Idexx Catalyst One Operator's Manual

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IDEXX Catalyst One* Chemistry Analyzer

Operator’s Guide

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Information in this document is subject to change without notice. Companies, names and data used in examples are fictitious unless otherwise noted. No part of this document may be reproduced or transmitted in any form or by any means, electronic, mechanical or otherwise, for any purpose, without the express written permission of IDEXX Laboratories. IDEXX Laboratories may have patents or pending patent applications, trademarks, copyrights or other intellectual or industrial property rights covering this document or subject matter in this document. The furnishing of this document does not give a license to these property rights except as expressly provided in any written license agreement from IDEXX Laboratories.

*IDEXX VetLab, Catalyst, Catalyst One, IDEXX VetTrol, SmartLink, IDEXX InterLink, IDEXX SmartService, SNAP, and 4Dx are trademarks or registered trademarks of IDEXX Laboratories, Inc. in the United States and/or other countries. All other product and company names and logos are trademarks of their respective holders.

Proprietary Rights Notice

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Contents

Preface ....................................................................................................................................................5

Safety Precautions .......................................................................................................................................5

Performance Precaution ..............................................................................................................................5

Care of the Analyzer ....................................................................................................................................5

International Symbol Descriptions ...............................................................................................................6

Other Symbols .............................................................................................................................................7

Getting Started ........................................................................................................................................8

Introduction ..................................................................................................................................................8

Catalyst One Components ..........................................................................................................................9

Analyzer Status ..........................................................................................................................................10

Responding to an Alert ..............................................................................................................................11

Installing the Catalyst One Analyzer ..........................................................................................................11

Catalyst One Analyzer Consumables ........................................................................................................12

Compatible Species ..................................................................................................................................13

Using the Catalyst One* Analyzer ........................................................................................................14

Analyzing Samples ....................................................................................................................................14

Slide Handling ...........................................................................................................................................14

Diluting Samples ........................................................................................................................................14

Viewing and Printing Test Results .............................................................................................................16

Outside of Reportable Range Samples ....................................................................................................17

Modifying the Settings on the Analyzer ..............................................................................................18

Modifying the Sound Settings‡ ..................................................................................................................18

Entering Standby Mode .............................................................................................................................18

Exiting Standby Mode................................................................................................................................18

Sample Preparation and Storage ........................................................................................................19

Supported Sample Types for Catalyst* CLIPs and Slides.........................................................................19

Preparing Samples for Use on the Catalyst One Analyzer........................................................................20

Proper Sample Cup Volume ......................................................................................................................22

Sample Inspection After Centrifugation .....................................................................................................22

Sample Storage .........................................................................................................................................23

Quality Control ......................................................................................................................................24

Overview ....................................................................................................................................................24

Quality Control Materials ..........................................................................................................................24

Quality Control CLIPs and Slides ..............................................................................................................25

Preparing Control Fluid ..............................................................................................................................26

Running Quality Control .............................................................................................................................27

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Maintenance .........................................................................................................................................28

Overview ....................................................................................................................................................28

Upgrading the Software.............................................................................................................................28

Cleaning the Internal Components of the Analyzer ...................................................................................28

Cleaning the Outside of the Analyzer

and the Sample Drawer .......................................................................................................................29

Emptying the Waste Drawer ......................................................................................................................29

Appendices ...........................................................................................................................................30

Chemistry Descriptions .............................................................................................................................30

Medical Protocol Descriptions ...................................................................................................................51

Profile Selection .........................................................................................................................................56

Differences in Results ................................................................................................................................57

Technical Specifications ............................................................................................................................57

IDEXX Technical Support Contact Information ..........................................................................................58

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Preface

Safety Precautions

Note: If the equipment is used in a manner other than specified, the protection provided by the equipment may be impaired.

The analyzer does not contain any user-serviceable components. DO NOT disassemble.

Line voltage for the Catalyst One AC power adapter is 100–240 V AC, 50–60 Hz. Be sure to plug all equipment into properly grounded electrical outlets.

Use only the AC power adapter and AC power cable supplied.

Disconnect the AC power cable from the wall outlet if the:

• AC power cable or the DC power cord becomes frayed or otherwise damaged.

• AC power adapter is exposed to water or other liquids.

Performance Precaution

Do not use certain liquids, aerosols (such as canned air), solvents, ammonia, and other substances on or near the analyzer which could influence results.

Care of the Analyzer

It is recommended that you do not stack other equipment or containers on top of the analyzer.

Keep analyzer away from sources of heat or flames.

PROTECT your equipment from damp conditions, wet weather, or liquid spills.

Take care not to spill water or other liquids on the unit.

DO NOT use solvents, ink markers, sprays containing volatile liquids, or polish on the analyzer as it may damage the outer case. Clean only with a mild soap and slightly moist cloth and only when the analyzer is not in use.

Clean only with a mild soap and slightly moist cloth and only when the analyzer is not in use.

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International Symbol Descriptions

International symbols are often used on packaging to provide a pictorial representation of particular information related to the product (such as expiration date, temperature limitations, batch code, etc.). IDEXX Laboratories has adopted the use of international symbols on our analyzers, product boxes, labels, inserts, and manuals in an effort to provide our users with easy-to-read information.

Preface

Symbol Description Symbol

Use by

A utiliser avant Verwendbar bis Usare entro Usar antes de

使用期限

Batch code (Lot)

Code de lot (Lot) Chargenbezeichnung (Partie) Codice del lotto (partita) Código de lote (Lote)

ロット番号

Serial number

Numéro de série Seriennummer Numero di serie Número de serie

シリアル番号

Catalog number

Numéro catalogue Bestellnummer Numero di catalogo Número de catálogo

製品番号

Authorized Representative in the European Community

Représentant agréé pour la C.E.E. Autorisierte EG-Vertretung Rappresentante autorizzato nella Comunitá Europea Representante autorizado en la Comunidad Europea

EC 内の正規販売代理店

Manufacturer

Fabricant Hersteller Ditta produttrice Fabricante

製造元

Caution, consult accompanying documents

Attention, consulter les documents joints Achtung, Begleitdokumente beachten Attenzione, consultare la documentazione allegata Precaución, consultar la documentación adjunta

注意、添付文書をご参照ください。

Description

Temperature limitation

Température limite Zulässiger Temperaturbereich Temperatura limite Limitación de temperatura

保存温度（下限）

Upper limit of temperature

Limite supérieure de température Temperaturobergrenze Limite superiore di temperatura Limite superior de temperatura

保存温度（上限）

Consult instructions for use

Consulter la notice d’utilisation Gebrauchsanweisung beachten Consultare le istruzioni per l’uso Consultar las instrucciones de uso

取扱説明書をご参照ください。

Keep away from sunlight

Conserver à l’abri de la lumière Vor direkter Sonneneinstrahlung schützen Mantener alejado de la luz solar Tenere lontano dalla luce diretta del sole

遮光してください。

WEEE Directive 2002/96/EC

Directive 2002/96/CE (DEEE) WEEE-Richtlinie 2002/96/EG Directiva 2002/96/CE RAEE Direttiva RAEE 2002/96/CE

廃電気電子機器指令（WEEE Directive 2002/96/EC）

Biological risks

Risques biologiques Biogefährlich Rischi biologici Riesgos biológicos

生物学的リスク

Do not reuse

Usage unique Nicht wiederverwenden No reutilizarw Non riutilizzare

再利用しないでください。

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Preface

Symbol Description Symbol

Caution, hot surface

Attention, surface très chaude Precaución, superficie caliente Vorsicht, heiße Oberfläche Attenzione, superficie rovente

高温注意

Keep dry

Conserver dans un endroit sec Mantener seco Vor Nässe schützen Tenere al riparo dall’umidità

濡らさないこと。

This side up

Haut Este lado hacia arriba Diese Seite nach oben Alto

この面を上にする。

Other Symbols

Description

Electrostatic-sensitive device

Appareil sensible aux charges éléctrostatiques Dispositivo sensible a descargas electrostáticas Gerät ist sensibel auf elektrostatische Ladung Dispositivo sensibile alle scariche elettrostatiche

静電気の影響を受ける装置

Fragile

Fragile Frágil Zerbrechlich Fragile

取扱注意

Date of manufacture

Date de production Fecha de producción Herstelldatum Data di produzione

製造年月日:

Symbol Description Symbol Description

USB symbol Ethernet/network symbol

Wireless symbol

‡

Feature coming soon

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Getting Started

Introduction

Welcome to IDEXX’s next-generation chemistry analyzer—the Catalyst One* Chemistry Analyzer.

The Catalyst One analyzer’s flexible test menu allows you to monitor the health status of specific organs, recheck values over time, customize profiles by adding single tests to CLIPs. You can even run up to 25 tests on a single sample (for a complete list of the individual slides and CLIPs available, see page 12).

The Catalyst One analyzer is for veterinary use only.

IDEXX VetLab* Station Connectivity

The Catalyst One analyzer is part of the IDEXX VetLab* suite of analyzers, all of which connect to the IDEXX VetLab Station (IDEXX’s laboratory information management system). Connecting multiple analyzers to the IDEXX VetLab Station helps you attain a comprehensive picture of your patient’s health, with the ability to view test results from multiple analyzers on a single report, determine disease progression with parameter-trending capabilities, and more.

By connecting the Catalyst One analyzer to the IDEXX VetLab Station, you can:

• Automatically review patients’ prior results on every printout for easy comparison.

• Improve client communications with illustrated diagnostic or treatment progress printouts.

• Link to expert descriptions and common causes of abnormal values.

• Print information to help explain the significance of results to your clients.

• Allow new staff to train independently.

• Learn proper protocols and tips for best techniques.

IDEXX Dry-Slide Technology

The Catalyst One analyzer uses dry-slide technology—the most accurate technology available for in-house testing. Dry-slide technology uses layers to remove impurities for the most accurate results from even compromised samples.

Patient sample is applied to the top of the spreading layer

Spreading layer

Sample is distributed evenly

Filtering layer

Filters out substances that interfere with results

Reagent layer Reagent reacts with sample

Indicator layer

Reacted sample collects for spectral analysis

Support layer

Optical interface

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How it Works

There are several important steps that the analyzer performs in order to present the results of a sample. Once the slides and sample have been inserted into the analyzer, the Catalyst One analyzer incubates the slides. Then, if using a Catalyst* whole blood separator, the plasma is separated from a whole blood sample. The sample is then accurately dispensed onto the slides, the analyzer measures the color development of the slide, and then all used materials are removed from the analyzer.

Catalyst One Components

Front of the Analyzer

Side door Status LED

Start button

Lock light Sample drawer

Waste drawer

Getting Started

Inside of the Sample Drawer

Note: This picture depicts where the sample cup and whole blood separator should be placed in

the sample drawer. Do not load a whole blood separator AND a sample cup for a single run.

Pipette tips

Whole blood separator

Sample cup

Slides/CLIPs Phenobarbital

Other reagent consumables

(PHBR) reagent consumable/automated dilution cups

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Side of the Analyzer

Getting Started

Side door

Back of the Analyzer

Power port

Analyzer Status

The light-emitting diode (LED) indicator on the front panel of the Catalyst One analyzer indicates the analyzer’s status.

Carousel cover (shown closed)

Lever to raise carousel cover

Ethernet port

Note: You can also view the analyzer status by viewing its icon on the IDEXX VetLab Station Home screen.

LED Color Description

Green (steady) READY; analyzer is ready to process samples or perform

maintenance tasks

Green (pulse) STANDBY MODE

Yellow (steady) IN PROCESS; analyzer is processing a sample or performing

another activity

Yellow (pulse) Analyzer is waiting for the user to begin processing a sample after

receiving the patient information from the IDEXX VetLab Station

Red (flashing) ERROR; an error has occurred; review error or alert messages on

the IDEXX VetLab Station

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Responding to an Alert

When the analyzer experiences a problem, an alert message appears on the upper right side of the IDEXX VetLab Station title bar, the LED on the front panel of the Catalyst One analyzer flashes red, and the Catalyst One icon on the IDEXX VetLab Station Home screen appears with an Alert status.

To View an Alert

Do one of the following:

• Tap the Catalyst One icon on the IDEXX VetLab Station Home screen.

• Tap the alert message in the title bar to display the alert message. Follow the instructions displayed in the alert message.

Installing the Catalyst One Analyzer

The Catalyst One analyzer works in conjunction with the IDEXX VetLab Station.

To Install the Catalyst One Analyzer

1. Before you unpack the analyzer, choose an optimum location for the instrument. The analyzer should be placed on a level surface in a well-ventilated area away from obvious sources of heat, direct sunlight, cold, humidity, or vibrations. For optimum results, room temperature should be at 15°C–30°C (59°F–86°F) and relative humidity at 15%–75%.

Getting Started

IMPORTANT: Ensure proper ventilation. The analyzer’s cooling vents are in the base and the back.

2. Connect the analyzer to the router:

– If you are planning to connect the device wirelessly to an IDEXX VetLab* Station,

proceed to step 3 (wireless-capable router required).

‡

– If you are connecting the device to an IDEXX VetLab Station using a wired router,

connect the device to a numbered port on the router using an Ethernet cable (provided).

Note: For more information about connecting your analyzer to the router, see the installation instructions that accompanied your router.

3. Power on the Catalyst One analyzer. Once the Catalyst One icon displays on the IDEXX VetLab Station Home screen, your connections are complete.

Note: If the Catalyst One icon does not appear on the IDEXX VetLab Station Home screen within 3 minutes, contact IDEXX Technical Support for assistance.

‡

Feature coming soon

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Catalyst One Analyzer Consumables

The following consumables are available for use with the Catalyst One analyzer:

CLIPs, Panels, and Slides

Chemistry Abbreviation

Albumin ALB

Alkaline Phosphatase ALKP

Alanine Aminotransferase ALT

Amylase AMYL

Aspartate Aminotransferase AST

Blood Urea Nitrogen BUN

Calcium Ca

Cholesterol CHOL

Creatine Kinase CK

Creatinine CREA

Chloride Cl

Fructosamine FRU

Gamma-glutamyltransferase GGT

Glucose GLU

Potassium K

Lactate LAC

Lactate Dehydrogenase LDH

Lipase LIPA

Magnesium Mg

Sodium Na

Ammonia NH

Phenobarbital PHBR

Inorganic Phosphate PHOS

Total Bilirubin TBIL

Total Protein TP

Tot a l T

Triglycerides TRIG

Urine Creatinine UCRE

Urine Protein UPRO

Uric Acid URIC

Getting Started

Chem 17 CLIP

Chem 15 CLIP

Chem 10 CLIP

Equine 15 CLIP

NSAID 6 CLIP

UPC Panel

Lyte 4 CLIP

QC CLIP

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Individual Slides

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Compatible Species

Canine

Feline

Equine

Bovine (beef cattle, dairy cow) Llama Sheep

Avian (budgerigar, cockatoos [grey cheek, Moluccan, umbrella], cockatiel, canary, conure, macaw [blue and gold, hyacinth, scarlet], parrots [Amazon blue, Amazon yellow, eclectus, African grey])

†

Species-specific intervals are available for these species. All other species are qualified as “other.”

†

Getting Started

Ferret Rabbit

Goat Rat

Lizard Sea Turtles

Monkey Snake

Mouse Tortoise

Pig

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Using the Catalyst One* Analyzer

Analyzing Samples

There are four different work flows that can be used to analyze a sample on the Catalyst One* analyzer:

• Analyze Sample Button—Use this work flow if you do not have a practice management system connected to your IDEXX VetLab* Station via IDEXX SmartLink* or IDEXX InterLink* technology.

• Pending List or Census List—Use one of these work flows if you have a practice management system connected to your IDEXX VetLab Station via IDEXX SmartLink or IDEXX InterLink technology. Using this work flow will save you time because you do not need to enter the client and patient information into the IDEXX VetLab Station (since it has already been entered into your practice management system).

• Ready to Run Icon—Use this work flow if you initiated the sample run using one of the other work flows, but the analyzer was busy at the time and the sample could not be run immediately.

For more information on these work flows, see the IDEXX VetLab Station Operator’s Guide.

Slide Handling

The Catalyst One analyzer allows you to run up to 25 tests on a single sample. Before you begin, please take note of the following:

• Frozen CLIPs/panels/slides can be run on the Catalyst One analyzer (no thawing required).

• Most CLIPs/slides should be loaded within 5 minutes of opening their foil packaging. The Lyte 4 CLIP should be loaded within 2 minutes of opening its foil packaging.

• If you are running a Lyte 4 CLIP, be sure to load it in the sample drawer before any other CLIPs or slides.

Diluting Samples

Dilutions should only be performed when a test value is outside the reportable range or when the sample contains interfering substances (e.g., medications) that cause a nonlinear or invalid result. The Catalyst One analyzer supports automated dilutions (the analyzer mixes the sample and diluent for you) and manual dilutions (you prepare the dilution outside of the analyzer). Select the appropriate option on the Identify Sample screen.

Remember the following important notes when diluting samples for analysis on the Catalyst One analyzer:

• Only dilute tests with results outside of the reportable range. Diluting tests with results in the normal range may produce invalid results.

• All chemistries should be analyzed first on the undiluted sample. Some analytes, such as GGT and total bilirubin, have low serum/plasma concentrations. These analytes may be diluted out even with the lowest dilution. Dilute the remaining sample and analyze any chemistries that were outside of the reportable range on the first analysis.

• Perform a dilution only when a test value is accompanied by a greater than symbol (>) or dashes (---) on the patient report or when the analyzer informs you a dilution is necessary to receive accurate results.

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• Use the proper diluent material for your sample type.

– For plasma and serum samples, use normal saline.

– IDEXX does not recommend manually diluting whole blood in a Catalyst* whole blood

separator—only dilute the separated plasma.

Using the Catalyst One* Analyzer

– For urine, use

• Use an accurate measuring device, such as a calibrated pipette or syringe.

• For best results, start with a 1:2 dilution (1 part sample to 1 part diluent)—do not exceed 10 parts diluent.

• Do not dilute samples that are undergoing ammonia, phenobarbital, fructosamine, total T electrolyte testing.

• Do not dilute small samples to achieve a minimum sample volume. Such dilutions on normal analyte concentration cannot be read accurately. When dilution is needed to determine some analytes at very high concentration, the sample should be diluted manually.

• An automated dilution run will be canceled if:

– There is insufficient diluent/sample volume.

– There are too many slides in the run.

Catalyst* Urine P:C Diluent.

Minimum Sample Volume for Dilutions

The minimum sample volume varies based on the dilution factor and the number of slides that are being diluted (see table below).

Parts Sample +

Parts Diluent =

Diluent Ratio

1 + 1 = 1:2 5 155 µ L 700 µL 300 µL

1 + 3 = 1:4 10 130 µL 700 µL 300 µL

1 + 5 = 1:6 10 130 µL 700 µL 300 µL

1 + 9 = 1:10 10 100 µL 700 µL 300 µL

Maximum

Number of

Slides per

Dilution

Minimum Sample Volume Diluent

Serum, Plasma,

or Urine

Whole Blood

Volume

, or

Preparing

To Prepare a 1:2 Dilution

1. Accurately measure the desired amount of sample to be diluted and gently transfer it to a sample cup.

2. Accurately measure an equal amount of diluent and transfer it to the sample collected in step 1.

3. Thoroughly mix the sample and diluent.

4. Analyze the sample.

Manual Dilutions

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Using the Catalyst One* Analyzer

To Prepare Dilutions Greater Than 1:2

If additional dilutions beyond 1:2 are necessary, always begin with the original, undiluted sample. Then, incrementally increase the parts diluent as indicated in the dilution chart (below).

Volumes are for example only. Parts Sample + Parts Diluent = Total Parts (Dilution Factor)

Parts Sample Parts Diluent Total Parts

(Dilution Factor)

1 (100 µL) 0 1 (undiluted sample)

1 (100 µL) 1 (100 µL) 2

1 (100 µL) 2 (200 µL) 3

1 (100 µL) 3 (300 µL) 4

1 (100 µL) 4 (400 µL) 5

1 (100 µL) 5 (500 µL) 6

1 (100 µL) 6 (600 µL) 7

1 (100 µL) 7 (700 µL) 8

1 (100 µL) 8 (800 µL) 9

1 (100 µL) 9 (900 µL) 10

1 (100 µL) 10 (1,000 µL) 11

Viewing and Printing Test Results

Analyzer results are automatically returned to the IDEXX VetLab Station and recorded in the appropriate patient’s record. The diagnostic results report is a comprehensive report of all the test results specified in a laboratory request for that patient on a specific day.

Patient test results can be printed automatically each time a set of results are returned or you can manually print the results when needed.

For more information about how to view and print test results, see the IDEXX VetLab Station Operator’s Guide.

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Outside of Reportable Range Samples

Occasionally a test value may be outside the analyzer’s reportable range capability. The test value may be greater than (“>”) the reportable range, or interfering substances in the sample may be causing a nonlinear or invalid result. See the following chart for reportable ranges on individual chemistries. If a value is required, it will be necessary to dilute the sample and repeat the test.

Chemistry U.S. Units S.I. Units French Units

ALB 0.1– 6 .0 g/dL 1–60 g/L 1–60 g/L

ALKP 10–2,000 U/L 10–2,000 U/L 10–2,000 U/L

ALT 10–1,000 U/L 10–1,000 U/L 10–1,000 U/L

AMYL 5–2,500 U/L 5–2,500 U/L 5–2,500 U/L

AST 0–1,083 U/L 0–1,083 U/L 0–1,083 U/L

BUN/UREA 2 –13 0 mg/dL 0.6–46.4 mmol/L 0.034–2.730 g/L

Ca 1.0–16.0 mg/dL 0.25–4.00 mmol/L 10–160 mg/L

CHOL 6–520 mg/dL 0.16 –13.4 4 mmol/L 0.06–5.20 g/L

CK 10–2,036 U/L 10–2,036 U/L 10–2,036 U/L

Cl 50 –160 mmol/L 50–160 mmol/L 50–160 mmol/L

CREA 0.1–13.6 mg/dL 9 –1202 µmol/L 1.0–136.0 mg/L

FRU 100–1,000 µmol/L 100–1,000 µmol/L 100–1,000 µmol/L

GGT 0–952 U/L 0–952 U/L 0–952 U/L

GLU 10–686 mg/dL 0 . 5 6 – 38 .11 mmol/L 0.10–6.86 g/L

K 0.8–10 mmol/L 0.8 –10 mmol/L 0.8–10.0 mmol/L

LAC 0.50 –12.0 0 mmol/L 0.50 –12.0 0 mmol/L 0.50–12.00 mmol/L

LDH 50–2,800 U/L 50–2,800 U/L 50–2,800 U/L

LIPA 10–6,000 U/L 10–6,000 U/L 10–6,000 U/L

Mg 0.5 –5.2 mg/dL 0. 21 – 2.17 mmol/L 5.0 –52.0 mg/L

Na 85 –180 mmol/L 8 5 –18 0 mmol/L 85 –180 mmol/L

†

PHBR

PHOS 0. 2 –16.1 mg/dL 0 . 06 –5 .19 mmol/L 2.00–161.00 mg/L

TBIL 0 .1–2 7. 9 mg/dL 2–477 µmol/L 1.0–279.0 mg/L

TP 0.5 –12.0 g/dL 5–120 g/L 5–120 g/L

TRIG 10– 375 mg/dL 0.11– 4. 23 mmol/L 0.10 –3 . 7 5 g/L

(canine) 0.5–10.0 µg/dL 6.43 –128.70 nmol/L 6.43 –128.70 nmol/L

(feline) 0.5–20.0 µg/dL 6.4–257.4 nmol/L 6.4–257.4 nmol/L

UCRE 6–350 mg/dL 0.06–3.50 g/L 0.06–3.50 g/L

UPRO 5–400 mg/dL 0.05–4.00 g/L 0.05–4.00 g/L

URIC 0.1 – 20 mg/dL 6–1,1 9 0 µmol/L 1–200 mg/L

†

1 µg/mL = 4.31 µmol/L

0–950 µmol/L 0–950 µmol/L 0–950 µmol/L

5–55 µg/mL 5–55 µg/mL 5–55 µg/mL

Using the Catalyst One* Analyzer

Page 18

Modifying the Settings on the Analyzer

Modifying the Sound Settings

The analyzer will beep when it encounters an alert. You can modify the Sound settings to turn the sound off or adjust its volume.

1. Tap Instruments on the IDEXX VetLab Station Home screen.

2. Tap the Catalyst One side tab.

3. If you do not want the analyzer to make any sounds, tap Off in the Sound area.

4. If you want the volume of the sound to be quiet, tap Low in the Sound area.

5. If you want the volume of the sound to be loud, tap High in the Sound area.

Entering Standby Mode

You can modify the settings of the analyzer so that it enters Standby mode at a certain time each day or put it in Standby mode immediately.

1. Tap Instruments on the IDEXX VetLab Station Home screen.

2. Tap the Catalyst One side tab.

3. If you do not want the analyzer to ever enter Standby mode, tap Never in the Standby area.

‡

4. If you want the analyzer to enter Standby mode at a certain time each day, tap Daily in the Standby area and then select the desired start time from the available drop-down list.

5. If you want the analyzer to enter Standby mode immediately, tap Now in the Standby area.

Exiting Standby Mode

You can set the analyzer to exit Standby mode at a certain time each day or immediately.

1. Tap Instruments on the IDEXX VetLab Station Home screen.

2. Tap the Catalyst One side tab.

3. If you want the analyzer to exit Standby mode at a certain time each day, tap Daily in the Exit Standby area and then select the desired start time from the available drop-down list.

4. If you want the analyzer to exit Standby mode immediately, tap Now in the Exit Standby area.

‡

Feature coming soon

Page 19

Sample Preparation and Storage

Supported Sample Types for Catalyst* CLIPs and Slides

The following sample types can be used with Catalyst* CLIPs and slides:

CLIPs/Slides Abbreviation

Serum

Lithium

Heparin-Treated

Plasma

Fluoride/

Chem 17 CLIP N/A

Chem 15 CLIP N/A

Chem 10 CLIP N/A

Equine 15 CLIP N/A

NSAID 6 CLIP N/A

UPC Panel N/A

Lyte 4 CLIP N/A

Albumin ALB

Alkaline Phosphatase ALKP

Alanine Aminotransferase ALT

Amylase AMYL

Aspartate Aminotransferase AST

Blood Urea Nitrogen BUN/UREA

Calcium Ca

Cholesterol CHOL

Creatine Kinase CK

Creatinine CREA

Fructosamine (part number 99-0000131) FRU

Fructosamine (part number 99-0003341) FRU

Gamma-glutamyltransferase GGT

Glucose GLU

Lactate LAC

Lactate Dehydrogenase LDH

Lipase LIPA

Magnesium Mg

Ammonia NH

Phenobarbital PHBR

Inorganic Phosphate PHOS

Total Bilirubin TBIL

Total Protein TP

Tot a l T

Triglycerides TRIG

Uric Acid URIC

  

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Oxalate-Treated

Plasma

Untreated Whole

Blood (using the

Catalyst* Lithium

Whole Blood

Urine

Separator)

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Page 20

Sample Preparation and Storage

Preparing Samples for Use on the Catalyst One Analyzer

You can run untreated whole blood, lithium heparinized whole blood, plasma, serum, and urine samples on the Catalyst One analyzer.

IMPORTANT: Do not use EDTA or sodium heparin for chemistry analysis.

To Prepare an Untreated Whole Blood Sample (Using a Lithium Heparin Whole Blood Separator)

1. Remove the green cap from the lithium heparin whole blood separator to prepare it for sample collection.

2. Immediately after sample collection (to avoid clotting), dispense 0.6–0.8 cc of untreated (no additive) whole blood into the lithium heparin whole blood separator using an untreated syringe with the needle removed.

Tip: Use the fill line on the separator to ensure proper fill volume.

Note: Heparinized samples can be used in the lithium heparin whole blood separator except

when running feline AST, LDH, or CK. Double dosing may elevate the results for these assays in feline samples.

3. Gently swirl (do not invert or shake) the whole blood separator at least 5 times to mix the sample with the anticoagulant.

Caution: Ensure that the cap is removed before loading the separator into the analyzer.

Fill to lowest line on separator (0.7 cc [700 µL])

To Prepare a Plasma Sample

1. Use the appropriate tube and collection device.

2. Draw the sample gently and transfer if necessary.

Note: Be sure to use the correct blood-to-lithium heparin ratio.

3. Gently invert (do not shake) the sample for 30 seconds to mix.

4. Centrifuge the sample.

5. Use a transfer pipette (or a 300 µL pipette) to transfer the appropriate volume of sample to a Catalyst sample cup (ensure there are no bubbles in the sample cup). The volume needed varies depending on the number of slides being used in the run—for more information, see “Proper Sample Cup Volume” on page 22.

2 3 4 5

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Sample Preparation and Storage

To Prepare a Serum Sample

1. Use the appropriate tube and collection device.

2. Draw the sample gently and transfer if necessary.

3. Let the sample clot for a minimum of 20 minutes.

4. Centrifuge the sample.

2 3 4 5

To Prepare a Urine Sample

1. Obtain the sample through cystocentesis (recommended), catheter, or free-catch method.

2. Transfer the sample to a disposable sample tube.

3. Centrifuge the sample.

4. Use a transfer pipette (or a 300 µL pipette) to transfer the appropriate volume of supernatant urine to a Catalyst sample cup (ensure there are no bubbles in the sample cup). The volume needed varies depending on the number of slides being used in the run—for more information, see “Proper Sample Cup Volume” on page 22.

2 3 4

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Proper Sample Cup Volume

The volume of plasma, serum, or urine sample required varies based on the number of slides being used in the run:

Number of slides Sample cup fill volume (µL)

1 60

2 70

3 80

4 90

5 100

6 110

7 120

8 130

9 190

10 200

11 210

12 220

13 230

14 240

15 250

16 260

17 270

18 280

Sample Preparation and Storage

Sample Inspection After Centrifugation

It is good practice to examine the sample carefully following centrifugation in a centrifuge and/or in the analyzer (by running a whole blood separator). If fibrin strands can be seen in the sample, they may interfere with sample pipetting. It may be necessary to rim the serum/plasma with a wooden stick, respin the sample, and proceed.

Various conditions, such as hemolysis, may affect results. You might also want to modify your test panel based on the following visual observations. Refer to the “Chemistry Descriptions” section on pages 30–51 for information about how each condition may affect specific chemistries.

Note: We recommend that after you have centrifuged a sample in a Catalyst whole blood separator that you inspect the sample for the conditions listed above.

Hemolysis

Visual: Sample has a transparent reddish hue ranging from pale pink to deep red.

Indications: Damage to red blood cells during sample preparation or intravascular

hemolysis.

Icterus

Visual: Plasma has a transparent yellow to opaque brown color.

Indications: Obstructive or toxic liver disease, intravascular hemolysis.

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Lipemia

Visual: Sample has a pale, milky appearance, possibly with floating fat globules.

Indications: Recent ingestion of a fatty meal or dysfunction in lipid metabolism.

Sample Storage

We recommend that you prepare and analyze samples immediately after collection for best results. However, if storage is necessary, follow these sample storage and testing guidelines.

Storing Serum/Plasma

For storage, the serum or plasma must be separated and removed immediately from the blood cells. Do not attempt to pour off the sample.

• Using a transfer pipette, carefully transfer the serum or plasma to an untreated collection tube, taking care not to draw up any white or red blood cells.

• Cap the tube tightly to avoid contamination and evaporation. Avoid frothing at any stage as this damages the serum proteins.

If you cannot perform analysis within 4 hours of drawing and processing the sample, refrigerate it at 2°C–8°C (36°F–46°F). If you cannot perform analysis for more than 48 hours, you should freeze the serum/plasma at -18°C (0°F).

Sample Preparation and Storage

Notes:

• For additional information on the effects of delays in removing serum or plasma from the cells, see the “Chemistry Descriptions” section on pages 30–51.

• See the calcium (Ca), total bilirubin (TBIL), lactate dehydrogenase (LDH), ammonia (NH3), electrolytes (Na, K, Cl), and glucose (GLU) chemistry descriptions for additional special handling and storage requirements.

• IDEXX does not recommend freezing samples that will be used to run electrolytes.

Storing Whole Blood

Lithium heparinized whole blood samples should be analyzed immediately. Samples that are not analyzed within 30 minutes should be placed in a tube to be separated and stored.

Important: Do not store whole blood samples in whole blood separators.

Storing Urine

Urine should be tested within 2 hours. Do not store urine in the refrigerator for more than 24 hours.

Analysis of Stored Samples

For samples stored at 2°C–8°C (36°F–46°F) and at -18°C (0°F):

• Allow the samples to come to room temperature (19°C–27°C/66°F–81°F).

• Mix the samples gently, but thoroughly, by inversion. Do not shake.

• Centrifuge the samples to remove any fibrin particles (or urine sediment) that may have formed during storage.

• Analyze the samples immediately after centrifugation.

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Quality Control

Overview

The purpose of quality control (QC) is to verify the integrity of your slides and also to verify that your Catalyst One* analyzer is functioning properly.

You should run a QC test:

• When the analyzer is first installed.

• After cleaning the internal components of the analyzer.

• If the analyzer has been moved.

• To verify system performance.

Quality Control Materials

IDEXX VetTrol* Control

In each box of IDEXX VetTrol* Control, there are four vials containing freeze-dried powder (dark brown bottle marked “VetTrol Control”) and four vials containing diluent (lighter bottles marked “Diluent for VetTrol”). The lot numbers for the diluent and the control are different and can be found on the product packaging.

For more information about IDEXX VetTrol Control, see its package insert.

Storage

Control and diluent vials should be stored frozen (-18°C/0°F). Discard opened control vials within 24 hours. Expired or unwanted material should be discarded with other clinical waste.

Note: Do not store in the freezer door; only in the main freezer compartment.

Stability and Handling

For most chemistries, IDEXX VetTrol Control can be used up to 24 hours after reconstitution when it is stored in the refrigerator and equilibrated to room temperature before running (do not leave at room temperature for more than 2 hours). For creatine kinase and ammonia values, IDEXX VetTrol Control fluid should be used within 2 hours following reconstitution. Exposure to light will affect total bilirubin and creatine kinase results. Ammonia concentration will increase with time.

UPRO Control

In each box of UPRO Control, there are six vials containing the control fluid. The lot number can be found on the product packaging.

Storage

Control fluid should be refrigerated (2°C–8°C/36°F–46°F). Discard at the expiration date. Expired or unwanted material should be discarded with other clinical waste.

Stability and Handling

Use within 24 hours after opening (refrigerate when not in use).

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Quality Control

Advanced Control

In each box of Advanced Control, there is one vial containing the control fluid. The lot number can be found on the product packaging.

Note: Each vial contains enough fluid for 2 runs, in the event a secondary run is necessary.

Storage

Store frozen until the expiration date, or store in the refrigerator for up to 5 days.

Stability and Handling

Once opened, Advanced Control cannot be stored and reused—discard remaining fluid after use.

PHBR Control

In each box of PHBR Control, there are six vials containing the control fluid. The lot number can be found on the product packaging.

Storage

Store frozen until the expiration date, or store in the refrigerator for up to 7 days.

Stability and Handling

Once thawed, PHBR Control cannot be stored and reused—discard remaining fluid after use.

Quality Control CLIPs and Slides

IDEXX recommends that you perform monthly quality control testing after you have cleaned the internal components of your analyzer. The convenient Catalyst* QC CLIP contains all of the chemistry slides needed to perform this task. It is also recommended that you perform a quality control for electrolytes using the Catalyst* Lyte 4 CLIP.

Run the QC CLIP and the Lyte 4 CLIP

Use the convenient QC CLIP and the Lyte 4 CLIP in conjunction with the IDEXX VetTrol Control fluid to perform quality control on your Catalyst One analyzer. It is recommended that you wait at least 30 minutes after running any slides before running the QC CLIP.

Run Individual Slides

You can use individual slides to create your own QC panel and perform a quality control test (one slide per group). If you want to use individual slides to run quality control, we recommend a minimum of one slide from each of the groups below.

Group 1 NH

Group 2 AMYL

CHOL GLU LAC LIPA TBIL TP TRIG

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Group 3 ALB

CREA Mg PHOS BUN/UREA URIC UCRE

Group 4 ALT

LDH

Group 5 ALKP

GGT

Group 6 AST

Ca CK UPRO (to be used with UPRO Control fluid only)

Preparing Control Fluid

The instructions for preparing control fluid vary depending on the type of control you are preparing.

Quality Control

To Prepare IDEXX VetTrol Control Fluid

1. Remove one diluent and one control vial from freezer. Allow 60–90 minutes for vials to acclimate to room temperature.

2. Slowly invert the diluent vial several times to thoroughly mix the contents. Do not shake.

3. Gently tap the control vial on the counter several times to dislodge any material adhering to the stopper.

4. Remove the seal and stopper from each vial just before adding the diluent to control. Do not leave the vials open.

5. Transfer exactly 3.0 mL of diluent to the control vial, using a clean, dry, Class A volumetric pipette or an equivalent automatic pipette. Discard the remaining diluent.

IMPORTANT: Measurement must be precise or results will be incorrect.

6. Replace the stopper on the control vial and hold it firmly in place. Gently invert the vial 6–10 times every 10 minutes for one hour (the use of a slow rocker is recommended). Do not shake. Reconstitution, with occasional inversion, will take 45–60 minutes. Visually verify that all freeze-dried material is dissolved before using.

7. Run quality control on the Catalyst One analyzer (see instructions below).

To Prepare UPRO Control Fluid

1. Take one vial of UPRO Control out of the refrigerator and gently invert it 6–10 times to mix thoroughly.

2. Transfer 300 µL of UPRO Control into a Catalyst* sample cup (to be loaded in the sample drawer).

3. Let the contents in the sample cups reach room temperature (approximately 10 minutes).

4. Run quality control on the analyzer.

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To Prepare Advanced Control Fluid

1. If the Advanced Control has been frozen, allow it to thaw for 30 minutes prior to use.

2. Invert the Advanced Control vial at least 5 times.

3. Transfer the contents of the Advanced Control vial to a Catalyst* sample cup.

4. Run quality control on the analyzer.

To Prepare PHBR Control Fluid

1. Take one vial of PHBR Control out of the freezer and allow it to reach room temperature (approximately 60 minutes).

2. Once you have confirmed that there is no visible frozen material in the vial, gently invert it 6–10 times to mix thoroughly.

3. Transfer 300 µL of PHBR Control into a Catalyst* sample cup.

Note: You will need one PHBR slide wash and one PHBR slide for the quality control procedure.

4. Run quality control on the analyzer.

Running Quality Control

Quality Control

To Run General Quality Control on the Catalyst One analyzer

1. Tap the Catalyst One icon on the IDEXX VetLab Station Home screen.

2. Tap Maintenance and then tap Quality Control.

3. Tap the quality control lot number you are using and then tap Run QC.

4. Follow the on-screen instructions for preparing and running quality control.

Notes:

• To view QC results at any time, tap Maintenance, tap Quality Control, tap View QC Results, select the desired date that QC was run, and then tap View Results.

• To view the expected ranges for each chemistry in a QC lot, tap Maintenance, tap Quality Control, select the desired QC lot, and then tap View QC Lot Information.

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Maintenance

Overview

In addition to performing monthly quality control checks on the Catalyst One* analyzer, it is recommended that you:

• Clean the outside of the analyzer with a damp (not wet) lint-free cloth. A mild liquid soap will remove grease.

• Clean the interior of the waste drawer with a lint-free cloth dampened with 70% isopropyl alcohol.

• Upgrade the software promptly.

Upgrading the Software

As new features and functionality are added to the Catalyst One analyzer, you will receive software upgrades from IDEXX. If you have IDEXX SmartService* Solutions, the upgrade will be sent via your IDEXX VetLab* Station automatically. If you do not have IDEXX SmartService Solutions, you will receive an upgrade disc in the mail. Be sure to read the software notes contained with each new release.

Cleaning the Internal Components of the Analyzer

To ensure optimal performance of your analyzer, it is important that you clean the internal components (incubator ring, optics window, and carousel) monthly and before performing quality control.

It is recommended that you wear clean powder-free latex or nitrile gloves when cleaning the internal components of the analyzer. Wearing these gloves helps to avoid smudges on the components and ensures an effective cleaning.

IMPORTANT: Never use cleaning materials (such as alcohol cleaning wipes containing sodium bicarbonate) that leave a residue once the alcohol/solvent evaporates.

To Clean the Internal Components

1. Tap the Catalyst One icon on the IDEXX VetLab Station Home screen.

2. Tap Maintenance, tap Clean, and follow these on-screen instructions.

a. Open the side door on your analyzer.

b. Raise the carousel cover until the green lever magnetizes

itself to the inside of the analyzer.

c. Lift up on the carousel and remove it from the analyzer.

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Maintenance

d. Using an IDEXX-supported alcohol prep pad, wipe the

incubator ring and optics window in a counterclockwise direction. Repeat this step at least three times using a new alcohol prep pad for each wipe.

e. Clean the white reference tile using a new alcohol prep pad.

f. Using a dry optical tissue, dry the optics window and

reference tile, ensuring all signs of dampness have evaporated from the cleaned components. If streaks or smudges remain, repeat the cleaning process.

g. Replace the carousel inside of the analyzer, lower the

carousel cover and close the side door.

h. Tap Done.

Cleaning the Outside of the Analyzer and the Sample Drawer

Clean the outside of the analyzer or sample drawer with a damp (not wet) lint-free cloth. A mild liquid soap will remove grease. Do not use any of the following near the analyzer: organic solvents, ammonia-based cleaning products, ink markers, sprays containing volatile liquids, insecticides, disinfectant, polish, or room freshener.

Care should be taken not to spill any samples, chemicals, cleaning agents, water, or other fluids on/in the analyzer.

Note: Dust and animal hair can lead to analyzer failures. Routinely dust off the analyzer with a

damp cloth and dust around its location. Do not block the cooling vents under the analyzer by allowing paper, loose materials, or dust to accumulate.

WARNING: Never wipe the analyzer or its surroundings with ammonia-based cleaning products. Avoid urine odors around analyzer. Ammonia in the atmosphere will falsely increase ammonia (NH3) quality control and patient test results.

Emptying the Waste Drawer

It is essential that you empty the waste drawer after every run or when prompted. The analyzer will not operate when the waste drawer is full. Pull the waste drawer to remove it from the analyzer.

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Appendices

Chemistry Descriptions

Serving veterinarians throughout the world, IDEXX Laboratories understands that medical content, including interpretation of diagnostic results and medical protocols may vary from country to country. A medical review board has approved the content presented in this document.

IDEXX has more than 40 reference laboratories worldwide employing over 100 veterinarians. If you have any questions about the medical content or interpretation of results in this document, please contact IDEXX Laboratories.

Introduction to Biochemical Profiling

By performing appropriate biochemical tests on quality samples, you can obtain information that, when combined with patient history and clinical findings, should assist you in making an accurate diagnosis. Appropriate biochemical tests are also essential for monitoring and prognostication purposes once a diagnosis is achieved.

Single tests are helpful in particular circumstances, such as following the course of an identified disease or for monitoring the effect of therapy. However, many individual chemistry tests give information about different organ systems and should be used in combination with other tests (panels or profiles) to help characterize disease.

Alanine Aminotransferase (ALT)

For practical purposes, the enzyme alanine aminotransferase is specific to the liver in dogs and cats. It is found in the hepatocyte cytoplasm and may be released into the blood during both reversible and irreversible (cell necrosis) changes.

Principal Reason for Performing the Test

To investigate hepatocellular injury in dogs and cats.

Note: This test is not useful in the detection of liver disease in ruminants, horses, and pigs as the enzyme activity in the liver is very low. Even with severe liver disease in these species, the increase in activity is minimal.

Most Common Abnormality Indicated by the Test

Hepatocellular injury.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. Hemolyzed specimens should not be used because ALT contamination from red blood cells will occur. If plasma is being collected, use only lithium heparinized samples.

Complementary Tests

Alanine aminotransferase activity is usually determined in conjunction with other tests of hepatic function or damage.

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Appendices

Reaction Sequence

Albumin (ALB)

Albumin forms the largest fraction of the total serum protein in the healthy animal. It is synthesized solely by the liver, has a relatively low molecular weight, and plays an important role in the transport of endogenous and exogenous compounds by binding with those compounds. Albumin also plays a major role related to osmoregulation.

Principal Reasons for Performing the Test

To investigate causes of hypoalbuminemia: protein-losing nephropathy, protein-losing enteropathy, as well as hepatic insufficiency (decreased production) and decreased absorption due to malabsorption (gastrointestinal disease) or malnutrition. In addition, it is helpful in characterizing the degree of dehydration with increases in serum albumin concentrations, and it is commonly decreased with active inflammatory disease (negative acute phase reactant).

The test should not be performed in isolation because of its lack of specificity.

Most Common Abnormalities Indicated by the Test

Decreased albumin—inflammatory disease, protein-losing nephropathy and enteropathy, and decreased production (hepatic insufficiency).

Increased albumin—dehydration.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. Hemolysis may occur if the sample is not handled properly. Although dry-slide technology minimizes the interfering effect of mild-to-moderate hemolysis, marked hemolysis will cause an increased albumin value.

Complementary Tests

Albumin concentration is usually determined in conjunction with the measurement of total protein and other tests of renal and hepatic function. When albumin is measured with total protein, the total globulins will be calculated automatically and given with the results.

Reaction Sequence

Alkaline Phosphatase (ALKP)

The enzyme alkaline phosphatase is found in many body tissues. Highest levels are found in the kidney cortex, small intestinal mucosa, and osteoblasts. The enzyme is also present in the liver primarily located on the bile canalicular; thus an increase in ALKP may indicate cholestasis.

In cats and horses, the half-life of hepatic alkaline phosphatase is very short for ALKP and even shorter for other natural tissue sources of ALKP due to rapid renal excretion/metabolism. Sensitivity of the test in cats and horses is low. Since the nonhepatic sources of ALKP have relatively short half-lives compared to the hepatic source, a mild-to-modest increase in ALKP in these species can be a specific indicator of cholestasis.

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Appendices

Principal Reason for Performing the Test

As an indicator of hepatic and/or biliary disease.

Most Common Abnormality Indicated by the Test

Obstructive changes in the biliary system. A special consideration for interpreting ALKP changes in the dog is required because there are “induced” forms of ALKP due to glucocorticoids and other influences that are not associated with the natural tissue sources of ALKP. The nonhepatic sources of ALKP (bone, intestinal, placental) in the dog will only rarely be measured as high as threefold above the high end of the reference range because of their relative short half-lives compared to the induced and hepatic forms of ALKP. With both the induced and hepatic source (cholestasis) of ALKP, serum enzyme activities are commonly greater than the threefold increase; therefore, when a greater than threefold increase is noted in ALKP in the dog, either cholestasis or induced enzyme is suspected.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. If plasma is being collected, use only lithium heparinized samples. Hemolyzed specimens should not be used because ALKP contamination from red blood cells will increase results while hemoglobin decreases results. Above normal total bilirubin levels may reduce ALKP results.

Complementary Tests

Alkaline phosphatase activity is usually determined in conjunction with other tests of hepatic function and damage.

Reaction Sequence

Ammonia (NH3)

Ammonia is the catabolic product of protein digestion and is extremely toxic. It is converted rapidly in the liver to urea, which is eliminated from the body by the kidneys.

Principal Reason for Performing the Test

To evaluate hepatic function.

Most Common Abnormality Indicated by the Test

Increased ammonia—decreased hepatic functional mass or hepatic vascular shunt.

Sample Type and Precautions

Use only lithium heparinized samples.

Blood should be processed and centrifuged immediately following collection; for this reason, plasma is recommended as the sample of choice.

Ammonia measurements in either plasma or serum are significantly affected by environmental factors and/or the passage of time. Minimal exposure of the sample to the air is essential. All sample containers should be capped unless sample is being introduced or withdrawn. Do not attempt to measure ammonia in hemolyzed samples. Contamination from the red blood cells will invalidate the test.

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Appendices

Complementary Tests

Ammonia may be determined in isolation but more often in conjunction with other tests of hepatic damage or dysfunction, such as pre- and postprandial bile acids.

Reaction Sequence

Amylase (AMYL)

This section should be read in conjunction with the Lipase (LIPA) section.

The main source of serum amylase is the pancreas, although pathology of the liver and small intestine may result in significant elevations of this enzyme (above the reference range). Since amylase is cleared by the kidneys, renal pathology may also result in elevation of amylase independent of pancreatic disease.

Principal Reason for Performing the Test

As an indicator of pancreatic disease and potential acute pancreatitis.

Most Common Abnormality Indicated by the Test

Acute necrotizing pancreatitis.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. Hemolyzed specimens should not be used. Do not use oxalate, citrate, or EDTA anticoagulants. If plasma is being collected, use only lithium heparinized samples.

Blood samples should be taken within one day of the onset of symptoms that suggest acute pancreatitis.

Complementary Tests

Amylase and lipase are usually determined in conjunction with one another. Evaluation of a comprehensive chemistry profile that includes electrolytes is generally recommended because of secondary effects of acute pancreatitis. Specific pancreatic lipase should be considered in suspected cases of pancreatitis.

Reaction Sequence

Aspartate Aminotransferase (AST)

The enzyme aspartate aminotransferase is present in large amounts in multiple tissues of dogs, cats, and many other animal species. Hepatocytes, cardiac muscle cells, and skeletal muscle cells have relatively high concentrations of AST. It is found in the cytoplasm and mitochondria of the cells and is released into the blood during cell injury. If no increase in ALT is seen in conjunction with an increased AST in the dog and cat, cardiac or skeletal muscle cell injury is most likely. For increased AST values with equine, bovine, and porcine samples, liver, cardiac, and skeletal muscle cell injury must be considered.

Principal Reason for Performing the Test

To investigate damage to liver, cardiac, or skeletal muscle.

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Appendices

Most Common Abnormalities Indicated by the Test

Dogs and cats—cardiac or skeletal muscle injury when ALT is not increased; liver, cardiac, or skeletal muscle injury if both ALT and AST are increased.

Horses, cows, and pigs —liver, cardiac, or skeletal muscle injury.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. Hemolyzed specimens should not be used because AST contamination from red blood cells will occur. EDTA and fluoride/oxalate should not be used as anticoagulants. If plasma is being collected, use only lithium heparinized samples.

Blood samples should be processed and centrifuged immediately after collection. Even slight hemolysis can cause marked increases in activity because of high intracellular concentrations of AST in red blood cells.

Complementary Tests

Aspartate aminotransferase activity is usually determined in conjunction with other tests of liver, cardiac, or skeletal muscle function or damage.

Reaction Sequence

Blood Urea Nitrogen (BUN)

The catabolism of proteins results in the production of ammonia, which is extremely toxic. Ammonia is converted to urea in the liver and eliminated from the body by glomerular filtration in the kidneys.

Principal Reason for Performing the Test

As an indicator of renal disease or pathologic conditions that result in bleeding into the gastrointestinal tract.

Most Common Abnormalities Indicated by the Test

Increased urea—prerenal, postrenal and renal azotemia with decreased glomerular filtration rate; high-protein diet or bleeding into the gastrointestinal tract.

Decreased urea —decreased protein intake; hepatic insufficiency; diuresis.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. If plasma is being collected, use only lithium heparinized samples.

Blood should not be drawn for urea determination within 6 hours of a meal. Do not use sodium fluoride or EDTA as anticoagulant. Samples that contain hemoglobin increase urea nitrogen.

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Appendices

Complementary Tests

Urea concentration should usually be determined in conjunction with measurements of creatinine, inorganic phosphate, total protein, albumin, and a complete urinalysis. Urea concentration is influenced by high-protein diet rather than creatinine.

Reaction Sequence

Calcium (Ca)

Calcium is an essential element that is involved in many body systems. These include the skeleton, enzyme activation, muscle metabolism, blood coagulation, and osmoregulation. In the blood, calcium exists in ionized and protein bound forms. Factors governing the total plasma, whole blood, or serum concentration are complex and include interaction with other chemical moieties, proteins, and hormones.

Calcium, phosphorus, and albumin metabolism are interdependent.

Principal Reason for Performing the Test

As an indicator of certain neoplasias, bone disease, parathyroid disease, eclampsia, and renal disease.

Most Common Abnormalities Indicated by the Test

Increased calcium—hypercalcemia of malignancy (due to tumor release of PTH-like substances), spurious.

Decreased calcium—potential renal failure with resultant hyperphosphatemia, dietary, spurious.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. If plasma is being collected, use only lithium heparinized samples.

Centrifugation should take place quickly after the sample has been drawn. The sample should not be exposed to the air for long periods. Glassware must be scrupulously cleaned to avoid contamination by sources of calcium (e.g., detergents). Prolonged contact with the clot may lead to lowered calcium values due to dilution by red blood cell water.

Do not use tubes containing fluoride, oxalate, citrate, or EDTA as these agents will cause significant negative interference due to calcium chelation.

If analysis cannot be performed within 4 hours, the sample should be removed from the red blood cells and refrigerated in a tightly stoppered container at 2°C–8°C (36°F–46°F) for short-term storage (up to 24 hours). The sample should not be frozen. The sample must be allowed to reach room temperature before analysis.

Complementary Tests

Calcium should be determined in conjunction with measurements of inorganic phosphate, albumin, total protein, and glucose. Ionized calcium measurement will provide more specific information related to the physiologic form of calcium.

Reaction Sequence

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Appendices

Chloride (Cl)

Chloride is the major anion, predominantly in the extracellular spaces, where it maintains cellular integrity by influencing osmotic pressure. Chloride determination is significant in monitoring acid-base balance and water balance.

Principal Reason for Performing the Test

Low chloride levels are usually found in severe vomiting or diarrhea, ulcerative colitis, severe burns, heat exhaustion, fever, and acute infections. Elevated values are found in dehydration, hyperventilation, anemia, and cardiac decompensation.

Most Common Abnormalities Indicated by the Test

Hyperchloremia—if elevated with sodium then the same cause of hypernatremia. Without a concurrent increase in sodium: hyperchloremic acidosis: GI or renal loss of HCO3.

Hypochloremia (without related change in sodium)—upper GI tract loss (vomiting).

Sample Type and Precautions

Avoid hemolysis—sample should be run as soon as possible after serum or plasma is separated from the cells or clot. If plasma is being collected, use only lithium heparinized samples.

Do not freeze samples for use with the Catalyst One analyzer.

Complementary Tests

Sodium, potassium, and chloride should always be assayed together to determine electrolyte balance. If sodium, potassium, chloride, and bicarbonate are measured together, accurate assessment of metabolic acid-base physiology is possible.

Reaction Sequence

Cholesterol (CHOL)

Serum cholesterol occurs predominantly at high concentration in the esterified form; the remainder is in the free form. Cholesterol is synthesized in the liver and other tissues and is also absorbed in the free form from the small intestine. It is esterified in the liver and is the precursor of steroid hormones.

Cholesterol is broken down in the liver to bile acids and eliminated via the bile duct.

Principal Reason for Performing the Test

May be a marker for cholestasis or endocrine disease, such as hypothyroidism, hyperadrenocorticism, diabetes mellitis, as well as nephrotic syndrome.

Most Common Abnormality Indicated by the Test

Increased cholesterol—hypothyroidism, postprandial, nephrotic syndrome.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. Blood should not be drawn within 12 hours of a meal. If plasma is being collected, use only lithium heparinized samples.

Complementary Tests

Cholesterol measurements should not be performed in isolation but as part of a profile of tests to investigate endocrine, hepatic, and renal disease. If high cholesterol is found in the absence of diabetes, hepatic, or renal disease, hypothyroidism may be present. This can be evaluated by measuring thyroid function.

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Appendices

Reaction Sequence

Creatine Kinase (CK)

Creatine kinase is found at high activity only in the cytoplasm of cardiac and skeletal muscle. This enzyme catalyzes the reversible phosphorylation of creatine by ATP to creatine phosphate and ADP. Creatine phosphate is the major source of high-energy phosphate used in muscle contraction.

Principal Reason for Performing the Test

To identify injury to skeletal or cardiac muscle.

Most Common Abnormality Indicated by the Test

Skeletal muscle lesions attributable to trauma or vigorous exercise.

Sample Type and Precautions

Samples must be processed and centrifuged immediately after drawing blood. Blood samples should be taken within 6 hours of a suspect lesion. It is important to determine that the patient has not been exercised vigorously during the 12 hours prior to sampling. This may cause marked increases in creatine kinase activity. Remove plasma or serum from the cells or clot. If plasma is being collected, use only lithium heparinized samples. EDTA and fluoride/oxalate will reduce creatine kinase results.

Complementary Tests

Creatine kinase determination provides a specific, sensitive indication of muscle cell damage. Aspartate aminotransferase and lactate dehydrogenase activities may also be measured but are less specific and show smaller corresponding increases when muscle damage is present.

Reaction Sequence

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Appendices

Creatinine (CREA)

Creatinine is a degradation product of creatine in muscle metabolism. The daily production of creatinine is fairly constant and not influenced markedly by age, diet, exercise, or catabolism. Creatinine is eliminated from the body by glomerular filtration and tubular secretion in the kidneys.

Principal Reasons for Performing the Test

As an indicator of renal disease and/or an index of glomerular filtration rate.

Most Common Abnormality Indicated by the Test

Increased creatinine—prerenal, postrenal, and renal azotemia.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. If plasma is being collected, use only lithium heparinized samples.

Interfering substances, such as creatine, in a sample can affect the analyzer’s ability to accurately provide creatinine results. When the analyzer detects such an interfering substance, dilution of the sample may be required to obtain an accurate creatinine value.

Complementary Tests

A complete urinalysis with a refractometry specific gravity measurement is essential for proper interpretation of increases in creatinine. Creatinine determinations should usually be performed in conjunction with measurements of BUN, inorganic phosphate, total protein, and albumin. A complete blood count (CBC) can sometimes demonstrate changes such as nonregenerative anemia with chronic renal failure.

Reaction Sequence

Fructosamine (FRU)

Fructosamine is glycated albumin or other proteins. Its concentration is related to blood glucose concentration during the preceding 2 to 3 weeks.

Principal Reason for Performing the Test

Measurement of fructosamine concentration as part of the routine evaluation of a diabetic patient undergoing therapy. It provides information about the status of glycemic control during the 2–3 weeks prior to evaluation. In cats, fructosamine concentrations can be measured to identify if a stress response or diabetes mellitus is the reason for high blood glucose concentrations. In addition, during management of diabetes in both canine and feline patients, fructosamine concentration is used to clarify discrepancies between the history and physical examination findings and serial blood glucose concentration measurements and it is also used to assess the effectiveness of therapy.

Page 39

Appendices

Most Common Abnormality Indicated by the Test

Increased fructosamine indicates lack of or inadequate glucose regulation due to diabetes mellitus. Fructosamine concentrations increase with poor glycemic control and decrease when glycemic control improves. Less common, a low fructosamine may indicate prolonged hypoglycemia.

Sample Type and Precautions IMPORTANT: FRU is currently available in two different formulations and their supported sample

types vary:

Part Number Supported Sample Type(s)

99-0000131 Serum

99-0003341 Serum or lithium heparin-treated plasma

(you can use the plasma generated from a

Catalyst* Lithium Heparin Whole Blood Separator)

Note: Please refer to part number and labeling on the slide box for supported sample type information.

It is important to separate the sample from the red blood cells as promptly as possible.

Serum is preferred for fructosamine testing as customer experience shows that it more consistently provides good quality samples.

Examine the serum or plasma for hemolysis. Although IDEXX dry-slide technology dramatically reduces the effect of this interfering substance, marked hemolysis can result in inaccurate fructosamine results. Typically, marked hemolysis will lower the reported value on the Catalyst analyzers.

Reaction Sequence

Gamma-glutamyltransferase (GGT)

The enzyme gamma-glutamyltransferase is membrane-bound. It is present in large quantities in the kidney medulla and cortex and to a lesser extent in the small intestinal mucosa and bile ductular epithelium.

Despite the high activity of gamma-glutamyltransferase in the kidney, renal disease does not result in high enzyme activity in the serum sample. GGT in the kidney is primarily related to tubular lining epithelial cells and the enzyme is localized to the apical portion of the cell. Pathologic changes in these tubular epithelial cells result in loss of GGT directly into the urine. Measurement of GGT in the urine can prove to be a sensitive indicator of tubular epithelial cell injury/nephrotoxicity.

Principal Reason for Performing the Test

As an indicator of cholestasis or gallbladder disease.

Most Common Abnormality Indicated by the Test

Increased GGT—cholestasis.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. If plasma is being collected, use only lithium heparinized samples. Hemolyzed specimens should not be used. Do not use fluoride/oxalate as an anticoagulant.

Complementary Tests

Serum gamma-glutamyltransferase activity is usually determined in conjunction with other tests of hepatic function or damage.

Page 40

Appendices

Reaction Sequence

Glucose (GLU)

Glucose is the principal source of energy in monogastric mammals. The circulating concentration in the healthy animal is maintained within narrow limits.

Principal Reason for Performing the Test

To investigate carbohydrate metabolism.

Most Common Abnormality Indicated by the Test

Increased glucose—diabetes mellitus; glucocorticoid influence; epinephrine influence.

Sample Type and Precautions

For glucose determinations, the animal should have been fasted for 5–8 hours before sampling. Hemolysis may affect glucose results.

For plasma samples: Use only lithium heparinized samples. When blood is collected in

lithium heparin, it is important that the sample be centrifuged immediately after collection. In this anticoagulant, glycolysis occurs quite rapidly in the presence of red blood cells and the glucose concentration in the sample can diminish at up to 10% an hour at room temperature. Remove plasma promptly from the red blood cells. Hemolyzed specimens should not be used.

For serum samples: Do not centrifuge serum samples until clotting is complete. Samples

must be centrifuged completely. Remove serum promptly from the clot to avoid metabolism of glucose by the cells. A maximum of 30 minutes between drawing and separation from the clot is recommended. Hemolyzed specimens should not be used.

Complementary Tests

When the patient is a diagnosed diabetic, glucose tests may be performed in isolation. It is, however, useful to perform other tests for renal and hepatic function and lipid metabolism to monitor secondary effects of poorly controlled diabetes. Because stress in companion animals, particularly cats, can significantly raise glucose above the reference range, a fructosamine level should be considered in suspected cases of diabetes mellitus. A concurrent urinalysis should also be performed to evaluate for the presence of glucose and ketones.

Reaction Sequence

Inorganic Phosphate (PHOS)

Phosphorus plays a major role as a metabolic intermediate and is a constituent of nucleic acids, phospholipids, and nucleotides. Phosphates are also important components of buffering systems within the body fluids. Phosphate and calcium are absorbed in the small intestine. Absorption is influenced by the presence of other minerals, nutrients, vitamins, and intestinal pH. Calcium and phosphorous metabolism are interdependent.

Page 41

Appendices

Principal Reason for Performing the Test

As a measure of glomerular filtration rate.

Most Common Abnormality Indicated by the Test

Increased inorganic phosphate—decreased glomerular filtration.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. If plasma is being collected, use only lithium heparinized samples. Do not use oxalate, fluoride, citrate, or EDTA as anticoagulants. Blood samples must be processed and centrifuged as soon as possible after collection as phosphates are released quickly from the red blood cells. Hemolysis can result in marked increases in phosphate concentration.

Complementary Tests

Inorganic phosphate determination should be performed in conjunction with measurements of calcium, albumin, total protein, and glucose. If renal disease is suspected, BUN, creatinine, albumin, total protein, and a complete urinalysis should also be determined.

Reaction Sequence

Lactate Dehydrogenase (LDH)

The enzyme lactate dehydrogenase is present in large amounts in all organs and tissues (including red blood cells) of most animals. It is found in the cell cytoplasm and is released into the blood during reversible and irreversible (necrosis) cell injury. The test is not a specific or sensitive indicator of damage to any organ or tissue.

Note: The normal range of lactate dehydrogenase in the dog and cat is wide, as can be the intra-animal variation from day to day. Consequently, small increases in activity due to minimal organ damage are difficult to identify. The measurement of lactate dehydrogenase is a somewhat traditional test whose diagnostic value is limited in practice.

Principal Reason for Performing the Test

To investigate damage to liver, cardiac or skeletal muscle.

Most Common Abnormality Indicated by the Test

Increased activity is usually associated with hepatic parenchymal lesions.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot and analyze as soon as possible. If plasma is being collected, use only lithium heparinized samples. Fluoride/oxalate and EDTA should not be used as anticoagulants.

Hemolyzed specimens should not be used because LDH contamination from red blood cells will occu r.

Complementary Tests

Lactate dehydrogenase activity is usually determined in conjunction with other tests of liver, cardiac, or skeletal muscle function or damage.

Page 42

Appendices

Reaction Sequence

Lactate (LAC)

Lactate is produced by anaerobic metabolism of glucose and its concentration depends on relative rates of production in muscle cells and erythrocytes and metabolism in the liver.

Principal Reason for Performing the Test

Elevated lactate levels usually are caused by overproduction or under metabolism. They result from tissue hypoxia, diabetes mellitus, malignancies, ethanol or methanol ingestion, and metabolic acidosis.

Most Common Abnormality Indicated by the Test

Hypoxia secondary to severe exercise, shock, hypovolemia, cardiac disease, pulmonary edema, and seizures.

Sample Type and Precautions

Use lithium heparinized or Fl/oxalated samples. When using lithium heparinized samples, separate the plasma from the red cells within 5 minutes of collection.

Complementary Tests

CBC, biochemical panel, complete urinalysis, and blood gas.

Reaction Sequence

Lipase (LIPA)

Lipase is secreted by the pancreas and to a lesser extent by the gastrointestinal mucosa. Lipase is a relatively sensitive indicator of pancreatic pathology (as compared to amylase). Generally a greater than threefold increase above the reference range is supportive of pancreatitis.

Principal Reason for Performing the Test

As an indicator of acute pancreatitis.

Most Common Abnormality Indicated by the Test

Acute pancreatitis.

Sample Type and Precautions

Blood samples should be taken within one day of the onset of symptoms suggesting acute pancreatitis. Promptly remove plasma or serum from the cells or clot. If plasma is being collected, use only lithium heparinized samples. Do not use oxalate/fluoride, citrate, or EDTA anticoagulants. Lipemia and icterus may increase lipase results.

Page 43

Appendices

Complementary Tests

Lipase and amylase are usually determined in conjunction with tests of hepatic and pancreatic function or damage. Canine and feline pancreas-specific lipase tests should be performed in questionable cases.

Reaction Sequence

Magnesium (Mg)

Magnesium plays an important intracellular role in the activation of enzymes including those responsible for many anabolic and catabolic processes. It is also involved in the formation and destruction of acetylcholine, which governs the transmission of electrical impulses at the neuromuscular junction. The adrenal, thyroid, and parathyroid glands appear to regulate serum magnesium concentration.

Principal Reason for Performing the Test

The importance of measuring serum magnesium concentration in dogs and cats has not been fully investigated. However, there have been reports of hypomagnesemia in dogs following the removal of the parathyroid gland.

Most Common Abnormalities Indicated by the Test

Increased magnesium—decreased glomerular filtration.

Decreased magnesium —parathyroid gland removal.

Sample Type and Precautions

Blood samples should be centrifuged immediately after collection as magnesium is released from hemolyzed erythrocytes and can give erroneously high magnesium results. Remove plasma or serum promptly from the cells or clot. If plasma is being collected, use only lithium heparinized samples. Do not use oxalate/citrate or EDTA as anticoagulants. Blood collection tubes preserved with sodium fluoride cause lower results.

Complementary Tests

See tests listed under Endocrine Profile in the “Profile Selection” table on page 54.

Page 44

Appendices

Reaction Sequence

Phenobarbital (PHBR)

Phenobarbital is a commonly used drug used to treat seizures in a variety of species. Phenobarbital levels should be evaluated during initial dosing and throughout treatment to ensure that the blood levels are within the targeted therapeutic range.

Principal Reasons for Performing the Test

Phenobarbital is a controlled barbiturate medication that is used to treat veterinary patients that have seizures. The dosage of phenobarbital needs to remain within a specific range to be effective. If the level is <10 µg/mL, there may not be a sufficient level of phenobarbital to prevent seizures. If the level >30 µg/mL in cats or >40 µg/mL in dogs, phenobarbital can be toxic and potentially life threatening.

In most patients, steady state is achieved after 2–3 weeks of consistent dosing with phenobarbital. Once steady state is achieved, timing of sample collection is not important in more than 90% of patients. However, there can be variability of the phenobarbital half-life in a small percentage of patients. Therefore, if toxicity is suspected, a peak sample (4–5 hours post-pill) may be helpful, and if breakthrough seizures are occurring and inadequate dosing is suspected, a trough level (collected immediately prior to the next dose) may be helpful.

Most Common Abnormalities Indicated by the Test

Over or under dosage of medication.

Sample Type and Precautions

Do not use separator tubes as contact with the gel may decrease levels.

Complementary Tests

CBC, full chemistry panel, urinalysis, bile acids (minimally 2 times per year)

Reaction Sequence

Potassium (K)

Potassium is the major cation of intracellular fluid, where it is the major buffer within the cell, facilitates nerve conduction and muscle function, and helps maintain osmotic pressure. Abnormally high or low potassium levels cause changes in muscle irritability, respiration, and myocardial function.

Page 45

Appendices

Principal Reasons for Performing the Test

High potassium (hyperkalemia) is usually found in urinary obstruction, renal failure, metabolic or respiratory acidosis, and hypoadrenocorticism as well as excessive hemolysis for horses, cattle, cats, and some breeds of dogs. Decreased values (hypokalemia) usually follow excessive salt loss through severe vomiting or diarrhea, inadequate intake, anorexia (especially cats), malabsorption, and severe burns.

Most Common Abnormalities Indicated by the Test

Hyperkalemia—renal failure, postrenal obstruction.

Hypokalemia—excessive loss of potassium.

Sample Type and Precautions

Remove plasma or serum promptly from cells or clot. If plasma is being collected, use only lithium heparinized samples. Avoid hemolysis.

Do not freeze samples for use with the Catalyst One analyzer.

Complementary Tests

Sodium, potassium, and chloride should always be assayed together to determine electrolyte balance. The additional measurement of bicarbonate will allow accurate assessment of metabolic acid-base physiology.

ACTH stimulation test for suspect cases of hypoadrenocorticism.

Reaction Sequence

Sodium (Na)

Sodium is the major cation of extracellular fluid, where it maintains osmotic pressure, acid-base balance, and transmits nerve impulses. The body maintains total sodium content, and only slight changes are found even under pathologic conditions.

Principal Reasons for Performing the Test

To evaluate electrolyte status in conjunction with potassium and chloride levels.

Low sodium (hyponatremia) is usually caused by a relative excess of body water. Reduced levels may be due to low intake, loss through vomiting or diarrhea plus adequate water and inadequate salt replacement, salt-losing nephropathy, osmotic diuresis, metabolic acidosis, and various glandular conditions.

Elevated values (hypernatremia) usually follow water loss in excess of salt loss through profuse sweating, severe vomiting or diarrhea, inadequate water intake, and dehydration of renal sodium conservation in hyperaldosteronism.

Most Common Abnormality Indicated by the Test

Hypernatremia secondary to dehydration, gastrointestinal fluid loss (vomiting or diarrhea).

Sample Type and Precautions

Remove plasma or serum promptly from cells or clot. If plasma is collected, use only lithium heparinized samples. Avoid hemolysis.

Do not freeze samples for use with the Catalyst One analyzer.

Page 46

Appendices

Complementary Tests

Reaction Sequence

Total Bilirubin (TBIL)

Hemoglobin from degenerated erythrocytes is converted to bilirubin in the monocyte-macrophage system. Free unconjugated bilirubin is transported to the liver bound to albumin, where it is conjugated with glucuronic acid and eliminated in the bile. In obstructive liver disease, the concentration of conjugated bilirubin in the blood increases.

During intravascular or extravascular hemolysis, very large numbers of erythrocytes may be destroyed quickly and the conjugation mechanism in the liver may become overloaded so that high concentrations of unconjugated bilirubin are found in the blood. If the loss of hemoglobin and erythrocytes is very large, anoxia may occur. Hepatocyte dysfunction follows leading to cellular swelling, which occludes the bile canaliculi preventing the elimination of conjugated bilirubin. A concomitant rise in circulating conjugated bilirubin then occurs.

Principal Reason for Performing the Test

To detect hepatobiliary disease and excessive erythrocyte destruction.

Note: In healthy dogs and cats, the concentration of total bilirubin in the serum is very low. Visual inspection of the sample will frequently indicate whether bilirubin determination is necessary (serum and plasma only).

Most Common Abnormality Indicated by the Test

Increased bilirubin—cholestatic liver disease (conjugated bilirubin) and hepatic insufficiency (unconjugated bilirubin), hemolytic disease (unconjugated and possible conjugated bilirubin), and intrahepatic obstruction.

Sample Type and Precautions

Remove plasma or serum promptly from cells or clot. Samples should be analyzed immediately as bilirubin degrades rapidly in light. If immediate analysis is impossible, the sample must be kept in the dark and preferably at 4°C–8°C (36°F–40°F) in a refrigerator. Sample must be allowed to come to room temperature before analysis. If plasma is collected, use only lithium heparinized samples.

It is critical that samples be properly centrifuged. Otherwise, leukocytes and platelets may remain in suspension, even when red blood cells have been separated. Cellular material on the slide may cause significant positive error. Also, hemoglobin increases total bilirubin results, so avoid even moderately hemolyzed samples.

Complementary Tests

Total bilirubin should be determined with other tests of hepatic function or damage. Hematocrit should also be performed to eliminate or confirm the presence of hemolytic disease. Determination of urinary urobilinogen and bilirubin may also be useful.

Reaction Sequence

Page 47

Appendices

Total Protein (TP)

The serum total protein concentration comprises all the proteins found in the aqueous phase of the blood. In healthy animals, albumin is the major single component. The remaining proteins are the alpha, beta, and gamma globulins. The globulin concentration is determined by subtracting the albumin from the total protein.

Principal Reason for Performing the Test

Total protein measurement may provide useful information when used in combination with tests to investigate hepatic and renal function, the degree of hydration, protein-losing enteropathies, or gammopathies. The test is nonspecific and, if performed in isolation, will be unlikely to provide diagnostic information.

Most Common Abnormalities Indicated by the Test

Increased total protein—dehydration, inflammatory disease.

Decreased total protein—loss of proteins through blood loss and gastrointestinal loss, decreased albumin associated with protein-losing nephropathy and enteropathy, and decreased albumin associated with hepatic insufficiency and inflammatory disease.

Impaired renal and hepatic function, dehydration, and gastrointestinal lesions.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. If plasma is collected, use only lithium heparinized samples. Moderate-to-marked hemolysis can result in false high total protein concentration.

Results obtained from the analysis of plasma may be slightly higher than serum due to the fibrinogen that remains in the plasma.

Complementary Tests

Total protein concentration is usually determined in conjunction with the measurement of albumin and other tests of renal and hepatic function.

Reaction Sequence

Tota l T4 (TT4)

An enzyme-linked immunosorbent assay (ELISA) for the quantitative measurement of total T4 (thyroxine) in canine, feline, and equine patients. With a total T4 test, you can assess thyroid function, provide comprehensive one-visit screening for feline hyperthyroidism, presumptive canine or equine hypothyroidism, as well as monitor response to treatment and adjust dosages immediately.

Principal Reason for Performing the Test

To screen, diagnose, and monitor thyroid disease. The measurement of total thyroxine helps veterinary practitioners to assess thyroidal function by measuring the bound and unbound thyroxine in the blood. Thyroxine is the principal hormone secreted by the thyroid gland and is critical to metabolic processes.

Most Common Abnormality Indicated by the Test Hyperthyroidism—an elevated TT4 is consistent with hyperthyroidism. Naturally occurring

hyperthyroidism is a common endocrine disorder in cats and rare in dogs.

Page 48

Appendices

Hypothyroidism—a decreased TT4 is consistent with but not necessarily definitively diagnostic of hypothyroidism. Naturally occurring hypothyroidism is a common endocrine disorder in dogs and rare in cats. Hypothyroidism can be seen in horses as well.

Nonthyroidal illness (NTI)—nonthyroidal illness can affect TT4 levels (and potentially other thyroid tests as well). Nonthyroidal illness can lower TT4 levels, potentially into the hypothyroid range. The more severe the nonthyroidal illness, the greater the potential impact on TT4 levels.

Sample Type and Precautions

For use with serum, plasma, and whole blood (when using the Catalyst Whole Blood Separator).

Remove plasma or serum promptly from the cells or clot. If plasma is being collected, use only lithium heparinized samples. Hemolyzed samples should not be used. Do not use fluoride/oxalate as an anticoagulant.

Complementary Tests

Total T

should be evaluated in conjunction with a comprehensive history, physical examination,

CBC, complete biochemical profile, and urinalysis to provide a comprehensive database of information in the diagnosis or suspicion of thyroid disease.

In dogs with low or low normal T

results and with consistent clinical signs, evaluate free T4 (fT4) and

endogenous thyroid-stimulating hormone (TSH) and possibly thyroglobulin autoantibodies (TgAA) to aid in confirming hypothyroidism.

Cats with consistent clinical signs and total T4 (TT4) values in the borderline high range (gray zone) may have early hyperthyroidism or a concurrent nonthyroidal illness (NTI). In these cases, consider a free T4 (fT4), a T3 suppression test or radionuclide thyroid imaging to aid in confirming the diagnosis.

Triglycerides (TRIG)

Triglycerides are usually present in the diet of dogs and cats, especially when the animals are fed table scraps. They are also synthesized in the liver, mainly from carbohydrates, to provide a secondary energy source and are stored in fatty tissue. Their hydrolysis to mono- and diglyceride glycerol and free fatty acids is catalyzed by pancreatic lipase.

Principal Reason for Performing the Test

To detect abnormalities in lipid metabolism.

Most Common Abnormality Indicated by the Test

Increased triglycerides—High-fat diet or abnormalities in fat metabolism.

Sample Type and Precautions

Blood should not be drawn within 12 hours of a meal.

Remove plasma or serum promptly from the cells or clot. If plasma is collected, use only lithium heparinized samples. Grossly lipemic specimens probably have very high triglycerides and should be diluted before analysis.

Complementary Tests

Triglycerides should not be measured in isolation. If the sample is turbid or milky, the test should be determined in conjunction with measurements of cholesterol and glucose, and hepatic and renal function tests. Also consider repeat sampling if the patient has not been fasted for 12 hours.

Page 49

Appendices

Reaction Sequence

Uric Acid (URIC)

Uric acid determinations are useful in avian patients and dalmatians in place of urea determinations. In all dogs (except dalmatians) with diffuse hepatic disease, there is marked elevation of blood uric acid above the normal levels of <1 mg/dL.

Principal Reason for Performing the Test

As an indicator of the severity of renal disease in avian populations (and dalmatians).

Most Common Abnormality Indicated by the Test

Increased uric acid—prerenal, postrenal, and renal azotemia associated with decreased glomerular filtration rate.

Sample Type and Precautions

Remove plasma or serum promptly from the cells or clot. If plasma is collected, use only lithium heparinized samples. Plasma collected from sodium fluoride, citrate, or EDTA preservative should not be used.

Complementary Tests

Creatinine, UCRE/CREA, UPRO

Reaction Sequence

Urine Creatinine (UCRE)

Urine creatinine is determined so that the concentration of electrolytes filtered or lost through the glomeruli or renal tubules, such as urinary protein or cortisol, can be quantitated, compared, and expressed as ratios with diagnostic significance.

Page 50

Appendices

Principal Reason for Performing the Test

To be performed with urine protein in order to determine the urine protein:creatinine ratio (UPC).

Most Common Abnormality Indicated by the Test

Proteinuria indicating early renal disease, protein-losing nephropathy.

Sample Type and Precautions

Urine, preferably collected through cycstocentesis, collected in a clean container. An inactive urinary sediment should be demonstrated and urinary tract infection (UTI) via culture and sensitivity should be ruled out before performing, as UTI may mildly to moderately raise the UPC.

Complementary Tests

Complete urinalysis with culture and sensitivity. Serum chemistries, such as creatinine, BUN, albumin, and globulin.

CBC

SNAP* 4Dx* Test

Storage Information

Handle and store urine samples in closed containers to avoid evaporation and contamination. Samples may be stored at room temperature for up to 3 days (refrigeration preferred). Frozen samples can be stored indefinitely.

Reaction Sequence

Urine Protein (UPRO)

Urinary protein is determined and compared to the concentration of creatinine in order to assess the level of renal protein (glomeruli and tubular) loss to determine the urine protein:creatinine (UPC) ratio.

Principal Reason for Performing the Test

To be performed with urine creatinine in order to determine the urine protein:creatinine (UPC) ratio.

Most Common Abnormality Indicated by the Test

Proteinuria indicating early renal failure, protein-losing nephropathy.

Sample Type and Precautions

Page 51

Complementary Tests

Complete urinalysis with culture and sensitivity. Serum chemistries such as creatinine, BUN, albumin, and globulin.

CBC

SNAP 4Dx Test

Storage Information

Handle and store urine samples in closed containers to avoid evaporation and contamination. Samples may be stored at room temperature for up to 4 hours. Refrigerated samples may be stored up to 3 days. Do not freeze samples.

Do not use hemolyzed specimens as hemoglobin increases results significantly. Intact red blood cells can be removed via centrifugation.

Reaction Sequence

Medical Protocol Descriptions

Appendices

Ammonia Protocol

Baseline ammonia levels should be assessed in animals with signs of hepatic encephalopathy or in patients suspected of having portosystemic shunts (PSS). Ammonia tolerance tests may be considered to evaluate for PSS where bile acids are not considered (for example, in Maltese).

Ammonia tolerance test: A baseline sample is drawn after the patient has been fasted for 12 hours. Ammonium chloride (0.1 g/kg) by mouth via stomach tube or gelatin capsules. A second sample is drawn 30 minutes after ammonium chloride administration.

Note: Vomiting during the procedure will invalidate results.

Sample Requirements: 1 mL heparinized plasma, separated from RBCs. Do not use serum.

Storage/Stability: 48 hours—store plasma frozen

Interferences: Hemolysis, glucose levels over 600 mg/dL (33.33 mmol/L), high BUN values

Comments: Anticoagulated blood must be centrifuged immediately after collection. Separate

plasma and place it in a glass container (RTT). Freeze immediately and keep frozen if not running sample immediately.

Note: Ammonia levels increase with time.

UPC Protocol

Principle Reason for Performing Test: To aid in the diagnosis of protein-losing nephropathies

such as glomerulonephritis and amyloidosis and as an early marker of chronic renal failure.

Includes: Urine protein (UPRO), urine creatinine (UCRE), protein:creatinine (UPC) ratio

Sample Requirements: 2 mL urine in a sterile container

Storage/Stability: 48 hours at 2°C–8°C (36°F–46°F)

Interferences: Gross hematuria, pyuria.

Complementary Tests: Complete urinalysis with culture and sensitivity. Serum chemistries such

as creatinine, BUN, albumin, globulin; CBC; SNAP* 4Dx* Test; and imaging studies.

Page 52

Appendices

Interpretation: Proteinuria requires proof of persistence and localization to prerenal, renal, or postrenal origins. Prove persistence of proteinuria by repeating the UPC ratio at least three times, a minimum of 2 weeks apart.

• Prerenal proteinuria is possible when a CBC and a biochemical profile detect hemolysis, hyperglobulinemia or evidence of muscle damage. Recommend investigation and management for the underlying cause.

• Postrenal proteinuria is caused by urogenital tract diseases, hematuria, or pyuria. Repeat the test with a cystocentesis sample or evaluate urine sediment for hemorrhage or inflammation. Consider a urine culture. Recommend investigation and management for the underlying cause.

• Renal proteinuria: evaluate in the face of azotemia.

Nonazotemic, persistent, renal proteinuria (dogs and cats):

UPC <0.5 = within reference range

UPC 0.5–1.0 = questionable, repeat at appropriate range

UPC 1.0–2.0 = excessive proteinuria; recommend investigation for underlying systemic diseases

UPC 2.0 = excessive proteinuria; recommend investigation for underlying systemic diseases and medical management

Azotemic, persistent, renal proteinuria (dogs):

UPC <0.5 = warrant monitoring and investigation

UPC ≥0.5 = excessive proteinuria; recommend investigation for underlying systemic diseases and medical management

Azotemic, persistent, renal proteinuria (cats):

UPC <0.4 = warrant monitoring and investigation

UPC ≥0.4 = excessive proteinuria; recommend investigation for underlying systemic diseases and medical management

Page 53

Appendices

Page 54

Tota l T4 Protocols

Common clinical signs in dogs

• Obesity

• Skin disease

• Lethargy

• Mental dullness

• Exercise/Cold intolerance

Canine hypothyroidism suspected

Initial database

• Total T

• CBC

• Chemistry with

• Complete urinalysis

electrolytes

Appendices

Low T

<1.0 µg/dL

(<13.0 nmol/L)

Address NTI

CBC = Complete blood count Note: 1 µg/dL is equal to 12.87 nmol/L. A result that falls within the low normal range of the assay should be considered ambiguous.

with NTI

Low T4

<1.0 µg/dL

(<13.0 nmol/L)

Low fT

high TSH

± positive TgAA

Hypothyroidism likely

Clinical trial

Low Normal T

1.0–2.0 µg/dL

(13.0–26.0 nmol/L)

TSH ± TgAA

Hypothyroidism unlikely

Repeat testing in 4–6 weeks if

hypothyroidism still suspected

Normal fT

negative TgAA

Normal T4

2.0–4.0 µg/dL

(26.0–51.0 nmol/L)

Hypothyroidism unlikely

and TSH

Page 55

Common clinical signs in cats

• Weight loss

• Hyperactivity

• Polyphagia

• Palpable goiter

• Unkempt coat

Feline hyperthyroidism suspected

Initial database

• Total T

• CBC

• Chemistry with

• Complete urinalysis

electrolytes

Appendices

Low T

<0.8 µg/dL

(<10.0 nmol/L)

Euthyroid sick

or iatrogenic

†

If strong suspicion of hyperthyroidism still exists, consider retesting in 4–6 weeks or a technetium scan.

CBC = Complete blood count Note: 1 µg/dL is equal to 12.87 nmol/L. A result that falls within the gray zone of the assay should be considered ambiguous.

Normal T4

0.8–4.7 µg/dL

(10.0–30.0 nmol/L)

High T4

>4.7 µg/dL

(>60.0 nmol/L)

Normal T4 (gray zone)

2.3–4.7 µg/dL

(30.0–60.0 nmol/L)

Low or

normal fT

Hyperthyroidism unlikely

†

High fT

Hyperthyroidism likely

Page 56

Seizures

Young

preanesthetic

profile



Renal

disease is

suspected.

Acute

pancreatitis is

suspected.

The

investigation

of fat

metabolism

in hypo-

thyroidism,

ob es ity,

Hepatic

damage is

suspected.

Renal

profile

or lipemic

samples.

Lipid profile Pancreatic

Hepatic

profile

  

Endocrine

disease is

suspected.

Results may

indicate

that specific

hormone tests

are required.

Endocrine

profile



Cardiac

disease is

suspected.

Cardiac

profile

Profile Selection

 

Gastrointestinal

diseases are

suspected.

As a general

precaution

for any

anesthetic

candidate.

A smaller

version of

the General/

Geriatric

profile.

Circumstances for the choice of the profile

A diagnosis

is not evident

on clinical

examination,

but one

or more

lesions are

Suggested CLIPs/profiles that will aid in the identification of abnormalities in tissues, organs, and metabolic systems in the most economical way are:

Gastrointestinal

profile

Chem 10

CLIP

Chem 15

CLIP

       

      

       

   

suspected.

Chem 17

CLIP

ALKP

ALT

ALB

AMYL

        

    

     

AST

BUN/UREA

CHOL

       

   

       

CREA

GGT

GLU

  

LDHLIPA

Mg2+NH

PHBRPHOS

    

  TP        

TBIL

TRIG

–

TT4Na

   

CK: Samples should be taken within 6 hours of a suspected lesion.

AMYL/L IPA: Samples should be taken within 1 day of the onset of pancreatitis symptoms.

UPC

Page 57

Differences in Results

With a Commercial Laboratory or Other Instrument

Reference ranges must be created for each analyte and each new instrument or method of analysis. Every commercial laboratory must establish its own species reference ranges for the equipment and methodology used. IDEXX is continually doing this work for you with every software release.

Comparing results from different laboratories that may be using different equipment or methods is imprecise at best. Any comparisons should be performed on the same sample that has been “split,” stored under like conditions, and tested at approximately the same time. Compare each result to the reference range stated by IDEXX or the commercial laboratory (as appropriate). Each result should have the same relationship to its method’s reference range. For instance, a sample giving a Catalyst One* result that is slightly below the Catalyst One analyzer’s normal range should give a laboratory result slightly below the laboratory’s normal range.

Technical Specifications

Dimensions

Width: 10.0 inches

Appendices

Depth: 14.8 inches

Height: 14.0 inches

Weight: approximately 25 pounds

Power Supply

Input: 100–240 V AC, 50–60 Hz, 2 Amps

Power Supply Protection: IPX0

Rated: 24VDC, 6.25A

Input/Output Connections

There are two user-accessible Input/Output connections on the rear of the Catalyst One analyzer (power connection and Ethernet port for connection to IDEXX VetLab* Station).

Operating Conditions

Indoor use only

Altitude: 2000 meters

Operating Storage

Temperature 15°C–30°C (59°F–86°F) 5°C–38°C (41°F–100°F)

Relative Humidity 15%–75% 20%–85%

Page 58

IDEXX Technical Support Contact Information

IDEXX Sales Representative:

Telephone/Voice Mail:

Appendices

United States

IDEXX Laboratories, Inc. One IDEXX Drive Westbrook, Maine 04092 USA

Toll-Free Technical Support ...... 1-800-248-2483

Main Telephone Number ........... 1-207-556-0300

Toll-Free Fax .............................. 1-800-248-3010

idexx.com

France

IDEXX Laboratories France 84 Rue Charles Michels 93200 Saint Denis France

Toll-Free Technical Support ...... 00800 1234 3399

Telephone .................................. 0810 433 999

Fax .............................................. 00 800 1234 3333

idex x.fr

Germany

IDEXX GmbH Mörikestraße 28/3 D-71636 Ludwigsburg Germany

Toll-Free Technical Support .... 00800 1234 3399

Fax ............................................ 0800 6645627

idexx.de

Italy

IDEXX Laboratories Italia, S.r.l. Via Guglielmo Silva, 36 20149 Mil ano Italy

Toll-Free Technical Support ...... 800 - 9179 4 0

Telephone .................................. (39) 02 319 20 31

Fax .............................................. (39) 02 319 20 347

idexx.it

Spain

IDEX X Laboratorios, S.L. c/ Plom, n° 2– 8, 3° 08038 Barcelona Spain

Toll-Free Technical Support ...... 00800 1234 3399

Telephone .................................. (34) 932 672 660

Fax .............................................. 00800 1234 3333

idexx.es

United Kingdom

IDEX X Laboratories Ltd. Riverside House, Riverside Walk Windsor, Berkshire SL4 1NA United Kingdom

Toll-Free Technical Support ...... 00800 1234 3399

Telephone .................................. (44) 01753 838900

Fax .............................................. (44) 01753 838901

idexx.co.uk

Australia

IDEX X Laboratories Pty. Ltd. Metro Centre Unit 20, 30-46 South Street Rydalmere, New South Wales 2116 Australia

Toll-Free Technical Support ...... 1300 44 33 99

Telephone .................................. (61) 2 9898 7300

Fax .............................................. (61) 2 9898 7302

idexx.com.au

Canada

IDEXX Laboratories Canada Corporation C/O UPS 4071 North Service Rd Burlington, ON L7L 4X6 Canada

Toll-Free Technical Support ...... 1-800-248-2483

Telephone .................................. 1-905-602-9499

Toll-Free Fax .............................. 1-800-248-3010

Fax .............................................. 1-905-602-6640

idexx.ca

Japan

IDEX X Laboratories KK 1-22-19, Izumi, Suginami-ku, Tokyo 168-0063 Japan

Toll-Free Technical Support ...... 0120-71- 4921

Telephone .................................. (81) 422 71 4921

Fax .............................................. (81) 422 71 4922

idexx.co.jp

Belgium/Netherlands

ID E X X L abora tori e s B.V. Scorpius 60F 2132LR Hoofddorp, Netherlands

Telephone .................................. 023 5587001

idexx.nl

Page 59

Denmark

IDEXX Laboratories Denmark ApS c/o Harbour House Sundkrogsgade 21 2100 Copenhagen, Denmark

Telephone .................................. 80 34 76 18

idexx.dk

Finland

IDEX X Laboratories Oy c/o Accounting Services Tilimatic Oy Mannerheimintie 16 A 3 00100 Helsinki, Finland

Telephone .................................. 0800 98458

idexx.fi

Norway

IDEX X Laboratories Norge AS c/o Corpnordic Norway AS v/Sunde Bryggetorvet 1 0250 Oslo, Norway

Telephone .................................. 800310 26

idexx.no

Appendices

Sweden

IDEX X Laboratories Sverige AB Box 16285 103 25 Stockholm, Sverige

Telephone .................................. 020 160 5890

idexx.se

Distributor

IDEX X Europe Scorpius 60F 2132LR Hoofddorp, Netherlands

Telephone .................................. 00800 1234 3399

idexx.eu

Idexx Catalyst One Operator's Manual

Specifications and Main Features

Frequently Asked Questions

User Manual