The answer to this question depends somewhat upon the type of practice your pet is registered with. Many practices these days may be large “hospitals” and may have an entire dedicated laboratory found within them. Other practices, however, may be smaller, or more remote or rurally situated; such that the ability to perform blood tests in house is more constrained. In this article we describe a number of typical blood tests that may be able to be performed in a practice “in-house” situation.
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Pre-operative bloods
One of the most common forms of blood tests undertaken within a practice, is that of a “pre-operative blood test” or more accurately, a “pre-anaesthetic” blood profile. The aim of these blood tests is typically to identify subclinical disease in our pets, which do not (yet) have any associated symptoms. They may be performed as part of an assessment of a pet, prior to an anaesthetic for a surgical or dental procedure.
These blood tests typically assess various biochemical markers. This is in order to assess the health of the liver, the kidneys, look at the blood sugar levels and perhaps, assess blood proteins too. There may well also be a basic assessment of red blood cell numbers performed (the PCV – packed cell volume); this is to check that the patient isn’t anaemic or overtly dehydrated. These tests may be offered to patients undergoing anaesthesia and typically, can either be discussed with staff when your pet is booked in for a procedure, or, when your pet is being admitted on the day for the procedure. On occasion, they may need to be performed ahead of the anaesthetic however, within a week of the anticipated procedure, if a practice does not have the capability to run them with immediate effect.
Biochemistry
A more in-depth assessment of various body organ systems can also often be performed at some practices; by running a broader spectrum set of biochemical tests in the laboratory. In addition to the tests described above (liver enzymes, kidney markers, proteins and blood glucose), electrolytes may be determined (including calcium and phosphorus levels, sodium potassium and chloride). Many in house laboratories will also have the ability to assess for pancreatitis; and to check for any sign of jaundice in a patient.
In certain clinic situations (such as out of hours or emergency facilities), there may well also be the availability of acid-base or blood gas analysis within the practice lab. Such analysis allows a detailed assessment of the metabolic and acid base status of the patient. And it can also enable oxygen levels within the bloodstream to be determined. In critical patients, assessing perfusion and delicate electrolyte status can be vital. A number of these blood tests will need to be performed regularly, to assess for “trends” in a patient’s clinical status.
Haematology
A haematological assessment of blood may also be possible in your practice laboratory. This will assess for anaemia (which is a lack of red blood cells); and may also enable white blood cell numbers to be assessed. White blood cells may be influenced by a variety of factors in the body; such as infection, inflammation, immunosuppression, and the presence of allergies or parasites. A platelet count can also be assessed in haematology tests; this is an assessment of how well the patient’s blood is able to clot. Some practices may also have means by which to perform additional tests of coagulation. (Which is the patient’s ability to consolidate and reorganise the initial clot). They do this by looking at the secondary pathways of the clotting cascade in more detail.
A key piece of kit kept at the practice is likely to be a microscope. And looking at blood smears can be a useful adjunct to the quantitative assessment performed automatically by a laboratory machine.
Endocrinology
Some busier and better-equipped practices may be able to assess thyroid hormones. Hyperthyroidism (an overactive thyroid gland) is a prevalent hormonal disease of middle and old-aged cats. And older dogs may suffer with the opposite disease, hypothyroidism. Your practice may also be able to assess cortisol values. This can be useful for cases of suspected Addison’s, or Cushing’s disease in dogs.
Infectious diseases
There are also a number of tests described as “snap tests”, which can be performed rapidly in practice to look for infectious diseases. These include, but are not limited to, the presence of lungworm infection in dogs and parvovirus infection in puppies and young adult dogs. In cats, snap tests are available to look for the presence of feline leukaemia virus (FeLV) and antibodies to feline immunodeficiency virus (FIV).
Faecal and urine tests
Many practice laboratories will readily be able to run urinalysis on urine samples provided; assessing the concentration of the urine (called the urine specific gravity USG), and by performing a dipstick analysis. Using the microscope again, a sediment analysis (looking at any “debris” within the urine) can help identify signs of infection, crystals and casts.
In addition, some practices may also be able to run a degree of faecal testing, using snap tests, microscopy, faecal floatation testing, and culture and sensitivity.
Alternatives
Whilst the presence of a functional, well-equipped, in-house laboratory can be exceedingly useful, there will, of course, be occasions when a practice needs to submit blood externally to a commercial laboratory. This may be the case for assessing antibody levels to certain infectious diseases or when more complex or rare testing needs to be performed. It can also be beneficial to vets involved with challenging cases to send blood externally; because often a specialist medic or pathologist will be available to comment on the results and perhaps discuss the case in more individual detail.
Discussion