. parasitology for all ages from newborn lambs to adults. Numerous other miscellaneous tests are also available such as Abortion investigations, Vasectomy checks, haematology and histopathology providing full laboratory support for both flock problems and individuals. The ICC/NIA - Birmingham STAND 714 VETS NORTH 26th - 27th June 2014 SCOTTISH BSAVA 29th - 31st August BEVA 10th - 13th September BCVA 16th - 18th October LVS 20th - 21st November New Method for Lipase NationWide Laboratory Services and NationWide Specialist Laboratories are using a new method for routine lipase analyses. • Overall agreement between our new Lipase and cPLI of 92% The new method replaces our previous Lipase method in relevant panels (e.g., Diagnostic Screen, Extra Profile, Pancreatic Profile, Investigation Screen 2, Elderly Profile). • All positive cPLI cases (>400 ug/L; n=18) had Lipase > 95 IU/L • All negative Lipase (<45IU/L; n=30) cases had negative cPLI (<200 ug/L) • 11 of 12 equivocal cPLI results (200 - 400 ug/L) were equivocal by our new Lipase (45 – 95 IU/L) • Based on this study, cPLI appears to offer little diagnostic advantage over our new Lipase • A similar smaller comparison study against fPLI yielded a cut-off of 25 IU/L You will notice a change in reference ranges for Lipase. In a study of 64 canine samples we derived cut-off values for the detection of pancreatic inflammation by comparison to Pancreatic Lipase Immunoreactivity (cPLI). This study confirmed excellent diagnostic agreement between our new Lipase and cPLI. New Lipase (IU/L) cPLI/fPLI (ug/L) Canine normal <45 <200 Canine probable pancreatic inflammation >95 <400 Feline normal <25 <3.6 All requests for routine Lipase (test code LIP) now benefit from this new methodology at the standard add-to-profile list price of £2.80 (£8.20 standalone) and of course it is included at no extra charge in the profiles listed above. head office & poulton Lanceﬁeld House 23 Mains Lane Poulton Le Fylde FY6 7LJ T: 01253 899215 F: 01253 891934 E:[email protected] leeds Laboratory Gate Way Drive Yeadon Leeds LS19 7XY T: 0113 250 7556 F: 0113 250 0198 E:[email protected] swanscombe Laboratory Unit 5 Galley Hill Industrial Estate Swanscombe, Kent T: 01253 899215 F: 01253 891934 E:[email protected] specialist laboratories PO Box 967 Stapleford Cambridge CB22 5XY T: 01223 493400 F: 01223 493404 E:[email protected] NEWS ISSUE 9 SPRING 2014 Yersinia enterocolitica in a Puppy Scrumpy was a happy, bright well grown 4 month old Cocker Spaniel, but his proud new owner was concerned that the pup’s faeces were consistently soft. A faecal sample was submitted to NWL Leeds for our Full Faeces Examination (code FFE). This useful, cost effective package includes routine bacterial cultures (aerobic and anaerobic where indicated), selective cultures for Salmonella and Campylobacter, plus a parasite screen including examination for Giardia. On the day the sample was received, we were able to report that Scrumpy had evidence of giardiasis, allowing fenbendazole therapy to begin promptly and his owner to be made aware of the potential zoonotic risk. Salmonella and Campylobacter cultures proved negative. However aerobic cultures turned up interesting results. Instead of the usual coliforms, the predominant organism appeared very much like the Yersinia species we regularly isolate from various exotic animals and birds. Further testing using the ID 32 E test system was undertaken and the organism was identified as Yersinia enterocolitica. This organism is zoonotic, causing gastroenteritis which may mimic appendicitis. However, most human cases are foodborne, rather than related to direct contact with an CPD 29/ 5 infected animal, although interestingly, strains isolated from dogs in particular have been found to share common genotypes with pathogenic strains isolated from humans. Pigs, as well as dogs and cats, are known to be potential carriers of the organism, so eating undercooked pork products is an important potential source of infection for both humans and their pets. Another interesting characteristic of the organism is that, like Listeria monocytogenes, it grows at refrigerator temperatures - with all the associated potential food hygiene issues! Although the organism has been associated with cases of both acute and chronic enteritis in dogs (and rarely, complications associated with systemic spread) most infected dogs remain asymptomatic, but can shed organisms for some weeks. We concluded that the clinical significance of the organism in Scrumpy’s case was equivocal, especially as giardiasis had already been diagnosed, but suggested that antibacterial therapy may still be appropriate to reduce the zoonotic risk FREE CPD so sensitivity testing was performed. Additionally, we commented that feeding him a prebiotic type diet rich in fermentable fibre, plus probiotics, would also be a useful strategy to support intestinal healing and function and encourage the development of a healthy intestinal flora. A comprehensive paper on Yersinia enterocolitica in diagnostic samples from dogs and cats is available at http:// jcm.asm.org/content/51/3/887.full - well worth a read! Vet Nurse training events Charlie Sale Orthopaedic Specialist Published events are available throughout the year to find out more please visit our website: www.nwlabs.co.uk NationWide Laboratories “It’s a lame dog, what next?” Tip based basic approach to further lameness investigation. Preston Marriott Hotel, contact Kate Fazakerley at [email protected] Pre-exam dates POULTON 9th April 9th July 19th November Refresher dates POULTON 12th March 11th June 10th September Specialist NEWS ISSUE 9 SPRING 2014 More Specialised Testing At Nationwide Specialist Laboratories we can assist with the more unusual analyses for Adrenocorticol investigations and are able to offer the following specialist tests not readily available at other laboratories. Endogenous ACTH: For dogs and cats to differentiate between adrenal and pituitary dependent hyperadrenocorticism and for horses to help diagnose Cushings disease/Pituitary pars intermedia dysfunction (PPID). SHAP: (Sex Hormone Alopecia Profile ) for the investigation of functional adrenal neoplasia and “atypical” hyperadrenocorticism Canine Adrenal Panel: A very comprehensive profile which includes Oestradiol, Testosterone, Cortisol, 17 hydroxy-progesterone and Androstenedione pre and post an ACTH stimulation test. To investigate functional adrenal neoplasia and certain dermatology conditions. Aldosterone: Single sample for investigation into hypertension and hypokalaemia (Conn’s syndrome) or aldosteronoma of the adrenal cortex. Can also be used as part of an ACTH stimulation for Addison’s investigations. Renin: Investigation of hypertension and hypokalaemia to discover if raised aldosterone levels are appropriate or inappropriate for the activity of renin. Special sampling requirements Androstenedione: As part of full canine adrenal panel and ferret adrenal disease panel. Two ferret adrenal profiles:See the “Did you Know” article at the bottom of this page Please contact client services who will be pleased to provide protocols, sampling requirements and any further details you require on any of these tests. Advice for diagnosis, treatment and monitoring of dogs with hyperadrenocorticism whilst synthetic ACTH is unavailable Most of you will be aware that there has been a problem obtaining Synacthen recently. We have had several calls from our practices asking how to proceed with diagnosing dogs with suspected hyperadrenocorticism, and monitoring those on treatment. Diagnosis - can be carried out using the low-dose dexamethasone suppression test. There will, because of the lower specificity of this test, be an increased risk of false positive results compared with the ACTH stimulation test. This is especially true in dogs with non-adrenal illness. To conserve what Synacthen you have (for example suspected Addison’s patients) we recommend using an alternative protocol of 5 - 10ug/ kg rather than using a whole vial per dog. The remaining Synacthen can then be aliquoted into 0.2ml aliquots (per 10kg dog) and frozen for suspected Addison’s. When defrosting it is better to round upwards so a 15kg dog would need 2 x 0.2ml aliquots. The Cortisol/Creatinine Ratio can be used to help rule out Cushing’s as this gives few false negatives, but does have a high false positive rate. Monitoring - of Vetoryl Clinical signs should be observed and a baseline cortisol level should be measured at 4-6 hours after the Vetoryl tablet. Nationwide Specialist Laboratories can carry out a baseline cortisol together with sodium and potassium ratio for £17.00 plus VAT Monitor the dog using a combination of clinical signs and baseline cortisol levels Baseline cortisol >50 nmol/l adrenal oversuppressioln EXCLUDED Baseline cortisol <50nmol/l adrenal oversuppression POSSIBLE Has the dog been treated with this dose of vetoryl for 28 days or more? YES Dog clinically unwell in any way or Dog exhibiting signs that could be consistent hypoadrenocorticism (e.g. weakness, lethargy, dull demeanour, inappetence, vomiting, diarrhoea, unexpected weight loss) STOP VETORYL EITHER CONINUE VETORYL (with caution) AS SAME DOSE Reassess at next monitoring test Did You Know Dog clinically well [Measurement of serum electrolytes (potassium and sodium) may assist with decision making - high K and low Na would be consistent with hypoadrenocorticism) or CONSIDER STOPPING VETORYL (‘safety first’ approach) Will be unnecessary in some cases (baseline cortisol level <50nmol/l could be consistent with adrenal oversuppresion but also with adequate or inadequate control of cortisol levels Clinical signs of HAC persisting and other causes reasonably excluded CAUTIOUSLY INCREASE DOSE OF VETORYL Monitor baseline cortisol levels and clinical signs 10 days, 28 days and 12 weeks after the dose increase and thereafter every 3 months We also offer ferret adrenocorticol profiles. There are two panels available the basic Ferret profile which includes oestradiol, cortisol and 17-Hydroxyprogesterone (OHP), and the Ferret profile plus which is all these tests and Androstenedione. Androstenedione was previously only available from local hospitals which resulted in delays in reporting. We have now validated an Androstenedione method for veterinary use and this is run on a weekly basis. NO No clinical signs of HAC CONTINUE VETORYL AT SAME DOSE Reassess at next monitoring test Information article Veterinary Support for Mauritian Avian and Reptile Species Wildlife Vets International (WVI) aims to save endangered species by putting veterinary expertise at the very heart of conservation. This expertise is used to enhance local capability, providing vital skills that contribute to an increase in both human and animal welfare. In the words of MWF’s Scientific Director, Prof. Carl Jones MBE: WVI provides training and support to local partners in the field. In Mauritius WVI have partnered since 1994 Mauritian Wildlife Foundation (MWF). They are a dedicated team working with habitat and population restoration who have successfully rescued a number of bird species from the brink of extinction. WVI provides a part of the armoury in the conservation tool box. In Mauritius WVI is training MWF field staff in correctly taking, storing and labelling samples as part of health checks for reintroduction projects as per the IUCN Reintroduction Guidelines, currently for Round Island boas and seabirds. MWF has reinstated native vegetation on a number of islands and is in the process of repopulating them with bird and reptile species. “The ongoing veterinary support provided by Andrew Greenwood FRCVS of WVI, has been one of the key components of our success in increasing the population of critically endangered Mauritian bird species from a handful to the more sustainable levels they are today. Not only has Andrew helped with day to day veterinary issues but he has helped develop long term studies on the diseases so that they can be also be managed at a population level.” www.wildlifevetsinternational.org Follow WVI on: Facebook/WildlifeVetsInternational and Twitter @WildlifeVetsInt On the Mauritian mainland, samples are routinely taken from recovering populations such as the echo parakeet whose growth has been stalled by disease such as Psitticine Beak and Feather Disease, introduced by an alien species (ring necked parakeet). Throughout the year, WVI oversees the analysis of the samples and assists with the interpretation of results, which WVI vet Andrew Greenwood does in his own time. WVI is seeking funds to provide the expertise for training MWF field staff and expand the training to conservation staff and government vets in the Seychelles. Wildlife Vets International was formed by a group of wildlife vets in 2004 to give the conservation community veterinary support and skills. The charity is now in a unique position to provide independent veterinary support to projects around the world. Detailed sample analysis enables WVI to get a real grasp on the disease threats to endangered species. WVI is grateful to NationWide Laboratory Services for the service they provide and the support they give to WVI. Wildlife Vets International, Station House, Parkwood Street, Keighley, West Yorkshire. BD21 4NQ. Tel: +44(0)1535 661 298 Fax: +44(0)1535 690 433 Email: [email protected] Trust in Excellence. Trust us. Poulton & Swanscombe Laboratories T: 01253 899215 Leeds Laboratory T: 0113 250 7556 www.nwlabs.co.uk 2529 1733 NationWide Laboratories is a trading business of National Veterinary Services Ltd