With 2006 now over half way through we would like to thank
you for your submissions so far this year, to share some interesting clinical
material, to inform you of how some of the new developments we have initiated
have progressed and also to highlight planned future developments from:
“The Quality Clinical Pathology Service” |
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| “Royal
Mail – Pricing in Proportion” |
When the Royal Mail informed us of the changes planned
to postal services we were initially faced with issues that may have had
a negative effect on how submissions could be transported to us. However,
after several meetings with Royal Mail, we can now announce that the changes
to the postal service will have little effect on your ability to submit
samples to us.
There is one major proviso to this news. As of the 21st
August all submissions sent to us in our patented Pre-paid P650 compliant
packaging will be classed as a large letter. This packaging ensures your
submissions reach us in optimum condition and meets health & safety
criteria to your staff, postal workers and our sample reception personnel
and therefore we recommend its use. The Pre-paid P650 compliant packaging
is FREE to all practices and if practices are members of our VIP
Scheme then we will not charge postage and packing for delivery of the packaging
/ supplies to you.
If as a practice you use your own packaging and either
frank the mail or add stamps, then please be aware that you may well see
an increase in costs with these changes. For more details of how your outbound
mail will be affected please visit the Royal Mail’s website which deals
with these changes @ http://www.pricinginproportion.co.uk.
In order to comply with these changes we will be withdrawing our Prepaid
labels. For those practices that use Prepaid labels, we have Pre-paid postal
bags that can be used as an alternative. These bags can be used with other
packaging, provided it meets with packaging standards. The basic rule is
that the package which contains your submissions must not be larger than
250mm x 353mm and not deeper than 50mm.
We can forward you details of packaging requirements, contact:
simonwootton@axiomvetlab.co.uk
or telephone +44 (0) 1626 355655 to request your copy or to discuss any
other points raised in this article. These changes only apply to UK based
practices. |
| “NEW
~ Price Lists” |
In our last newsletter (April 06) we informed all
our clients of our decision to withhold updating our prices until we had
discovered the outcome of our discussions with the Royal Mail. Now that
this process has ended we are in a position to begin sending out our 2006
/ 2007 Price List.
These updated price lists will be effective as of
1st August 2006.
The updated pricing structure has been revised to ensure that we remain
extremely cost-effective against other services, and whilst there are increases,
we have through efficiency savings managed to keep these to a minimum.
Along with our usual printed copies, we also have various electronic formats
available. These include Microsoft Word, Excel, plus plain text. We have
also taken account of some client requests to produce these electronic formats
with VAT included if required. |
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| “CLINICAL VIGNETTE - Mycobacterial Infection
in Cats” |
 Lymph node aspirates were received
from a cat with gradual weight loss and slowly progressive submandibular
and prescapular lymphadenomegaly. Histiocytic inflammation was identified,
with negative-staining bacilli within macrophages (Figure 1). Special
staining confirmed the bacilli were acid-fast, consistent with mycobacterial
species (Figure 2).
Mycobacterial infection in cats may take 3 forms: (1)
classic tuberculous form, associated with obligate parasites/pathogens
including M. bovis, M. tuberculosis (considered a reverse zoonosis),
and M. microti; (2) opportunistic infection by saprophytic species
such as the M. avium-intracellulare complex; and (3) lepromatous
form (M. lepraemurium). Definitive species identification by specialised
tissue culture is required to determine zoonotic potential. Infection may
be cutaneous or disseminated, the latter more likely associated with pathogenic
forms although saprophytic infections may also become disseminated if cell-mediated
immunity is compromised. |
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| Polycystic Liver and Kidney Disease - Case Study |
History: An 11-year-old
MN Persian cat was presented with a 3-month history of abdominal distension.
Daily vomiting was also reported although appetite remained good. The cat
was also lethargic and had lost weight.
Clinical Findings: On clinical examination the cat was
underweight but had a distended abdomen. A large, firm abdominal mass was
palpable which was non-painful. |
Diagnostic Imaging: A
lateral thoracic radiograph was unremarkable. A lateral abdominal radiograph
confirmed the extent of the abdominal mass (See Figure 1).
The soft tissue mass extended from the diaphragm cranially
almost to the level of the bladder. The caudal edge of the mass was irregular
and ill defined. The small intestines were being displaced caudally. The
renal shadows were not obvious due to the extent of the mass. A loss of
contrast was noted suggestive of abdominal fluid. |
The mass appeared to originate from the liver. The hepatic
parenchyma however was markedly abnormal and the mass contained numerous
thin-walled cystic structures with anechoic contents. Some of these showed
distal acoustic enhancement. Only a very small area of 'normal' hepatic
parenchyma was identified. A moderate volume of free abdominal fluid was
present. The right kidney was found to contain several anechoic cysts in
the cortex. The stomach and the left kidney could not be identified.
Clinical Pathology:
Haematology mostly un-remarkable. Some mild and non-specific biochemical
changes were noted. A bile acid stimulation test was performed and suggested
adequate liver function in this cat. Clotting times were unremarkable.
Abdominocentesis was performed and a straw-coloured fluid
collected for analysis. The free abdominal fluid was a modified transudate
containing non-degenerate neutrophils and occasional reactive mesothelial
cells. |
 Surgical Exploration: The abdomen was surgically explored under general anaesthesia.
The abdomen contained a significant quantity of straw-coloured free fluid.
The liver was massively enlarged and cystic.
The left medial and proximal left lateral, quadrate, right
medial lobes and papillary process of the caudate lobe were diffusely affected.
The right lateral lobe, and distal extremity of left lateral lobe had a
more normal appearance, although the liver tissue was firm and had a nodular
appearance (See Figure 3).
Both kidneys were identified at surgery and both had cystic
changes. The rest of the abdomen was unremarkable. The stomach was unaffected
but was being compressed by the mass. Two liver biopsies were obtained and
were sent for histology (See Figure 4). Surgical resection of the
mass was not possible, but numerous cysts were drained resulting in a 30-40%
reduction in the size of the liver. The cat recovered uneventfully from
anaesthesia and was discharged 24 hours later with an S-Adenosyl methionine
supplement.
Cytological examination: cystic
fluid with evidence of both previous and iatrogenic haemorrhage. |
 Histopathology: was consistent with multiple biliary cysts with some areas of
nodular hyperplasia with vacuolar change. There was no evidence of neoplasia
or inflammation in any of the sections.
Follow-up: unfortunately the abdominal fluid recurred quickly again in this
case. Diuretics were administered to help reduce the volume of the free
abdominal fluid. Response to diuretics was suboptimal and a significant
quantity of abdominal fluid was detected. Occasional vomiting was reported
but appetite was now significantly reduced and weight loss was noticeable.
The cat was euthanized 12 weeks post-operatively. |
| Discussion: polycystic
kidney disease (PKD) commonly occurs in Persian cats as a result
of an autosomal dominant mode of inheritance. As the name suggests, mostly
the cystic changes are confined to the kidneys, however rarely other organs
including the liver and uterus may be involved. In cases where hepatic cysts
are identified, they tend to be considered an incidental finding and are
not associated with clinical signs. Cats with PKD may also be asymptomatic
but renal failure may follow as the cysts increase in size. In this case
clinical signs were associated with the hepatic changes as opposed to renal
pathology. Differential diagnoses for the liver changes could have included
biliary cystadeno-carcinoma, but this was excluded once results of histopathology
were available. |
| “NEW ~ Updated
Lab Guide” |
We are pleased to announce that an updated version of our
laboratory guide has been produced and is available to practices.
There is also an updated version on our web site at http://www.axiomvetlab.com/Laboratory%20Guide.html
A copy can be obtained by emailing admin@axiomvetlab.co.uk or by telephone
+44 (0) 1626 355655. |
| “Express Post” |
Irish practices that post samples into Dublin, can now order subsidised
pre-paid Express Post postal bags. These bags are guaranteed by An Post
to be delivered the following working day, and provided they are posted
at an An Post Office they can be tracked on-line at
http://track.anpost.ie/track/trackone.html.
The subsidised pre-paid bags can be ordered in quantities of 15 or 30 and
cost €3 each. The cost will then be added as a separate charge to your
monthly invoice. To order your supply of pre-paid bags please contact us
at admin @axiomvetlab.co.uk
or by telephoning our low-call number 1850 946912.
Simon will be attending this year’s UVH conference at UCD so if
you are attending, please visit our stand in the exhibition hall. |
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| “South Eastern Service” |
As part of our drive to increase service provision to clients who use
our South Eastern Service, based at our facility in Vauxhall, London, we
now offer same-day results for clotting times. Previously these were forwarded
to our main laboratory facility in Devon, but due to client demand we are
pleased to offer this increase in service provision.
Practices in the South East who are interested in our free courier services
into our London facility, with same-day results for Biochemistry and Haematology
testing options, are requested to contact our main facility in Devon by
telephoning 01626 355655 or email: admin@ axiomvetlab.co.uk |
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