This month's survey question

Thank you for responding to our June survey! Here are the results:

Approximately how many patients has your practice seen due to the pet food recall?

Our survey shows that 85% of respondents saw an increase in patients as a result of the pet food recall.

The widespread effect of the recall on practices, clients and patients has been unprecedented, calling on practices to take unusual measures to prepare for the influx of patients and concerned pet owners.

Many of you have been to the pet food recall section of idexx.com to access helpful information and suggestions. Our site continues to be a resource for veterinary professionals, offering:

• Consulting services
• Informational articles
• Monitoring guidelines
• Urine sediment evaluation guidelines
• And much more

Visit the pet food recall section of idexx.com with your questions and take advantage of our helpful tools and materials. Your patients and clients depend on you for answers and to help ensure the safety and good health of their pets. Cover all your bases today, and be prepared for the next crisis!

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Featured case study:
6-month-old female chocolate Labrador retriever, Ruca
By Fred Metzger, DVM, DABVP, owner of Metzger Animal Hospital, State College, PA

The following case illustrates the value of preanesthetic testing.

Physical examination
Patient is alert with normal temperature, and auscultation of the chest reveals no murmurs or abnormal lung sounds.

Plan
Preanesthetic blood work and urinalysis before surgery

Erythron—Mild nonregenerative anemia (normocytic, normochromic and lack of reticulocytosis)

Leukon—Normal

Thrombon—Normal

Interpretation
Azotemia, hyperphosphatemia, nonconcentrated urine specific gravity and nonregenerative anemia indicate renal failure (most likely chronic because of the unremarkable history and nonregenerative anemia).

Presumptive Diagnosis
Chronic renal failure (congenital)

A case of mandatory evaluation
Ruca, a 6-month-old female chocolate Labrador retriever, was presented at Metzger Animal Hospital for a routine ovariohysterectomy. The client was informed that preanesthetic diagnostic testing would be performed and was included in the cost of the procedure. Unfortunately, the results revealed evidence of kidney failure. The blood work was repeated and an abdominal ultrasound was performed, which confirmed the presence of kidney abnormalities that were likely congenital. The patient’s prognosis was poor to grave. The client was devastated, but she expressed appreciation that the condition had been diagnosed. She was able to take Ruca home and make her as comfortable as possible in her remaining weeks. A necropsy was performed, which confirmed chronic renal failure (renal dysplasia).

Summary
Ruca’s case emphasizes the value of preanesthetic evaluation and testing—anesthesia could have resulted in many complications, including death. If Ruca had survived surgery only to present with renal failure several days later, the owner (and perhaps the veterinarian) might have speculated that the surgical procedure resulted in renal failure. Ill feelings and even legal action are potential consequences of not performing a thorough preanesthetic evaluation that includes diagnostic testing—or at least offering this service to every client.

While anesthetic complications are rare and significant preanesthetic testing abnormalities uncommon, when they do arise they can be deadly. Remember, statistics are irrelevant to a grieving pet owner. The benefits of a thorough preanesthetic evaluation and testing program are numerous, and each veterinary hospital must develop and implement a program that is suited to its needs.

For more information about Ruca’s case, visit the Web site created by Ruca’s owner, Mel Fox: www.personal.psu.edu/users/m/k/mkr127/tribute.htm.

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 history, 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.

Tell us what you think of this case, or let us know if you have a case that you would like to submit. E-mail us at diagnosticedge@idexx.com to get the process started.

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IDEXX Learning Center

Visit the IDEXX Learning Center to see a full listing of available Webinars, seminars, teleconferences and online training courses from IDEXX about emerging trends and best practices in veterinary diagnostics in a forum designed to involve, educate and motivate you and your staff. Click the date to view the details and fill out and submit the form to register.

Here are some of the opportunities available this month:

Online Training Courses VetTest® Certificate Course—Promote best practices and utilize every new enhancement on the VetTest analyzer. Feline Course One: Building Your Feline Dentistry Practice NEW! Feline Course Two: Testing for and Managing Retrovirus-Positive Cats

Webinar Making Real-Time PCR an Everyday Diagnostic Option Christian M. Leutenegger, DrVetMed, PhD, and Jane Robertson, DVM, DACVIM

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VetTest® Chemistry Analyzer Slide-Spotting Failure Tip
IDEXX is continually improving its products and services. Here’s a perfect example!

If you have seen the following message appear on your VetTest® Chemistry Analyzer screen, we have a new patent-pending pipette tip that may help.

RESULTS INVALIDATED
SLIDE SPOTTING FAILURE
One or more slides received inadequate sample.

If you have recently seen this message, we can help. In the United States, please call our customer support team at 1-800-248-2483 for assistance and resolution. They are available 24 hours a day, 7 days a week to assist you in providing the best medicine and care for your patients.

Visit our locations page for inquiries outside of the United States.

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Earn Points

As an IDEXX Practice Developer® member, you can earn points based on your quarterly purchases across specific IDEXX categories. It's possible to earn points worth up to 8% of your total purchases.

You can earn points in two ways:

1. Meet or exceed the quarterly purchase minimums in at least three of the following IDEXX product categories:

IDEXX Reference Laboratories	$3,000
IDEXX VetTest® Chemistry Analyzer slides	$1,500
IDEXX LaserCyte® Hematology Analyzer tubes	$750
Feline SNAP® tests (SNAP® FIV/FeLV)	$750
Canine SNAP® tests (SNAP® 4Dx®, 3Dx® and Heartworm)	$625

2. Meet "tiered" purchase levels in the following single categories:

IDEXX Reference Laboratories	Tier 1 Tier 2	$4,500.01–$10,000 >$10,000
IDEXX VetTest® Chemistry Analyzer slides	Tier 1 Tier 2	$2,500.01–$5,000 >$5,000
Canine SNAP® tests (SNAP® 4Dx®, 3Dx® and Heartworm)	Tier 1 Tier 2	$1,250.01–$2,800 >$2,800

Now there’s an easy tool to help you tally your points! Try out our new Practice Developer points calculator and see how your points can grow!

Questions? Call us at 1-800-248-2482.

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2007 Cornerstone® Users Conference
Learn what integration means for your practice.

This conference is designed to help you use Cornerstone® practice management software to maximize your practice’s potential, increase efficiency and provide faster and more effective care for your patients. Meet our certified trainers and your colleagues to learn quick tips and tricks to in-depth procedures that can help you build your practice.

Join us for three days of educational workshops and:

• Learn about key practice management concepts from industry experts Dr. Dennis Cloud, Dr. Jim Guenther, Dr. Jim Wilson and Fritz Wood, CPA, CFP.
• Meet IDEXX staff face-to-face and get help from support, education and development experts in our open laboratory.
• Share best practice ideas with other Cornerstone users.

See the IDEXX Integrated Practice—Powered by SmartLink™ Technology
The integrated practice approach provides extraordinary value by advancing the way you provide medical care, increasing your staff’s productivity and boosting your practice’s profitability. IDEXX SmartLink technology provides simple and seamless electronic connections to and from Cornerstone to each of IDEXX’s other offerings. Take a look!

Sign up by 7/31/07 and save $100 per person!
Three convenient ways to register: Visit www.idexx.com/csconference, e-mail ecfinance@idexx.com or call 1-800-283-8386, option 4.

Conference dates and location: September 30-October 3, 2007, at the Hilton Minneapolis Hotel in downtown Minneapolis, MN.

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Integration: A better way to practice medicine and manage your practice—see for yourself!

See how IDEXX integrates your entire practice, seamlessly meshing diagnostic, management and billing information for easy access. Entire medical records can be viewed at any workstation, charges are not lost and each patient’s complete medical picture can be viewed in one printout.

The IDEXX integrated practice helps you streamline workflows and increase efficiencies for better service, and most important, it offers a better way to practice medicine.

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With FREE Continuing Education Credit!*

NOW Approved in Australia and Parts of Canada!†

Have you taken advantage of every qualifying Interactive Challenge for FREE CE credits?
Every Interactive Challenge from June 2006 on has each been worth 0.5 continuing education credits in the United States—and you get the credit just for participating! Check out the Diagnostic Edge archive and take any qualifying challenges you may have missed. Don't let these fun credits slip away!

Question:
Can you identify the cells indicated and suggest which process is most likely present in the concentrated cellular preparation of a thoracic fluid (total protein = 3.0 g/dL; total nucleated cell count = 673/µL) from a dog with heart failure, Wright’s stain, 100x objective field of view?

1. Identify the cells indicated with arrows and the letter "A."
2. Identify the cells indicated with arrowheads and the letter “B.”
3. Which of the following pathologic processes is most likely present?
1. No pathologic process – normal
2. Chylothorax
3. Pyothorax
4. Malignant lymphoma, small cell type

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Thanks for taking the Diagnostic Edge Interactive Challenge!

*Each interactive challenge meets the requirements for 0.5 hour of continuing education credit in jurisdictions that recognize AAVSB’s RACE approval, however, participants should be aware that some boards have limitations on the number of hours accepted in certain categories and/or restrictions on certain methods of delivery of continuing education.

AAVSB Provider Number 106

^†Interactive Challenges are also approved in Australia for 0.5 AVA Vet Ed Point and from the following Canadian Veterinary Medical Associations: Alberta, Saskatchewan, New Brunswick and Prince Edward Island.

Not a Diagnostic Edge subscriber? Subscribe now!

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