Clinical Connections  –  Spring 2018

The rapid turnaround of clinical pathology cases at the RVC can mean the difference between life and death for an animal, whether treated by RVC clinicians or vets in the wider community. 

The bulk of the haematology, biochemical, endocrinology and cytology samples sent to the clinical pathology team are for cases from RVC clinicians. However, the service also takes cases from veterinary practices around the UK, as well as zoos, other wildlife collections and charities (e.g. Battersea, Dogs Trust).

In addition to the same day turnaround for routine tests on samples received before 1:30pm, the pathologist working on a case is happy to speak to vets to discuss findings and suggest possible further investigation. This can help vets in practice target their approach to casework up, especially with unusual or unexpected diagnoses.

As the RVC team is relatively small compared to large corporate labs, the same pathologist tends to deal with or have knowledge of the majority of samples from an animal throughout its patient journey. This continuity is useful in terms of communication with treating vets and patient diagnosis, meaning that the pathologist can have a working diagnosis from previously submitted samples and an awareness of the case as a whole rather than just a scientific sample to be examined.

Rapid and accurate case handling by the RVC can save lives by enabling vets to quickly initiate the most suitable treatment. The service routinely receives samples from sepsis cases where time is of the essence. Being closely connected with the hospitals on site, eliminates cell degradation which can occur with samples in transit, allowing more accurate evaluation of patient samples.

Septic-peritoneal fluid

Commenting on cases and on communication with vets who send samples, Lecturer in Clinical Pathology, Emma Holmes, said: “Through the RVC Emergency Referrals and Critical Care Services, we commonly see samples from patients with septic peritonitis or pyothorax. With the urgent processing of these samples we are able to give the clinician a verbal report, allowing stabilisation and appropriate treatment of these cases as priority. From the Neurology Service, CSF samples are also prioritised due to the special sample handling required. Nucleated cells within the fluid collected degrade quickly, so rapid processing allows accurate counts and assessment of cell morphology. This urgent processing extends to our external clients, allowing turnaround of samples within working hours to the benefit of the clinicians.

“In other cases, in which cytological findings are more complex or unexpected, discussion of our findings with the clinicians, in an attempt to develop a more detailed clinical picture, allows more accurate interpretation, with further diagnostic testing discussed as appropriate. Having a close working relationship with our anatomic pathology colleagues further adds to case discussion and accurate diagnosis.”

The particular expertise at the RVC means the service is well positioned to assess samples from zoo animals, wildlife collections or domestic exotics. Due to the nature of exotic samples (i.e. in some species all cell lines being nucleated and species-specific cell morphology) handling (especially haematology) and interpretation can be different to that of our companion animal species. This example illustrates that, while the RVC is fortunate to have advanced equipment, the expertise of pathologists - who rapidly make sense of what they are sent to support the treating vet - is key.

This pathology expertise is also key to veterinary education at the RVC. As well as receiving lectures from the clinical pathologists, undergraduates can take an option to spend two weeks in the service in addition to their core rotation, where they can learn on a one-to-one basis.

Alongside the clinical pathology residents, residents from the different clinical teams at RVC Small Animal Referrals also spend time with the team, which gives them a greater awareness of clinical pathology, its roles and its limitations. For veterinary pathology training (both clinical and anatomic), the RVC is a leading institution and numerous RVC residents have passed their American College of Veterinary Pathologists qualifications under the guidance of the pathologists at the College.

For diagnostic and pathology services, please call: 01707 666208

Email diagnosticlabs@rvc.ac.uk

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