Details

Low-Cost Veterinary Clinical Diagnostics

1. Aufl.

von: Ryane E. Englar, Sharon M. Dial
84,99 €
Verlag:	Wiley-Blackwell
Format:	EPUB
Veröffentl.:	23.11.2022
ISBN/EAN:	9781119714569
Sprache:	englisch
Anzahl Seiten:	368

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Beschreibungen

Titelbeschreibung

Low-Cost Veterinary Clinical Diagnostics A practical guide to maximizing the diagnostic value of in-house quick assessment tests (QATs) In Low-Cost Veterinary Clinical Diagnostics, the authors provide a hands-on resource designed to facilitate healthcare delivery across the spectrum of care. Historically, clinicians have been taught to apply the gold standard approach to the practice of medicine. However, recent advances in veterinary medical care and associated technologies have made practitioners question whether a one-size-fits-all approach is truly best. After all, when we perform diagnostic tests, are we testing out of the desire for completeness, to cover all bases for the good of the patient? Or are we testing because we are expected to? The reality is that gold standard care is not always advisable and not always possible. In clinical practice, veterinarians frequently encounter obstacles that limit their approaches to case management. Cost of care is a significant constraint that requires practitioners to rethink which diagnostic tests are essential. Not every patient requires a complete blood count (CBC), chemistry profile, urinalysis, and fecal analysis to obtain diagnostic value. This text suggests that the “best” approach to case management be determined by the situation, the context, the patient, and the client. While sophisticated panels of tests may remain the recommended approach to case management, Low-Cost Veterinary Clinical Diagnostics outlines entry-level, in-house diagnostic blood, urine, fecal, and body cavity fluid tests: how to perform them as well as the breadth and depth of patient-specific data that can be gleaned from quick assessment tests (QATs). Readers will also find: <ul><li>A thorough introduction to patient care considerations, communication strategies that facilitate cost-conscious shared decision-making</li> <li>Comprehensive explorations of quick assessment tests (QATs) in hematology, including packed cell volume (PCV), total solids (TS), buffy coat analysis, blood smears, blood glucose, blood urea nitrogen (BUN), saline agglutination tests, and activated clotting time.</li> <li>Practical discussions of quick assessment tests (QATs) involving urine, including urine color, dipstick analysis, specific gravity (USG), and urine sediment analysis</li> <li>Pragmatic evaluation of fecal analysis, including considerations surrounding fecal color, volume, consistency, and odor; saline smears or wet mounts, and fecal flotation.</li> <li>Discussion on body cavity fluid analysis</li> <li>Sample case vignettes, complete with question and answer (Q&A)</li></ul> Perfect for veterinary practitioners, veterinary technicians, veterinary and veterinary technician students, Low-Cost Veterinary Clinical Diagnostics offers a quick and easy reference guide to maximizing diagnostic value in those cases where care is cost-prohibitive.

Inhaltsverzeichnis

About the Authors xiv About the Contributors xvii Preface xviii Acknowledgments xxi Part 1 Patient Care Considerations 1 1 The Gold Standard, Standards of Care, and Spectrum of Care: An Evolving Approach to Diagnostic Medicine 3 Ryane E. Englar 1.1 Defining the Gold Standard 3 1.2 Limitations of the Gold Standard 4 1.3 Returning to the Case of the Cat with Stranguria: a Different Perspective on Standards of Care 4 1.4 Limitations to Standards of Care 5 1.5 Spectrum of Care 6 References 7 2 Consultation Room Communication Strategies that Facilitate Dialogue on the Diagnostic Approach to Patient Care 9 Ryane E. Englar 2.1 Emergence of Communication as a Clinically Relevant Skill in Human Health Care 9 2.2 The Evolution of Communication in Veterinary Health Care 10 2.3 Communication Skills That Are Essential to Diagnosis-Making 11 2.4 Concepts of Health Literacy and Compliance 13 2.5 Using Easy-to-Understand (Nonmedical) Language 14 2.6 Checking in 15 2.7 Assessing the Client’s Knowledge 17 2.8 Signposting 18 2.9 Addressing the Cost of Care 20 References 22 Part 2 Quick Assessment Tests (QATS) Involving Blood 27 3 Packed Cell Volume 29 Sharon M. Dial 3.1 Procedural Definition: What Is this Test About? 29 3.2 Procedural Purpose: Why Should I Perform this Test? 29 3.3 Equipment 29 3.4 Procedural Steps: How Do I Perform this Test? 30 3.5 Time Estimate to Perform Test 33 3.6 Procedural Tips and Troubleshooting 33 3.7 Interpreting Test Results 34 3.8 Clinical Case Example(s): Can We Link to the Cases in Chapter 5? 35 3.9 Add-On Tests That You May Need to Consider and Their Additive Value 35 3.10 Key Takeaways 36 References 36 4 Total Protein as Measured by Refractometry 37 Sharon M. Dial 4.1 Procedural Definition: What Is This Test About? 37 4.2 Procedural Purpose: Why Should I Perform this Test? 37 4.3 Equipment 38 4.4 Procedural Steps: How Do I Perform this Test? 38 4.5 Time Estimate to Perform Test 42 4.6 Procedural Tips and Troubleshooting 43 4.7 Interpreting Test Result 43 4.8 Clinical Case Example(s) 44 4.9 Add-On Tests That You May Need to Consider and Their Additive Values 44 4.10 Key Takeaways 44 Reference 45 Suggested References 45 5 Gross and Microscopic Evaluation of the Buffy Coat 46 Sharon M. Dial 5.1 Procedural Definition: What Is This Test About? 46 5.2 Procedural Purpose: Why Should I Perform this Test? 46 5.3 Equipment 47 5.4 Procedural Steps: How Do I Perform this Test? 47 5.5 Time Estimate to Perform Test 50 5.6 Procedural Tips and Troubleshooting 53 5.7 Interpreting Test Results 53 5.8 Clinical Case Example(s) 54 5.9 Add-On Tests That You May Need to Consider and Their Additive Value 54 5.10 Key Takeaways 54 Reference 54 6 The Blood Film 55 Sharon M. Dial 6.1 Procedural Definition: What Is This Test About? 55 6.2 Procedural Purpose: Why Should I Perform This Test? 55 6.3 Equipment 55 6.4 Procedural Steps: Preparing the Blood Film How Do I Perform This Test? 56 6.5 Time Estimate to Perform Test 64 6.6 Procedural Tips and Troubleshooting 64 6.7 Interpreting Test Results 69 6.8 Clinical Case Example(s) 70 6.9 Add-On Tests That You May Need to Consider and Their Additive Value 70 6.10 Key Takeaways 70 References 70 Suggested Bench-Side Reference 71 7 Blood Glucose 72 Sharon M. Dial 7.1 Procedural Definition: What Is This Test About? 72 7.2 Procedural Purpose: Why Should I Perform This Test? 72 7.3 Equipment 73 7.4 Procedural Steps: How Do I Perform This Test? 73 7.5 A Note on Quality Control 73 7.6 Procedure for Patient Samples 74 7.7 Time Estimate to Perform Test 76 7.8 Procedural Tips and Troubleshooting 76 7.9 Interpreting Test Results 77 7.10 Clinical Case Example(s) 78 7.11 Add-On Tests That you May Need to Consider and Their Additive Values 78 7.12 Key Takeaways 78 References 78 8 Blood Urea Nitrogen 79 Sharon M. Dial 8.1 Procedural Definition: What Is This Test About? 79 8.2 Procedural Purpose: Why Should I Perform This Test? 79 8.3 Equipment 80 8.4 Procedural Steps: How Do I Perform this Test? 80 8.5 Time Estimate to Perform Test 81 8.6 Procedural Tips and Troubleshooting 81 8.7 Interpreting Test Results 82 8.8 Clinical Case Example(s) 82 8.9 Add-On Tests That You May Need to Consider and Their Additive Value 82 8.10 Key Takeaways 83 9 Whole Blood Lactate 84 Sharon M. Dial 9.1 Procedural Definition: What Is This Test About? 84 9.2 Procedural Purpose: Why Should I Perform This Test? 84 9.3 Equipment 85 9.4 Procedural Steps: How Do I Perform This Test? 85 9.5 A Note on Quality Control 85 9.6 Procedure for Patient Samples 85 9.7 Time Estimate to Perform Test 87 9.8 Procedural Tips and Troubleshooting 87 9.9 Interpreting Test Results 87 9.10 Clinical Case Example(s) 88 9.11 Add-On Tests That You May Need to Consider and Their Additive Value 88 9.12 Key Takeaways 88 References 88 10 Saline Agglutination Test 89 Sharon M. Dial 10.1 Procedural Definition: What Is This Test About? 89 10.2 Procedural Purpose: Why Should I Perform This Test? 89 10.3 Equipment 89 10.4 Procedural Steps: How Do I Perform This Test? 89 10.5 Time Estimate to Perform Test 91 10.6 Procedural Tips and Troubleshooting 91 10.7 Interpreting Test Results 92 10.8 Clinical Case Example(s) 92 10.9 Add-On Tests That You May Need to Consider and Their Additive Value 92 10.10 Key Takeaways 92 Reference 93 11 Activated Clotting Time 94 Sharon M. Dial 11.1 Procedural Definition: (“What Is This Test About?”) 94 11.2 Procedural Purpose: Why Should I Perform This Test? 94 11.3 Equipment 94 11.4 Procedural Steps: How Do I Perform This Test? 94 11.5 Time Estimate To Perform Test 96 11.6 Procedural Tips and Troubleshooting 97 11.7 Interpreting Test Results 97 11.8 Clinical Case Example(s) 97 11.9 Add-On Tests That You May Need to Consider and Their Additive Value 97 11.10 Key Takeaways 97 Part 3 Quick Assessment Tests (QATS) Involving Urine 99 12 Assessing Urine’s Physical Properties 101 Ryane E. Englar 12.1 Procedural Definition: What Is This Test About? 101 12.2 Procedural Purpose: Why Should I Perform This Test? 101 12.3 Equipment 102 12.4 Procedural Steps 103 12.5 Time Estimate to Perform Test 105 12.6 Procedural Tips and Troubleshooting 105 12.7 Interpreting Test Results 106 12.8 Clinical Case Example(s) 111 12.9 Add-On Tests That You May Need to Consider and Their Additive Value 113 12.10 Key Takeaways 113 12.11 Clinical Pearls 114 References 115 13 Urine Specific Gravity 116 Ryane E. Englar 13.1 Procedural Definition: What Is This Test About? 116 13.2 Procedural Purpose: Why Should I Perform this Test? 117 13.3 Equipment 117 13.4 Procedural Steps 118 13.5 Time Estimate to Perform Test 124 13.6 Procedural Tips and Troubleshooting 124 13.7 Interpreting Test Results 124 13.8 Clinical Case Example(s) 126 13.9 Add-On Tests That You May Need to Consider and Their Additive Value 127 13.10 Key Takeaways 127 13.11 Clinical Pearls 127 References 128 14 Chemical Evaluation of Urine 130 Ryane E. Englar 14.1 Procedural Definition: What Is This Test About? 130 14.2 Procedural Purpose: Why Should I Perform This Test? 132 14.3 Equipment 132 14.4 Procedural Steps 132 14.5 Time Estimate to Perform Test 136 14.6 Procedural Tips and Troubleshooting 136 14.7 Interpreting Test Results 138 14.8 Clinical Case Example(s) 141 14.9 Add-On Tests That You May Need to Consider and Their Additive Value 142 14.10 Key Takeaways 143 14.11 Clinical Pearls 144 References 145 15 Urine Sediment Examination 146 Sharon M. Dial 15.1 Procedural Definition: What Is This Test About? 146 15.2 Procedural Purpose: Why Should I Perform This Test? 146 15.3 Equipment 147 15.4 Procedural Steps: How Do I Perform This Test? 147 15.5 Time Estimate to Perform Test 149 15.6 Procedural Tips and Troubleshooting 151 15.7 Interpreting Test Results 152 15.8 Clinical Case Example(s) 157 15.9 Add-On Tests That You May Need to Consider and Their Additive Value 157 15.10 Key Takeaways 157 Reference 157 Suggested Bench-Side References 158 Part 4 Quick Assessment Tests (QATS) Involving Feces 159 16 Assessing the Physical Properties of Fecal Matter 161 Ryane E. Englar 16.1 Procedural Definition: What Is This Test About? 161 16.2 Procedural Purpose: Why Should I Perform This Test? 161 16.3 Equipment 164 16.4 Procedural Steps 166 16.5 Time Estimate to Perform Test 166 16.6 Procedural Tips and Troubleshooting 166 16.7 Interpreting Test Results 172 16.8 Clinical Case Example(s) 183 16.9 Add-On Tests That You May Need to Consider and Their Additive Value 183 16.10 Key Takeaways 185 16.11 Clinical Pearls 186 References 187 17 Direct Smears 191 Ryane E. Englar 17.1 Procedural Definition: What Is This Test About? 191 17.2 Procedural Purpose: Why Should I Perform This Test? 191 17.3 Equipment 194 17.4 Procedural Steps [1–5, 20, 30, 60–62] 194 17.5 Time Estimate to Perform Test 196 17.6 Procedural Tips and Troubleshooting 196 17.7 Interpreting Test Results 197 17.8 Clinical Case Example(s) 198 17.9 Add-On Tests That You May Need to Consider and Their Additive Value 201 17.10 Key Takeaways 203 17.11 Clinical Pearls 204 References 204 18 Fecal Flotation 207 Ryane E. Englar and Jeremy Bessett 18.1 Procedural Definition: What is This Test About? 207 18.2 Procedural Purpose: Why Should I Perform This Test? 210 18.3 Options Available for Fecal Flotation 211 18.4 Equipment 213 18.5 Procedural Steps: Fecal Flotation with Fixed-Angle Centrifuge [1–4, 8, 11, 22, 23, 28] 213 18.6 Time Estimate to Perform Fecal Flotation with Fixed-Angle Centrifuge 216 18.7 Brief Consideration of the Procedural Steps in the Event a Swinging Bucket Centrifuge Is Used 217 18.8 Equipment 217 18.9 Procedural Steps 217 18.10 Time Estimate to Perform Passive Fecal Flotation 221 18.11 Procedural Tips and Troubleshooting for Fecal Flotation 221 18.12 Interpreting Test Results 221 18.13 Clinical Case Example(s) 227 18.14 Add-On Tests That You May Need to Consider and Their Additive Value 227 18.15 Key Takeaways 229 18.16 Clinical Pearls 229 References 230 Part 5 Quick Assessment of Body Cavity Fluids 235 19 Body Cavity Fluid Analysis 237 Sharon M. Dial 19.1 Procedural Definition: What Is This Test About? 237 19.2 Procedural Purpose: Why Should I Perform This Test? 237 19.3 Equipment 238 19.4 Procedural Steps: How Do I Perform This Test? 238 19.5 Time Estimate to Perform Test 240 19.6 Procedural Tips and Troubleshooting 240 19.7 Interpreting Test Results 241 19.8 Clinical Case Example(s) 244 19.9 Add-On Tests That You May Need to Consider and Their Additive Value 244 19.10 Key Takeaways 245 References 245 Suggested Bench-Side References 245 Part 6 Clinical Cases 247 20 Clinical Cases 249 Jeremy Bessett, with support from Sharon M. Dial Case 1: Fred 249 Case 2: Bella 253 Case 3: Benji 258 Case 4: Mittens 266 Case 5: Star 272 Case 6: Earl 277 Case 7: Sammy 281 Case 8: Coffee 286 Case 9: Dexter 291 Case 10: Tabitha 297 Case 11: Ace 301 Case 12: Timothy 304 Case 13: Duckie 307 Case 14: Angel 311 Case 15: Chase 314 Index 321

Autorenportrait

Ryane E. Englar, DVM, DABVP (Canine and Feline Practice) is Executive Director of Clinical and Professional Skills and Associate Professor at the University of Arizona College of Veterinary Medicine in Oro Valley, Arizona, USA. Sharon M. Dial, DVM, Ph.D., DACVP (Clinical and Anatomic Pathology) is Research Scientist at the University of Arizona College of Veterinary Medicine in Oro Valley, Arizona, USA.

Back cover copy

A practical guide to maximizing the diagnostic value of in-house quick assessment tests (QATs) In Low-Cost Veterinary Clinical Diagnostics, the authors provide a hands-on resource designed to facilitate healthcare delivery across the spectrum of care. Historically, clinicians have been taught to apply the gold standard approach to the practice of medicine. However, recent advances in veterinary medical care and associated technologies have made practitioners question whether a one-size-fits-all approach is truly best. After all, when we perform diagnostic tests, are we testing out of the desire for completeness, to cover all bases for the good of the patient? Or are we testing because we are expected to? The reality is that gold standard care is not always advisable and not always possible. In clinical practice, veterinarians frequently encounter obstacles that limit their approaches to case management. Cost of care is a significant constraint that requires practitioners to rethink which diagnostic tests are essential. Not every patient requires a complete blood count (CBC), chemistry profile, urinalysis, and fecal analysis to obtain diagnostic value. This text suggests that the “best” approach to case management be determined by the situation, the context, the patient, and the client. While sophisticated panels of tests may remain the recommended approach to case management, Low-Cost Veterinary Clinical Diagnostics outlines entry-level, in-house diagnostic blood, urine, fecal, and body cavity fluid tests: how to perform them as well as the breadth and depth of patient-specific data that can be gleaned from quick assessment tests (QATs). Readers will also find: <ul><li>A thorough introduction to patient care considerations, communication strategies that facilitate cost-conscious shared decision-making</li> <li>Comprehensive explorations of quick assessment tests (QATs) in hematology, including packed cell volume (PCV), total solids (TS), buffy coat analysis, blood smears, blood glucose, blood urea nitrogen (BUN), saline agglutination tests, and activated clotting time.</li> <li>Practical discussions of quick assessment tests (QATs) involving urine, including urine color, dipstick analysis, specific gravity (USG), and urine sediment analysis</li> <li>Pragmatic evaluation of fecal analysis, including considerations surrounding fecal color, volume, consistency, and odor; saline smears or wet mounts, and fecal flotation.</li> <li>Discussion on body cavity fluid analysis</li> <li>Sample case vignettes, complete with question and answer (Q&A)</li></ul> Perfect for veterinary practitioners, veterinary technicians, veterinary and veterinary technician students, Low-Cost Veterinary Clinical Diagnostics offers a quick and easy reference guide to maximizing diagnostic value in those cases where care is cost-prohibitive.