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Intro to Terminology
Word Structure & Basics
Veterinary terms are often composed of prefixes, suffixes, and root words. Understanding these components is key to deciphering complex medical language.
Key Components:
- Prefixes: Modify the meaning of the root word (e.g., ante- before, endo- within, peri- around).
- Suffixes: Indicate a procedure, condition, disease, or part of speech (e.g., -ectomy surgical removal, -logy study of, -pathy disease).
- Root Words: Often derived from Greek or Latin, provide the core meaning (e.g., hemo/hemato for blood, osteo for bone, nephro for kidney).
Common abbreviations (e.g., SID - once daily, q - every) are also vital for efficient communication.
Directional & Positional Terms
Precise terms describe locations on an animal's body. Examples include anterior/cranial, posterior/caudal, dorsal, and ventral.
Common Directional Terms:
- Anterior (Cranial): Toward the head end of the body.
- Posterior (Caudal): Toward the tail end of the body.
- Dorsal: Toward or pertaining to the back or upper surface.
- Ventral: Toward or pertaining to the belly or lower surface.
- Medial: Toward the midline of the body.
- Lateral: Away from the midline, toward the side.
- Proximal: Nearer to the point of attachment or origin (limbs).
- Distal: Farther from the point of attachment or origin (limbs).
- Palmar: Pertaining to the caudal (back) surface of the forelimb, distal to the carpus (wrist).
- Plantar: Pertaining to the caudal (back) surface of the hindlimb, distal to the tarsus (ankle).
Body Planes:
- Sagittal Plane: An imaginary vertical plane that divides the body into left and right portions. (Midsagittal or median plane is exactly down the midline).
- Transverse Plane: An imaginary horizontal plane that divides the body into cranial (anterior) and caudal (posterior) portions.
- Frontal (Dorsal) Plane: An imaginary vertical plane that divides the body into dorsal (back) and ventral (belly) portions.
Diagnostic Principles
Purpose & Importance
Diagnostic tests are essential for detecting disease, monitoring health, guiding treatment decisions, and establishing prognoses in animals. They provide objective data to support clinical findings.
Effective diagnostic testing allows veterinarians to:
- Screen for subclinical diseases.
- Confirm or rule out differential diagnoses.
- Assess organ function and damage.
- Monitor response to therapy.
- Provide a prognosis (likely outcome) for the patient.
Sample Collection & Handling
Accurate diagnostic results depend heavily on proper sample collection, correct anticoagulants/preservatives, and appropriate storage and transport.
Key Considerations:
- Patient Preparation: Fasting status, stress levels.
- Correct Site & Technique: Aseptic technique for sterile samples.
- Appropriate Collection Tubes/Containers: E.g., EDTA for CBC, serum separator tubes for chemistry.
- Proper Labeling: Patient ID, date, sample type.
- Timely Processing & Transport: Temperature requirements, avoiding hemolysis or degradation.
Preanalytical errors are a common source of inaccurate results.
Test Interpretation
Interpreting results involves comparing them to reference intervals and understanding concepts like sensitivity, specificity, and predictive values.
Key Concepts:
- Reference Interval: Established from a healthy population; results outside this range may indicate abnormality but must be interpreted in context of the individual patient.
- Sensitivity: True Positives / (True Positives + False Negatives). High sensitivity tests are good for ruling OUT disease (SNOUT - Sensitive test, Negative result, rules OUT).
- Specificity: True Negatives / (True Negatives + False Positives). High specificity tests are good for ruling IN disease (SPIN - Specific test, Positive result, rules IN).
- Predictive Value Positive (PVP): Probability that a patient with a positive test result actually has the disease. Influenced by disease prevalence.
- Predictive Value Negative (PVN): Probability that a patient with a negative test result actually does not have the disease. Influenced by disease prevalence.
- Quality Control (QC): Procedures and systems within a laboratory to ensure the reliability, accuracy, and precision of test results.
Laboratory Diagnostics
Hematology
Evaluation of blood cells: RBCs, WBCs, and platelets. Key test is the CBC.
Common Hematology Tests & Terms:
- Complete Blood Count (CBC): Includes RBC count, WBC count (total and differential), platelet count, hemoglobin, hematocrit/PCV.
- Anemia: Deficiency in RBCs or hemoglobin. Can be regenerative or non-regenerative.
- Leukocytosis: An increase in the total number of white blood cells, often indicating infection or inflammation.
- Leukopenia: A decrease in the total number of white blood cells, potentially increasing susceptibility to infection.
- Thrombocytopenia: A decrease in the number of platelets, which can lead to bleeding problems.
- Blood Smear Evaluation: Microscopic assessment of blood cell morphology (shape, size, appearance) for abnormalities.
- Coagulation Profile: Tests like PT and aPTT assess blood clotting ability.
Clinical Chemistry
Measures enzymes, metabolites, and electrolytes in serum/plasma to assess organ function (liver, kidney, pancreas) and metabolic status. Often run as a "panel."
Key Chemistry Analytes:
- Kidney: BUN, Creatinine, SDMA.
- Liver: ALT, AST, ALP, GGT, Bilirubin, Bile Acids.
- Pancreas: Amylase, Lipase, PLI.
- Proteins: Total Protein, Albumin, Globulin.
- Electrolytes: Sodium (Na), Potassium (K), Chloride (Cl), Calcium (Ca), Phosphorus (P).
- Glucose: Blood sugar; levels regulated by insulin. High (hyperglycemia) or low (hypoglycemia) values are significant.
- Endocrine: T4 (thyroid), Cortisol (adrenal).
Urinalysis (UA)
Provides insights into kidney function, hydration status, and can detect urinary tract inflammation, infection (UTI), or other systemic diseases.
Components of a Urinalysis:
- Gross Examination: Color, clarity, odor.
- Specific Gravity (USG): Measures urine concentration, reflecting the kidney's ability to concentrate or dilute urine.
- Chemical Analysis (Dipstick): pH, protein, glucose, ketones, bilirubin, blood (heme).
- Microscopic Sediment Exam: Cells (RBCs, WBCs, epithelial), casts, crystals, microorganisms (bacteria, fungi).
- Urine Culture & Sensitivity: If infection suspected, to identify bacteria and effective antibiotics.
Cystocentesis is the preferred collection method for culture.
Fecal Analysis
Primarily used to detect helminth ova and protozoal cysts/oocysts. Can also identify indicators of maldigestion or bleeding.
Common Fecal Tests:
- Fecal Flotation: Concentrates parasite eggs/cysts using solutions of differing specific gravity (e.g., zinc sulfate, sugar solution) for microscopic viewing.
- Direct Smear: For detecting motile protozoa (e.g., Giardia trophozoites) or assessing bacterial populations.
- Fecal Occult Blood Test: Detects hidden (non-visible) blood in feces, indicating gastrointestinal bleeding.
- Fecal PCR Panels: Detect DNA of specific enteric pathogens (bacteria like Salmonella, Campylobacter; viruses like Parvovirus; parasites like Giardia, Cryptosporidium).
- Fecal Cytology: Microscopic examination of fecal smears for inflammatory cells, abnormal cells, or specific microorganisms.
Microbiology
Involves culturing samples to identify pathogenic bacteria or fungi, and determining their antibiotic/antifungal sensitivity.
Key Microbiology Procedures:
- Culture & Sensitivity (C&S): For bacteria (aerobic, anaerobic) and fungi from sites like urine, wounds, ears, blood.
- Stains: Gram stain, Acid-fast stain (for Mycobacterium).
- PCR (Polymerase Chain Reaction): Highly sensitive detection of pathogen DNA/RNA, often faster than culture.
- Serology: Detects antibodies (host immune response) or antigens (pathogen parts) for infectious diseases (e.g., FeLV, FIV, Heartworm, Lyme).
Cytology
Rapid evaluation of cell types from FNAs, impression smears, or body fluids to identify inflammation, infection, or neoplasia.
Common Cytology Applications:
- Fine Needle Aspirates (FNA): From skin masses, lymph nodes, internal organs (often ultrasound-guided).
- Impression Smears: From ulcerated lesions or surgical biopsies, by pressing a slide onto the tissue surface.
- Fluid Analysis: CSF, synovial (joint) fluid, effusions (abdominal, thoracic). Differentiates transudates, modified transudates, and exudates.
- Helps differentiate inflammation (e.g., neutrophilic, eosinophilic) from neoplasia.
Histopathology
Evaluation of biopsied tissue architecture and cellular detail by a pathologist to provide a definitive diagnosis, especially for cancer (grading/staging).
Key Aspects of Histopathology:
- Sample Collection: Incisional biopsy, excisional biopsy, punch biopsy, endoscopic biopsy.
- Fixation: Usually 10% neutral buffered formalin is crucial for preserving tissue structure. Ratio of tissue to formalin should be 1:10.
- Processing: Embedding in paraffin, sectioning into thin slices, staining (commonly Hematoxylin and Eosin - H&E).
- Interpretation: Identifies cell types, tissue architecture, presence of inflammation, infection, necrosis, dysplasia, or neoplasia.
- Cancer Diagnosis: Determines if a tumor is benign or malignant, its type (e.g., carcinoma, sarcoma), grade (aggressiveness), and status of surgical margins.
Molecular Diagnostics
Utilizes techniques like PCR to detect genetic material (DNA/RNA) of pathogens, genetic mutations associated with disease, or cancer biomarkers.
Applications of Molecular Diagnostics:
- Pathogen Detection: Highly sensitive and specific for viruses, bacteria (e.g., Mycoplasma, Bartonella), fungi, and parasites (e.g., Tick-borne disease panels).
- Genetic Disease Testing: Identifies inherited conditions (e.g., PRA in eyes, HCM in hearts).
- Oncology: Detection of cancer-specific mutations (e.g., BRAF mutation in TCC), clonality testing for lymphoma (PARR), liquid biopsies for cancer screening.
- Pharmacogenomics: Predicting drug response/sensitivity based on genetic makeup (e.g. MDR1 gene mutation).
Immunology
Focuses on tests evaluating the immune system, including antibody/antigen tests for infectious diseases, allergy testing, and markers for autoimmune conditions.
Common Immunological Tests:
- Serology (Antibody/Antigen Tests):
- ELISA: Common for FeLV/FIV, Heartworm, Parvovirus, Lyme.
- IFA: For tick-borne diseases, Feline Infectious Peritonitis (FIP).
- Titers: Measure antibody levels (e.g., post-vaccination or for certain infectious diseases).
- Allergy Testing: Serum IgE testing or intradermal skin testing to identify environmental or food allergens.
- Autoimmune Disease Markers: ANA for lupus-like diseases, Coombs' Test for IMHA.
- Measurement of Immunoglobulins: E.g., IgG, IgA, IgM levels, useful for diagnosing immunodeficiencies like Failure of Passive Transfer in neonates.
Diagnostic Imaging
Radiography (X-rays)
Uses X-rays to create 2D images of internal structures. Excellent for bones, chest (lungs, heart silhouette), and abdomen (organ size/shape, foreign bodies, gas patterns).
Key Aspects of Radiography:
- Indications: Trauma (fractures), coughing/dyspnea, vomiting/diarrhea, suspected masses, lameness.
- Views: Typically at least two orthogonal views (e.g., lateral and ventrodorsal/dorsoventral) are needed.
- Interpretation: Based on radiographic densities (gas, fat, soft tissue/fluid, bone, metal). Assesses size, shape, position, opacity of structures.
- Contrast Studies: Using contrast agents (barium for GI, iodinated contrast for urinary/vascular) to highlight specific organs or tracts.
Ultrasonography
Uses high-frequency sound waves to create real-time images of soft tissues and organs, assessing internal architecture. Excellent for abdomen, heart (echocardiography), and eyes.
Key Aspects of Ultrasonography:
- Indications: Abdominal pain, organomegaly, fluid accumulation, suspected masses, cardiac murmurs, pregnancy.
- Advantages: Non-invasive, no radiation, excellent soft tissue detail, allows for guided sampling (FNA, biopsy).
- Echocardiography: Specialized ultrasound of the heart to assess chamber sizes, wall thickness, valve function, blood flow (Doppler).
- Interpretation: Based on echogenicity and tissue patterns.
Advanced Imaging & Endoscopy
CT and MRI provide detailed cross-sectional images. Endoscopy allows direct visualization.
Computed Tomography (CT):
- Excellent for bone detail, lungs, nasal passages, complex fractures, surgical planning for masses, angiography. Uses X-rays.
Magnetic Resonance Imaging (MRI):
- Superior for soft tissue detail, especially brain, spinal cord, nerves, and joints (ligaments, tendons). Uses magnetic fields and radio waves.
Endoscopy:
- Visual examination of internal organs using a scope (e.g., gastroscopy, colonoscopy, bronchoscopy, rhinoscopy). Allows for biopsy and foreign body retrieval.
These modalities often require general anesthesia.
Other Specialized Tests
Cardiac, Systemic & Ocular
ECG/EKG assesses heart rhythm. Blood gas analysis measures oxygenation/acid-base. Tonometry checks eye pressure.
Key Specialized Tests:
- Electrocardiography (ECG/EKG): Records electrical activity of the heart.
- Blood Pressure Measurement: Crucial for diagnosing hypertension or hypotension, monitoring anesthesia and critical patients.
- Blood Gas Analysis: Measures PaO2, PaCO2, pH, bicarbonate.
- Tonometry: Measures intraocular pressure (IOP), essential for diagnosing and monitoring glaucoma.
Specialized Function Tests
Dynamic tests assess organ responses, like the ACTH stimulation test for adrenal function or bile acid stimulation for liver function.
Examples of Function Tests:
- ACTH Stimulation Test: Evaluates adrenal reserve; used to diagnose hypoadrenocorticism and hyperadrenocorticism.
- Dexamethasone Suppression Test (LDDST/HDDST): Helps differentiate pituitary-dependent vs. adrenal-dependent Cushing's disease. LDDST = Low-Dose, HDDST = High-Dose.
- Bile Acid Stimulation Test: Assesses liver function, particularly portosystemic shunts, by measuring pre- and post-prandial (after meal) bile acids.
- Thyroid Stimulating Hormone (TSH) Response Test: Historically used for diagnosing hypothyroidism (less common now due to availability of other thyroid tests like free T4 and endogenous TSH).
Advanced Diagnostics & Panels
Specialized Panels & Technologies
Leading diagnostic laboratories like Antech Diagnostics offer a wide array of specialized panels and cutting-edge technologies to aid in comprehensive veterinary care. This includes advanced molecular diagnostics, cancer screening, and tailored wellness panels.
Modern veterinary diagnostics often involve:
- Comprehensive Wellness Panels: Tailored for different life stages (e.g., senior, pre-anesthetic) combining hematology, chemistry, and urinalysis.
- Vector-Borne Disease Screening: Panels detecting multiple tick-borne and flea-borne pathogens (e.g., Lyme, Anaplasma, Ehrlichia, Heartworm antigen) often using multiplex PCR or ELISA. (e.g., Antech Accuplex™).
- GI Parasite PCR Panels: Broader detection of gastrointestinal parasites, including those difficult to find on routine flotation. (e.g., Antech KeyScreen™).
- Molecular Oncology Diagnostics:
- Liquid Biopsies & Cancer Markers: Blood tests for early cancer detection by identifying circulating tumor DNA or specific mutations.
- Tissue-based molecular tests for specific cancer markers or mutations to guide therapy.
- Digital Cytology and Pathology: Utilizing digital imaging and AI-assisted tools for faster and potentially more accurate interpretations.
Consult your diagnostic laboratory's catalog (e.g., Antech Diagnostics) for the most current and specific test offerings and their clinical applications.