What could be more important than making your clients’ clinic experience as convenient as possible? How about better protecting the health of their pets by adding capabilities to your practice? Of course, nothing says you can’t do both, notes Gary D. Norsworthy, DVM, Dipl. ABVP (feline practice). Convenience and cutting-edge care are at the heart of his clinic’s shift to in-house lab analysis. Dr. Norsworthy’s hospital, Alamo Feline Health Center in San Antonio, sees cases of hyperthyroidism and kidney disease every day. That’s a key reason he and his colleagues added an in-house blood analysis system six or seven years ago, he says. The clinic still uses a commercial lab for some of its more comprehensive profiles, but it now does the bulk of its lab work in-house, “And the biggest advantage of our equipment is I can get answers from tests in less than 15 minutes,” Norsworthy adds. That means clients get the convenience of swift test results and a diagnosis without having to make a follow-up trip to the veterinary office. With three doctors and six exam rooms, Alamo Feline Health Center prides itself on its efficiency as well as its clinical expertise. “If I’m examining for weight loss,” Norsworthy notes, “I can say, ‘There’s a concern about diabetes, renal disease and hyperthyroidism. If you can wait 15 minutes, we can do some testing and I can be back with some numbers.’ ” When he returns with lab results and a diagnosis, clients often are amazed, Norsworthy says. Their experiences with lab work tell them to expect results in a week or more. Convenience and client satisfaction might be enough to make the case for in-house testing. But the kicker is the difference it makes in compliance and quality of care, he says. If the diagnosis is hyperthyroidism, he can be sure clients won’t leave without the prescribed tablets and that they will know how to administer them. “I at least know the cat is going to get an immediate start on treatment,” he says. In-house analysis also provides a big advantage in kidney cases where rechecks are necessary, Norsworthy adds. “If electrolytes or kidney values are not where they need to be—if phosphorous levels are up and potassium down, if we need to make a change in medication—we can send something new home with the client. We can put the medication in their hand, and that makes a big difference when it comes to compliance.” That difference can be life-sustaining for pets facing debilitating illness, Norsworthy says. For instance, if the feline patient is at risk for diabetic ketoacidosis, “You need to have an answer in minutes so you can start an IV catheter,” he says. “Some of these cats are really in crisis. I’ve seen dozens of cases where kidney values are very high and electrolytes are off badly. In these cases, one day can make a huge difference. “If you have a cat that has found its way into some antifreeze, that will cause kidney failure, and if it’s not diagnosed and the treatment started within six hours, the kidneys will be past the point of no return. “If you have to wait for blood work to come back tomorrow, it’s too late.” Norsworthy has become such a devoted convert to in-house testing that he now has three analyzers, all in the Abaxis VetScan family. “After I bought one machine, I got to using it so much I started thinking, ‘If this machine goes down, I’m going to lose hundreds of dollars each day it’s out of service.’ So I bought a second, and now that I have three, it really allows us to keep the flow going. With three doctors, things are much more efficient.” When he first made the leap to in-house testing, Dr. Norsworthy wanted to confirm the accuracy of his results. So he divided samples from about 20 cats with thyroid disease, sending one set to a commercial lab, keeping one set in-house and sending the third to the endocrinology lab at the College of Veterinary Medicine at Michigan State University, which Norsworthy considers the gold standard for feline hyperthyroidism testing. His clinic’s results were “at least as good as those of Michigan State and the commercial lab,” he says. “It was very satisfying to know we were getting reliable numbers.” The reliability of test results and the dependability of equipment are both critical, Norsworthy says, but he also advises practitioners to evaluate analyzers by their physical footprint. Some are “monsters,” he notes—too big for a veterinary hospital that’s already short on space. His other big consideration? Ease of use. “The equipment we have is so easy,” he says, “I think I could train some of my patients to use it.” This article first appeared in the September 2009 issue of Veterinary Practice News <HOME>
