I’ve written before about changes in the veterinary world since I qualified as a vet: I still find it hard to believe that it’s now thirty eight years ago. This week, I want to focus on one aspect that has made more difference than any other factor to the diagnosis of illnesses in pets in vet clinics around Ireland: the in-house practice laboratory.
Back in the 1980’s, vets were unable to carry out many diagnostic tests in their clinics. We could do basic urine tests: “dip sticks” to check for sugar and protein, and a device to measure the concentration of the urine. But that was the sum of it.
Then in the 1990’s, the first automated blood biochemistry machines were introduced. Our clinic in Bray was one of the first in the country to install one of these. It was called the Vettest – a machine about the size of a flattened microwave oven. A sample of blood was placed into a slot, and the Vettest had automated internal mechanisms that placed a drop of blood on a series of up to a dozen slides. These were then passed beneath a scanner that measured the colour change on each slide. This allowed up to a dozen biochemical parameters to be measured in the animal’s blood.
Most people will have some knowledge of these types of tests from having them carried out on themselves: chemicals like urea and creatinine (giving information on how well the kidneys are working), glucose (allowing instant diagnosis of a diabetic pet), enzymes like ALT, ALKP and GGT (which are higher than normal if the liver is damaged) as well as amylase and lipase (used to diagnose inflammation of the pancreas, known as pancreatitis).
Before this machine was available, vets would only be able to suspect serious illnesses, and they would have to send blood samples off to external professional laboratories. While a next-day service might be available, if a crisis happened on a Friday night, at the weekend, or on public holidays, there was always a long delay until results were available. This meant that acutely ill animals might have to be given a general treatment, with only a provisional diagnosis, for several days. Now that an immediate diagnosis was available, instant treatment, of the optimal kind for the specific condition, could be given.
So if I see a cat that has stopped eating, I can immediately work out if he has liver disease, kidney disease or diabetes, and each of these conditions needs a different type of treatment. If a dog is vomiting, I am now able to make an on-the-spot diagnosis of pancreatitis. These diagnoses could never have been made so quickly before. There’s no doubt that the Vettest must have saved many pets’ lives.
Over the past twenty years, that original type of Vettest machine has been continually updated and improved. The latest version can test for up to 39 animal species and 26 parameters in just 6 minutes, and it’s used by over thirty thousand vets around the world. It has become almost standard for many companion animal veterinary clinics to offer this type of service.
There are now many variants of the Vettest, with competing companies offering similar types of machines. The original basic list of tests that were available has been expanded, and it’s now possible to measure extra profiles, including some types of hormonal assays.
New machines are now also available that are about to carry out analyses of the cells in blood samples, a service known as “haematology”. This can instantly tell vets if a pet has a raised white blood cell count (which indicates infection or inflammation) or a reduced red blood cell count (which indicates anaemia), as well as many other variations of abnormalities. In-house blood cell counters work well as screening tools, working out if an animal has a normal blood cell profile. If a strange abnormality is found, the external professional laboratory may then be used so that a clinical pathologist can check the subtleties of a diagnosis with a detailed review.
In-house laboratories also have a range of other tests that can be done immediately: these are plastic kits that are kept in the fridge. Some of them are similar to the COVID test that we have all grown used to in the past three years. These can be used to diagnose serious animal viral infections, such as Lungworm and Parvovirus in dogs, and Feline Leukaemia and Feline Immunodeficiency Virus (Cat AIDS) in cats. The rapid diagnosis means that the most appropriate treatment can be given at once, rather than having to wait for a few days until the external laboratory has reported back to the clinic.
A good quality microscope is another part of an in-house laboratory, and this has multiple uses, from checking out faeces samples for parasites, viewing skin scrapes (looking for mites that can make pets itchy), looking at urine sediment (crystals and stones are common, and it’s important to identify them precisely so that the right treatment can be given), looking at ear swabs (checking to see what bugs are making the ear so sore), and these days, examining simple biopsies from lumps and bumps. The advent of digital imaging means that if something odd is seen under the microscope, it’s easier than ever to send it off to an expert for a second opinion.
For rapid and accurate diagnoses of sick pets, the in-house practice laboratory has been a game-changer.