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Webinars & courses for chemistry and haematology

This three-part course will help veterinary professionals gain the basic knowledge they need to understand and interpret small-animal haematology results, including using an automated haematology analyser and performing a confirmatory blood film.

Module 1: The IDEXX Guide to Hematology: An Introduction to Hematology and the Red Blood Cell

Module 2: The IDEXX Guide to Hematology: The White Blood Cells

Module 3: The IDEXX Guide to Hematology: Platelets and the Blood Film Evaluation

 

This course is designed to give you a general overview of the most common canine and feline heart diseases and their effect on the cardiovascular system.

Canine and Feline Heart Disease Basics

This online course provides detailed instructions for using the Catalyst Dx® Chemistry Analyzer. We'll begin by reviewing the analyzer components, available slides and CLIPs, and the benefits of connecting the Catalyst Dx analyzer to the IDEXX VetLab® Station. You will learn how to prepare and analyze whole blood, plasma, serum and urine samples and how to view results on one patient report. We will also cover quality control and routine maintenance procedures that will help you get the most out of your Catalyst Dx Chemistry Analyzer.

Learning More About the Catalyst Dx Analyzer

 

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Further details on the diagnostic capabilities to detect Pancreatitis in dogs.

Clinical signs of pancreatitis are non-specific in dogs, with the most commonly reported signs being vomiting, abdominal pain, anorexia, weakness and dehydration.

Pancreatitis

Pancreatitis occurs commonly in dogs, but is difficult to diagnose because patients with this disease often present with non-specific clinical signs and because of the limited performance of classical diagnostic tests.

In severe cases pancreatitis can lead to death of the dog. Recognising these challenges, Dr. Jörg Steiner and Dr. David Williams, of the Gastrointestinal Laboratory at Texas A&M University, developed and validated the canine pancreatic lipase immunoreactivity (cPLI) assay for the diagnosis of pancreatitis. Serum cPLI is highly sensitive and specific for pancreatitis in dogs. In contrast to serum lipase activity, serum cPLI concentration is not affected by renal failure or administration of prednisone.

Until 2005 this was the only laboratory test for canine pancreatitis with such a high sensitivity. In that year IDEXX Laboratories, in cooperation with Dr. Williams and Dr. Steiner, developed an improved and readily available version of the cPLI-test, the Spec cPL® test. This new test offered the same diagnostic advantages as the original cPLI-test however with a shorter turnaround time (TAT). Consecutively this test was made available on the SNAP® platform as an in-clinic test in 2008.

Pancreatitis aetiology and pathogenesis
Definition

Pancreatitis is an inflammatory disease of the pancreas that can be either acute (2/3 of cases) or chronic (1/3 of cases), and mild or severe. 

The consequence of pancreatitis is an intra-pancreatic activation of proteolytic and lipolytic digestion processes leading to auto-digestion of pancreatic tissues. Besides inflammatory processes histological findings also show vascular damage and necrosis.

Mild cases often heal without lasting damage; however, they could evolve into the severe necrotising form [table 1]. The auto-digestion processes may involve adjacent tissues and inflict serious multiple systemic complications with a poor prognosis. Histology differentiates between the acute interstitial or oedematic pancreatitis and the acute necrotising pancreatitis, the latter mostly showing a severe course with lethal results. Chronic pancreatitis will either follow a fibrotising course with subclinical symptoms, or a chronic recurrent course with permanent or recurrent symptoms comparable to the acute pancreatitis.

Acute Pancreatitis
Chronic Pancreatitis
Occurs abruptly Continuing inflammatory disease often accompanied by irreversible changes to the pancrea
Inflammatory condition that is often reversible after treatment Flare-ups may occur, resulting in acute pancreatitis
May lead to chronic pancreatitis Often manageable with close monitoring and dietary discretion
Acute necrotising (cell death) pancreatitis is a life-threatening condition  

 

The triggering event of the canine pancreatitis is mostly unclear; however several risk factors can be determined [table 2], concurrent endocrine disease, medications, trauma and shock, age (middle-age) and breed (miniature Schnauzers and Terriers) seem to pre-determine. Nutrition plays an important part also. High fat diets and fat "people food" seem to increase the risk of pancreatitis.

Pancreatic risk factors
Obesity

Hyperadrenocorticism

Fatty meals Hyperadrenocorticism
GI disease Trauma
Epilepsy Duoden-al reflux

Hyperlipidaemia (congenital in some breeds)

Ischaemia (shock)

Diabetes Mellitus

Drugs:

Some diuretics
Tetracyclines
Sulfonamides
Thiazide
Azathrioprine


Incidence/Prevalence

The true prevalence of pancreatitis in dogs is unknown. Studies of necropsy findings have shown evidence of pancreatitis in 1% of all canine pancreata examined. However, recent evidence looking at 200 dogs presented for necropsy would suggest that, as in humans, more than 90% of all cases of pancreatitis in dogs remain undiagnosed.

Signs

Clinical signs of pancreatitis are non-specific in dogs, with the most commonly reported signs being vomiting, abdominal pain, anorexia, weakness and dehydration [table 3]. Abdominal pain is the key clinical sign in humans with pancreatitis.

Acute Pancreatitis
(Mainly gastro-intestinal symptoms)
Chronic Pancreatitis
(Serious and recurrent periods with):
Anorexia (91%2)  Pain
Vomiting (90%2)  Vomiting
Abdominal Pain (58%2)  Diarrhoea
Diarrhoea (33%2)  Weakness
Weakness (79%2)   
Dehydration (46%2)   
Fever (21%) Shock  
DIC  
 
Diagnosing Pancreatitis
Algorithm for the diagnosis of canine pancreatitis

Accuracy of the SNAP CPL
Correlation with Spec cPL

70 canine serum samples were measured using the Spec cPL assay. The same samples were then run on the SNAP cPLTM assay. A densitometer was used to measure the optical density of results from the SNAP cPLTM test for direct comparison and correlation with Spec cPL day-to-day and across lots. Results: Densitometer readings produced a correlation coefficient of 0.92. Importantly, none of the cPL concentrations greater than 400 (i.e. “consistent with pancreatitis”) were read as Normal using the SNAP cPLTM test. This was confirmed in a second study of 48 samples where an overall correlation of 95.8% between SNAP cPLTM and Spec cPL was found.

Readability
Study Design:
  • Twenty canine serum samples with known Spec cPL concentrations were assayed on SNAP cPLTM devices.
  • Each device was visually interpreted twice by each of 14 veterinary professionals for a total of 28 observations per sample (total n = 560). The study was conducted twice, for an n > 1,000.
  • Veterinary professionals were blinded as to the Spec cPL concentrations of the samples.
Results:

The results showed a 95% correlation on both sensitivity and specificity measures against Spec cPL, with over 1,000 sample reads. Densitometer readings were performed on the discrepant samples. As might be expected, the interpretations which caused the most difficulty were at the transition point between the high end of the normal range and the low end of the elevated range (noted as visual discrepants on the graph).

Summary and Conclusions

SNAP cPLTM has a 95% correlation to the reference laboratory Spec cPL test, the most accurate test currently available for canine pancreatitis.2,8
IDEXX recommends that veterinarians run the SNAP cPLTM test pet-side or the Spec cPL test at the reference laboratory on dogs presenting with signs of vomiting, anorexia, abdominal pain or other clinical signs of pancreatitis.

cPL Results
Interpretation of test results

The test result is displayed as a coloured spot that must be compared to a reference spot. If the colour intensity of the sample spot is lighter than the colour intensity of the reference spot, then the cPL concentration is normal. If the colour intensity of the sample spot is equal to or darker than the reference spot, then the cPL concentration is abnormal (either “elevated” or “consistent with pancreatitis.”)

Interpretation Guide for SNAP cPL

≤ 200 µg/L

serum Spec cPL concentration is in the normal range

201-399 µg/L the patient may have pancreatic inflammation or pancreatic inflammatory disease and serum Spec cPL® should be re-evaluated. If clinical signs are present, treat appropriately and perform additional diagnostics to investigate other differential diagnoses. Repeat the Spec cPL® after 1–2 weeks. If the dog is asymptomatic, retesting should be performed after 3-4 weeks
≥ 400 µg/L consistent with pancreatic inflammation or panreatitic inflammatiory disease

In this online course, veterinary staff will identify and understand the presenting signs and risk factors associated with canine pancreatitis, differentiate between acute and chronic pancreatitis, recognize the benefits and limitations of the current diagnostic options and discuss common treatment options.

Launch this course

This course is designed to give you a general overview of the most common canine and feline heart diseases and their effect on the cardiovascular system.

Launch this course

This three-part course will help veterinary professionals gain the basic knowledge they need to understand and interpret small-animal haematology results, including using an automated haematology analyser and performing a confirmatory blood film.

Launch this course

Internal medicine


Fluid Therapy Calculator

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Webinars & courses for internal medicine

Feline pancreatitis is more common than many practitioners realize. This online training course will help you diagnose and treat feline pancreatitis. You will learn that pancreatitis in cats is very different from pancreatitis in dogs and will be able to recognize the presenting signs and common concurrent illnesses. This course will help you determine when to test for feline pancreatitis and how to implement the protocol in your practice. Lastly you will become familiar with the latest treatment recommendations for feline pancreatitis.

Launch this course

In this online course, veterinary staff will identify and understand the presenting signs and risk factors associated with canine pancreatitis, differentiate between acute and chronic pancreatitis, recognize the benefits and limitations of the current diagnostic options and discuss common treatment options.

Launch this course

This course is designed to give you a general overview of the most common canine and feline heart diseases and their effect on the cardiovascular system.

Launch this course

This three-part course will help veterinary professionals gain the basic knowledge they need to understand and interpret small-animal haematology results, including using an automated haematology analyser and performing a confirmatory blood film.

Launch this course

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