SST:
Serum Separator Tube
Contains: separator gel and clot activator
Common use: chemistry panel
Blood is collected and tube should be inverted to mix in clotting factor
Blood is allowed to clot and then spun down in centrifuge to remove serum from blood cells

LTT:
Lavender top tube
Contains: EDTA to prevent clotting of blood
Common use: collection of whole blood for CBC - breakdown of red and white blood cells, viral tests
Blood should be inserted by removing cap or with 22g or larger needle to prevent lysis of RBC
Do not rock tube with needle inside tube - will become coated with CaEDTA
Allow automatic fill with suction and then gently rock tube to mix cells and CaEDTA

RTT:
Red top tube
Does not contain the separator gel
Common use: Phenobarbital levels
A serum separator gel can interfere with the Phenobarbital level

GrayTT:
Contains: Potassium oxalate and sodium fluoride
Common use: not commonly used, glucose level

GreenTT:
Contains: Lithium Heparin - to prevent clotting
Common use: exotics with small sample can run both cbc and chem panel off one tube
Use of plasma panels

BTT:
Blue top tube
Contains: Sodium citrate as an anticoagulant
Common use: coagulation profiles
Must completely fill the tube

Blood flow shown with a square red heart (pump) in the middle of the drawing.

The pump is a box divided into 4 chambers: right and left atria and ventricles. The atria are on the top and the ventricles are on the botton. Blood flows through the AV valves between these chambers.

The right side of the heart is accepting poorly oxygenated blood from the body and pumping to the lungs for oxygenation.The right side is a thinner/weaker muscle because the pump is only used to send blood to the lungs.

The left side of the heart is a larger/thicker/stronger muscle because it is receiving well oxygenated blood from the lungs and then pumping it throughout the body.

BLOOD PRESSURE

Blood pressure can be measured with many different devices and each hospital will have access to various equipment. However we use a Doppler unit with an ultrasonic probe and a cuff at our practice to obtain an indirect measurement of blood pressure on both dogs and cats and this is a vary common and reliable tool.

Doppler blood pressure is best used to measure systolic pressure and not diastolic pressures. One value is obtained and that is the reading on the gage, as the cuff is deflated, when the first sound is heard. Normal animal pressures are 120/80 with the 120 being the systolic pressure and the 80 being the diastolic pressure.

Definition:

Systolic Pressure: The pressure in the arteries when the heart (ventricles) is at work or pumping out blood

Diastolic Pressure: The pressure in the arteries when the heart (ventricles) is resting or filling up with blood.

 

Pitfalls when taking blood pressure include:

- A stressed patient in chaotic surroundings
- Incorrect cuff size
- Low volume - turn the sound of the Doppler up to hear the 1st sound.
- Cuff placed too tight or too lose
- Not getting an audible pulse sound with the probe prior to inflating the cuff.
- Not getting the average of several measurements
- Vessel not at heart level. Pet should be in lateral recumbency if using a digital artery.
- Not using headphones to better hear the first sound

Stress:

We like to place the pet in a darkened room on a comfy bed and have the owners talk to the pet while we are measuring the blood pressure to help calm the pet while obtaining measurement and this results in more accurate readings.

Sizing:

Blood pressure cuffs come in different sizes and it is important to select the correct size for the patient.

The width of the cuff needs to be between 0.3-0.4 times the diameter of the limb. To quickly check the "fit" of the cuff align the cuff with the limb lengthwise and the wide part of the cuff should go at least a quarter of the diameter around the limb and less than half way around the diameter

Too small a cuff (width of cuff is less than 1/4 of limb circumference) = too high a reading.

Too large a cuff (width of the cuff is greater than 1/2 the circumference of the limb) = too low a reading.

Use:

Regular blood pressure measurements can be useful for cats with kidney disease and hyperthyroidism and dogs with kidney disease or glomerulonephritis.

Placement:

Digital artery on the Palmar or Plantar aspect of foot
-or-
Tail base

Pet should be in lateral recumbency to ensure that the probe is level with the heart.

Correct placement involves setting the Doppler probe (with gel on it) over the arterial pulse which has been palpated. The cuff is applied but not inflated and the Doppler should be checked to assure that the pulse is heard. The cuff is than inflated. If the cuff is inflated prior to listening to the pulse, the cuff could potentially be too tight which causes restriction of the vessel and results in an erroneous reading.

Ideal reading:

Goal is to keep the pressure between 100-150

If Too Low:

Defined as: 70-80

First check the patient: compare the mm color, heart rate, respiratory rate and pulse quality to pre-anesthesia results.

If patient is too deep the vaporizer should be turned down

If pressures are still low the pet should be bolused with IV fluids at 10ml/kg and the pressure is retaken.

Remember pounds are larger than kilograms
•  Divide weight in pounds by 2.2
Example: 10 lb. dog/ 2.2 = 4.54 Kg

Convert MG of Drug into ML of Drug

- Need to know the concentration (mg/ml) of drug
- Concentration is found on the bottle label
- take Mg of drug needed and multiple by concentration on bottle

EXAMPLE: 100Mg of Amoxicillin = 100/125 = 0.8ml

A FEW OF THE MORE COMMON EXAMPLES

NEMATODES:

Roundworms or ascarids

Ascarids: are large nematodes of several inches in length that live in the small intestines of dogs and cats. Studies have shown that >90% of puppies are infected with roundworms at birth.

Zoonosis: YES
visceral larval migrans with Toxocara canis
Cutaneous larval migrans with toxocara cati

Prepatent Period: T. canis 21-35 days , T. lenoina 72 days
Time to become infectious: requires 4 weeks in the environment
Diagnosis: eggs in feces, or adult worms, Float and direct , these are large eggs
Hosts: transport host is an infected rodent or bird (second stage larva)
Treatment: anthelmintics

All puppies and kittens should be dewormed at least twice 2 weeks apart
Clean up, eggs can survive extended periods in the soil

1.Toxocara canis (canine roundworm)
puppies infected via placenta and mammary glands
2. Toxocara cati
kittens infected via mammary glands
3. Toxascaris lenoina
4.Baylisascaris propyonis: raccoon roundworm, can infect pets

Hookworms: Ancylostoma

1. Ancylostoma caninum: dogs, racconns, coyotes...
2. Ancylostoma tubaeforme: cats

Diagnosis: fecal float or direct: eggs are large, thin walled with mass of cells in the center (see above photo)
Adults: are small parasites of only 1-2 cm and have cutting teeth
Zoonosis: potential skin penetration
Lifecycle: have a free living stage, can penetrate skin, 3rd stage larva are infectious
Treatment: Fenbendazole (Panacur), ivermectin, pyrantel, praziquantel

WHIPWORMS: Trichuris vulpis
Eggs are oval shaped with “caps” on each end, adults have a "tail" that is curled like a whip

Whipworms are another gastrointestinal nematode of dogs. Cats are rarely infected.

Infection with whipworms can be mistaken for Addisons disease. They cause diarrhea +/- blood.

Prepatent period: 3 months
Diagnosis: fecal float or direct
Treatment: anthelmintics to kill adults, treatment every 3 months to prevent
Avoid infected soil, eggs can survive up to 2 years in soil

THREADWORMS: Strongyloides stercoralis
Threadworms are very small parasites of only a few mm in length and adult females live in the small intestines

Infections is usually in animals < 6mos old and can involve the lungs and small intestines. Initial infection via the skin, also transmammary and placental infection occurs.

Infects: dogs and cats
Zoonosis : YES
Diagonosis: larva in feces - NOT OVA
Prepatents period: 8-14 days
Treatment: Many anthelmintics kill adults
Retreat every 7-10 days to prevent autoinfection

HEARTWORMS: Dirofilaria immitis

A nematode of dogs, cats, ferrets and potentially other animals which can result in heart failure.

Adult heartworms are large 6+ inch worms of males and females that live and reproduce in the right side of the heart and pulmonary artery. The adults mate and the females releases embryos called microfilariae (above photos) into the blood, the pet is bitten by a mosquito and the microfilariae are picked up and develop into first stage larvae, the larvae molt twice and 3 rd stage larvae move to the mosquito’s mouth, upon the mosquito biting another pet the larvae are transferred and travel the pets body for ~6 months until they reach the heart and mature into adults ready for breeding.

Diagnosis : ELISA Heartworm Ag test, Echocardiogram, Buffy coat examination, Blood Smear…

Treatment: MELARSOMINE DIHYDROCHLORIDE (Immiticide) arsenic derivative
Can be difficult, worms are killed but still have large adult worms in the heart
Dead worms can block blood vessels of the lungs
Given deeply in the muscle by injection over 1-2 days, t reated dogs are often confined

Prevention : Easy and effective with many medications
Heartgard: ivermection
Revolution: selamectin

TREMATODES:

Tapeworms:

The common tapeworm of both dogs and cats, it lives in the small intestines. Are large worms of ~50cm in length, but cause little harm. No clinical signs may be noted.

Diagnosis: usually via proglottids seen on the rectum
Look like moving rice grains, Can do squash prep and examine for eggs under microscope
Infection: typically from ingestion of fleas, so must also treat for fleas
Treatment: Cestex, Droncit

2. Taenia

Also, note the thick, "striated" shell and several of the larval hooks which are seen in all tapes

3. Echinococcus

Potentially a dangerous zoonotic parasitic tapeworm that can produce hydatid cysts in humans, eggs are similar to taenia, infection is via a sheep, dog, human cycle

PROTOZOANS :

1. Coccidia
isospora canis, isospora felis

Common infection in young puppies and kittens, causes vomiting and diarrhea. These are very small organisms. May see with single circle in middle or sporulated (double). Prepatent Period is short: 7-14 days. Becomes infective after several days in the environment whey it sporulates.

2. Toxoplasma gondii

These are very small! The oocyst contains two sporocysts, each of which contain four sporozoites.  Thus, they resemble the oocysts of Isospora but are much smaller.   Only cats will produce and pass Toxoplasma oocysts in their feces.

Zoonosis: Yes, potential cause of abortion in pregnant women
Diagnosis: Fecal float and direct
Avoidance: Don’t feed cats raw meat, wear gloves when gardening, clean litter box daily, pregnant women should avoid cleaning the litter box.

3. Sarcocystis

Intermediate host is a hoofed animal, and many species of reptiles, birds and vertebrates will serve as the definitive host

4. Giardia

Cysts are passed in the feces of an infected host, and the next host is infected when it ingests cysts in food or water contaminated with feces. These cysts are resistant to environmental conditions. They are zoonotic, typically cause diarrhea, are very small and difficult to diagnose (see under microscope), ELISA snap test is available.