Newsletter Archives 

  Contents 

• Investigate Haematuria 
• Clin Path Club: first meeting 
• Case Notes : Chronic haematuria in a Boxer 
• Updates 

...Samples for Haematology 
...Virus Transport Medium 
...Post Mortem Cadavers 
• More on Blue Green Algae Poisoning 
• Rabies Blood Testing 
• Tail End 

1. Urinalysis examination of sediment and culture (UACS). If an infection is identified, treat as appropriate and recheck a further sample. If haematuria is persistent, recurrent, or sterile then go to step 2. 
2. Coagulation screen (COAG) which includes a full haemogram, Activated Partial Thromboplastin Time (APTT) and One Step Prothrombin Time (OSPT) in addition a test for von Willebrand's factor (VW) can be performed. See Labfax Manual, Disease Investigation Protocol 5 
3. Plain and contrast radiography and or ultrasound examination of the urinary tract and prostate gland. 
4. If a calculus is identified, reference to crystals seen in the urinary sediment (US) may help to identify the possible composition of the stone but calculi frequently occur without accompanying crystalluria. Specific calculus analysis (CALC) after removal may assist with control of further problems. 
5. If neoplasia or chronic changes are seen in the bladder, prostate or kidney then biopsy via exploratory laparotomy may be required. Ultrasound guided fine needle aspirates/biopsies (CYTF) can be successful. Cytology of a prostatic wash can be performed (CYTO).

See Labfax Manual, Sampling Guide 5. 
6. Prostatic or renal cysts. 
7. Rupture of the urinary bladder or urethra are usually acute presentations. 

If the patient is a cat then sterile cystitis may be the diagnosis. 
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Case Notes 

Chronic haematuria in a Boxer 

A 3 years old male Boxer, was presented with haematuria in November 1998. A urinalysis at the time confirmed the presence of blood together with struvite crystals. Cystitis was diagnosed and treatment with antibiotics and low pH diet was initiated. Regular urinalysis was carried out until over a month the crystalluria and haematuria resolved. A month later the haematuria returned and urinalysis again revealed struvite crystals. Antibiotic treatment, dietary and urine modification were again introduced. In house biochemistry tests had shown no sign of kidney disease. Radiography of the bladder had shown it to be small and thickened but there was no indication of any lesion or other abnormality. 

This pattern of treatment and symptoms continued until August 99 when the dog was submitted with a severe haematuria. Prior to examination a proposal for further investigation was discussed with a pathologist. (Samples were first submitted to NWL in April 99 and there had been no discussion of the case). The possibility of idiopathic haematuria and renal abnormalities were considered and an initial repeat urinalysis suggested, followed by a x-ray examination of the kidneys. The urinalysis showed greater than 250 red blood cells per high power field and on this occasion there were no struvite crystals or inflammatory cells present. Clinical examination did however reveal an enlarged prostate. The clinical history showed that an indication of slight prostate enlargement had been noted on a previous occasion. A decision was made to deal with the prostate. A dose of Tardak was given and 4 days later the patient was castrated. Whilst under anaesthetic it was decided to to x-ray the kidneys. The x-ray revealed an abnormal shape and positioning of both kidneys. Two weeks after surgery there is no evidence of a haematuria. Further investigation of the kidney abnormalities has been suspended for a month pending the outcome of the surgery. 

This case highlights the dilemma of investigating haematuria where you may be dealing with more than one possible cause. If the initial approach to diagnosis is unsuccessful the case should be reassessed and the investigation widened on a step wise basis 
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CLIN PATH CLUB 

First Meeting Arranged 

The first meeting of the NWL Clin Path Club has been arranged for Thursday 14th October at 7.30 pm. The venue is at North Western Laboratories and refreshments will be available from 7.00 pm. 

The objective of the club is to provide an opportunity for veterinary surgeons with an interest in clinical pathology to meet together, exchange knowledge and ideas, discuss cases with an input from the veterinary pathologists at the laboratory. 

We hope the club will become a regular event. At the moment it is proposed that meetings will be held on the second Thursday every other month but this depends upon the support for this first meeting. 

Future meetings will include invited speakers and provide workshops in various aspects of clinical pathology. Initial response has been good but we do need your support if the venture is to take off. 

Please make a note in your diary. Reserve a place now, call 01253 899215 and ask for Alistair Parker. A Location map is also available on request. 

STOP PRESS - Excellent support, only a few places left. 

Updates 
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Samples for Haematology 

To ensure the best possible results from your haematology sample please note the following points:- 

1. Make at least two blood smears using freshly drawn blood ie before adding to the EDTA anticoagulant. This is important in cats where Haemobartonella examination may be required, EDTA can detach the organism from the erythrocytes. 
2. Making blood smears from fresh blood ensures that the morphology of the cells is preserved allowing for a more meaningful appraisal of any abnormal cells which may be present. 
3. Use EDTA anti-coagulant and fill the tube to the capacity mark. Under filling leads to distortion of the cells. Overfilling can result in clot formation. MIX WELL 
4. Check the sample for clots while you still have the patient available for re-sampling. 
5. Reptiles and birds - submit a HEPARIN blood sample but please submit two blood smears as well. 

Item 20 on the Sampling Supplies Order Form is Viral Transport Medium (VTM). This item should only be ordered when required for immediate use. Please do not order for stock. 

VTM contains antibiotics and has a very short shelf life. Store in the refrigerator on arrival. 
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Post Mortem Cadavers 

We occasionally receive requests to return cadavers following post mortem. It is not always practical to do this following a full post mortem and even when it is, the cost of reinstating the cadaver to an acceptable condition adds considerably to the cost of the Post Mortem. 

The alternative is for us to arrange for a cremation and for the return of the ashes. Most owners seem quite happy to accept this alternative. We make no additional charge other than the cost of the cremation. Please enquire for an indication of cost. 

BEWARE 

Toxic Shellfish 

Following on from the item last issue about blue green algae toxins. A news item this summer reports that scallop fishing off the west coast of Scotland has been banned. Shellfish such as Scallops have been found to be contaminated with the toxin demoic acid. People who consume this toxin can suffer from Amnesic Shellfish Poisoning, with symptoms including nausea, numbness and permanent memory loss. 

The acid is produced by blooms of algae such as Pseudonitzchia that are eaten by the scallops. Shell fishermen and environmentalists blame the blooms on nutrients discharged from fish farms, but the Scottish government says the blooms are a natural phenomenon. 
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RABIES 

Pets Travel Scheme 

On the 3rd August the government announced the details of the new Pet Travel Scheme (PETS) for short. The scheme is to replace the 100 year old Rabies quarantine scheme. 

To qualify for entry or re-entry to the UK under the scheme, owners must have their pet:- 

• Microchip identified 
• Vaccinated 6 months before import or export 
• Blood tested within 30 days of vaccination by a recognised laboratory to check immunity. 

Further information for pet owners and veterinary surgeons is available from the following web sites :- 

http://www.maff.gov.uk/animalh/quarantine/index.htm

Rabies Blood Testing 

Currently the only laboratory accredited for rabies blood testing in the UK is MAFF CVL Weybridge. 
We hope to be able to provide a testing service but this is unlikely to be available before October 2000. 
Testing requires category 4 containment and compliance with a very stringent accreditation procedure. 
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Tail End 

Emu egg dust poses threat to Viagra 

Australian Emu farmers have recently started marketing powdered Emu eggs overseas as an aphrodisiac. In Asia the product is seen as an alternative to Rhino horn and Tiger bone. The product is proving popular in China and tests run by the Pioneer Trading Company in England say the product has raised (sic) a lot of interest. 

World Poultry Vol 15, No 6, 1999. 
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