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IDEXX LaserCyte TM

IDEXX LaserCyte TM. LaserCyte™ Parameters. LaserCyte Parameters Medical Reasons The “What” and “So What” Summary. LaserCyte™ Parameters. Red blood Cells. White blood Cell. Platlets. Red Blood Cells . Is there evidence of anemia?

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IDEXX LaserCyte TM

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  1. IDEXX LaserCyteTM

  2. LaserCyte™ Parameters • LaserCyte Parameters • Medical Reasons • The “What” and “So What” • Summary

  3. LaserCyte™ Parameters Red blood Cells White blood Cell Platlets

  4. Red Blood Cells • Is there evidence of anemia? • Regenerative or nonregenerative with reticulocyte count • Is there evidence of dehydration? • Polycythemia

  5. Red Blood Cells • HCT (Hematocrit) • Percentage of the red cell population relative to the total volume of blood • It is a calculation by the LaserCyte • 40 – 59% dogs; 29 – 50% cats • Used to diagnose anemia or polycythemia • RBC (Red Blood Cell Count) • Actual number of RBCs in a given quantity of blood • Average is 5.9 - 8.6 X 106μL for dogs or 5 -10 X 106μL for cats

  6. Red Blood Cells • HGB (Hemoglobin) • A measurement of the oxygen carrying capacity of the red blood cells • The LaserCyte uses four LEDs and photodetectors that measure Hgb concentration by at least three different wavelengths of light and two different aspirates, unlysed and lysed.

  7. Red Blood Cells A retic count offers a quick and easy assessment of an anemia state. A count, unlike a percentage is not affected by dehydration. • # Retics • The number of reticulocytes is a definitive indicator to distinguish between regenerative and non-regenerative anemias. • The LaserCyte gives aggregate retics in the cat • A retic count above 60,000 μL in cats and 80,000 μL in dogs in considered a regenerative anemia • % Retics • Percentage of reticulocytes in a given quantity of blood • Average is 0.0 – 1.5% for dogs or 0.0 – 0.4% for cats

  8. Red Blood Cells • MCV (Mean Corpuscular Volume) • The mean volume of all the RBCs counted in the sample • Smaller than normal is microcytic larger is macrocytic • Used to indicate spherocytes, anisocytosis, or schistocytes all of which must be confirmed with a morphology exam • RDW (Red Cell Distribution Width) • Measurement of the variation of size with in the RBC population. Given as a percentage • Used to indicate anisocytosis, also used by impedance analyzer users to indicate the presence of retics with MCV

  9. Red Blood Cells • MCHC (Mean Corpuscular Hemoglobin Conc) • The mean concentration of hemoglobin in the red cell • Calculated by dividing the hemoglobin by the hematocrit and expressing the answer as a percentage • Important in classifying anemias • Normal ranges are 30.0 – 36.9% • MCH (Mean Corpuscular Hemoglobin) • Mean mass of hemoglobin in each RBC • Calculated by dividing the hemoglobin by the number of RBCs

  10. White blood cell data answers • Is there evidence of inflammation? • Acute, chronic or overwhelming • Is there evidence of stress or excitement? • High levels of glucocorticoids cause mild neutrophilia, lymphopenia and eosinophilia • Is there a demand for phagocytosis or evidence of tissue necrosis? • Elevated monocytosis is almost always seen in chronic inflammation

  11. White Blood Cells • WBC (White Blood Cell Count) • Total count of all White blood cells • Reported as X 103μL • Indicator of infection (not diagnostic alone)

  12. White Blood Cells • Lymphocytes • White blood cell that produces antibodies • 20 – 30% of WBC population • Lymphocytosis: Prolonged illness, chronic inflammation, • Lymphopenia: Acute inflammation, viral infection, stress, steroid therapy • Monocytes • Reported as X 103μL • Indicator of infection (not diagnostic alone)

  13. White Blood Cells • Neutrophils • Most common leukocyte • Two classifications: Banded and Segmented • Engulf disease causing bacteria, viruses, and particles (phagocytosis) • Eosinophils • Involved in allergies and parasitic infection • Usually only in circulation for about 30 min • .1 – 1.5 X 103μL normal range

  14. White Blood Cells • Basophils • Having the basophil # and % aids in identifying • Systemic hypersensitivity • Acute allergic reactions • Mast cell sarcomas

  15. The Medical Reasons • White Blood Cells WBC NEUTS EOS LYMPHS MONOS Acute Inflammation Increased Increased Variable Decreased variable Chronic Inflammation Increased/ no change Increased/ no change Variable Increased/ no change Increased Parasites Increased/ Variable Decreased/ no change Increased Variable Increased/ no change Stress Leukogram Increased Increased Decreased/ no change Decreased Increased/ no change

  16. Is it a stress leukogram or inflammation? Parameters Stress Inflammation WBC Count High High Neutrophils High High Lymphocytes Low Normal Eosinophils Low Normal Monocytes Slightly high Slightly high

  17. 3-part versus 5-part differential 5-part 3-part Elevated neutrophils Inflammation No Yes Infection No Yes Stress No Yes Excitement No Yes Steroid therapy No Yes Decreased neutrophils Parvo No Yes Erhlichiosis No Yes Overwhelming infection No Yes FIV No Yes

  18. 3-part versus 5-part differential 3-part Elevated basophils and eosinophils 5-part Parasites No Yes Allergies No Yes Mast cell tumors No Yes Heartworm No Yes Addison’s disease No Yes Parvo No Yes Stress No Yes Distemper No Yes No Yes Cushing’s syndrome

  19. Platelet data answers • Is there evidence of autoimmune disorders, occult infections or inflammation? • Suspected coagulopathies?

  20. With LaserCyte®, your platelet information increases** • PLT • Involved in clotting • PLT is a platelet count • Thrombocytopenia can be seen in Ehrlichia, FIV, FELV • MPV • MPV (mean platelet volume) aids in the identification of what may be causing a severe thrombocytopenia • PDW • PDW (platelet distribution width) is an objective measure of the degree of variability in the size of platelets and can indicate bone marrow response **Absolute count—Available using the LaserCyte analyzer.

  21. The CBC is a time-sensitive test • Hematology samples are composed of living cells and should be analyzed as soon as possible: • To prevent cell distortions due to shipment or storage • To prevent artifacts created by long-term exposure to EDTA

  22. Blood cells continue to develop and change • Samples should be processed within three hours to avoid artificially increased Hct and MCV, and decreased MCHC • Platelet counts should be performed within one hour after collection • Red cells crenate, reticulocytes mature, and lymphocytes’ nuclei become distorted Rebar A, et al. Guide to Hematology in Dogs and Cats. Jackson, WY: Teton New Media; 2002:11.

  23. Which system is ideally suited for your needs? LaserCyte QBC VetAutoread™ Lab Impedence RBC Count Yes --- Yes Yes PCV/Hct Yes Yes Yes Yes Hgb Yes Yes Yes Yes Reticulocytes Yes % only Request --- MCV Yes --- Yes Yes MCHC Yes Yes Yes Yes RDW Yes --- Yes Yes

  24. Which system is ideally suited for your needs? LaserCyte QBC VetAutoread™ Lab Impedence Yes, corrected for nRBC Not corrected for nRBC Yes, corrected for nRBC nRBCs misclassified WBC Count Lymphocytes Yes, absolute count and % Grouped with monocytes Yes, absolute count and % Small-sized cells number and % Middle-sized cells number and % Monocytes Yes, absolute count and % Grouped with lymphocytes Yes, absolute count and % Neutrophils Yes, absolute count and % --- Yes, absolute count and % ---

  25. Which system is ideally suited for your needs? LaserCyte QBC VetAutoread™ Lab Impedence Eosinophils Yes, absolute count and % Elevated canine and bovine Yes, bsolute count and % --- Basophils Yes, absolute count and % Yes Yes, bsolute count and % --- Platelet Count Yes, optical signature,clumps do not interfere with WBC count Yes, good correlation with clumped platelet samples Not always, usually reports broad categories (i.e., adequate) Yes, size only, clumps may go uncounted or misidentified as WBCs Yes, absolute count MPV --- Yes Yes Yes, absolute count PDW --- Yes Yes

  26. The Doctor’s view • “I have a QBC VetAutoread that is nearly paid off, why should I go in debt again for a new one” • The QBC Vet AutoRead is and was a good in-clinic system. However, as with anything the advances in technology now make it affordable and possible to practice the best medicine available right in your clinic. … • A five part differential is a must for diagnosing many very common diseases or states. • allergies, parasitic infection, chronic inflammation, stress, feline asthma, systemic toxemia, and more.

  27. The Doctor’s view • “I let my lab deal with the equipment cost and maintenance, they get me the results I need in plenty of time” • As discussed, a CBC is a time sensitive test. Platelets clump, red cells change shape and size, bands change to segs, lymphocytes, neutrophils, and eosinophils can change size, etc. • This immediate information is critical in many cases. • Not only does the cells change, the animals condition changes between draw and results from the lab

  28. The Doctor’s view • “Other in-clinic analyzer’s are just as good, and cost about $5k to $8k less” • Laser Flow Cytometry is the standard in automated hematology. • Other in-clinic analyzers interrogate cells based on size only. This can cause erroneous results in the case of artifacts, nRBCs, reticulocytes, and more.

  29. Summary (1 of 3) You need to show a Dr. why the LaserCyte® is a good investment medically. • Increased ability to diagnose common problems • Immediate results mean immediate treatment and decreased effects from artifacts

  30. Summary (2 of 3) The LaserCyte® is not meant to “replace” the reference lab, it is meant to give the Dr. reference lab results for their in-clinic testing needs. • Do not try to compare to ref lab prices or say that they can now make more $ by doing test in-house. • They will however, increase their testing volume by having ref lab accuracy immediately available.

  31. Summary (3 of 3) Do not try to sell the LaserCyteTM on price or testing volume. • If the Dr. is already doing in-clinic testing, the LaserCyteTM will not make them more money right away, it will give them the ability to make more accurate and rapid diagnosis. • If the Dr. is using the reference lab, the LaserCyteTM will be more expensive to use, but he will do more testing if he/she has the availability to do so.

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