Menu Expand
Small Animal Clinical Diagnosis by Laboratory Methods - E-Book

Small Animal Clinical Diagnosis by Laboratory Methods - E-Book

Michael D. Willard | Harold Tvedten

(2011)

Abstract

A quick guide to appropriately selecting and interpreting laboratory tests, Small Animal Clinical Diagnosis by Laboratory Methods, 5th Edition helps you utilize your in-house lab or your specialty reference lab to efficiently make accurate diagnoses without running a plethora of unnecessary and low-yield tests. It provides answers to commonly asked questions relating to laboratory tests, and solutions to frequently encountered problems in small animal diagnosis. For easy reference, information is provided by clinical presentation and abnormalities, and includes hundreds of tables, boxes, key points, and algorithms. This edition, now in full color, is updated with the latest advances in laboratory testing methods and diagnostic problem solving. Written by noted educators Dr. Michael Willard and Dr. Harold Tvedten, this book may be used as an on-the-spot guide to specific problems or conditions as well as a reference for more detailed research on difficult cases.

  • Concise discussions address laboratory approaches to various disorders, possible conclusions from various test results, artifacts and errors in diagnoses, and interpretations leading to various diagnoses.
  • Hundreds of tables, boxes, algorithms, and key points offer at-a-glance information including cautions, common pitfalls, and helpful "pearls," and lead to proper differential and clinical diagnostic decision making.
  • Note boxes identify key considerations in correlating clinical signs with test data for accurate diagnoses, highlight safety precautions, and offer helpful tips for sample preparation and interpretation.
  • Chapters on laboratory diagnostic toxicology and therapeutic drug monitoring help in handling potentially fatal poisonings and other special situations.
  • Expert editors and contributors provide clinical knowledge and successful diagnostic problem-solving solutions.
  • A practical appendix lists referral laboratories that may be contacted for certain diseases, and reference values with the normal or expected range for coagulation, hematology, and more.
  • Updated coverage integrates the newest advances in testing methods and diagnostic problem solving.
  • Full-color photos and schematic drawings are placed adjacent to related text, and accurately depict diagnostic features on microscopic slide preparations as well as test procedures and techniques.

Table of Contents

Section Title Page Action Price
Front Cover cover
Pageburst Ad ifc_1
Small Animal Clinical Diagnosis by Laboratory Methods i
Copyright Page iv
Contributors v
Preface vii
Dedication ix
Table Of Contents xi
1 General Laboratory Concepts 1
Test Selection and Asking the Right Question 1
Simple Statistics and Practical Interpretations 1
Reference Values 3
International System of Units 4
Sources of Laboratory Error 4
Preanalytical Errors 4
Hemolysis 4
Lipemia 5
Analytical Errors 5
Sample Collection: Right and Wrong 5
Profiles Versus Individual Test Selection 6
Stat Tests 6
Send It out or Do It Yourself? 7
In-Clinic Laboratory Testing 7
Veterinary Referral Laboratories 7
Use of Human Laboratories 8
Point-of-Care Chemistry Analyzers 8
Cost Analysis for In-Clinic Analyzers 10
Quality Control 11
References and Suggested Readings 11
2 The Complete Blood Count, Bone Marrow Examination, and Blood Banking 12
Complete Blood Count 12
Magnitude of Hematologic Abnormalities 13
Frequency of Abnormalities 14
Quantitation Techniques 15
Sample Submission 15
Microhematocrit 15
Hemoglobin Concentration 16
Total Cell Counts 16
Hemocytometer 17
Corrected White Blood Cell Count 18
Absolute Nucleated Red Blood Cell Count 18
Erythrocyte Indices 18
Automated Hematology Cell Counters 18
Impedance Counters 18
Laser Light Scatter Cell Counters 19
Quantitative Buffy Coat VetAutoread 22
Feline Platelet Counts 22
Blood Smear Analysis 23
Making the Smear 24
Stains 25
Evaluating Blood Smears 25
Platelet Estimation 25
Platelet Morphology 25
Leukocyte Estimation 26
Leukocyte Aggregation 26
Leukocyte Differential Count 26
Leukocyte Morphology 26
Left Shift • 26
Toxic Neutrophils • 26
Reactive Lymphocytes • 28
Leukemia • 28
Erythrocyte Estimation 28
Erythrocyte Morphology 28
Polychromasia • 28
Spherocytes • 29
Autoagglutination • 29
Poikilocytosis • 31
Acanthocytes • 31
Red Blood Cell Fragmentation • 31
Leptocytes • 31
Other RBC Morphologic Changes • 31
Other Determinations 31
Plasma Protein Determination 31
Acute Phase Proteins 31
Lipemia, Hemolysis, and Icterus 32
Color of Blood 32
Bone Marrow Examination 32
Hypoplasia and Aplasia 33
Hyperplasia and Neoplasia 33
Myelodysplastic Syndromes 33
Acute Leukemia 33
Bone Marrow Histopathology 34
Bone Marrow Biopsy and Aspirate 34
Evaluation of Bone Marrow Aspiration Smears 34
Cellularity 35
Myeloid/Erythroid Ratio 35
Maturation of Myeloid and Erythroid Lines 35
Hemosiderin 35
Cellular Morphology 35
Summary of Bone Marrow Smear Evaluation Procedure 35
Blood Banking 36
Crossmatching 36
Blood Typing 36
References and Suggested Readings 36
3 Erythrocyte Disorders 38
Anemia Diagnosis 38
Determining Erythroid Regeneration 41
Reticulocyte Evaluation 41
Manual Reticulocyte Counting 41
Automated Reticulocyte Counting 42
Absolute Reticulocyte Count 42
Reticulocyte Index and Corrected Reticulocyte Percentage 43
Canine Reticulocyte Response 43
Feline Reticulocyte Response 44
Polychromasia 44
Macrocytosis 44
Anisocytosis, Red Blood Cell Distribution Width, Hemoglobin Distribution Width 45
Nucleated Red Blood Cells, Basophilic Stippling, Howell-Jolly Bodies 45
Siderocytes, Sideroblasts 45
Morphologic Classification of Anemia 45
Classification of Anemia by Use of Erythrocyte Volume and Hemoglobin Concentration 45
Normocytic Normochromic Anemia 46
Macrocytic Hypochromic Anemia 46
Microcytic Hypochromic Anemia 46
Macrocytic Normochromic Anemia 46
Classification of Anemia by Regenerative Response 46
Regenerative Anemia 46
Blood Loss Anemia 47
External Blood Loss 47
Internal Blood Loss 48
Hemolytic Anemia 48
Immune-Mediated Hemolytic Anemia 48
Direct Coombs Test • 49
Canine Immune-Mediated Hemolytic Anemia • 49
Feline Immune-Mediated Hemolytic Anemia • 51
Cold Hemagglutinin Disease • 51
Heinz Body Anemia 52
Eccentrocytes • 52
Canine Heinz Body Anemia • 52
Feline Heinz Body Anemia • 52
Methemoglobinemia 53
Blood Parasites 53
Hemoplasmas • 53
Mycoplasma haemocanis • 53
Babesia spp. • 53
Cytauxzoon felis • 54
Zinc or Copper Toxicity 54
Hypophosphatemia 54
Pyruvate Kinase Deficiency 54
Phosphofructokinase Deficiency 55
Other Hereditary Hemolytic Anemias 55
Nonregenerative Anemia 55
Diagnostic Approach 55
Secondary Anemias 55
Anemia of Inflammatory Diseases 55
Anemia of Chronic Renal Disease 56
Anemia of Chronic Hepatic Disease 56
Hypothyroidism and Hypoadrenocorticism 56
Severe Nonregenerative Anemia 56
Nonregenerative Immune-Mediated Hemolytic Anemia 56
Pure Red Cell Aplasia 56
Myelodysplastic Syndromes 57
Congenital Dyserythropoiesis Syndromes 57
Sideroblastic Anemia 57
Iron Deficiency Anemia 57
Feline Leukemia and Feline Immunodeficiency Virus Infection 58
Pancytopenia or Bicytopenia 58
Aplastic Anemia 58
Bone Marrow Necrosis/Inflammation 58
Myelofibrosis 59
Drug-Induced Hematologic Dyscrasia 59
Estrogen Toxicity • 59
Sulfadiazine Toxicity • 59
Phenylbutazone Toxicity • 59
Ehrlichiosis 59
Feline Leukemia Virus 60
Feline Immunodeficiency Virus 60
Parvovirus 60
Myelodysplastic Syndromes and Leukemias 60
Macrophage Proliferative Disorders 60
Blood Transfusion and Blood Typing 60
Polycythemia 60
Relative Polycythemia 61
Absolute Polycythemia 61
Primary Absolute Polycythemia 61
Secondary Absolute Polycythemia 62
References and Suggested Readings 62
4 Leukocyte Disorders 63
Basic Leukocyte Concepts 63
Leukogram 63
Automated Versus Manual Differential Leukocyte Counts 63
Absolute Versus Relative Differential Leukocyte Counts 64
Leukocyte Production, Circulation, and Emigration 64
Leukocyte Production 64
Neutrophil Circulation 66
Neutrophil Emigration into Tissues 66
Leukocytosis And Neutrophilia 66
Differential Diagnosis of Neutrophilic Leukocytosis 66
Inflammation 67
Left Shift 67
Leukogram Changes in Inflammation 68
Bone Marrow Response During Inflammation 69
Prognosis 69
Toxic Neutrophils 70
Stress and Corticosteroid Response 70
Exercise and Epinephrine Response 71
Leukopenia And Neutropenia 71
Bone Marrow Problems Causing Neutropenia 72
Parvovirus Infection 73
Feline Leukemia Virus and Feline Immunodeficiency Virus Infections 73
Cyclic Hematopoiesis 73
Monocytosis And Monocytopenia 73
Lymphocytosis 73
Reactive Lymphocytes and Blast-Transformed Lymphocytes 74
Lymphopenia And Eosinopenia 74
Eosinophilia 74
Diagnostic Approach 75
Basophilia 76
Abnormal Nuclear Morphology And Cytoplasmic Inclusions 77
Pelger-Huët Anomaly 77
Genetic Diseases with Cytoplasmic Inclusions 78
Chédiak-Higashi Syndrome 78
Birman Cat Neutrophil Granulation Anomaly 79
Lysosomal Storage Diseases 79
Leukocyte Function Defects 79
Canine CD11/CD18 Adhesion Protein Deficiency 79
Chronic Granulomatous Disease in Doberman Pinschers 79
Myeloperoxidase Deficiency 79
Recurrent Infections in Weimaraners 80
Acquired Neutrophil Dysfunction 80
Dysplastic And Neoplastic Conditions Of Blood Cells 80
Non-Neoplastic Myelodysplasia 80
Congenital Myelodysplasia 81
Secondary Myelodysplastic Syndrome 81
Leukemia 81
General Laboratory Findings 81
Advanced Diagnostic Testing 82
Classification Schemes 82
Lymphoid Neoplasia 83
Precursor Lymphoid Neoplasms 85
Acute Lymphoblastic Leukemia • 85
Mature Lymphoid Neoplasms 85
Chronic Lymphocytic Leukemia • 85
Granular Lymphocyte Leukemia/Lymphoma • 86
Plasma Cell Neoplasms • 86
Nodal Lymphoma • 86
Extranodal Lymphoma (Mycosis Fungoides) • 87
Myeloid Neoplasms 87
Myelodysplastic Syndromes 87
Acute Myeloid Leukemia 87
Myeloproliferative Neoplasms 88
Histiocytic Neoplasms 89
Histiocytic Sarcoma 89
Hemophagocytic Histiocytic Sarcoma 89
Acknowledgments 90
References and Suggested Readings 90
5 Hemostatic Abnormalities 92
Goals of Hemostasis Testing 92
Hemostasis and Diagnosis of Disorders 92
Components of Normal Hemostasis 94
Vascular Endothelium and Wall 94
Platelets and Primary Hemostasis 94
Coagulation Factors 95
Fibrinolysis 96
Laboratory Tests 96
Blood Collection for Hemostatic Testing 96
Blood Vessel Evaluation 97
Platelet Enumeration 97
Platelet Morphology 98
Platelet Function Testing 100
Buccal Mucosal and Capillary Bleeding Time 100
Platelet Function Analyzer 100
Platelet Aggregation 100
Tests of Coagulation 100
Activated Coagulation Time 100
Prothrombin Time 101
Activated Partial Thromboplastin Time 101
Thrombin Time 101
Specific Factor Analysis 102
D-dimer 102
Thromboelastography 102
Disorders Of Hemostasis 102
Disseminated Intravascular Coagulation • 102
Thrombocytopenia • 104
von Willebrand Disease • 105
Disorders of Vascular Endothelium 106
Inherited Vascular Wall Disease 106
Ehlers-Danlos Syndrome • 106
Familial Vasculopathy • 106
Acquired Vascular Wall Disease 106
Rocky Mountain Spotted Fever • 106
Heartworm Disease • 106
Leishmaniasis • 106
Acquired Hemostatic Disease • 106
Thrombocytosis • 106
Inherited Disorders of Primary Hemostasis 107
Acquired Disorders of Primary Hemostasis 107
Immune-Mediated Thrombocytopenia • 107
Ehrlichiosis • 107
Anaplasma phagocytophilum • 108
Hemolytic Uremic Syndrome • 108
Retroviral Disease • 108
Hyperthermia • 108
Drug-Associated Platelet Dysfunction • 108
Disorders of Secondary Hemostasis 108
Inherited Disorders of Secondary Hemostasis 109
Acquired Disorders of Secondary Hemostasis 109
Vitamin K Antagonism • 109
Acknowledgments 109
References and Suggested Readings 109
6 Electrolyte and Acid-Base Disorders 112
Serum Potassium Concentration 112
Commonly Indicated • 112
Analysis • 112
Normal Values • 112
Danger Values • 112
Artifacts • 112
Drugs That May Alter Serum Potassium Concentration • 112
Causes of Hypokalemia • 113
Causes of Hyperkalemia • 113
Urinary Fractional Excretion Of Potassium 115
Seldom Indicated • 115
Normal Values • 115
Abnormalities • 115
Serum Sodium Concentration 115
Commonly Indicated • 115
Analysis • 116
Normal Values • 116
Danger Values • 116
Artifacts • 116
Drugs That May Alter Serum Sodium Concentration • 117
Abnormal Serum Sodium Concentrations • 117
Causes of Hyponatremia • 117
Causes of Hypernatremia • 118
Urinary Fractional Excretion Of Sodium 118
Seldom Indicated • 118
Normal Values • 118
Abnormalities • 118
Serum Chloride Concentration 119
Commonly Indicated • 119
Analysis • 119
Normal Values • 119
Danger Values • 119
Artifacts • 119
Drugs That May Alter Serum Chloride Concentration • 119
Causes of Hypochloremia • 120
Causes of Hyperchloremia • 120
Osmolality And Osmolal Gap 120
Occasionally Indicated • 120
Disadvantage • 120
Analysis • 120
Normal Values • 120
Danger Values • 120
Normal Values (Osmolal gap) • 120
Danger Values (Osmolal gap) • 120
Causes of Serum or Plasma Hypo-osmolality • 121
Causes of Serum or Plasma Hyperosmolality • 121
Causes of Increased Osmolal Gap • 121
Blood Gas Analysis 121
Occasionally Indicated • 121
Advantages • 121
Disadvantages • 121
Analysis • 121
Normal Values • 121
Danger Values • 121
Artifacts • 121
Drugs That May Alter Blood Gas Results • 121
Analysis of Blood Gas Results • 122
Metabolic Acidosis • 122
Respiratory Acidosis • 122
Metabolic Alkalosis • 123
Respiratory Alkalosis • 123
Total Carbon Dioxide For Acid-Base Evaluation 124
Frequently Indicated • 124
7 Urinary Disorders 126
Differentiation Of Polyuria-Polydipsia, Dysuria, And Incontinence 126
Polyuria-Polydipsia 126
Dysuria 129
Incontinence 129
Urinalysis 131
Commonly Indicated • 131
Advantages • 131
Analysis • 131
Color and Turbidity 132
8 Endocrine, Metabolic, and Lipid Disorders 156
Calcium 156
Commonly Indicated • 156
Analysis • 156
Normal Values for Total and Ionized Serum Calcium • 156
Danger Values • 157
Artifacts • 157
Drug Therapy That May Alter Serum Calcium Concentration • 157
Causes of Hypercalcemia • 157
Causes of Hypocalcemia • 160
Phosphorus 161
Commonly Indicated • 161
Analysis • 161
Normal Values • 161
Danger Values • 162
Artifacts • 162
Drug Treatments That May Alter Phosphorus Values • 162
Causes of Hyperphosphatemia • 162
Causes of Hypophosphatemia • 162
Magnesium 163
Occasionally Indicated • 163
Analysis • 163
Normal Values • 163
Danger Values • 163
Artifacts • 163
Drug Therapy That May Alter Serum Magnesium Concentration • 163
Causes of Hypomagnesemia • 163
Causes of Hypermagnesemia • 164
Parathyroid Hormone 164
Occasionally Indicated • 164
Advantages • 164
Disadvantages • 164
Analysis • 164
Normal Values • 164
Danger Values • 164
Artifacts • 164
Drug Treatment That May Alter PTH Concentrations • 164
Causes of Increased Serum PTH Concentration • 164
Causes of Decreased Serum PTH Concentration • 164
Glucose 165
Commonly Indicated • 165
Advantages • 165
Disadvantages • 165
Analysis • 165
Normal Values • 165
Danger Values • 165
Artifacts • 165
Drug Therapy That May Alter Blood Glucose Concentration • 165
Causes of Hypoglycemia • 165
Causes of Hyperglycemia • 166
Insulin 168
Occasionally Indicated • 168
Advantages • 168
9 Gastrointestinal, Pancreatic, and Hepatic Disorders 191
Differentiation of Expectoration, Regurgitation, and Vomiting 191
Expectoration 191
Regurgitation 191
Vomiting 193
Diet and Parasites 193
Obstruction 193
Extra–alimentary Tract Disease 194
Pancreatitis 194
Gastritis, Enteritis, and Colitis 196
Hematemesis 196
Abdominal Inflammation 196
Amylase 196
10 Fluid Accumulation Disorders 226
Diagnostic Approach 226
Fluid Collection Techniques 226
Collection of Fluid • 226
Abdominocentesis • 226
Abdominal Lavage • 226
Thoracocentesis • 227
Pericardiocentesis • 227
Collection of Edema Fluid • 227
Characterization of Fluid 228
Fluid Analysis • 228
Physical Assessment of an Effusion • 228
Cell Counts and Cytology • 230
Determining Fluid Protein Concentration • 231
Distinguishing Different Types of Effusions 231
Transudates 231
Pure Transudates 231
Modified Transudates 231
Hemorrhagic Effusions 231
Exudates 231
Bilious Effusions 234
Chylous Effusions 234
Pseudochylous Effusions 235
Malignant Effusions 235
Eosinophilic Effusions 236
Specific Body Cavity Effusions: Diagnostic Considerations 236
Abdominal Effusions 236
Pleural Effusions 243
Bicavity Effusions 246
Pericardial Effusions 246
Joint Effusions 249
Volume 249
Gross Appearance 250
Viscosity 251
pH 251
Total Protein 251
Fluid Analysis 251
Total Nucleated Cell Count 251
Cytologic Features 251
Inflammatory Arthropathies 253
Immune-Mediated Arthropathies 253
Infectious Arthropathies 253
Exudative Joint Disease 254
Noninflammatory/Degenerative Arthropathies 254
Edema and Anasarca 255
Scrotal Effusions 258
References and Suggested Readings 258
11 Respiratory and Cardiac Disorders 260
Respiratory Problems 260
Dyspnea 260
Useful Tests 260
Coughing, Including Hemoptysis 263
Nasal Discharge, Sneezing, and Epistaxis 264
Nasal Radiography 264
12 Immunologic and Plasma Protein Disorders 278
Serum Total Protein and Albumin 278
Commonly Indicated • 278
Advantages • 278
Disadvantages • 278
Analysis • 278
Normal Values • 278
Danger Values • 278
Artifacts • 278
Drug Therapy That May Alter Protein Values • 278
Causes of Alteration in Plasma and Serum Protein • 278
Causes of Hyperalbuminemia • 278
Causes of Hypoalbuminemia • 278
Causes of Altered Globulins • 281
Acute Phase Proteins 281
Occasionally Indicated • 281
Advantages • 281
Disadvantages • 281
Analysis • 281
Normal Values • 281
Danger Values • 281
Artifacts • 281
Causes of Increased Acute Phase Proteins • 281
Causes of Decreased Acute Phase Proteins • 281
Protein Electrophoresis 282
Occasionally Indicated • 282
Advantages • 282
Disadvantages • 282
13 Reproductive Disorders 294
General Diagnostic Approach 294
Vaginal Cytology 294
Hemorrhage 294
Purulent or Septic Discharge 295
Neoplastic Cells 295
Mucus 295
Uteroverdin 295
Vaginal Epithelial Cells 296
Canine Breeding and Whelping Management 296
Mismating 297
Mammary Glands 297
Mastitis 297
Mammary Hyperplasia 297
Mammary Neoplasia 298
Semen Evaluation 298
Technique 298
Volume 298
Color 298
Concentration 298
Motility 298
Morphology 300
Seminal Alkaline Phosphatase 300
Interpretation of Semen Evaluation 300
Prostate 300
Testes and Epididymides 300
Endocrine Evaluation 301
Luteinizing Hormone 301
Progesterone 301
Testosterone 301
Estradiol 301
Relaxin 303
Ancillary Tests 303
Complete Blood Count 303
Urinalysis 303
Suggested Readings 303
14 Neurologic Disorders 304
Neuroanatomic Localization 304
Differential Diagnoses 305
Neuroimaging 305
Vertebral Column Indications • 305
Intracranial Indications • 305
Electrodiagnostics 305
Cerebrospinal Fluid Analysis 308
Common Indications • 308
Contraindications • 308
Procedure for CSF Collection • 308
CSF Handling • 308
Analysis • 308
CSF Appearance • 308
CSF Protein Concentration • 309
CSF Red Blood Cell Count • 309
CSF Nucleated Cell Count • 309
CSF Cytology • 309
CSF Biomarkers • 309
Antibody-Based Infectious Disease Testing 309
Occasional Indications • 309
Analysis and Interpretation of Specific Tests • 312
Infectious Disease Polymerase Chain Reaction 312
15 Microbiology and Infectious Disease 315
When to Suspect Bacterial/Fungal/Rickettsial Viral Agents 315
Cytology 315
Common Indications • 315
Advantages • 316
Disadvantages • 316
Specimen Procurement and Analysis 316
Bacterial Diseases 316
Cutaneous Parasitic Diseases 316
Fungal Diseases 316
Viral Diseases 317
Culture and Antimicrobial Susceptibility 317
Common Indications • 317
Advantages • 317
Disadvantages • 317
Bacterial Culture 317
Specimen Procurement 317
Body Cavities • 317
Cardiovascular System • 317
Central Nervous System • 318
Eye • 318
Gastrointestinal Tract • 318
Genitourinary Tract • 320
Integument and Ear • 320
Musculoskeletal System • 320
Respiratory System • 320
Specimen Transport 320
Analysis • 321
Sensitivity Testing • 321
Dilution Test • 321
16 Cytology of Inflammatory or Neoplastic Masses 337
Role of Cytology in Diagnosis 337
Cytologic Techniques 337
Sample Collection and Slide Preparation 337
Stains 339
Microscopes 342
Cytologic Conclusions 342
Slide Reading Approach 343
Inflammatory Masses 344
Neutrophilic Inflammation 344
Bacterial Sepsis • 344
Degenerative Neutrophils • 345
Necrosis • 346
Pathologic Bleeding • 346
Granulomatous and Pyogranulomatous Inflammation 346
Chronic Inflammation 347
Eosinophilic Inflammation 347
Lymphocytic Inflammation or Hyperplasia 347
Selected Causative Agents 347
Fungal Characteristics 348
Histoplasmosis 349
Sporotrichosis 349
Cryptococcosis 349
Rhinosporidiosis 349
Coccidioidomycosis 350
Blastomycosis 350
Candidiasis 350
Malassezia 350
Protothecosis 350
Aspergillosis 350
Mycetoma 351
Mucormycosis 351
Alternaria 351
Dermatophytes 351
Higher Bacteria 351
Mycobacteriosis 352
Salmon Disease 352
Ehrlichiosis 352
Toxoplasmosis 353
Leishmania 353
Cytauxzoonosis 353
Parasitic Infestations 353
Ocular Cytology 353
Proliferative Masses (Neoplasia) 354
Initial Decisions 354
Cell Typing 355
Malignant Criteria 357
Selected Cytologic Diagnoses 359
Mammary Neoplasms 359
Perianal Gland Tumor 360
Lipoma 360
Mast Cell Neoplasms 360
Histiocytoma 361
Transmissible Venereal Tumor 361
Follicle or Epidermal Inclusion Cyst 361
Hematoma and Seroma 361
Hepatic Cytology 361
Lymph Node Cytology and Lymphoma 362
Acknowledgment 363
References and Suggested Readings 363
17 Laboratory Diagnostic Toxicology 364
Principles of Toxicologic Diagnosis 364
Clinical Laboratory Tests 364
Obtaining and Shipping Specimens 373
Selecting An Analytical Laboratory 373
Thin-Layer Chromatography 374
Gas Chromatography 374
High-Pressure Liquid Chromatography 374
Mass Spectrometry 374
Atomic Absorption Spectroscopy 374
Inductively Coupled Plasma Emission Spectroscopy 374
Inductively Coupled Plasma Mass Spectrometry 374
Diagnosis of Specific Toxicants By Laboratory Analysis 374
Acetaminophen 375
18 Therapeutic Drug Monitoring 385
Indications 385
Analysis And Laboratory Availability 385
Artifacts 386
Implementing Therapeutic Drug Monitoring 386
Handling Procedures and Decisions 386
Steady State 386
Loading Dose 389
Number of Samples 390
Timing of Sample Collection 390
Modifying Dose Regimens 390
Therapeutic Monitoring Of Selected Drugs 391
Aminoglycosides (Amikacin, Gentamicin) 391
Appendix I: Listing of Selected Referral and Commerical Laboratories 395
Listing of Selected Referral and Commercial Laboratories 395
Full-Service Laboratories as per the American Association of Veterinary Laboratory Diagnosticians (AAVLD) 395
Listing of National Animal Health Laboratories 395
Centers for Disease Control and Prevention (CDC) 395
Appendix II: Listing of Selected Reference Values 399
Listing of Selected Reference Values 399
Reference 399
Index 403
A 403
B 405
C 405
D 407
E 407
F 408
G 409
H 409
I 410
J 411
K 411
L 411
M 412
N 413
O 413
P 413
Q 414
R 414
S 415
T 416
U 417
V 417
W 418
X 418
Y 418
Z 418