Volume 56 - Veterinary Diagnostics

advertisement
An
International Publication
VOLUME 56, 2015
Featured Case:
Liza Dadone, VMD
Advances in Giraffe Care:
Trained Medical Behaviors
To watch Dr. Ward’s story, visit
vet.abaxis.com/beinspired
“ I love Abaxis! I love having the test results there
(within minutes) so that I can put the entire picture
together for a client... and that way I can more
effectively tailor the treatment option for them.”
Dr. Heidi Ward
Gulfcoast Veterinary | Oncology | Internal Medicine | Sarasota, FL.
Abaxis customer
It’s not just better diagnostics, it’s a Better way.
800.822.2947
vet.abaxis.com/beinspired
#beinspired
GLOBAL DIAGNOSTICS
Abaxis and VetScan are registered trademarks of Abaxis, Inc. © Abaxis 2015.
Learn more about all of our products and services at www.abaxis.com
2
|
Vetcom
|
Volume 56
vetscan@abaxis.com
Volume 56
INSIDE VETCOM
26
18
10
14
42
WHAT’S INSIDE
38
06 Abaxis Distributors
A comprehensive list of North
American Abaxis distributors
09 Coming to a Show Near You
Abaxis Tradeshow Schedule
38 Saving Endangered Grey
Crowned Cranes in Rwanda
By Dr. Olivier Nsenginama
42 Animal Embassy: The
Message of the Animals
By Dr. Matthias Reinschmidt
Dr. David Waugh
46 Vector-borne disease center
established, Kansas State
University College of Veterinary
Medicine
$250,000 KSU donation for Vector
Borne research
10 Advances in Giraffe Care: Trained
Medical Behaviors
By Liza Dadone, VMD
14 Adult-onset Demodicosis in a Shih Tzu
By Thomas Lewis DVM DACVD
Carine Laporte VMD
18 Understanding Radioactive Iodine (I131)
Therapy
By Gary Norsworthy, DVM, DABVP (Feline)
26 Smokey the Sick Ferret
By Karen Rosenthal, DVM
30 The Importance of Testing for
Ehrlichiosis in Dogs with Persistent
Lymphocytosis
By Mary Anna Thrall, DVM, MS, DACVP
35 Sometimes it’s More Than Periodontal
Disease
By Jan Bellows, DVM
Volume 56
|
Vetcom
| 3
GLOBAL DIAGNOSTICS
An Abaxis International Publication
OUR PROMISE
to our customers
• Excellent customer service
• Giving back
• Doing the ‘right thing’
• Respect for all people
ABAXIS TODAY
Abaxis Editorial Staff & Advisory Board
• Entrepreneurial spirit
• Building strong
relationships
• Taking care of our people
• Creating value by virtue
of world-class products
EDITORIAL TEAM
Valerie Goodwin-Adams
Baerbel Koehler
Director, Global Marketing
Editor-in-Chief
Manager, Wildlife Medicine
Abaxis Europe
Andrew Rosenfeld, DVM, ACVIM
Andrew Ghiringhelli
Animal Health Director
Medical Editor
Graphic Designer
Abaxis
ADVISORY BOARD
Vetcom is also available
online at www.abaxis.com.
For article reprints and
back issues, email us at
vetcom@abaxis.com or
valeriegoodwin@abaxis.com
STA FF & MI SSI ON
Printed in the U.S.
Deborah Horwitz
Sharon Dial
DVM ACVB
DVM ACVP
Gary Norsworthy
Steve Levy
DVM ABVP (Feline)
DVM
Heidi Ward
Tom Divers
DVM ACVIM (Oncology)
DVM ACVIM (Equine)
Jan Bellows
Tom Lewis
DVM (Dentistry)
DVM ACVD
Karen Rosenthal
Victoria Lukasik
DVM (Exotics)
DVM ACVA
Kent Adams
Dr. Mark Mitchell
DVM (Equine General Practice)
Abaxis, Inc.
Worldwide Headquarters
3240 Whipple Road
Union City, CA 94587
Tel 800.822.2947
Fax 510.441.6150
ABAXIS Europe
ABAXIS Europe GmbH
Bunsenstr. 9-11
64347 Griesheim Germany
Tel +49 6155 780 21 0
Fax +49 6155 780 21 111
follow us on Facebook:
facebook.com/AbaxisVeterinary
4
|
Vetcom
|
Volume 56
Mary annA Thrall
Kendall Harr
DVM ACVP
DVM, MS ACVP
Interested in having your case
featured in Vetcom? Send to
vetcom@abaxis.com or click
vet.abaxis.com/vetcom
Words from the Editor of Vetcom Publications
Welcome to Vetcom, an Abaxis International Publication, volume #56. Vetcom is read by veterinarians, veterinary
technicians and office staff from all over the world, therefore, our issues always have some international news
and cases. Vetcom offers readers case studies, practice tips from a clinical perspective as well as educational
opportunities and recent news from Abaxis.
ON THE CUTTING EDGE
O
Veterinary and Medical practices around the world benefit from cost efficiencies
UR mission at Abaxis is to improve the efficiency of the delivery of care and the
quality of life of patients in both the medical and veterinary markets, and we’re
proud of the work we do to meet these patient needs. Abaxis’ portable blood
analysis systems are used in a broad range of medical specialties in human and
veterinary care to provide clinicians with rapid blood constituent measurements.
In this issue of Vetcom, multiple scenarios are detailed in Case Studies from the
around the world which best describe the global use of our Veterinary product line.
Recent news I would like to share is the following Abaxis products received approval from the
Center for Veterinary Biologics of the U.S. Department of Agriculture for three rapid diagnostic
test kits – VetScan Canine Anaplasma Rapid Test, VetScan Canine Ehrlichia Rapid Test and
VetScan Feline FeLV/FIV Rapid Test. We believe that the continuous expansion of our portfolio
of rapid diagnostic tests in the veterinary market helps veterinarians achieve greater efficiency
and productivity and make the most informed, timely decision about a pet’s health. These single
tests, using lateral flow immunoassay technology, aid in the detection of specific diseases, offer
cost effective, easy to use, and fast, accurate and easy to read results, while improving patient
outcomes and reducing costs for veterinarians.
Thank you for your readership and continued participation in Vetcom International Publications.
Sincerely,
LET TER FR OM T HE EDI TOR
Valerie Goodwin-Adams
Editor-in-Chief - Vetcom Publications
Director, Global Marketing
valeriegoodwin@abaxis.com
510-675-6604
Volume 56
|
Vetcom
| 5
Want to learn more about Abaxis Products and Services?
Log onto the Abaxis Veterinary Reference Center at
www.abaxis.com/veterinary to view videos on:
•
•
•
•
VetScan Analyzers
Abaxis University
VetScan Rapid Tests
Abaxis Service and Support
VIDEO
LEARNING
Abaxis is Hiring
1. Multiple positions at corporate headquarters in Union City, CA
2. Field Sales
3. Marketing Professionals
4. Professional Service Veterinarians
For more information, go to www.abaxis.com
A BAXIS I NFOR MATION
AUTHORIZED US ABAXIS DISTRIBUTORS
ANIMAL HEALTH INTERNATIONAL, A PATTERSON COMPANY
877-289-9252
CESAR CASTILLO, INC.
7 8 7- 9 9 9 -1 6 1 6
EQUIPMENT OUTREACH, INC.
888-996-9968
FIRST VETERINARY SUPPLY
800-998-4661
HAWAII MEGA-COR, INC.
8 0 0 - 3 6 9 -7 7 1 1
HENRY SCHEIN ANIMAL HEALTH
8 5 5 -724 -3 4 61
MERRITT VETERINARY SUPPLIES, INC.
800-845-0411
MIDWEST VETERINARY SUPPLY
800-328-2975
MWI VETERINARY SUPPLY
800-824-3703
NORTHEAST VETERINARY SUPPLY (NEVSCO)
7 1 7- 52 6 -79 9 0
PATTERSON VETERINARY
8 0 0 - 2 2 5 -7 9 1 1
PENN VETERINARY SUPPLY, INC.
800-233-0210
VICTOR MEDICAL COMPANY
800-888-8908
WESTERN MEDICAL SUPPLY INC.
800-242-4415
CANADIAN DISTRIBUTORS
ASSOCIATED VETERINARY PURCHASING
604-856-2146
CDMV
45 0-77 1 -23 68
MIDWEST VETERINARY DISTRIBUTORS
2 04 -23 3 -8 1 5 5
VETERINARY PURCHASING
519-284-137 1
WESTERN DRUG DISTRIBUTION
780-413-2508
*Distributor of Equipment only. No Reagents
6
|
Vetcom
|
Volume 56
LIVE SUMMER & FALL CONTINUING EDUCATION SERIES
For more information go to www.abaxisuniversity.com
INDUSTRY THOUGHT LEADERS
ONLINE CONTINUING EDUCATION (CE) FOR VETERINARIANS,
TECHNICIANS AND PRACTICE MANAGEMENT PROFESSIONALS.
LEARN LIVE OR ON-DEMAND. YOU CHOOSE.
(some of the course offerings listed below)
LIVE ONLY
Jan Bellows, DVM, DAVDC, DABVP
Renal Insufficiency in Cats
Dental Anatomy and Nomenclature – Cat
Dental Anatomy and Nomenclature – Dog
How to Skyrocket Your Dental Practice
Andrew Rosenfeld, DVM, DABVP
Fluid Therapy and Diagnostic Monitoring of the Patient on IV Fluids
Evaluating for Liver Damage and Dysfunction
Managing the Acute and Chronic Renal Patient
Debra Horwitz, DVM, DACVB
Twitching, Itching and Licking: Behavioral Dermatology in Cats
Kendal Harr, DVM, MS, DACVP
Mineral Metabolism & Pathology - Part I
Mineral Metabolism & Pathology - Part II
General Quality Assurance
ABAXIS
UNIVERSITY
Committed to Education
www.abaxisuniversity.com
Abaxis, Inc. – Animal Health 3240 Whipple Road, Union City, CA 94587. Abaxis and VetScan are registered trademarks of Abaxis, Inc. ©2015
Volume 56
|
Vetcom
| 7
ABAXI S INFOR MATION
Gary Norsworthy, DVM, DABVP
A FEW OF OUR CUSTOMERS...
Veterinary
Facilities
& Foundations
y Facilities
Veterinary
& Foundations
Facilities
& Foundations
Research
Medical/Research
Veterinary Facilities & Foundations
uariums
Zoos/Aquariums
Medical/Research
Medical/Research
es Zoos/Aquariums
Universities
Veterinary
Facilities & Foundations
Zoos/Aquariums
Veterinary Facilities
Facilities &
& Foundations
Foundations
Veterinary
Universities
A BAXIS I NFOR MATION
Medical/Research
Medical/Research
Medical/Research
Zoos/Aquariums
Zoos/Aquariums
Zoos/Aquariums
Universities
Universities
Universities
Universities
8
|
Vetcom
|
Volume 56
The Abaxis Tradeshow Schedule
ON THE ROAD
CANWEST 10/18
OMVQ 11/20
ONTARIO VMA 01/28
10/13 ACVC
10/08 WILD WEST VET CONFERENCE
AAEP 12/06
10/19 MWI EQUINE EVENT
12/04 CVC IN SD
01/17 NAVC
10/19/15 – 10/23/15
MWI EQUINE EVENT
Las Vegas, NV
12/06/15 – 12/08/15
AAEP
Las Vegas, NV
10/13/15 – 10/15/15
ACVC
Atlantic City, NJ​
11/20/15 – 11/21/15
OMVQ
Quebec City, QC
01/17/16 – 01/20/16
NAVC
Orlando, FL​
10/18/15 – 10/19/15
CANWEST
Banff, AB
12/04/15 – 12/06/15
CVC IN SD
San Diego, CA
01/28/16 – 01/30/16
ONTARIO VMA
Toronto, ON
Volume 56
ABAXI S INFOR MATION
10/08/15 – 10/11/15
WILD WEST VET CONFERENCE
Reno, NV
|
Vetcom
| 9
CONTRIBUTING AUTHORS FEATURED CASE
Trained Medical Behaviors
Featured Case:
Contributing Author:
Liza Dadone, VMD
Director of Animal Health and Conservation | Cheyenne Mountain Zoo
T
RADITIONALLY, giraffe in human care have been considered
to be challenging patients, partly due to their tall stature, unique
anatomy, and neophobic nature. However, zookeepers and
veterinary staff at Cheyenne Mountain Zoo are challenging
these assumptions by incorporating operant conditioning methods for
medical behaviors. By using positive reinforcement procedures to shape
medical behaviors, we are able to do an increasingly wide range of
diagnostics and treatments. This allows our 17 reticulated giraffe to be
active participants in their own medical care.
10
|
Vetcom
|
Volume 56
ADVANCES IN GIRAFFE CARE: TRAINED MEDICAL BEHAVIORS
Diagnostic Procedures
With the help of target training, we perform a wide
range of diagnostic procedures on our giraffe. This
includes venipuncture for routine CBC/Chem monitoring,
ophthalmic exams, trans-abdominal pregnancy
ultrasounds, and skull radiographs. Additionally, using a
series of trained behaviors and a restricted contact set-up,
the entire giraffe herd is trained for voluntary front foot
radiographs.
Medical Treatments
Operant training also facilitates husbandry care and
medical treatments. The giraffe get front hoof farrier trims
every 6-12 weeks. Annually, they get vaccine booster
injections and other injections if needed. After a neck
injury to our breeding bull giraffe five years ago, he was
trained for range of motion neck exercises, chiropractic
adjustments, and cold laser therapy treatments; with
these, he’s made a full clinical recovery and has since
fathered two calves.
Wild Giraffe and Their Silent Crisis
In 1998, the IUCN estimated that there were over 140,000
wild giraffe in Africa. In 2012, follow-up population studies
indicate that fewer than 80,000 wild giraffe remain.
Despite the decline, there has been relatively little global
attention surrounding giraffe conservation. Cheyenne
Mountain Zoo helps support the Giraffe Conservation
Foundation’s conservation fieldwork with our Quarters
for Conservation program. For more info about how you
can help support giraffe conservation, please see www.
cmzoo.org/q4c.
Acknowledgments
Thanks to the dedicated team at Cheyenne Mountain
Zoo: the animal department for their exceptional training:
Amy Schilz, Andrea Bryant, Diana Cartier, Jason
Bredahl, and Jeremy Dillon; and to our veterinary team
for medical care: Dr Eric Klaphake, DeeAnn Wilfong,
Harley Thompson, and Erica Veal. Thanks also to farrier
Steve Foxworth at the Equine Lameness Prevention
Organization for helping provide giraffe foot care.
CONTRIBUTING AUTHORS FEATURED CASE
Using a restricted contact set-up and extensive safety training protocols, the giraffe herd is trained for voluntary front foot radiographs.
Volume 56
|
Vetcom
| 11
ADVANCES IN GIRAFFE CARE: TRAINED MEDICAL BEHAVIORS
Msitu positions for a voluntary phlebotomy.
Bloodwork was run on an in-house Abaxis VS2
serum chemistry analyzer and VetScan HM5
CBC machine, and Msitu was given a clean bill
of health.
Msichana, giraffe, positions for a skull radiograph.
CONTRIBUTING AUTHORS FEATURED CASE
VetScan VS2 Large Animal Profile
Patient
ALB
g/dL
ALP
U/L
AST
U/L
BUN
mg/dL
Ca
mg/dL
CK
U/L
GGT
U/L
Glob
g/dL
Mg
mg/dL
Phos
mg/dL
TP
g/dL
Msitu
4.1
366
95
17
9.2
433
20
4.9
2.6
6.3
9.0
1.7-4.1
67- 1512
31- 163
7-34
7.1-12.9
90-3144
9-84
1.7-6.8
1.14-3.13
3.2-13.9
4.5-10.0
ISIS
Reference
Values
VetScan HM5 CBC
Patient
Neut
Lymph
Mono
Eos
Baso
RBC
WBCC
109cells/µL 109cells/µL 109cells/µL 109cells/µL 109cells/µL 109cells/µL 1012cells/µL
Msitu
11.53
8.35
ISIS
Reference 3.38-21.91 1.58-17.40
Range
12
|
Vetcom
|
Volume 56
2.82
0.11
0.22
0.03
0.46-5.30
61-1110
< 0.953
< 0.570
9.92
Hgb
g/dL
Hct %
PLT
109cells/µL
12.3
36.87
126
5.15-15.44 6.9-15.6 19.6-46.9
94-1041
ADVANCES IN GIRAFFE CARE: TRAINED MEDICAL BEHAVIORS
Mshichana, giraffe, positions for hoof care in the outdoor restricted contact paddock.
Volume 56
|
Vetcom
| 13
CONTRIBUTING AUTHORS FEATURED CASE
Khalid, bull giraffe, injured his neck five years ago. Part of his
treatment includes a physical therapy exercise routine. He is cued
to touch his nose to each hip to stretch out his neck muscles. Since
starting his treatments, Khalid has made a full clinical recovery.
(For more details on this case, see the Journal of Zoo and Wildlife
Medicine, 4(1): 181-185, 2013.)
Adult-onset
Demodicosis
in a Shih Tzu
Contributing Authors:
Thomas Lewis, DVM, DACVD
Carine Laporte, VMD
Dermatology for Animals
D
CONTR IBUTI NG AUTH OR S
EMODICOSIS, also called “red mange” or “demodectic mange,” is an
inflammatory skin disease caused by an overabundance of demodex mites.
The most common causative demodex species in dogs is Demodex canis;
however, D. injai and D. cornei have also been reported and are seen in practice.
Different species can be seen simultaneously in the same patient. Hallmarks of the
disease in dogs include alopecia, erythema, comedones, increased keratosebaceous
exudate (greasy skin), and folliculitis, which can progress to deep furunculosis.
Secondary pyoderma is common.
Canine demodicosis has classically been categorized
as either juvenile or adult onset, and as either localized
or generalized disease. These classifications play a
role in determining the underlying cause, as well as
the prognosis, of the disease. Though true adult-onset
generalized demodicosis is uncommon, it is more serious
than juvenile-onset and is more often associated with
underlying immunosuppression. Generalized demodicosis
is one of the most serious canine skin diseases, with a
potentially fatal outcome in the absence of treatment.
cannot be documented at the time of diagnosis with
demodicosis; however, these dogs should continue to be
closely monitored, as malignancy or systemic illness may
become obvious in the subsequent weeks to months.
While demodicosis is initially diagnosed by skin scraping
and cytology, additional diagnostic testing, including
hematologic and urologic assessments are important
when evaluating these patients. Concurrent disorders
recognized in dogs with adult-onset demodicosis include,
but are not limited to: hypothyroidism, spontaneous or
iatrogenic hypercortisolism, leishmaniasis, malignant
neoplasia, and concurrent immunosuppressive therapy.
In more than 50% of cases, an underlying disease
An 11-year old, female spayed Shih Tzu was presented
with a 5-month history of non-seasonal dorsal and pedal
draining and crusted lesions that had been unresponsive
to enrofloxacin. Similar lesions had occurred 2 years
prior and had resolved with an unknown medical therapy.
The patient showed no signs of systemic illness apart
from mild lethargy and intermittent stranguria. No other
animals or people in the household were affected with
dermatologic disease.
14
|
Vetcom
|
Volume 56
The case described herein is one of adult-onset
generalized demodicosis, deep pyoderma, and
furunculosis in which hematologic and urologic
evaluations were an important part of the diagnostic workup and patient monitoring.
ADULT-ONSET DEMODICOSIS IN A SHIH TZU
On presentation, the patient had numerous, thick, yellowblack crusts overlying draining tracts, erosions, and
ulcerations along the cranial dorsal trunk and ventral chin.
All paws were markedly swollen and had similar draining
tracts, erosions, ulcerations, and matting of the hair with
hemorrhagic exudate (Image 1). Otoscopic examination
revealed bilateral moderate ear canal erythema and
ceruminous debris; however, ear canals were normally
distensible on palpation. The presentation was consistent
with truncal and pedal folliculitis and furunculosis, with
bilateral otitis.
Image 2
Image 1
Dorsal trunk and pedal hemorrhagic crusting associated with deep furunculosis due to
concurrent demodicosis and Staphylococcus pyoderma.
Diagnostics
A skin scraping of the dorsal crusted area, as well as a
pluck of the interdigital hair, revealed numerous (5-10/low
power field) D. canis mites (Image 2). Impression cytology
of the dorsal trunk draining tracts revealed significant
presence of intra- and extracellular coccoid bacteria in a
neutrophilic milieu. Dermatophyte culture was obtained
and was determined to be negative three weeks later.
Cytology of the ceruminous debris revealed D. injai mites
within the cerumen but no other microorganisms.
Based on these results, a diagnosis of adult-onset
demodicosis with a deep pyoderma, otitis and
pododermatitis was made.
Labwork, including blood chemistry, complete blood
count, thyroid evaluation and urinalysis with culture, is an
important minimum data base when evaluating a case of
adult-onset demodicosis. Diagnostic imaging may also be
warranted. Aerobic skin culture was also obtained, given
the history of non-response to enrofloxacin.
Aerobic culture of the dorsal trunk draining tracts
revealed a methicillin-susceptible Staphylococcus
pseudintermedius. Urinalysis revealed significant
bacteriuria and hematuria with mild proteinuria. Aerobic
culture of the urine identified Enterococcus species.
Both bacterial species were susceptible to amoxicillinclavulanate.
Blood chemistry results revealed a marked
hyperproteinemia of 11.2 g/dL (range 5.5-7.5) with
marked hyperglobulinemia of 9.6 g/dL (range 2.4-4.0)
and moderate hypoalbuminemia of 1.6 g/dL. Albumin
to globulin ratio was correspondingly decreased at
0.2 (range 0.7-1.5). The complete blood count was
unremarkable and the total T4 was just below the
normal range at 0.9 ug/dL (range 1.0 – 4.0ug/dL). Given
the concurrent extent of skin disease and the lack of
corresponding hematologic and chemistry abnormalities
(e.g. hypercholesterolemia, anemia, etc.), the patient
was considered euthyroid. Differential diagnoses for the
significant serum protein abnormalities included
Volume 56
|
Vetcom
| 15
CONTRI BUT ING AU THOR S
The three primary causes of folliculitis in the dog are
demodicosis, pyoderma, and dermatophytosis. In some
dogs, the three conditions may be present simultaneously.
Initial diagnostic testing for these conditions should
include skin scraping, dermatophyte culture, and cytology.
Demodex canis mites found on skin scraping.
ADULT-ONSET DEMODICOSIS IN A SHIH TZU
neoplastic versus a severe inflammatory process. It
was not suspected that the hypoalbuminemia reflected
urinary or gastrointestinal losses given the patient’s
clinical appearance, lack of suggestive history, and mild
proteinuria on urinalysis. Hypoalbuminemia was attributed
to a compensatory response to severe hyperglobulinemia.
To further evaluate the hyperglobulinemia,
Coccidioidomycosis titers (endemic in the region) were
performed and were negative for IgG and IgM. Protein
electrophoresis indicated a polyclonal gammopathy.
Based on these results, inflammatory processes remained
a potential cause for the hyperglobulinemia. The owners
elected to perform serial monitoring of globulin levels
via chemistry panel over time with treatment of the
demodicosis, pyoderma and cystitis.
Ivermectin (0.5 mg/kg PO daily) and a 6-week course of
oral antibiotic (amoxicillin-clavulanate at 22 mg/kg PO
BID) therapy were initiated. Twice weekly bathing with a
benzoyl peroxide shampoo was initiated for antibacterial
and follicular flushing effects.
At the scheduled recheck four weeks after initiating
therapy, the patient was significantly improved. The
crusting and draining tracts from the trunk and feet had
resolved indicating clearing of the deep pyoderma. The
ears contained only subtle amounts of ceruminous debris.
Multiple skin scrapings, ear cytology and hair plucks
revealed one dead adult mite. A urinalysis was normal
indicating the cystitis had cleared. Repeating the blood
work showed improvement in the hyperproteinemia (9.0
down from 11.2 g/dL) and hyperglobulinemia (7.0 down
from 9.6 g/dL) and hypoalbuminemia (2.0 up from 1.6 g/
dL).
Examination and blood work after three months of
ivermectin therapy revealed normal skin, feet and ears
with negative skin scrapings and blood work all within
normal levels.
This case illustrates the importance of additional
laboratory testing in the diagnosis of adult-onset
demodicosis. Though this patient had no history of known
underlying disease, hematologic and urologic evaluation
revealed concurrent urinary tract infection and a marked
hyperproteinemia and hyperglobulinemia. Continued
monitoring of this patient with serial complete blood
counts and chemistry panels constitute an important
element of care for these patients and may help to identify
an underlying disease in its earlier stages.
Figure 3
CONTR IBUTI NG AUTH OR S
Figure 1
4 weeks after initiating antibiotic and anti-parasitic therapy, all crusting and deep pyoderma has resolved. Follicular casting and comedones with residual hyperpigmentation
are evident.
16
|
Vetcom
|
Volume 56
Abaxis announces
ABAXIS VETERINARY CONSULTING
Exclusive to Abaxis customers
Preventive Care for ALL life stages.
The Abaxis Veterinary Consulting Group is an established group of veterinarians
and veterinary technicians with business acumen whose goal is to optimize your
preventive care for all life stages. The complimentary program consists of:
•
•
•
•
Staff training from AVC Veterinarians
A dedicated concierge team to help monitor your success
Personalized forms and client education handouts
On-site diagnostics to help initiate and oversee the program in your practice
It’s not just better diagnostics, it’s a Better way.
800.822.2947
www.abaxis.com AVC@abaxis.com
GLOBAL DIAGNOSTICS
Abaxis and VetScan are registered trademarks of Abaxis, Inc. © Abaxis 2015.
Learn more about all of our products and services at www.abaxis.com
Volume 56
|
Vetcom
| 17
CONTR IBUTI NG AUTH OR S
UNDERSTANDING
RADIOACTIVE
131
IODINE (I )
THERAPY
H
Contributing Author:
Gary D. Norsworthy, DVM, DABVP (Feline)
Alamo Feline Health Center | San Antonio, Texas
YPERTHYROIDISM is considered the most common endocrine disease of the older cat. It has been
estimated that approximately 10% of cats over 10 years of age are or will be affected. The disease begins
as an adenoma of one or both of the thyroid lobes. Over several years the adenoma may transform to
adenocarcinoma. Treatment of the latter is much more intense and often not successful; therefore, it is
highly desirable to rid the cat of the adenoma.
There are four treatments in two categories. Treatments in the “Control” category are the administration of methimazole or
y/d, an iodine restricted diet. Treatments in the “Cure” category are thyroidectomy and radioactive iodine (radioiodine or
I131) therapy. The obvious advantage for using a Cure approach is the avoidance of thyroid adenocarcinoma.
Each treatment approach has pros and cons. The approach with the most pros and the least cons is I131 therapy. Although its availability is somewhat limited, it can rid the cat of the benign tumor without destruction of the normal thyroid
tissue or the parathyroid gland. When dosed properly, I131 therapy will cure the disease without resulting in any further
treatment of the cat for thyroid disease, either hypo- or hyper-.
Since 2004 my practice, Alamo Feline Health Center, has treated over 500 hyperthyroid cats with I131. During that time
many questions have arisen regarding this treatment modality. Below are the questions we have received and the answers. Note that radiation laws vary from state to state so some of the legal aspects of these answers may not apply to all
states.
18
|
Vetcom
|
Volume 56
UNDERSTANDING RADIOACTIVE IODINE (I 131 ) THERAPY
1. What is the cost? The treatment cost is usually based on the dose of I131 that is administered. Cats diagnosed early
get a smaller dose so their treatment cost averages $1000-1500, which includes isotope administration and the required
hospitalization until discharge. Cats with advanced disease require a higher dose; however, it is very unusual for the
higher doses to cost more than $2000. In addition to the actual treatment cost, there is usually an examination/referral
exam fee of $75.00-150.00 and the cost of any needed pretreatment tests. The latter may be several hundred dollars
depending on the facility and the tests performed. Some cats require sedation for safe I131 administration. There will be a
charge for sedation; the cost will depend on the drug and the route of administration.
2. How is the dose determined? There is not a precise way to determine the dose of I131 for any given cat. Formerly, in
the U.K., every cat received the same dose. However, notable treatment failures forced U.K. veterinarians to re-examine
their dosing protocol. Despite the absence of a precise method, satisfactory dosing techniques do exist. Rather than
basing dosage on the size of a cat, it is based on the size of the tumor.
The size of the tumor can be estimated in several ways. Thyroid palpation can be used in most cats. After many years of
practice, we have developed a sizing system that works well. More precise size determination may be made with a technetium scan, not available at all treatment facilities.
For best results, we use a combination of palpation and total T4 (TT4) levels to determine tumor size and are correct over
99% of the time. In order to attain this level of accuracy, we need an exact TT4 value.
3. What pre-treatment laboratory tests are needed? In addition to a total T4 (or fT4), we need to be sure the kidney
function is normal or nearly normal. High thyroxine levels increase heart rate and blood pressure with resulting increased
perfusion of the kidneys. This process results in temporarily lowered creatinine (especially) and BUN values. Note that the
higher the TT4 or fT4 the more the kidney values are lowered. Therefore, we need to have the renal values at the time of
diagnosis and any values since.
4. If the cat’s renal values increase above normal after treatment, what are the consequences? If the one month
post-treatment values are in late IRIS Stage 2 or early IRIS Stage 3 (creatinine = 2.9-4.0 mg/dl) range, there are great
options to control renal disease and slow the progression of age-induced renal deterioration. However, these cats need
support quickly. If the creatinine rises to 4.0 mg/dl or greater, more aggressive therapy is needed, but this is still feasible.
Note that after treating over 500 cats, we have only had 4 cats (0.8%) in the latter category.
5. What about the Methimazole Test? The “Methimazole Test” has been employed to determine what level of renal
function is likely to be present after treatment with I131. Methimazole is given until the TT4 is normal (about 2-4 weeks),
and then the TT4 is rechecked.
We will treat cats with I131 with or without a methimazole test. If one is performed, the cat needs to be off the drug for at
least 5 days before I131 treatment.
6. Ordering the Isotope: By law, we are not permitted to store I131 on our premises. When it is delivered to us, we must
pay for it, and it must be given to a cat. We cannot store it for future use or return it. Therefore, we do not order it until our
patients are physically in the building.
7. How long does a cat need to be hospitalized? Our patients are generally treated on Mondays. Their release is
governed by state rules which mandate we perform a scan to determine when the level of radioactivity is safe. Most cats
are then cleared for release on Thursdays or Fridays; however, if the results of the scan are not appropriate, they stay
until they are. It is very unusual for discharge clearance to go past Saturday, but I131 excretion is largely dose related.
The higher the dose, the longer the isolation period must be. NOTE: The answer to this question varies from state to state.
Volume 56
|
Vetcom
| 19
CONTRI BUT ING AU THOR S
This is a test that comforts many people – veterinarians and owners alike. It gives us an understanding of what the kidneys are likely to do after I131 treatment. However, Dr. Mark Peterson, the guru of hyperthyroidism, is of the opinion that it
is rarely needed. His perspective is that if hyperthyroidism exists, it needs to be treated or else it will be fatal. If the kidney
values increase after treatment, renal disease can be addressed with diet, electrolyte correction, SC fluids, etc.
UNDERSTANDING RADIOACTIVE IODINE (I 131 ) THERAPY
The safe level is not all the way down to zero. If the owner is concerned about the minuscule amount of residual radioactivity, we are happy to board the cat until it reaches zero. The additional stay is charged as a boarding fee only; there is no
charge for further scanning.
The radioactivity is principally eliminated through the urine and the stool. If the cat does not eat while it is here, the elimination is slower and the stay prolonged. Therefore, we request that owners bring a few days of the cat’s favorite food in
order to encourage the cat to eat, and thus expedite the elimination process.
8. Can my clients bring bedding or toys for their cats to have during the treatment time? Yes. However, State
regulations prohibit them from being returned. NOTE: The answer to this question varies from state to state.
9. My patient’s liver enzymes are elevated. Should I perform more diagnostics or treat for liver disease? Elevation
of liver enzymes (LEs), especially ALT, is expected in cats with hyperthyroidism. It is the result of prolonged TT4 elevation.
The LEs will return to normal 4-6 weeks after treatment. That said, it is possible for a cat to have two concurrent diseases
which elevate LEs. If you are concerned about a dual diagnosis, a liver biopsy is indicated. We can do that if you are not
comfortable doing so. We generally perform a fine needle biopsy with a 22 gauge needle guided by ultrasound. However,
we cannot do a liver biopsy the same day as I131 treatment due to the turnaround time required by the veterinary
pathology laboratory.
10. Are there side effects? No. When the proper
adenoma dose is given the effects of I131 are limited
to hyperactive thyroid cells; other body cells, including
normal thyroid cells, are not affected in any way. If
the adenocarcinoma dose is given (5-10X adenoma)
normal thyroid cells are killed, the cat becomes
hypothyroid; however, no other body cells are
adversely affected.
CONTR IBUTI NG AUTH OR S
11. Can clients visit their cats? No. The State
regulations prohibit this.
12. Is it permissible to administer medications for
other diseases? State law prohibits us from handling
these cats for the first 24 hours after treatment. If
doing without medications for that period of time is
life-threatening, we should not treat the cat. Although
limited contact is permitted after the first 24 hours, we
can then administer oral or injectable medications.
NOTE: The answer to this question varies from state
to state.
13. What post-treatment care is needed at home?
There are state-mandated rules the owner is
expected to follow when the cat returns home. These
release criteria are listed for your clients. NOTE: The
answer to this question varies from state to state.
14. Will this cat be a danger to my other pets at
home? No. The I131 treated cat does not need to be
separated from other cats or use a different litter box.
Dogs that eat cat stools are also not at-risk.
15. I am not sure of the diagnosis. Should I
confirm it with a free T4? The fT4 is said to be more
sensitive than the TT4 for hyperthyroidism. However,
in some situations it is not specific. A study published
20
|
Vetcom
|
Volume 56
UNDERSTANDING RADIOACTIVE IODINE (I 131 ) THERAPY
in JAVMA (June 15, 1996) showed that cats with non-thyroidal illnesses frequently have a decreased TT4 and an
increased fT4. Therefore, this test must be used with care.
Our preferred test for clarifying confusing cases is the T3 Suppression Test. It is described in The Feline Patient, eds. 3
and 4 or other standard textbooks.
16. What follow-up is needed after treatment? One month after treatment, the cat needs to have its TT4 and renal
values determined. These tests are usually performed by the referring veterinarian, which is our preference. If any values
are abnormal, the treating veterinarian should be contacted for recommendations.
17. How often does hypothyroidism occur after I131 treatment? It is not unusual for the TT4 to be subnormal at one
month post-treatment. When a thyroid tumor is active, negative feedback stops TSH production causing normal thyroid
cells to become dormant. When the thyroid tumor is destroyed by I131 treatment, it may take more than one month for
the dormant thyroid cells to rebound. This is called “transient hypothyroidism.” If the TT4 is subnormal at one month posttreatment, repeat it four to six weeks later. “Persistent hypothyroidism” following treatment is dose related and occurs less
than 1% of the time in the cats we treat.
18. I understand that a thyroid (technetium) scan can differentiate a thyroid adenoma from a thyroid
adenocarcinoma. Is that correct? No. Thyroid disease begins as a thyroid adenoma. Over time, the benign adenoma
may transform to a malignant thyroid adenocarcinoma. It is frequently stated that 2% of hyperthyroid cats have
malignancy, but it should be noted that these are the cats with advanced disease. Therefore, a cat with early or mid-range
thyroid disease is extremely unlikely to have adenocarcinoma.
A thyroid scan can determine the number of thyroid masses and their sizes and give a suggestion of differentiation. However, a histological diagnosis can only be made by a pathologist with a microscope. If malignancy is suspected, a thyroid
biopsy is the only way to accurately differentiate thyroid adenoma from thyroid adenocarcinoma.
19. Does treatment with methimazole or y/d prevent the transformation from adenoma to adenocarcinoma? No.
Neither of these treatment modalities destroys the thyroid tumor. Over time, the tumor gets larger requiring higher doses
of methimazole to control the disease. We do not know the long-term success rate and long-term side effects of y/d.
Dr. Mark Peterson reported on a large number of cats on methimazole for four years. He found the incidence of malignancy to be about 20%. Only destroying the benign tumor can prevent its change to adenocarcinoma.
CONTRI BUT ING AU THOR S
20. Can thyroid adenocarcinoma be treated successfully? Possibly. The size of the tumor and the extent of
metastasis are the major determinants in success and survival. In order to have a realistic chance of remission, the dose
of I131 is increased about 5-10 fold. Some survive 1-2 years and have quality life for most of that time. However, this
very high dose of I131 will kill normal thyroid tissue leaving the cat persistently hypothyroid. These cats need thyroid
replacement hormone therapy for the remainder of their lives.
The poor response rate for thyroid adenocarcinoma means that cure (not just control) during the stage of adenoma is
highly desirable. Radioactive iodine has the ability to do this.
Volume 56
|
Vetcom
| 21
Rapid Tests
S I N G U L A R LY
BETTER
PROVIDING THE FLEXIBILITY YOU NEED
The Abaxis VetScan Canine Ehrlichia Rapid Test!
For the qualitative detection of antibodies of
E. canis, E. chaffeensis, and/or E. ewingii in
canines
Single Tests for Vector-Borne and Fecal Diseases
VetScan Rapid Tests — Singles
The VetScan Rapid Test portfolio gives you more of what you want and less of what you don’t want from
a single, rapid test — more options, more confidence, less hassle, less waiting. VetScan Rapid Tests deliver
exactly what you’ve come to know from Abaxis. The perfect balance of price and performance.
Fast, accurate, easy and affordable — It’s a singularly better approach to rapids.
It’s not just better diagnostics, it’s a better way.
800.822.2947
vet.abaxis.com/rapids
GLOBAL DIAGNOSTICS
Abaxis and VetScan are registered trademarks of Abaxis, Inc. © Abaxis 2015.
Learn more about all of our products and services at www.abaxis.com
22
|
Vetcom
|
Volume 56
vetscan@abaxis.com
Performance of the Abaxis VetScan® Canine Ehrlichia Rapid Test
Steven Levy, VMD
Andrew J. Rosenfeld, DVM ABVP
Introduction
The genus Ehrlichia consists of tick-transmitted gramnegative obligate intracellular bacteria from the order
Rickettsia and family Anaplasmataceae that primarily infect
leukocytes.1 The three most relevant species found in dogs
at this time are E. canis, E. chaffeensis, and E. ewingii, with
E. chaffeensis having significance as a human pathogen.2
The vector for E. canis is the brown dog tick (Rhipicephalus
sanguineus) which has worldwide distribution throughout
tropical and temperate climates, including all of the United
States except Alaska. The vector for E. ewingii is the Lone
Star Tick (Amblyomma americanum) which is found from
Texas, Oklahoma, Kansas, Missouri and Iowa in the Midwest
and eastward to the Atlantic coast. The primary vector for
E. chaffeensis is the Lone Star Tick as well, but the organism
is also found in the American dog tick (Dermacentor
variabilis).3
Clinical signs of E. canis infection range from non-specific
(depression, lethargy, anorexia, weight loss), to red/purple
subcutaneous bleeding, nose bleeds, ocular signs (retinal
hemorrhage/ Inflammation), and / or neuromuscular signs
(e.g. seizures, balance issues, or pain). Diagnosis of canine
ehrlichiosis can be made by the observation of infected
morulae in macrophages in blood smears or monocytes in
tissue aspirates or impression smears.4
With E. chaffeensis infection, clinical signs are similar
to, but often less apparent, than those of dogs infected
with E. canis. Thrombocytopenia is common, but other
observations, including identification of morulae, are not
routinely observed.5
With E. ewingii, infection can be mild or unapparent,
however symptomatic, infected dogs display signs of fever,
lethargy, anorexia, polyarthritis, vomiting, diarrhea, and / or
neurologic signs.6
After infection with Ehrlichia species organisms an acute,
subacute or chronic infection can occur. The acute phase
can last from 1 to 4 weeks. Most dogs that are treated
appropriately with antibiotics during the acute phase will
recover. Dogs that are either untreated or inappropriately
treated may clinically recover, but then enter the subclinical
phase for months to years. Dogs that are persistently infected
may spontaneously recover or develop severe chronic
disease. Dogs in acute phases are often antibody negative
while dogs in subacute and chronic phases are generally
antibody positive. In chronic disease, the bone marrow
is typically infected resulting in pancytopenia. The severity
of chronic ehrlichiosis can vary in severity from mild to lifethreatening.7
Materials and Methods
Four hundred twenty-six samples were obtained from
private practices, humane societies and laboratories.
The overall sensitivity and specificity of the VetScan®
Test were determined versus commercially available
immunofluorescence assay (IFA).
Results
Of the 426 samples tested in this study, 214 were found
to be negative and 212 samples were positive by IFA. The
sensitivity and specificity are calculated below.
VetScan Canine
Ehrlichia Rapid
Test
Negative
VetScan Canine
Ehrlichia Rapid
Test
Positive
IFA Negative
207
7
IFA Positive
14
198
Results
Sensitivity = 93.4% (95% CI: 88.9 - 96.2%)
Specificity = 96.7% (95% CI: 93.1 - 98.6%)
There were 14 samples which were positive by IFA but
negative on the VetScan Ehrlichia Rapid Test. However 8
of those 14 were confirmed as negative when tested on a
commercially available kit and ELISA. These are likely false
positives on IFA. Taking this into consideration the actual
sensitivity of the VetScan Ehrlichia Rapid Test is 97%.8
From a subset of these positive samples, species
identification was accomplished by using a combination
of commercially available IFA reagents for E. canis and E.
chaffeensis, commercially available Ehrlichia antibody test
kits, and Abaxis proprietary ELISA tests. Of these, 45 were
found to be positive for E. canis, 40 for E. chaffeensis, and
47 for E. ewingii.
Volume 56
|
Vetcom
| 23
Results for E. canis
Results
VetScan Canine
Ehrlichia Rapid
Test
Negative
VetScan Canine
Ehrlichia Rapid
Test
Positive
1
44
All criteria
positive for
E. canis
Sensitivity for E. canis = 97.7% (95% CI: 88.2 - 99.9%)
Recent developments in laboratory methodology and the
corresponding in-clinic VetScan Canine Ehrlichia Rapid
Test offer a cost-effective and time-saving option. The
VetScan Canine Ehrlichia Rapid Test is both a sensitive
and specific test for the detection of antibodies to three
Ehrlichia species.
Conclusions
This study demonstrates that the VetScan Canine Ehrlichia
Rapid Test is a reliable, cost effective and time saving point
of care assay to detect the presence of antibodies against
E. canis, E. chaffeensis, and E. ewingii species affecting
dogs, allowing for the effective diagnosis and treatment of
infected patients.
Results for E. chaffeensis
Results
VetScan Canine
Ehrlichia Rapid
Test
Negative
VetScan Canine
Ehrlichia Rapid
Test
Positive
2
38
All criteria
positive for
E. chaffeensis
Bibliography
1
Little, S.E. (2010). Ehrlichiosis and anaplasmosis in dogs and cats. Vet Clin
North Am Small Anim Pract., 40(6), 1121-40.
2
Berrada, Z.L., & Telford, S.R. 3rd. (2009). Burden of tick-borne infections
on American companion animals. Top Companion Anim Med., 24(4),
175-81.
3, 5, 6
4
Foglia Manzillo, V., Cappiello, S., & Oliva, G. (2006). Tick-transmitted
diseases in dogs: clinicopathological findings. Parassitologia, 48(1-2),
135-6.
4
Harrus, S., & Wane, T. (2011). Diagnosis of canine monocytotropic
ehrlichiosis (Ehrlichia canis): an overview. Vet J. 187(3), 292-6.
7
Sainz, A., Roura, X., Miro, G., Estrada-Pena, A., Kohn, B., Harrus, S., &
Solano-Gallego, L. (2015). Guidelines for veterinary practitioners on
canine ehrlichiosis and anaplasmosis in Europe. Parasites & Vectors, 8:75.
8
Walker et al. (2014). Serology of Tick-Borne Diseases in Dogs. Cambridge
HealthTech Institute Conference “Targeting Tick-Borne Diseases.” Boston.
Oct 28-29. Poster presentation. For a copy of the poster handout, go to:
www.abaxis.com
Sensitivity for E. chaffeensis = 95.0% (95% CI: 83.1 - 99.4%)
Results for E. ewingii
Results
VetScan Canine
Ehrlichia Rapid
Test
Negative
VetScan Canine
Ehrlichia Rapid
Test
Positive
1
46
All criteria
positive for
E. ewingii
Green, Craig, E. (2012). Infectious Diseases of the Dog and Cat 4th
Edition. Athens, Ga: Elsevier, 227-259.
Sensitivity for E. ewingii = 97.9% (95% CI: 88.7 - 99.9%)
Discussion
In general, Canine Ehrlichia infection (or Ehrlichiosis) is not
only evaluated in sick patients, but also evaluated to identify
asymptomatic chronically infected canines in endemic
regions. Diagnosis of Ehrlichiosis is based upon history,
tick infestation, hematologic abnormalities and serologic
findings. Polymerase Chain reaction (PCR testing) has also
been used to determine infection and monitor response to
medications.
The VetScan Canine Ehrlichia Rapid Test is ideally suited
to detect antibodies to all three species of Ehrlichia, and is
labeled for all three species.
Information on how Ehrlichia species were identified is available at Abaxis, Inc.
Abaxis and VetScan are registered trademarks of Abaxis, Inc. © Abaxis 2015
24
|
Vetcom
|
Volume 56
888-4281 Rev. A
“ The fact that Abaxis Chemistry is utilized on
the human side says a lot about the company
and the Quality of their product.”
Erica Kent
Director of Operations | Newman Veterinary Centers | Daytona, FL.
Abaxis customer
To watch NVC’s story, visit
vet.abaxis.com/beinspired
It’s not just better diagnostics, it’s a Better way.
800.822.2947
vet.abaxis.com/beinspired
vetscan@abaxis.com
#beinspired
GLOBAL DIAGNOSTICS
Abaxis and VetScan are registered trademarks of Abaxis, Inc. © Abaxis 2015.
Learn more about all of our products and services at www.abaxis.com
Volume 56
|
Vetcom
| 25
SMOKEY
SICK FERRET
THE
Contributing Author:
Karen Rosenthal, DVM, MS
Dean | School of Veterinary Medicine
ST. MATTHEW’S UNIVERSITY
P. O. Box 32330, Grand Cayman KY1-1209
Cayman Islands, B. W. I.
“S
CONTR IBUTI NG AUTH OR S
MOKEY,” a five-year-old male neutered ferret, is brought to your hospital for a
physical examination. Although your associate saw this ferret only three months
ago for a yearly check-up, since then, the owner says that “Smokey” has become
slightly less active. That is why “Smokey” is here to see you today. At his appointment three months ago “Smokey” had no unusual physical examination findings and the
owners had no complaints about anything out of the ordinary at home with “Smokey.” There are
no other pets in the house and “Smokey” was acquired from a local pet store as a kit and has no
health issues his entire life. Usually, “Smokey” spends the day in his large cage that has a litter
pan, a hammock, and a hide box. When the owners come home, “Smokey” is allowed out to
run around the “ferret-proof” living room with supervision.
From talking with the owners, it becomes apparent that
“Smokey” is not acting like his normal-self. When the
owners come home, instead of bounding out of his cage,
“Smokey” stays in his hammock or takes a look around
at the open door, and decides to stay inside his enclosure. Not content to let him sleep in the cage, once
they are home, “Smokey’s” owners pick him up out of
his enclosure, put him on the living room floor and start
playing with him. After a few minutes, he seems to perk
up a little, especially now that they are coaxing him to run
around by offering him some ferret treats. They report
that he does seem more energetic after he eats, but he
is less interested in eating his food compared to when he
used to finish his dinner quickly. To further encourage
“Smokey” to eat, they have started giving him a little bit of
meat-based baby food in jars as a way to get him to eat
more of his dry food.
26
|
Vetcom
|
Volume 56
Your physical examination of “Smokey” is fairly normal
except for a couple of unusual findings that you discuss
with the owners. When you place “Smokey” on the carpeting to watch him walk, he does seem less active than your
associate reported a few months ago. Also, you can hear
a grade II heart murmur on the left side of his thorax. You
tell “Smokey’s” owners that you are not exactly sure what
is wrong but in an older ferret that is less active, insulinoma disease has to be high on your rule out list. Likewise,
heart disease is known to occur in older ferrets and there
is a heart murmur present now. Finally, you remind them
that there may be other causes then those two you just
listed that are responsible for “Smokey’s” condition and
murmurs are not always associated with serious or clinical heart disease in a ferret. Therefore, you recommend
a CBC and biochemistry profile along with whole body
radiographs. “Smokey’s” owners agree to the plan
SMOKEY THE SICK FERRET
and they leave him with you for the day. Radiographs are
taken and the blood work is sent off to a laboratory.
The radiographs show an enlarged heart silhouette and
some pleural effusion. An echocardiogram confirms that
heart disease, specifically dilated cardiomyopathy, is present and “Smokey” is in the early stages of heart failure.
He is started on appropriate medications for the dilated
cardiomyopathy and associated pleural effusion. We also
let the owners know that at this point, we are not sure if
the heart disease is the only reason for the weakness
“Smokey” was exhibiting at home since we do not have
the blood tests back yet. We tell the owners we have a
bit of a dilemma. We could start him on prednisone for a
presumptive insulinoma since he has the signs and signalment for an insulinoma, but you are concerned about
the potential effect prednisone might have on pre-load for
his heart. Since “Smokey’s” laboratory results will not be
back until tomorrow, you decide to send “Smokey” home
on just his heart medications and will call the owners
with the results and update any medications at that time.
The results come back late the next day and the CBC is
normal. The biochemistry panel has only one abnormal
result. The blood glucose concentration is reported to be
40 mg/dl. The laboratory reports the normal range to be
between 85 and 150 and so 40 mg/dl appears to be very
low. Here is the dilemma- if “Smokey’s blood glucose is
truly 40 mg/dl, then he needs surgery to debulk the disease in his pancreas and/or medication to combat the low
glucose. Both forms of treatment have serious implications to a ferret with heart failure.
Ferrets acclimate to the hypoglycemia, therefore, owners
may miss the subtle signs at the start of this disease. So
when the laboratory reports a blood glucose concentration
of 40 mg/dl, is it not unusual that the ferret did not appear
sicker- both at home and in your office due to this ability to acclimate to the hypoglycemia. But now we have a
treatment dilemma. If the blood glucose concentration is
40 mg/dl, then treatment must be started. Both diazoxide
and prednisone are reported to increase pre-load which is
something that we would try to avoid in a ferret with heart
failure. Plus, with a 40 mg/dl concentration, it is likely we
would need to start at the higher end of the dose of these
medications, potentially increasing the risk of improperly
effecting pre-load. Surgery, on a ferret with heart failure,
will make this ferret a more challenging anesthetic patient.
Neither choice for treatment brings a smile to your face!
The questions are, is insulinoma treatment necessary and
would having an Abaxis Vetscan have improved your care
of this patient?
“Would having an Abaxis
Vetscan have improved
your care of this patient?”
The answer is yes for two
reasons.
Let’s first answer the question- “would having an Abaxis
Vetscan have improved your care of this patient?” The
answer is yes for two reasons. First, we recommend
ferrets over the age of three visit the veterinarian twice
a year and at each visit, have a biochemistry panel
performed. Since insulinoma disease is so common in
ferrets over the age of three, you can pick up early insulinoma disease during a visit, just by running a biochemistry
panel. This disease is so insidious that the blood glucose
concentration can be low for weeks or months before the
owners notice a problem. If an in-house biochemistry
panel had been performed three months ago when
Volume 56
|
Vetcom
| 27
CONTRI BUT ING AU THOR S
Insulinoma is a common disease in pet ferrets. The
incident rate is unknown but it is not an exaggeration to
state that probably at least 50% of pet ferrets will develop
this disease, if they live long enough. Insulinoma may be
present for months before owners notice a change in their
ferret’s behavior. The changes are due to hypoglycemia.
Signs of disease include varying amounts of lethargy,
drooling, difficulty to wake from sleep, and ataxia. It is
believed the disease is due to malignant beta cells in
the pancreas that will eventually spread to the liver and
lymph nodes. It can take months to years before these
malignant cells spread from the pancreas to other organs
and during that time, ferrets can have a decent quality
of life with the proper treatment. There are both surgical and medical approaches to treatment for insulinoma
disease in ferrets. Surgical treatment involves removing
the masses in the pancreas, usually via a partial pancreatectomy. Surgery is a debulking procedure rather than
removal of the entire malignant tumor. If there is spread
of this disease beyond the pancreas, surgical treatment is
not advised. Medical treatment is aimed at increasing the
blood glucose concentration. Two of the most commonly
used medications are prednisone and diazoxide. Medical
treatment controls the signs of this disease (which are
due to the hypoglycemia) but will not prevent eventual
metastasis of the malignant cells. As the disease progresses, increases in the amount of medication given
is necessary to fight the hypoglycemia. Once the ferret
develops resistant to the highest doses of the medications, only a surgical approach will alleviate the signs of
disease. Neither surgery nor medications will cure this
disease but surgery can provide a longer survival time.
SMOKEY THE SICK FERRET
CONTR IBUTI NG AUTH OR S
“Smokey” visited for a health check, it is possible the diagnosis of an insulinoma could have been made at that
time. That would have been before the cardiac disease
and he would have been a better candidate for anesthesia and surgery. Now there is a suspicion of a diagnosis
of insulinoma but “Smokey” is in heart failure. An early
diagnosis three months ago would have put “Smokey”
at much less risk for a poor anesthetic outcome than
he is now if he has an insulinoma and if surgery is
performed. The second reason that having an Abaxis
Vetscan would have improved care is because there is
doubt that the 40 mg/dl truly represents what the blood
glucose concentration was at the time of venipuncture.
Since the sample was not spun down, whole blood was
sent to the laboratory, and the sample was run at least
24 hours after venipuncture, there is a good chance the
value is artifactual. A blood glucose of 40 mg/dl would
require medical treatment at a high dose of medication
that could negatively affect treatment of his heart failure
or surgery with anesthesia for the debulking procedure.
28
|
Vetcom
|
Volume 56
In fact, “Smokey” ended up the evening before he was
to come back for a recheck at an emergency hospital
due to his tail being stepped on as he was more active
than he has been in weeks and was running around
in the living room. The emergency clinic ran a vetscan
rotor and to everyone’s surprise, his blood glucose
was 80 mg/dl! What caused the difference? The whole
blood was run immediately and the result was unaffected by transport, time and most importantly, blood cells
lowering the blood glucose concentration. In the end,
“Smokey” had a normal blood glucose concentration
and did not have an insulinoma. His treatment for heart
failure greatly improved his quality of life but unnecessary surgery and medication were avoided because
a precise measurement of his blood glucose via the
Vetscan was performed.
To watch Dr. Kamiya’s story, visit
vet.abaxis.com/beinspired
“Having the Rapid Tests has changed the
game. Being able to quickly run the test & get
your results —
­ that has been a tremendous
benefit to our medical center.”
Dr. Cristie Kamiya
CONTRI BUT ING AU THOR S
Humane Society Silicon Valley | Milpitas, CA.
Abaxis customer
It’s not just better diagnostics, it’s a Better way.
800.822.2947
vet.abaxis.com/beinspired
vetscan@abaxis.com
#beinspired
GLOBAL DIAGNOSTICS
Abaxis and VetScan are registered trademarks of Abaxis, Inc. © Abaxis 2015.
Learn more about all of our products and services at www.abaxis.com
Volume 56
|
Vetcom
| 29
THE
IMPORTANCE
OF
TESTING
FOR
EHRLICHIOSIS IN DOGS
WITH
PERSISTENT LYMPHOCYTOSIS
Contributing Authors:
Mary Anna Thrall, DVM, MS, DACVP
Diana Scorpio, DVM, MS, DACLAM
Ross University School of Veterinary Medicine
Basseterre, St. Kitts, West Indies
INTRODUCTION
​ esting for monocytic ehrlichiosis is warranted in dogs with unexplained persistent lymphocytosis,
T
particularly in endemic areas. The list of causes of persistent lymphocytosis in dogs is quite short and
includes leukemia, canine ehrlichiosis, and rarely, hypoadrenocorticism. Canine ehrlichiosis is endemic in St. Kitts, West
Indies, and persistent lymphocytosis in affected dogs is quite common. The following case presentations are examples of
dogs with canine ehrlichiosis and persistent lymphocytosis.
CASE 1: SWIGGLES
CONTR IBUTI NG AUTH OR S
Swiggles, a male dog infested with ticks and assumed
to be approximately three years of age, was presented
to the Ross University School of Veterinary Medicine
(RUSVM) community clinic for testing for ehrlichiosis, and
was PCR positive. Complete blood counts were performed over a three-month period (Table 1). Abnormalities
on 11/20 included leukocytosis due to lymphocytosis, and
eosinophilia. The apparent thrombocytopenia on that day
is erroneous due to platelet clumping, as can be observed
on the platelet histogram (Figure 1). Large granular lymphocytes were observed (Figure 2). The manual differential count performed that day was also erroneous due
to neutrophil agglutination likely due to hyperproteinemia
and subsequent uneven distribution of leukocytes in the
counting area of the blood film. Doxycycline therapy (10
mg/kg sid) was initiated on 1/26/15 and was continued for
28 days. A biochemical profile using the Abaxis Vet Scan
VS2 was performed on 1/30/15. The only abnormalities
noted were total protein of 9.6 g/dl (reference interval is
5.4-8.2) and globulin concentration of 6.2 g/dl (reference
interval is 2.3-5.2). Biochemical profile was repeated on
2/27/15 revealing total protein of 8.2 g/dl and globulin
concentration of 4.7g/dl, both within the reference interval.
Table 1. Swiggles’ complete blood counts (Abnormalities are bolded)
​​​​​
11/20/14^​
1/30/15^​2/13/15^​2/27/15​​Ref Interval​
PCV (%)​​​​30​​44​​43​​44​​​37-55
MCV (fl)​​​​
55​​55​​59​​59​​​60-77
Total Protein (g/dl)​​​
9.5​​11.1​​9.5​​8.8​​​6.0-8.0
TNCC* (x 103µl)​​​
19.5​​
11.3​​8.1​​8.5​​​6.0-17.0
Segmented neuts(x 103µl)​​
9.0​​
4.1​​1.2​​2.5​​​3.0-12.0
Lymphocytes(x 103µl)​​
9.5​​5.5​​5.0​​4.4​​​1.0-4.8
Monocytes(x 103µl)​​​
0.1​​0.6​​0.3​​0.3​​​0.2-1.5​
Eosinophils(x 103µl)​​​
0.9​​1.1​​1.6​​1.3​​​0-0.8
Platelets(x 103µl)​​​
57.5**​​257​​280​​268​​​200-500
^Technician observations re blood film exam: Rouleaux present (due to increased globulin); numerous large granular lymphocytes present; neutrophil agglutination present
* Total nucleated cell count (White blood cell count or WBC)
** Platelet count is erroneously low due to platelet clumping (observed on blood film)
30
|
Vetcom
|
Volume 56
THE IMPORTANCE OF TESTING FOR EHRLICHIOSIS IN DOGS WITH PERSISTENT LYMPHOCYTOSIS
Figure 1
CONTRI BUT ING AU THOR S
Figure 2
Volume 56
|
Vetcom
| 31
THE IMPORTANCE OF TESTING FOR EHRLICHIOSIS IN DOGS WITH PERSISTENT LYMPHOCYTOSIS
CASE 2: SURPRISE
Surprise, an intact female dog assumed to be approximately three years of age was presented to the RUSVM
community clinic for testing for ehrlichiosis and was PCR
positive. Complete blood counts were performed over a
one-month period (Table 2). Abnormalities include lymphocytosis, increased total protein, and on 2/18/15, one
day after she had aborted a dead puppy, increased band
neutrophils (Table 2). Doxycycline therapy (10 mg/kg sid)
was initiated on 1/30/15 and was continued for 28 days.
A biochemical profile was performed on 1/30/15. The
only abnormalities noted were total protein of 9.7 g/dl and
globulin concentration of 7.2 g/dl. The biochemical profile
was repeated on 2/27/15, and both the total protein and
globulin continued to be above the reference interval (9.7
g/dl and 6.7 g/dl, respectively).
Table 2. Surprise’s complete blood counts
​​​​​
1/30/15^​2/6/15^​
2/18/15​2/27/15^​​Ref Interval​
PCV (%)​​​​
33​​34​​34​​41​​​37-55
MCV (fl)​​​​
57​​61​​62​​62​​​60-77
Total Protein (g/dl)​​​
11.1​​10​​9.1​​10​​​6.0-8.0
TNCC* (x 103µl)​​​
15.2​​15.5​​23.5​​13.2​​​6.0-17.0
Segmented neuts(x 103µl)​​
5.9​​5.9​​15.1​​7.0​​​3.0-12.0
Band Neutrophils (x 103µl)​​
-​​-​​3.8**​​-​​​0-0.3
Lymphocytes(x 103µl)​​
7.8​​7.6​​3.1​​5.3​​​1.0-4.8
Monocytes(x 103µl)​​​
0.9​​0.5​​1.6​​0.8​​​0.2-1.5​
Eosinophils(x 103µl)​​​
0.6​​1.6​​-​​0.1​​​0-0.8
Platelets(x 103µl)​​​
304​​248​​197​​325​​​200-500
CONTR IBUTI NG AUTH OR S
^Technician observations re blood film exam: Rouleaux present (due to increased globulin); numerous large granular lymphocytes present
* Total nucleated cell count (White blood cell count or WBC)
** Neutrophils and band neutrophils exhibited marked toxic change
CASE 3: WHISKEY
Whiskey, a male dog assumed to be approximately three
years of age, was presented to the Ross University School
of Veterinary Medicine (RUSVM) community clinic for testing for ehrlichiosis and was PCR positive. Complete blood
counts were performed over a three-month period (Table
3). Abnormalities on 11/20/14 included lymphocytosis and
eosinophilia. The apparent thrombocytopenia is erroneous
due to platelet clumping. Large granular lymphocytes were
32
|
Vetcom
|
Volume 56
observed. Doxycycline therapy (10 mg/kg sid) was initiated
on 1/26/15 and continued for 28 days. A biochemical profile
using the Abaxis Vet Scan VS2 was performed on 1/30/15.
The only abnormalities noted were total protein of 11.3 g/
dl (reference interval, 5.4-8.2) and globulin concentration
of 8.7 g/dl (reference interval, 2.3-5.2). Biochemical profile
was repeated on 2/27/15 revealing a total protein of 10.5 g/
dl and globulin concentration of 7.7g/dl.
THE IMPORTANCE OF TESTING FOR EHRLICHIOSIS IN DOGS WITH PERSISTENT LYMPHOCYTOSIS
Table 3. Whiskey’s complete blood counts
11/20/14^​1/23/15^​2/13/15^​2/27/15^​​Ref Interval​
PCV (%)​​​​
23​​31​​28​​33​​​37-55
MCV (fl)​​​​
57​​59​​62​​63​​​60-77
Total Protein (g/dl)​​​
10​​11.5​​11.1​​10.6​​​6.0-8.0
TNCC* (x 103µl)​​​
9.8​​13.0​​11.6​​12.9​​​6.0-17.0
Segmented neuts(x 103µl)​​
3.0​​2.9​​2.8​​4.5​​​3.0-12.0
Lymphocytes(x 103µl)​​
5.3​​8.1​​4.9​​6.2​​​1.0-4.8
Monocytes(x 103µl)​​​
0.3​​0.9​​0.7​​0.6​​​0.2-1.5​
Eosinophils(x 103µl)​​​1.3​​1.2​​0.3​​1.5​​​0-0.8
Platelets(x 103µl)​​​
18**​​58**​​98**​​91​​​200-500
^Technician observations re blood film exam: Rouleaux present (due to increased globulin); many large granular lymphocytes present
* Total nucleated cell count (White blood cell count or WBC)
**Electronic platelet count erroneously low due to platelet clumping (observed on the blood film)
DISCUSSION
Testing for ehrlichiosis is warranted in dogs with unexplained persistent lymphocytosis. However, in areas not endemic for
ehrlichiosis, a neoplastic lymphoproliferative disorder is the most common cause of persistent lymphocytosis. Lymphoid
leukemia may be seen with chronic lymphocytic leukemia (CLL), acute lymphoblastic leukemia (ALL), and lymphoma with
circulating neoplastic cells (stage V lymphoma). Unlike ALL and stage V lymphoma, lymphocytes in dogs with CLL usually appear mature and normal. The diagnosis of CLL can sometime be made based on the magnitude of the lymphocytosis, since a lymphocyte concentration of greater than 35,000/µl would almost certainly be due to leukemia. In patients
with a lymphocytosis of lesser magnitude, ehrlichiosis can be eliminated as a differential based on testing, and CLL can
be confirmed using either immunophenotyping by flow cytometry or by clonality testing using the PCR for antigen rearrangement assay (PARR) (Avery et al, 2007).
Volume 56
|
Vetcom
| 33
CONTRI BUT ING AU THOR S
Canine monocytic ehrlichiosis, first reported in 1935, is caused by Ehrlichia canis, a small, coccoid, gram-negative bacterium transmitted by Rhipocephalus sanguineus, a ubiquitous tick. Clinical signs and lesions of canine ehrlichiosis are
related to the infection and immune response produced by the host. It is known from small studies that dogs with ehrlichiosis have increased numbers of circulating large granular lymphocytes and a higher lymphocyte concentration than
normal dogs (Lorente et al, 2008). Although chronic infectious disease of all types is often listed as a differential for lymphocytosis in dogs, a review of the literature suggests that with the exception of Ehrlichia canis infection, lymphocytosis is
not a feature of canine chronic infectious disease (Avery et al, 2007). Numerous studies have shown that naturally occurring E. canis infection can result in lymphocytosis with values up to 17,000 lymphocytes/µL (Kuehn et al, 1985; Codner
et al, 1986; Weiser et al, 1991; Frank et al, 1999; Heeb et al, 2003), although not all case series describe lymphocytosis
(Breitschwerdt et al, 1998). Anecdotal reports and the experience of some clinicians and clinical pathologists suggest that
lymphocyte counts up to 30,000 cells/µL are possible in E canis infection. The lymphocyte response usually consists of
an increased percentage of cells with a large granular lymphocyte (LGL) phenotype (McDonough et al, 2000; Lorente et
al, 2008), which were shown to be CD8+ T cells. Therefore, an important differential for lymphocytosis in dogs is E. canis
infection, but the frequency with which E. canis is associated with lymphocytosis is not known. The lymphocytosis may
persist for several months, even after treatment.
​
THE IMPORTANCE OF TESTING FOR EHRLICHIOSIS IN DOGS WITH PERSISTENT LYMPHOCYTOSIS
​ hese cases also emphasize the importance of blood film examination. For example, the thrombocytopenia reported on
T
three of Whiskey’s CBCs and the first CBC performed on Swiggles were erroneous due to platelet clumping, which was
observed on the blood film. Another example is Surprise’s CBC performed on 2/18/15. The presence of band neutrophils
detected on the manual differential count were important in diagnosing significant inflammation, but they were not detected by the electronic cell counter, as band neutrophils cannot be differentiated from segmented neutrophils. On the other
hand, the instrument may be reporting more reliable differential counts than can be obtained by a manual count if neutrophil agglutination is present, as was seen on Swiggles’ blood films on numerous occasions.
References
Avery AC, Avery PR. Determining the significance of persistent lymphocytosis. Vet Clin Small Anim. 2007;37: 267–282.
Breitschwerdt EB, Hegarty BC, Hancock SI. Sequential evaluation of dogs naturally infected with Ehrlichia canis, Ehrlichia chaffeensis,
Ehrlichia equi, Ehrlichia ewingii, or Bartonella vinsonii. J Clin Microbiol 1998;36:2645–51.
Codner EC, Farris-Smith LL. Characterization of the subclinical phase of ehrlichiosis in dogs. J Am Vet Med Assoc 1986;189:47–50.
Frank JR, Breitschwerdt EB. A retrospective study of ehrlichiosis in 62 dogs from North Carolina and Virginia. J Vet Intern Med
1999;13:194–201.
Heeb HL, Wilkerson MJ, Chun R, et al. Large granular lymphocytosis, lymphocyte subset inversion, thrombocytopenia, dysproteinemia,
and positive Ehrlichia serology in a dog. J Am Anim Hosp Assoc 2003;39:379–84.
Kuehn NF, Gaunt SD. Clinical and hematologic findings in canine ehrlichiosis. J AmVet Med Assoc 1985;186:355–8.
Lorente C, Sainz A, and Tesouro MA. Immunophenotype of Dogs with Subclinical Ehrlichiosis. Animal Biodiversity and Emerging Diseases: Ann. N.Y. Acad. Sci. 2008;1149:114–117.
McDonough SP, Moore PF. Clinical, hematologic, and immunophenotypic characterization of canine large granular lymphocytosis. Vet
Pathol 2000;37:637–46.
CONTR IBUTI NG AUTH OR S
Weiser MG, Thrall MA, Fulton R, et al. Granular lymphocytosis and hyperproteinemia in dogs with chronic ehrlichiosis. J Am Anim Hosp
Assoc 1991;27:84–8.
34
|
Vetcom
|
Volume 56
Sometimes
IT’S MORE THAN
Periodontal Disease
Contributing Author:
Jan Bellows, DVM
A
On presentation the dog appeared to be thin with a body condition
score of 3/9, well hydrated, had a normal respiratory rate with a
temperature of 102.6. Her heart and lungs asculted normally. The
systolic and diastolic blood pressure readings were normal. Palpation
of her abdomen gave the impression of hepatomegaly. There was
evidence of halitosis and moderate periodontal disease. There were
also areas of petechial hemorrhage on the skin and gingiva.
The owner was informed that before dental care could be provided
to care for the periodontal disease and oral malodor we would need
to access the dog’s health status. A hematology and chemical profile
were analyzed with our in house Abaxis VS2 and HMT, a 4 DX vector
born diseases profile, fecal, urinalysis, chest and abdomen images
were also performed.
Initial in house results revealed a non-regenerative slight anemia, and
a marked thrombocytopenia which was confirmed with a visual
Volume 56
|
Vetcom
| 35
CONTRI BUT ING AU THOR S
N 11-year-old Shih Tzu dog living in the Bahamas was referred
to ALL PETS DENTAL in Weston, Florida for dental care. Her
owners complained that after eating a bone on the beach a week
before presentation, the dog had not “acting like herself” , had breath odor
like dead fish, and began to bleed from the left nostril. The dog was current on core vaccines and prevented against fleas, ticks, and heartworm
disease. According to their local veterinarian other than slight anemia, and
mild hepatic and renal laboratory elevations, the dog’s problem was probably due to advanced periodontal disease.
SOMETIMES IT’S MORE THAN PERIODONTAL DISEASE
stained slide examination. The profile results also revealed elevated
hepatic enzyme activity, hypoalbuminemia, moderately elevated BUN,
creatinine, and phosphorus levels. 4Dx test was negative as was testing for gastrointestinal ova and parasites. A urinalysis revealed a low
specific gravity of 1.014 with 3+ protein and 3+ blood. Bacteria, casts
or crystals were not noted in the urine. A urine protein creatinine ratio
was sent out to assess the extent of the proteinuria as was a urine
culture.
Thoracic and abdominal imaging revealed moderate hepatomegaly and
moderate to marked soft tissue opacities in the caudodorsal lung lobes.
The radiologist felt the opacities were consistent with bronchopneumonia or thromboembolic disease.
A summary of the dog’s abnormal examination findings at the time
included:
• Thin
• Petechial hemorrhages
• Halitosis
• Hepatomegaly
• Periodontal disease
• Left nostril epistaxis
A summary of the abnormal laboratory results at the time included:
• Mild non-regenerative anemia
• Low urine specific gravity
• Marked thrombocytopenia
• Suspect proteinuria
• Azotemia
• Hematuria
• Hyperphosphotemia
A tentative diagnosis was renal / hepatic disease as the dog’s major
problems. Further laboratory testing included urine protein/creatinine
ratio to assess the extent of proteinuria, leptospirosis and tick serology
evaluation, and a coagulation profile.
36
|
Vetcom
|
Volume 56
A coagulation profile was sent to the reference
lab which revealed an elevated D-Dimer @
774 ng/ml (normal <250 ng/ml ), and a fibrinogen @ 824 MG/DL (normal < 256 MG/DL).
The prothrombin level was within the normal
range of 7.0 seconds, the partial thromboplastin (PTT) was slightly elevated at 25.2 seconds
(10.6-16.8 seconds). The tick serology showed
positive PCR results for Ehrlichia spp. The
PCR was negative for leptospirosis.
SOMETIMES IT’S MORE THAN PERIODONTAL DISEASE
We felt the life limiting problem in this patient was persistent epistaxis and needed to know if it was due to
neoplasia vs. potentially treatable thrombocytopenia from
ehrlichiosis. The dog was sedated for nasal imaging,
which revealed abnormal opacification nasal turbinate
destruction consistent with rhinitis, hemorrhage or neoplasia. Nasal swabs were also acquired and cytologically
examined which were consistent with rhinitis.
The next day the urine protein creatinine ratio came back
as 8.1 (normal <2.0) consistent with significant proteinuria.
Due to the multiple organ system involvement (renal, hepatic, respiratory, dental, and hematologic) with a guarded prognosis for long term success the owner opted to
euthanize the dog. A necropsy was not performed.
The degree of periodontal disease observed on the nasal
films was minimal but the dog’s fish breath halitosis was
marked. It could be surmised that the chronic bleeding due to thrombocytopenia from the ehrlichiosis was
responsible.
Volume 56
|
Vetcom
| 37
RWANDA
SAVING ENDANGERED
GREY CROWNED CRANES
IN RWANDA
T
Contributing Author:
Dr. Olivier Nsenginama
HE Grey Crowned Crane (Balearica regulorum) is the only species of crane in Rwanda and a spectacular and
iconic species in the country’s diverse natural landscape. Sadly however, they face increasing threats to their
habitat and a growing illegal trade. Rwanda is a country challenged with population growth and poverty which
often results in a huge competition for resources. Much of the natural marshy habitat of the cranes has been
taken over by agricultural activities and a lack of conservation awareness within communities readily results
in the poaching of cranes, chicks and eggs even though it is illegal to do so.
ON LOC ATION RWANDA
Grey Crowned Cranes are often kept domestically by hotels and wealthy families who are unaware
of the environmental consequences of doing so. In captivity, the cranes are usually stressed,
malnourished, have broken wings to prevent them flying and cannot breed. As a result, the
population of Grey Crowned Cranes has dramatically fallen by 80% over the past 45 years; with
less than 500 living in the wild in Rwanda today. In 2012 the International Union for Conservation of Nature (IUCN)
raised the threat listing for the crane to “endangered”, highlighting the need for immediate action.
38
|
Vetcom
|
Volume 56
RWANDA
This project has been designed to reverse the trend in illegal trade and boost the wild populations of Grey Crowned
Cranes in Rwanda. It adopts a holistic approach, to tackle the problem from all angles to ensure the impact is long-term
and sustainable.
The first step was to launch a national media campaign in collaboration with the Rwanda Development Board to raise
awareness amongst the general public about the Grey Crowned Crane and its endangered status and the laws that exist to protect it. This led to a nationwide amnesty calling for people to register any cranes they have in captivity so that
we could issue every captive crane in the country with a unique identifying leg band. A national database was set up to
provide a baseline of the extent of the illegal trade and will allow us to more easily prosecute people who are found with
newly poached cranes. So far 130 captive cranes have been registered, mainly in Kigali city but it is expected that with
further media campaigns, this number will exceed 200.
The second step was to work with local communities around the marshland where the biggest population of Grey
Crowned Cranes live. Engaging and educating them to understand the importance of protecting the habitat of the cranes
will ensure that the problem of illegal trade is tackled from the source.
We provided training to local leaders and security officials and will
work with local school children, setting up conservation clubs to
inspire the future generation of conservationists. We also
plan to work with poachers to support them in finding
alternative means of income and to volunteer as
rangers in the region to report any illegal activities.
continue
ON LOCATION RWAN DA
Volume 56
|
Vetcom
| 39
RWANDA
Dr. Nsengimana using the VetScan VS2.
ON LOC ATION RWANDA
Captive Crane with the registration leg band. Photo credit: Thierry Grobert Rolex
In addition, we recently moved 40 Grey Crowned Cranes
from captivity back to the wild. We had assessed all the
captive cranes and selected those that were most likely
to do well in the wild to be rehabilitated and reintroduced.
This is a momentous achievement and one of the first of
its kind. We built a purpose made quarantine facility and
during the quarantine period, the cranes underwent a
complete physical exam and samples were collected to
test for different diseases.
One crucial component of medical diagnosis of disease
is the clinical chemistry and we could not have conducted
this without the support of ABAXIS. ABAXIS donated
The Avian/Reptilian Profiles Plus for the VetScan VS2
analyzer. These rotors are specific to avian species and
provide 12 blood parameters. Looking at the blood chemistry results of every crane is very important as it gives an
indication of the overall health of the crane and the
Wild Crane in Akagera National Park. Photo credit: Thierry Grobert Rolex
40
|
Vetcom
|
Volume 56
RWANDA
function of specific organs. The blood chemistry results,
alongside haematology, physical examination and disease test results enabled us to make a detailed assessment of every crane. Through this, we could ensure they
were completely healthy before their
reintroduction as well as avoiding the risk
of introducing a new disease to the wild
that could be a threat to other birds or
animals. All blood chemistry analysis we
carried out using the VetScan VS2
analyzer donated for use by the Gorilla
Doctors in Rwanda.
One of the first reintroduced cranes had chicks!
Photo credit: Sarah Hall - Akagera Management Company
Team members processing samples from the cranes during health checks.
For more information on the project please contact
Dr. Olivier Nsengimana at nsengolivier@gmail.com
or follow our the progress of the project at
www.facebook.com/cranesrwanda
Dr. Nsengimana talking to students who study near Rugezi Marshland about
cranes.
ON LOCATION RWAN DA
Once all the cranes were clear of disease and the
quarantine period was complete, they were moved to
the release site at Akagera National Park. The rehabilitation facility gives the cranes time to relearn or remember
behaviours such as foraging that they will need to survive
in the wild, as well as re-grow feathers that were cut in
captivity. During this time, the cranes are supplemented
with food but this is slowly reduced to encourage them
to look for their own food and become less reliant on
people. As we monitor the cranes closely in the rehabilitation facility, we are assessing how they are adapting to
their new environment. The facility has no roof so when
the cranes are ready and able to fly again, they are free
to return to the wild. We hope to take another group of
Grey Crowned Cranes back to the wild in the near future
and hope that one day, we will see flocks of cranes flying
overhead as we used to do years ago.
Previous captive cranes in the quarantine facility.
Volume 56
|
Vetcom
| 41
SPAIN
Animal Embassy
the Message of the Animals
Contributing Authors:
Dr. Matthias Reinschmidt, Zoological Director, Loro Parque Fundación
Dr. David Waugh, Director, Loro Parque Fundación
ON LOCAT ION SPA IN
L
ORO Parque was voted in 2015 the best zoo in Europe
and the second best in the world (by Trip Advisor, the
largest Internet portal for attractions). This is not only a
wonderful appreciation of the work done in Loro Parque
for the animals and visitors, but also an incentive to continue along
the same path. The transparency shown in hundreds of TV documentaries for many years, where the audience can look behind the scenes
of Loro Parque, is what we want to share now with all visitors in
our latest project. Therefore, a completely new part of the park with
more than 2,200 square meters has been developed.
42
|
Vetcom
|
Volume 56
SPAIN
In this area themed as an African village, visitors have
the opportunity, in different pavilions separated by glass
panels, to observe the employees directly in their daily
work without disturbing them. We want to show how much
love and dedication with which our animals are cared for,
but also how much expertise and effort is needed for such
a large animal population, to meet all the needs of the
creatures entrusted to us. We also want to promote respect for animals and the environment among our visitors,
to address our commitment for the preservation of the
planet and nature for future generations. So, in this new
part of the park visitors connect with the animal species
and nature conservation in a wonderfully clear and easily
comprehensible manner.
Continuing the tour, visitors pass in front of two huge
artificial, but completely realistic African baobabs, which
in the base of one is a large aviary for Grey parrots (Psittacus erithacus). Like the group of Blue-headed macaws
(Primolius couloni) in a second aviary, these parrots are
regularly integrated into the research programmes of the
Max Planck Institute and otherwise live in this beautiful
aviary.
On-site diagnostic laboratory - Abaxis, Inc.
In the following pavilion are the Loro Parque laboratories,
which give visitors the chance to see with how much technical equipment the two biologists are working with daily
to manage the essential routine tests of a zoo like Loro
Parque. Thus every day, sometimes several times, in all
pools and ponds at the orcas, dolphins, sea lions, the
aquarium and the lakes water samples are taken, which
are immediately analyzed and evaluated. Furthermore,
many virus tests for parrots, such as Circovirus and Polyomavirus, are also done here.
Volume 56
|
Vetcom
| 43
ON LOC ATION SPA IN
In a tour through “Animal Embassy”, the first African
pavilion encountered houses the Baby Station for parrots.
Here visitors can experience through the glass panes how
our nurses lovingly feed the newly hatched parrot chicks.
They can even see their growing stages and how they
finally perch in a large aviary where they become slowly
independent by starting to fly and, step by step, to eat
alone and become independent from the feeding syringe.
On average three hundred young parrots are reared by
hand here every year, and especially in endangered parrot species this is an important method to maintain and
increase the populations.
The second pavilion is dedicated to research. To this end,
there is collaboration between Loro Parque the renowned
German Max Planck Institute. From a darkened room,
visitors can observe behavioural experiments with different species of parrots. The birds are not disturbed,
because the examination rooms are designed so that
viewers can see inside, but the birds in the rooms cannot
see the audience. The main objective of the research is
to examine in more detail the cognitive abilities of parrots because, as with crows, parrots are among the most
intelligent bird species and many researchers put them on
the same level of intelligence as dogs, dolphins or even
apes. The Director of the international research team is
Princess Auguste von Bayern, who has a doctorate in
biology and internationally known in science circles for
her pioneering research on New Caledonian crows. Thus,
Animal Embassy offers a unique opportunity to learn
more about our parrots and simultaneously therefore the
Zoo supports an important area of ​​research.
ON LOCAT ION SPA IN
SPAIN
This is followed by three grouped pavilions where, with
four visible rooms, the clinic of Loro Parque is located.
Here, visitors also have the opportunity to see live, and
separated only by glass panels, the treatments and even
the operating theatres and to see with how much effort
the three-member veterinary team and technicians work
to help the animals. Visitors can see the X-ray room and
diagnostic work taking place in the clinic’s laboratory
next door. This is where the blood analyses take place,
and where the professional cooperation with Abaxis is
most in evidence. Abaxis has for fourteen years partnered with Loro Parque and the Loro Parque Fundacion to provide an out-standing service and first-class
cooperation. This has included the constant use of an
array of Abaxis blood analyzers, as well as rotors, for
in-house diagnostics, the net result being a much better
understanding of the health of the animal collection, and
consequent improvements in welfare and conservation,
in particular for the parrots. With the analyzers on view
at close range, the visitors can appreciate the extent
of partnership between Loro Parque and Abaxis. This
professional relationship between the two parties has
recently extended into fundamental research, including
to establish blood profiles of parrot chicks as they grow
and develop, and to map the changes that take place in
the profiles over time.
The tour concludes in the largest pavilion, where Loro
Parque Fundación (LPF) is presented. On a video wall, visitors can select each one of the 36 current protection projects
for endangered species by using one of eight front-mounted
tablets. The 30 to 40 second videos are in English, Spanish or German and present the most important things about
the projects that are initiated and supported by LPF. In its 20
years of existence, LPF has invested almost US$ 16 million in 109 different projects. As a result, in more than two
thirds of the projects, the populations of endangered species are increasing again, an effect most clearly seen in the
IUCN Red List. Now, nine species of parrots that have been
supported by LPF in conservation projects in the field have
been down-listed in their threat category due to the positive
population figures, for example, the Yellow-eared Parrot (Ognorhynchus icterotis) and the Lear’s Macaw (Anodorhynchus
leari) from the category “Critically Endangered” to “Endangered.”
In the LPF pavilion the employees are available to answer
any questions. The most relevant is that 100% of the membership fees and donations flows to the conservation projects. Since Loro Parque has committed to pay all maintenance costs of LPF, such as salaries, maintenance, care of
animals, etc., LPF has the possibility to invest all donations
directly for protection programmes. This is an important motivation for visitors to become members or make donations to
the LPF as a result of experiencing Animal Embassy.
Animal Embassy has a lower level, reserved for the staff.
Here the Baby Station, the Max Planck research centre,
the clinic and the Loro Parque Fundación have their spacious administration and service areas. The LPF library is
equipped as a conference room for visitors, students or
student groups of up to 40 participants. Also from Animal
Embassy, videoconferences directly into the classrooms
of schools are regularly conducted. This is an innovative
way by which the educational department of LPF brings the
animals, their needs and the need to protect them, closer
to children and young people, because it is precisely the
children in whom the basics for a sustainable understanding
of nature have to be laid.
44
|
Vetcom
|
Volume 56
SPAIN
L
Founder: Wolfgang Kiessling, President, Loro Parque Fundación
Website: www.loroparque-fundacion.org
Photos: Loro Parque Fundación
Facebook: www.facebook.com/loroparquefundacion
Email: lpf@loroparque-fundacion.org
Volume 56
|
Vetcom
| 45
ON LOC ATION SPA IN
iving every day close to wildlife definitely inspires a
love of nature. In this sense, the most important goal of
Loro Parque with this new facility is that the animals
of the park are the ambassadors of their own species,
raising the awareness of the visitors to support their
conservation in their natural habitats
– the Message of the Animals
VECTOR-BORNE DISEASE
CENTER ESTABLISHED
Kansas State University College of Veterinary Medicine
250,000 KSU Donation for Vector-Borne Research
A
$250,000 gift from diagnostics company Abaxis to the Kansas State University College of Veterinary Medicine
has helped establish the new Center of Excellence for Vector-Borne Disease. The center, publicly launched
April 8, is an interdisciplinary research center with a mission to combat vector-borne diseases, focusing on
pathogenesis, surveillance, and disease prevention.
Roman Ganta, PhD, professor of diagnostic medicine and pathobiology, is director of the center. “This gift will, in
part, allow us to promote the advancement of knowledge on vector-borne diseases of importance to companion and
agricultural animals and humans, including the diseases caused by Ehrlichia, Anaplasma, Rickettsia, and Borrelia
species,” he said.
The center’s goals are to develop programs to prepare future generations of scientists with expertise on vector-borne
diseases, offer continuing education workshop, and develop resources, such as repository to maintain culture stocks of
vector-borne pathogens. The center also hopes to establish a tick-rearing facility.
The center plans to develop a network to build research programs that promote collaborations among Kansas State
University faculty who have shared interests as well as faculty and researchers at other academic institutions and
industry in the U.S. and foreign countries.
“We have followed the excellent work of Dr. Ganta and his group in their pursuit of understanding vector-borne
diseases-including the pathogen’s evasion mechanisms and hosts’ response to these infections. His group brings
together molecular biology, immunology, animal models, and cell culture systems to pursue its goals,” said Dr. Dennis
Bleile, Senior Director of Research and Development at Abaxis.
46
|
Vetcom
|
Volume 56
To watch Dr. Work’s story, visit
vet.abaxis.com/beinspired
“ We chose the Abaxis Line of Products because
we need reliable and cost effective diagnostic
equipment for our busy practice.”
Dr. Lauren Work
Peninsula Equine Medical Center | Menlo Park, CA.
Abaxis customer
It’s not just better diagnostics, it’s a Better way.
800.822.2947
vet.abaxis.com/beinspired
vetscan@abaxis.com
#beinspired
GLOBAL DIAGNOSTICS
Abaxis and VetScan are registered trademarks of Abaxis, Inc. © Abaxis 2015.
Learn more about all of our products and services at www.abaxis.com
Volume 56
|
Vetcom
| 47
To watch Dr. Casuccio’s story,
visit vet.abaxis.com/beinspired
“What I really like about Abaxis is that
they’re a step above in Quality, and the
customer service is extraordinary.”
Dr. Alex Casuccio
Scottsdale Animal Healthcare | Scottsdale, AZ.
Abaxis customer
It’s not just better diagnostics, it’s a Better way.
800.822.2947
vet.abaxis.com/beinspired
vetscan@abaxis.com
#beinspired
GLOBAL DIAGNOSTICS
Abaxis and VetScan are registered trademarks of Abaxis, Inc. © Abaxis 2015.
Learn more about all of our products and services at www.abaxis.com
888-9300 Rev. AP
Download