Veterinary Lab Request Form: Urine, Faeces, Fluid Analysis

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LABORATORY NO.
OWNER’S NAME AND ADDRESS
SPECIES
ANIMAL’S NAME
BREED
PRIMARY COMPLAINT
AGE
SEX
SAMPLING DATE AND TIME
DURATION OF ILLNESS
TYPES OF SAMPLE(S)
CLINICIAN/PRACTICE
CHARGE TO
LABORATORY REQUESTS
URINE CHEMISTRY
ROUTINE URINE ANALYSIS
CORTISOL (nmol/l):
SPECIFIC GRAVITY:
PROTEIN (g/l):
pH:
CREATININE (umol/l):
BLOOD:
BILIRUBIN:
GLUCOSE:
ACETONE:
URINARY CALCULI ANALYSIS
PROTEIN:
DEPOSIT:
FAECAL PARASITES
FLUID ANALYSIS
STRONGYLES (eggs/g):
APPEARANCE:
ASCARIDS
(eggs/g):
SPECIFIC GRAVITY:
(eggs/g):
PROTEIN (g/l):
(eggs/g):
CELL COUNT (x109/L):
COCCIDIA:
GIARDIA:
CYTOLOGY (MONO/PMN DIFF [SYNOVIAL FLUID ONLY]):
FLUKE (eggs):
ANOPLOCEPHALA (eggs):
FAECAL OCCULT BLOOD:
CYTOLOGY (DETAILED):
OTHER TESTS/COMMENTS
ECTOPARASITES
CLINICAL LABORATORY | EASTER BUSH PATHOLOGY | THE (ROYAL) DICK SCHOOL OF VETERINARY STUDIES | UNIVERSITY OF EDINBURGH | EASTER BUSH CAMPUS | MIDLOTHIAN EH25 9RG
Tel 0131 651 7458 fax 0131 650 6599 email ebp.enquiries@ed.ac.uk
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