Infectious Disease Management in Animal Shelters. Группа авторов

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Infectious Disease Management in Animal Shelters - Группа авторов


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nitrate solution (e.g. Fecasol, Vetoquinol, Fort Worth, TX)

      Mineral oil

      Coverslips

      Cotton swabs

      Scalpel blades

      Small containers with 10% formalin

      Equipment

      Stethoscope

      Scale

      Thermometer

      Microscope (10×, 40×)

      Microhematocrit centrifuge

      Refractometer

      Portable blood glucose monitor or glucose reagent strips

      Wood's Lamp (ultraviolet light, 365 nm wavelength)

      Refrigerator

      Test Kits

      Urine chemical reagent strips

      Blood urea nitrogen test strips (e.g. Azostix®, Shelby Scientific, Macomb, MI)

      Commercial diagnostic test kits (e.g. heartworm antigen, canine parvovirus antigen, feline leukemia virus, feline immunodeficiency virus)

      Many diagnostic tests rely on the collection of a sample of tissue, blood, urine, feces, or other bodily fluid (versus those that rely on contemporary historical, physical, or clinical findings). For such specimens, the diagnostic utility of the sample is often only as good as the collection technique and specimen handling. With careful planning and staff training, many diagnostic samples can be collected cage‐side or even in a foster‐home environment. Test kit manufacturers and diagnostic laboratories often have instructions and consultative services readily available to provide such direction when needed. Though veterinarians should direct the process, many individuals comfortable with basic animal handling can be trained to perform the actual sample collection for the most common diagnostic tests where permissible under applicable laws and regulations.

      Once collected, diagnostic samples should be handled with care, particularly when being prepared for shipment to an outside laboratory. In general, cytologic samples should be rapidly air‐dried and stored at room temperature; care should be taken not to crush or smear slide preparations. If not evaluated within 4 hours of collection, samples of blood, bodily fluids, or those intended for culture should be stored under refrigeration and processing should occur within 24 hours. See Chapter 5 for information on the collection and handling of necropsy specimens.

      Common diagnostic tests described in this chapter have been divided into core, primary, secondary, and diagnostic laboratory tests based on their resource requirements, knowledge and skill needed to conduct the tests and interpret the results, and their feasibility for being conducted within the resource limitations of most animal shelters.

      Core diagnostic tools include a case history, physical examination findings, and response to treatment. These tools require minimal to no equipment, can be performed and interpreted by trained non‐veterinary personnel and, with the exception of diagnosis by the response to treatment, should be performed on every animal that enters the shelter system.

      Primary diagnostic testing in the animal shelter encompasses routine use of enzyme‐linked immunosorbent assay (ELISA) test kits, diagnostic cytology, fecal examination and urinalysis. In most cases, these tests can be performed and interpreted by trained non‐veterinary personnel within the shelter itself and are commonly used as both screening tests and first‐line diagnostic tests for animals exhibiting specific clinical signs.

      Secondary diagnostic testing includes complete blood count and blood chemistry analysis, diagnostic imaging, culture, and necropsy. These are utilized in specific clinical scenarios and when core and primary diagnostic tests are unable to provide a definitive diagnosis or direct the management plan. Many of the secondary tests can be conducted by in‐house laboratories but results require interpretation and application by a veterinarian.

      Diagnostic laboratory tests should be conducted by trained personnel in a diagnostic laboratory, and these results also require interpretation and application by a veterinarian. These tests are often reserved for select cases requiring a definitive diagnosis. Though all these tools (and many more not covered here) can provide a wide variety of clinical diagnostic information, this chapter will focus on those tools most likely to be applicable to the diagnosis and management of infectious diseases encountered in the shelter environment.

      4.3.1 Core Diagnostic Tools

      4.3.1.1 Case History

      4.3.1.2 Physical Examination

      The patient examination should progress from pure observation and least invasive measures and, as safety and comfort of both the examiner and the patient increase, proceed to an evaluation of areas that require a hands‐on approach or may include manipulation of painful or diseased body parts. Unless an urgent medical need is apparent, an in‐depth evaluation of a presenting complaint or existing condition is generally left until the end of the procedure. This allows the practitioner to have completed the entire physical examination in case a patient's pain or sensitivity to a diseased or injured area limits further evaluation.

      Subjective patient assessment typically includes details about the presenting complaint, evaluation of the animal's mental state, food and water consumption, and any obvious signs of pain or discomfort. Assessment of respiratory rate and character should also occur at this time to avoid over‐interpretation of abnormal findings that may be attributed to the stress and/or discomfort of animal


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