Today’s in-house laboratories allow veterinarians to test patients’ blood for an increasing range of conditions and diseases—but what’s news about the devices is how practitioners are using them. Besides using analyzers to test sick patients, clinicians are also using them to keep them well. Kate Hunter, DVM, invested in a blood chemistry analyzer 15 years ago when she opened her practice, Carver Lake Veterinary Center in Woodbury, Minn. “We felt it was important to be able to do pre-surgical testing on all surgical patients and to be able to provide diagnostics on sick patients right away,” she says. By testing her surgical patients before the procedures, she says she and her team can identify the 10 percent of patients that have underlying disease and delay surgery or tailor their anesthetic protocol appropriately. The Good and the Bad “When we’re presented with sick patients, [in-house testing] has allowed us to discuss both normal and abnormal results face-to-face with owners at the time of their appointments,” Dr. Hunter says. “We are then able to provide any additional diagnostics or treatment needed right away. This has improved compliance and value.” The approach has worked so well that she expanded her program to include wellness testing for senior pets, she says. “This has allowed us to assure clients with older pets that we can go ahead with any needed surgical procedures, such as treatment for dental disease or lump removals,” Hunter says. “It also allows us to identify disease processes before the pet has shown signs; we can start any treatments early to reduce costs, improve the prognosis and limit suffering by the pet.” She says her clients love getting results right away. “It adds a significant value to them. They can discuss the results face-to-face with the doctor and begin treatments right away, without telephone tag or an additional visit to the clinic,” she says. Craig Tockman, DVM, director of professional services for Abaxis North American Animal Health in Union City, Calif., says Hunter’s wellness testing illustrates practitioners’ increased push toward better patient care and customer service. “A lot of veterinarians use their in-house laboratories for the sick or critical patients and send the rest out,” he says. “But when you add a wellness program and run lab work in-house, you reduce the need for the client to come back for additional follow-ups. You get the results immediately.” Survey Says … The recent Bayer Veterinary Care Usage Study offers insight into today’s pet owners, Dr. Tockman says. Clients want to keep their pets healthy and thriving as long as possible, but they’re also keeping an eye on their finances and resources. The study reported that half of dog- and cat-owning respondents said they would take their pets to the veterinarian more often if visits were less expensive. It also reported that more than half would take their pets in if they knew the visit could prevent problems and expensive treatments later on. One way to catch problems before they surface, Tockman says, is wellness testing. “The study also said people would come in more frequently and more regularly if they believe that by coming in they would extend the life of their pet,” he says. “So can we provide that feeling with only a vaccine visit and a physical exam? Will the client understand how that might help their pets live longer? “The reality is that blood work is what does that for you,” Tockman continues. “Blood work, with real hard numbers and data, says your pet is healthy or your pet is getting unhealthy internally. It’s a tremendous addition to a practice.” Besides providing that instant information to clients, in-house laboratory testing may also improve pet owner compliance, says Cheryl Roge, DVM, former director of professional services for scil Animal Care Company in Gurney, Ill. Rather than send the samples out, wait for the results to come back, contact the pet owner and arrange for a follow-up appointment, practitioners can start treatment on sick animals right away, she says. “Sometimes, there’s nothing to be gained by waiting,” Dr. Roge says. “I can take care of these patients as they come in, as they flow through my clinic, meeting their needs as well as I possibly can. It also cuts down on my calls at the end of the day.” In-house blood analyzers allow clinics the flexibility to improve customer service, implement additional diagnostics if necessary and implement medications without a return visit, Tockman says. “That’s particularly important for clients with cats,” he notes. “They don’t like getting in the car and coming in any more than they have to.” Reference Labs Still Needed Today’s in-house analyzers can test for a range of diseases, including giardiasis and parvovirus, as well as do complete blood counts and chemistry panels, test thyroid function and more, Tockman says. Do they deliver better results than a reference laboratory? Yes, in some cases, he says. “First, when you have the sample and you run it immediately, you know that it’s the sample from that patient,” he says. “Second, fresh is better, no matter what. So when we’re running blood within five minutes of taking it from the patient, that’s going to be a better sample than one that’s put into a plastic bag, into an ice chest, into a car and driven to a lab.” Analyzers designed to run their own quality control checks make it even easier for practitioners, Hunter says, adding that she performs her own quality-control tests quarterly, comparing her results to a reference laboratory to ensure equipment accuracy. She says that having the equipment in-house benefits her practice all the way around. “Because the equipment is so easy to use and maintain, it does not take up much staff time,” she says. “Compared to the steps needed to send samples to an outside lab, including the logging we do, it actually takes less staff time to run our lab work in-house. That, in addition to the increased compliance, has made our in-house laboratory an excellent investment.” She says she still uses a reference laboratory for tests she can’t run in-house, such as cytopathology and microbiology. Some offices with bare-bones staff, however, may not have the time to run laboratory work, particularly for healthy patients, notes Jeff Mayo, DVM, Dipl. ABVP, a mobile surgeon based in Mountlake Terrace, Wash. That’s where outside references laboratories fit the bill. “Busy clinics don’t always have time to stop and run what they think might be normal blood work, so they’ll still send them out,” Mayo says. “The way the economy is, a lot of veterinary clinics are running really lean on employees,” he continues. “If one veterinarian needs to go to surgery and another needs to see patients in the room, and they only have two technicians, that doesn’t allow the tech to utilize his/her time to go run what may be a normal blood test.” Though Tockman says most—if not all—veterinary clinics and hospitals can benefit from such in-house diagnostic tools, he says outside reference laboratories are still necessary. “Nobody can do every test in house,” he says, noting that Abaxis is opening a reference laboratory this year near Kansas City in conjunction with Kansas State University. “There’s always the need for a reference lab, and there always will be the need for a reference lab. What you can run in house, you should run in house, and what you can’t, we’ll send out to a reference lab.” 10/21/2011 5:33 PM
