"What we appreciate most with LaserCyte® is the repeatability of results—its improvement over our former instrument, which was an impedance analyzer. We also are pleased with its ease of use thanks to the single-use reagents, and high accuracy, which correlates with clinical signs. In a nutshell, we appreciate having a cutting-edge technology instrument, with high performance and ease of use."

So. Dr. Balouka
Clinique Vétérinaire du Cap Martin
Roquebrune Cap Martin, France

Adverse Drug Experiences (ADEs) and Hematology

The frequency of drug usage in veterinary medicine is significant and increasing. Veterinary reports conservatively show that more than eight million pets in the United States are administered prescription medications each year. The rise in pet medication usage has led to an increase in reported potentially harmful side effects associated with long-term usage of drugs, including the potential to develop liver disease. The Center for Veterinary Medicine (CVM), a branch of the Food and Drug Administration in the United States, defines an adverse drug experience as "any side effect, injury, toxicity or sensitivity reaction (or failure to perform as expected) associated with use of an animal drug, whether or not determined to be attributable to the drug."¹ In fiscal year 2003, CVM reviewed nearly 20,000 adverse drug experience reports.²

Commonly used to help relieve pain in pets, Nonsteroidal anti-inflammatory drugs (NSAIDs) have been able to dramatically increase the quality of life in pets suffering from immobility due to osteoarthritis or postoperative pain. NSAIDs witnessed a $50 million jump in veterinary sales in 2003, pushing the veterinary total pain management market past $150 million.³ NSAIDs, however, can have undesirable side effects. Nonsteroidal anti-inflammatory drugs are the most commonly reported ADEs, with more than 16,000 cases logged with FDA since the late 1990s.⁴ The most common adverse experiences that have been reported following the use of NSAIDs in dogs are vomiting, anorexia, depression and diarrhea. Less commonly reported, but more serious ADEs, include gastric ulceration, intestinal ulceration, renal failure, hepatic failure and even death.

Animals that appear healthy may hide their ailments for a long time before owners notice that something is wrong. An initial routine blood chemistry and hematology screening, as well as regular follow-up testing, helps reduce the risk of unwanted side effects associated with drug therapy. In many of the severe ADEs, such as organ damage or death, the issue may have been preventable by early detection of abnormalities with blood testing. Preliminary blood tests, along with a physical examination, may help determine any potential pre-existing conditions. A complete CBC, in conjunction with serum chemistry and urinalysis profiling can help detect pre-existing illness and may indicate early diseases developing in the liver, kidney and other organs. While a complete CBC will not directly help identify specific toxic changes associated with most long-term medications like NSAIDs, it does provide information regarding the overall health status of the animal, including:

• Recognizing mildly regenerative anemia due to blood loss
• Changes in RBC indices (microcytosis, hypochromasia) that may indicate developing iron deficiency due to chronic blood loss from the GI tract
• Characterizing nonregenerative anemia due to chronic illness or renal failure
• Identifying RBC morphology changes that could lead to insight into possible liver problems such as acanthocytes, target cells, etc. (when a fresh blood smear is used in combination with complete RBC data)
• Recognizing thrombocytopenia that will increase the risk for hemorrhage with NSAIDs therapy
• Identifying possible leukogram changes that support chronic inflammatory diseases, progressive inflammatory disease, glucocorticoid influences, etc.

These simple tests—a CBC, chemistry panel and urinalysis—can reduce the risk associated with starting a new medication and help monitor the patient's health during the use of long-term medications.

The IDEXX LaserCyte Hematology Analyzer provides the veterinarian with a complete in-house blood count (CBC) that allows serial monitoring of a patient currently on long-term medication, which is one component of the monitoring process. Although specific changes may not be seen associated with a certain drug class, such as NSAIDs, early changes may prove helpful in identifying underlying or developing problems that would direct further, more specific testing to confirm an ADE.

References

The recommendations contained in Diagnostic Edge educational materials are intended to provide general guidance only. As with any diagnosis or treatment, you should use clinical discretion with each patient based on a complete evaluation of the patient, including physical presentation and complete laboratory data. With respect to any drug therapy or monitoring program, you should refer to product inserts for a complete description of dosages, indications, interactions and cautions.

This summary was written by Drs. Jim Matthews and Dennis DeNicola of IDEXX Laboratories.

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Include the full text of LaserCyte® messages or print only the message codes as part of the LaserCyte results report

With LaserCyte software version 1.18 and later, you now have the ability to customize the way your LaserCyte messages are printed on the results report. You can choose to print the codes with their related messages, or just the codes. As with all laser-flow cytometry hematology analyzers, messages exist to help the user find out more about the sample being evaluated. With the use of laser-flow cytometry, the LaserCyte hematology analyzer is able to see more of what is going on with the cells within a sample, and, therefore, is better able to give you complete information, and warn you if further investigation into the sample is necessary, such as a quick scan of a blood smear to view cell morphology.

To select this reporting option, tap the Settings button on the main screen and tap the Reports tab. Under the Hematology Message Codes options, select the Short option to print just the message codes (e.g., RBC 5) or select Full Text to print the codes and their related messages. (59 KB)

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Education and Events
We offer a variety of seminars and teleconferences about emerging trends and best practices in veterinary diagnostics—in a forum designed to involve, educate and motivate you and your staff.

• Visit the seminar and teleconference calendar and click the date to view the details.
• Fill out and submit the form to register.

East Lansing, Michigan
Wednesday, October 6, 2004, 6:30 p.m.
Dinner and Talk: 7:00 p.m.
Kellogg Hotel & Conference Center, Michigan State University
RSVP to Martin Van Almen by October 4, 2004 at 1-800-551-0998, ext. 4770.

Increasing Your In-Clinic Capabilities to Evaluate Anemias
Anne Hale, DVM, PhD

Atlantic City, New Jersey
Wednesday, October 13, 2004, Morning Session
Atlantic Coast Veterinary Conference (ACVC)
Trump Taj Mahal Resort Hotel

Clinical Pathology—Interactive Diagnostic Cytology for Practitioners
Allan Rebar, DVM, PhD

Atlantic City, New Jersey
Wednesday, October 13, 2004, Afternoon Session
Atlantic Coast Veterinary Conference (ACVC)
Trump Taj Mahal Resort Hotel

Interactive Clinicopathologic Case Discussions
Allan Rebar, DVM, PhD

Atlantic City, New Jersey
Thursday, October 14, 2004, Morning Session
Atlantic Coast Veterinary Conference (ACVC)
Trump Taj Mahal Resort Hotel

Clinical Pathology—Biochemical Profiling in Urinary Tract Disease
Allan Rebar, DVM, PhD

Atlantic City, New Jersey
Thursday, October 14, 2004, Afternoon Session
Atlantic Coast Veterinary Conference (ACVC)
Trump Taj Mahal Resort Hotel

Clinical Pathology—Biochemical Profiling in Hepatic Disease
Allan Rebar, DVM, PhD

Dallas, Texas
Thursday, October 23, 2004, 2:00–4:30 p.m.
IDEXX Laboratories, 4444 Trinity Mills Rd., Suite 300
RSVP to Matt Standefer at 1-469-222-9597 or 1-972-539-9992 (fax).

IDEXX Wet Lab—Learn/Review blood-smear techniques and cell morphology with an hour lecture and a 1½-hour wet lab.
Dean Cornwell, MT (ASCP), DVM, PhD

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Now Available: The QBC® VetAutoread™ Sample Preparation Poster (235 KB)

The QBC VetAutoread is designed to analyze whole-blood samples. Good sample collection and preparation are necessary for optimum results on the QBC VetAutoread analyzer. While the QBC VetAutoread manual has complete instructions on the correct way to collect, prepare and run samples on the instrument, this handy poster can be hung in your laboratory as a quick reference.

For a copy of this poster, please contact technical services at: 1-800-248-2483.

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How does your LaserCyte® Hematology Analyzer help you deliver better patient care?

We would like to hear your thoughts about how your LaserCyte analyzer helps you test, diagnose and treat patients... and so would your peers.

Submit your comments or case studies to share with your peers.

With your permission, your name and comments may be featured in upcoming issues of the Diagnostic Edge.

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