Allergy - Cytology - Endocrinology - Haematology - Microbiology - Pathology - Serology - London, St. Helens & Dublin Services

HOME		AXIOM PRICE LIST 2007 PRICE LIST ON REQUEST - PHONE +44 (0) 1626 355655 Index of contents details only   COMMON TESTS ~ QUICK REFERENCE 4 /5 ALL SPECIES 6/8 CANINE SCREENING/INVESTIGATIVE PROFILES 9/10  CANINE SEROLOGY/ENDOCRINOLOGY 12/15  FELINE SCREENING/INVESTIGATIVE PROFILES 15/16 FELINE SEROLOGY/ENDOCRINOLOGY  17/18 EQUINE SCREENING/INVESTIGATIVE PROFILES 19  EQUINE SEROLOGY/ENDOCRINOLOGY   20 BOVINE SCREENING/INVESTIGATIVE PROFILES   21  BOVINE SEROLOGY/ENDOCRINOLOGY 22  BOVINE METABOLIC PROFILES 23/24 EXOTIC SCREENING/INVESTIGATIVE PROFILES  25  PCR TESTING & INFECTIOUS DISEASE 26/27 MICROBIOLOGY 28 DERMATOLOGY 29 ALLERGY TESTING/IMMUNOTHERAPY 30  ENDOCRINE PROTOCOLS Adrenal Function Testing (Dog, Cats & Horses) Thyroid Function Testing (Dogs, Cats & Horses) Miscellaneous Endocrine Protocols Reproductive Endocrinology 35 TERMS & CONDITIONS
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Page 30 - Axiom Veterinary Laboratories Price List 2005 ENDOCRINE RPOTOCOLS (Summary of Endocrine Protocols for Quick Reference)	INDEX OF CONTENTS
ADREANAL FUNCTION
ACTH Stimulation Test (Dogs) 1. Collect fasted clotted blood sample (0 hour) 2. Inject 250 mg synthetic ACTH (Synacthen) intravenously or intramuscularly (use 125mg Synacthen if patient <5kg) 3. Collect second clotted blood sample one hour later. 4. Cortisol is measured on both samples Indications & Uses: · Confirming spontaneous hyperadrenocorticism · Confirming iatrogenic hyperadrenocorticism · Confirming hypoadrenocorticism · Monitoring treatment of hyperadrenocorticism (perform test 4-6 hours post-pill) Low Dose Dexamethasone Suppression Test (Dogs) 1. Collect fasted clotted blood sample (0 hour) 2. Inject 0.015mg/kg dexamethasone intravenously 3. Collect two further clotted blood samples 3 and 8 hours after the dexamethasone 4. Ensure sample times are labelled on tubes 5. Cortisol is measured on all three samples Indications & Uses: · Screening test for spontaneous hyperadrenocorticism Urine Cortisol : Creatinine Ratio (Dogs, Cats and Horses) 1. Collect morning urine sample from patient in normal home environment Indications & Uses: · Screening test for spontaneous hyperadrenocorticism High Dose Dexamethasone Suppression Test (Dogs) 1. Collect fasted clotted blood sample 2. Inject 0.1mg/kg dexamethasone intravenously 3. Collect two further clotted blood samples 3 and 8 hours after dexamethasone. 4. Ensure sample times are labelled on tubes 5. Cortisol is measured on all three samples Indications & Uses: · Can only be used AFTER hyperadrenocorticism has been confirmed by other methods · Used to help differentiate between pituitary dependent hyperadrenocorticism and adrenal tumours. Endogenous ACTH Assay (Dogs) 1. Collect blood into chilled plastic EDTA tube (do not use glass tubes) 2. Centrifuge immediately 3. Decant plasma into chilled plain plastic tube 4. Freeze immediately 5. Contact lab to request a cool box 6. Sample MUST arrive at lab frozen. Indications & Uses: · Differentiating pituitary dependent HAC from an adrenal tumour. Adrenal Function Testing (Cats) Hyperadrencorticism is rare in cats. Urine cortisol to creatinine ratio may be used as a screening test and is performed on a morning urine sample collected by the owner in the home environment. Dexamethasone suppression test: 1. Collect fasted clotted blood sample 2. Inject 0.1mg/kg dexamethasone intravenously 3. Collect further clotted blood samples at 3-4 hours and 8 hours after dexamethasone injection 4. Ensure sample times are labelled on tubes 5. Cortisol is measured on all three samples ACTH stimulation test: This test has a low sensitivity and specificity for the detection of hyperadrenocorticism in cats 1. Collect clotted blood sample 2. Inject 125mg of synthetic ACTH (Synacthen) intravenously 3. Collect further blood samples 60 and 90 minutes later (NB: If Synacthen given IM then collect samples at 30 and 60 minutes later) 4. Ensure sample times are labelled on all three samples Adrenal Function Testing (Horses) The dexamethasone suppression test and TRH response test are used to help confirm Cushings in horses. Dexamethasone suppression test: 1. Collecting whole blood at approximately 5pm 2. Administer 40 mg/kg dexamethasone intravenously. 3. Collect second whole blood sample 19 hours later (approximately 11am, day 2). TRH response test: 1. Collect clotted blood sample (perform test in the morning). 2. Administer 1 mg TRH intravenously (slowly over approximately one minute). 3. Collect whole blood samples at 0, 30 and 60 minutes.
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THYROID FUNCTION
Thyroid Function Testing (Dogs) The minimum database for the diagnosis of hypothyroidism in dogs includes TT4 and cTSH measurement. In equivocal cases measurement of free T4 and thyroglobulin antibodies may be beneficial. Standard Profile (TT4 and cTSH): · Clotted blood sample · Used to confirm hypothyroidism · Used to monitor thyroid hormone supplementation (collect sample at 6 hrs post-pill) Premium profile (TT4, cTSH & fT4d): · Clotted blood sample · Used to confirm hypothyroidism · Free T4 (compared to TT4) is less affected by non-thyroidal illness and certain drug therapies Comprehensive profile (TT4 cTSH fT4d & TgAb): · Clotted blood sample · Used to confirm hypothyroidism · The presence of TgAbs strongly suggests the presence of immune-mediated lymphocytic thyroiditis TSH stimulation test (Dogs) 1. Collect clotted blood sample for basal TT4 measurement 2. Administer 0.1 international units of bovine TSH intravenously (NOT licensed for this use) 3. Collect a second clotted blood sample 4-6 hours later 4. TT4 is measured on both samples Indications & Uses: · Used to confirm hypothyroidism in dogs where standard tests have been equivocal TRH Stimulation Test (Dogs) 1. Collect clotted blood sample for basal TT4 measurement 2. Administer 200 mg TRH intravenously (for dogs <5kg use 100mg TRH) 3. Collect clotted blood sample 4-6 hours later 4. TT4 is measured on both samples Indications & Uses: · Used to help rule out hypothyroidism where other standard test have been equivocal Thyroid Function Testing (Cats) TT4 is the diagnostic test of choice in cats with suspected hyperthyroidism. It is often useful to combine measurements of TT4 with renal parameters when monitoring response to therapy. Standard (TT4) · Clotted blood sample · Used to confirm hyperthyroidism · Used to monitor response to treatment Monitoring (TT4, urea, creatinine) · Clotted blood sample · Used to confirm hyperthyroidism and assess renal function · Used to monitor response to therapy Premium (TT4, fT4d) · Clotted blood sample · Used to confirm hyperthyroidism in equivocal cases T3 Suppression Test 1. Collect clotted blood sample for TT4 and TT3 measurement 2. Administer 20 mg T3 three times daily orally for 7 doses 3. Collect clotted blood 3 hours after the final dose 4. TT4 and TT3 measured on both samples Uses & Indications: · Not routinely recommended · Used for diagnosis of equivocal hyperthyroidism Thyroid Function Testing (Horses) TSH stimulation Test 1. Collect clotted blood for basal TT4 measurement 2. Administer 5 i.u. TSH intramuscularly 3. Collect second clotted sample 6 hours later Uses & Indications: · Used to evaluate thyroid function
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Miscellaneous Endocrine Protocols
Fructosamine (Dogs and Cats) 1. Collect blood into both heparin (fructosamine) and fluoride oxalate (glucose) tubes. Indications & Uses: · Used in diabetic patients to monitor the adequacy of therapy · Indicates degree of glycaemic control over previous 1-2 weeks · Used to help differentiate stress hyperglycaemia from diabetes mellitus in cats Serum Insulin (Dogs, Cats and Horses) 1. Collect clotted blood 2. Centrifuge immediately 3. Decant serum into plain tube 4. Freeze immediately 5. Transport to lab chilled/on ice 6. Send fluoride oxalate tube for concurrent glucose measurement Indications & Uses: · Diagnosis of insulinoma in dogs (Must have concurrent glucose measurement for interpretation) · Investigation of Cushings in horses Parathyroid function (Dogs & Cats) Parathyroid Hormone (PTH) 1. Collect blood into chilled plastic EDTA tube 2. Centrifuge immediately 3. Decant plasma into chilled plain plastic tube 4. Freeze immediately 5. Contact lab to request a cool box 6. Sample MUST arrive at lab frozen 7. Collect serum sample at same time for calcium measurement!! Indications & Uses: · Investigation of persistent hypercalcaemia · Investigation of persistent hypocalcaemia · Interpretation requires concurrent measurement of serum calcium Parathyroid Hormone Related Peptide (PTHrP) 1. Collect blood into chilled plastic EDTA tube 2. Centrifuge immediately 3. Decant plasma into chilled plain plastic tube 4. Freeze immediately 5. Contact lab to request a cool box 6. Sample MUST arrive at lab frozen 7. Collect serum sample at same time for calcium measurement!! Indications & Uses: · Investigation of persistent hypercalcaemia · Increased levels usually associated with malignancy · Interpretation requires concurrent measurement of serum calcium HAC - Hyperadrenocorticism TSH Thyrotropin (thyroid stimulating hormone) PDH - Pituitary dependant hyperadrenocorticism cTSH Canine thyrotropin AT - Hyperadrenocorticism caused by an adrenal tumour TgAb Thyroglobulin autoantibodies TT4 - Total thyroxine T3 Triiodothyronine FT4d - Free thyroxine (measured by dialysis) TRH - Thyrotropin releasing hormone
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Reproductive Endocrinology

CRYPTORCHIDISM This test is based on the measurement of dynamic (pre and post HCG) Testosterone. Horses: · Take basal serum or heparinised plasma samples · inject 6000 iu HCG I.V. · Collect a second sample between 30 mins - 2 hours post injection, noting the time taken on the post sample. Dogs: · Take basal serum or heparinised samples · Inject 750 iu HCG · Collect second sample between 30 mins - 2 hours post-injection Cats: · If testicular tissue is present then a significant rise in testosterone is detected post stimulation. · Single sample Oestrone sulphate tests may be used in horses over 3 years of age, but are not of any value under this age and cannot be used in donkeys. This laboratory recommends the dynamic Testosterone test in most cases. Identification of ovarian remnants in the Cat This test is based on the measurement of dynamic (pre and post HCG) progesterone. In the cat the following protocol is advised: · Take basal serum or heparinised plasma samples, inject 500 iu HCG I.V. · Collect a second sample as above seven days later · If ovarian tissue is present then a significant rise in progesterone is detected post stimulation. DYNAMIC TESTING FOR ADRENAL SEX HORMONE PRODUCTION The protocols for this are undergoing constant change. As such it is advisable to telephone the laboratory prior to any testing to discuss the current protocols. OVULATION DETECTION IN BITCHES · This involves sequential heparinised plasma or serum samples for progesterone. · As the values vary slightly between plasma and serum, it is advised that either sample is used, but not mixed, i.e., do not use a plasma sample, followed two days later by a serum sample. · Most bitches ovulate on day 13 of the cycle, it is recommended that basal levels are established on days 9-10, then the lab will advise on when the next sample should be taken, based on the following: <6   nmol/L  NOT OVULATED  6-10   nmol/L  OVULATED MATE WITHIN 72 HOURS  10-20   nmol/L  OVULATED MATE WITHIN 48 HOURS  20-32   nmol/L  OVULATED MATE WITHIN 24 HOURS  32   nmol/L  TOO LATE  · It is wise to note that these values are usually reported 24 hours post sampling and those 24 hours need to be taken off the above times, i.e. the above times relate to the time of sampling. PREGNANCY TESTING In equine serum PMSG levels can be measured for pregnancy between days 45-90. The production of PMSG is biologically variable and it is better to sample between these dates e.g. around 60 days, rather than at either end of the range. Oestrone sulphate will be present at approximately day 70 and in significant amounts between days 110 & 240. It is present until the end of pregnancy but values fall in the last 4-6 weeks and interpretation can be difficult in this period. The cow and pig have raised oestrone sulphate levels at certain periods through pregnancy. It is advisable to therefore contact the lab first to discuss. Single progesterone values have been used in the horse and cow, at the predicted return to oestrus dates, to indicate possible early pregnancy. They are not specific indicators of pregnancy, just indicators of luteal activity, from which assumptions are made.

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