Idexx SNAPshot Dx Operator's Manual

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IDEXX SNAPshot Dx*

Analyzer

Operator’s Guide

Page 2

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, SNAPshot Dx, Catalyst, SNAP, SNAP cPL, SNAP fPL, 4Dx, VetStat, and IDEXX SmartService are trademarks or registered trademarks of IDEXX Laboratories, Inc. in the United States and/or other countries. Lysodren is a registered trademark of Bristol-Myers Squibb Company. All other product and company names and logos are trademarks of their respective holders.

Proprietary Rights Notice

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Contents

Preface ....................................................................................................................................................v

Safety Precautions ....................................................................................................................................... v

International Symbol Descriptions .............................................................................................................. vi

Other Symbols ........................................................................................................................................... vii

A Getting Started .............................................................................................................................. A-1

Introduction .............................................................................................................................................. A-1

SNAPshot Dx Analyzer Components....................................................................................................... A-2

Installing the SNAPshot Dx Analyzer ....................................................................................................... A-2

Powering On the Analyzer ....................................................................................................................... A-4

Shutting Down the Analyzer..................................................................................................................... A-4

Connecting/Disconnecting the Power Cord ............................................................................................ A-4

Printing Test Results................................................................................................................................. A-4

B Using the SNAPshot Dx* Analyzer ...............................................................................................B-1

Overview .................................................................................................................................................. B-1

Using the Touch Screen ...........................................................................................................................B-1

Loading a SNAP* Test ............................................................................................................................. B-1

Running a SNAP* Test ............................................................................................................................B-1

Viewing Test Results ...............................................................................................................................B-2

C SNAP* Test Procedures ................................................................................................................C-1

Overview ..................................................................................................................................................C-1

SNAP* Total T4.........................................................................................................................................C-2

SNAP* Cortisol ........................................................................................................................................C-5

SNAP* Bile Acids .....................................................................................................................................C-9

SNAP* fPL*............................................................................................................................................C-11

SNAP* cPL* ...........................................................................................................................................C-12

SNAP* 4Dx* Plus ...................................................................................................................................C-13

SNAP* FIV/FeLV Combo .......................................................................................................................C-14

SNAP* Heartworm RT ...........................................................................................................................C-15

SNAP* Feline proBNP ...........................................................................................................................C-16

D Modifying the Settings on the Analyzer .......................................................................................D-1

Overview ..................................................................................................................................................D-1

Changing the Language/Local Settings ..................................................................................................D-1

Adjusting the Volume of the Analyzer ......................................................................................................D-2

Deleting a Patient from the Pending or In Process List ...........................................................................D-2

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E Sample Preparation and Storage ................................................................................................. E-1

Overview .................................................................................................................................................. E-1

IDEXX Quality Sample Preparation .......................................................................................................... E-2

Sample Collection Order ......................................................................................................................... E-3

Centrifuged Sample Inspection ............................................................................................................... E-3

Sample Storage ....................................................................................................................................... E-4

F Maintenance .................................................................................................................................. F-1

Overview .................................................................................................................................................. F-1

Upgrading the Software........................................................................................................................... F-1

Cleaning the Case ................................................................................................................................... F-1

Cleaning the SNAP Ports ......................................................................................................................... F-1

Cleaning the Screen ................................................................................................................................ F-1

Cleaning the Incubator Wells ................................................................................................................... F-1

Calibration ................................................................................................................................................ F-1

G Troubleshooting ............................................................................................................................G-1

Differences in Results ..............................................................................................................................G-1

Wrong SNAP* Device Removed .............................................................................................................G-1

Touch Screen Not Responsive ................................................................................................................G-1

SNAP Bar Code Cannot Be Read ...........................................................................................................G-1

Viewing the Event Log .............................................................................................................................G-2

Other Problems with Your Analyzer .........................................................................................................G-2

Sending Your Analyzer to IDEXX .............................................................................................................G-3

Frequently Asked Questions ...................................................................................................................G-3

H Appendices ...................................................................................................................................H-1

Technical Specifications .......................................................................................................................... H-1

IDEXX Technical Support Contact Information ........................................................................................ H-2

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Preface

Safety Precautions

• The IDEXX SNAPshot Dx* Analyzer contains no user-serviceable components. DO NOT disassemble. Call IDEXX Technical Support for any service issues.

• Do not insert anything in the SNAP* ports except devices approved for use with the SNAPshot Dx Analyzer.

• Do not insert anything in the incubator wells except for the plastic sample tubes provided in the SNAP test kits.

• DO NOT stack other equipment or containers on top of the analyzer.

• Keep analyzer away from sources of heat or flames.

• DO NOT place or operate the analyzer near x-ray equipment, photocopiers, or other devices that generate static or magnetic fields.

• PROTECT your equipment from damp conditions or wet weather.

• Take care not to spill water or other fluids on the analyzer.

• DO NOT use any of the following liquids, abrasives, or aerosol sprays on or near the analyzer, as they may damage the outer case and may influence the results:

– Organic solvents

– Ammonia-based cleaners

– Ink markers

– Sprays containing volatile liquids

– Insecticides

– Disinfectant

– Polish

– Room freshener

• Line voltage for the SNAPshot Dx Analyzer power supply is 100–240 V AC, 50–60 Hz. Be sure to plug all equipment into properly grounded electrical outlets.

• Use only the power cable supplied.

• Disconnect the power cable from the AC power outlet:

– If the power cable becomes frayed or otherwise damaged.

– If anything is spilled onto the equipment.

– If your equipment is exposed to excessive moisture.

– If your equipment is dropped or the case has been damaged.

– If you suspect that your analyzer needs service or repair.

– Whenever you clean the case.

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

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Preface

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.

Symbol Description Symbol Description

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

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）

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Preface

Symbol Description Symbol Description

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。

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。

Other Symbols

Symbol Description Symbol Description

USB symbol Ethernet/network symbol

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A Getting Started

Introduction

The IDEXX SNAPshot Dx* Analyzer is an assay reader designed for use with certain IDEXX SNAP* consumables, such as SNAP* Total T4 and SNAP* 4Dx* Plus Tests. By using the SNAPshot Dx Analyzer, you can keep a record of your patient’s SNAP test history as well as add tests to an existing patient’s record.

The analyzer’s touch-screen interface provides easy-to-follow instructions to help you navigate the system, specify testing information, and more.

The SNAPshot Dx Analyzer is for veterinary use only.

IDEXX VetLab* Station Connectivity

The SNAPshot Dx 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 allows you to view 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 SNAPshot Dx 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.

• View educational on-screen guides and videos, such as how to properly prepare a plasma sample.

• Learn proper protocols and tips for best techniques.

How It Works

The SNAPshot Dx Analyzer is a digital imaging system that records and interprets the colorimetric response of enzymes immobilized on the surface of a SNAP test. During operation, the analyzer records digital images of each SNAP device and uses test-specific algorithms to calculate the results. All SNAP tests that are loaded into the SNAPshot Dx Analyzer must have a bar code on the top of the device so that the analyzer can confirm the SNAP test type.

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Getting Started

SNAPshot Dx Analyzer Components

Installing the SNAPshot Dx Analyzer

The SNAPshot Dx Analyzer must be connected to the IDEXX VetLab Station (to be used in conjunction with the IDEXX VetLab suite of analyzers).

To Install the SNAPshot Dx Analyzer

1. Before you unpack the analyzer, choose an optimum location for the analyzer. The analyzer should be placed on a level surface with at least 4 inches (10 cm) of clearance above the analyzer. The area underneath the analyzer should remain clean and clear. Choose a well-ventilated area away from obvious sources of heat, direct sunlight, cold, humidity, or vibrations. For optimum results, room temperature should be 19°C–27°C (66°F–81°F) and relative humidity should be 30%–85%.

2. Unpack the analyzer using the following steps:

a. Remove the analyzer, power supply, and Ethernet cable from the box and then from the

bag.

b. Position the analyzer so the power switch can be accessed and the analyzer can be

unplugged.

3. Connect the power cord using the following steps:

a. Plug the round power connector into the receptacle on the back of the analyzer.

b. Plug the power cord into a wall outlet or power strip.

Note: Do not power on the analyzer at this time.

To Install the IDEXX VetLab Station Connectivity Router

Note: If you already have a network router connected directly to the IDEXX VetLab Station computer, you can skip this section and move to the “To Connect the SNAPshot Dx Analyzer to the IDEXX VetLab Station” section on page A-3.

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Getting Started

1. Connect the AC power adapter to the power port on the back of the network router supplied

2. Plug the AC power adapter into an electrical outlet.

3. Connect one end of the Ethernet cable (provided with the router) into any available port on the

4. Connect the other end of the Ethernet cable (from step 3)

by IDEXX Laboratories.

router.

IMPORTANT: Do not connect the IDEXX VetLab Station directly to the Internet port on the router.

into the IDEXX VetLab Station computer’s Ethernet port, which is located near the center panel on the back of the computer.

Note: If this Ethernet port on the IDEXX VetLab Station computer is currently being used to connect the IDEXX VetStat* Electrolyte and Blood Gas Analyzer (red Ethernet cable) to your IDEXX VetLab Station, disconnect the red Ethernet cable.

Ethernet port on the back panel of the IDEXX VetLab Station computer’s CPU

Then complete step 4 above. The “To Reconnect the VetStat Analyzer” section, found at the bottom of this page, explains how to reconnect the VetStat analyzer after the router is installed.

To Connect the SNAPshot Dx Analyzer to the IDEXX VetLab Station

1. Connect the Ethernet cable provided with the SNAPshot Dx Analyzer to the next available port on the back of the router.

IMPORTANT: Do not connect the SNAPshot Dx Analyzer directly to the Internet port on the router.

2. Connect the other end of the Ethernet cable (from Step 1) to the Ethernet port on the back of the SNAPshot Dx Analyzer.

3. Power on the IDEXX VetLab Station. Once the IDEXX VetLab Station is at its Home screen, power on the SNAPshot Dx Analyzer. Once both systems have completed their initialization process, the IDEXX VetLab Station will establish connectivity with the SNAPshot Dx Analyzer. When the SNAPshot Dx icon appears on the IDEXX VetLab Station Home screen, your connections are complete.

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

To Reconnect the VetStat* Analyzer

IMPORTANT: The direct connection between the VetStat analyzer and the IDEXX VetLab Station uses a standard Ethernet cable with a light purple cross-over adapter. This light purple cross-over

adapter, which is located on one end of the cable, must be removed before connecting the Ethernet cable to the router.

1. Ensure the light purple cross-over adapter has been removed from the VetStat Ethernet cable.

2. Connect one end of the VetStat Ethernet cable to the VetStat analyzer and the other end to the next available port on the router.

IMPORTANT: Do not connect the VetStat analyzer directly to the Internet port on the router.

3. On the VetStat Home screen, tap System Manager and then tap Setup.

4. Use the alphanumeric keypad to enter the setup password, 207, and tap OK.

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Getting Started

5. From the Setup screen, tap Hardware and then tap the Ethernet tab.

6. Select Dynamic as the network setting and then tap OK to save the change.

7. Turn off the VetStat analyzer by toggling the power switch to OFF. Then, turn on the analyzer. After the VetStat analyzer returns to the Home screen, the VetStat icon will appear at the bottom of the IDEXX VetLab Station Home screen.

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

Powering On the Analyzer

To turn on the analyzer, press the power switch on the back of the analyzer. The analyzer will take several minutes to warm up. It is ready for use when the Home screen appears.

Shutting Down the Analyzer

To Shut Down the SNAPshot Dx Analyzer

1. Tap Tools.

2. Tap Shutdown and then tap Ye s to confirm that you want to shut down the analyzer.

3. When the analyzer indicates it is okay to do so, press the power switch on the back of the analyzer to power the analyzer off.

Important: If you need to unplug the analyzer, ensure you disconnect the power cord from the wall outlet/power strip BEFORE you disconnect it from the analyzer.

Connecting/Disconnecting the Power Cord

It is important that you follow these instructions carefully as improper connection/disconnection could result in the hazard of an electrical shock.

To Connect the Power Cord

1. Ensure the analyzer is powered off.

2. Plug the round power connector into the receptacle on the back of the analyzer.

3. Plug the power cord into a wall outlet or power strip.

4. Press the power switch on the back of the analyzer to the on (I) position.

To Disconnect the Power Cord

1. Shut down the analyzer (see “Shutting Down the Analyzer” above).

2. Press the power switch on the back of the analyzer to the off (O) position.

3. Unplug the power cord from the wall outlet or power strip.

4. Unplug the round connector from the receptacle on the back of the analyzer.

Printing Test Results

The SNAPshot Dx Analyzer is connected to the IDEXX VetLab Station. Therefore, you print your SNAPshot Dx Analyzer test results using the print settings on the IDEXX VetLab Station (compatible printer required). For more information on printing while connected to the IDEXX VetLab Station, see the IDEXX VetLab Station Operator’s Guide.

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B Using the SNAPshot Dx* Analyzer

Overview

The SNAPshot Dx Analyzer is controlled via a touch-screen monitor on the front of the analyzer and by the IDEXX VetLab* Station.

Using the Touch Screen

To get the best results when using the touch screen:

• Do not rest your hand on the touch screen. The screen is sensitive to touch; pressure from your hand prevents the touch screen from functioning properly.

• Tap the screen firmly.

• Never tap the touch screen with a sharp or abrasive object.

The touch screen is on whenever the analyzer is on.

Loading a SNAP* Test

The proper way to load a SNAP test device into the analyzer is horizontally, sample well end first. Do not insert the SNAP device into the SNAPshot Dx Analyzer until the SNAPshot Dx Analyzer is ready to process the device.

Important: Do not remove a SNAP test from the analyzer during analysis—removing the device prematurely may result in loss of the run. Analysis is complete when the patient’s name is moved from the In Process list to the Results list.

Running a SNAP* Test

For detailed instructions on running a specific SNAP test, see the “SNAP Test Procedures” chapter in this guide.

IMPORTANT: Do not load a SNAP device until prompted by the analyzer.

To Run a SNAP Test

1. Enter the patient information on the IDEXX VetLab Station (for more information, see the “Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen, tap the patient’s name and then tap Select.

3. Follow the on-screen instructions for preparing, incubating (SNAP Total T4 and Cortisol only), and loading the SNAP test.

When analysis is complete, the patient’s name moves from the In Process list to the Results list (you may also receive a “New Results” alert message and/or hear a beep on the IDEXX VetLab Station, depending on the option(s) you selected in the New Results Alert tab on the IDEXX VetLab Station’s Settings screen). You can then remove the SNAP device from the analyzer by gently pushing the SNAP device until you hear a click. The device will slide out of the port.

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Using the SNAPshot Dx* Analyzer

Viewing Test Results

To View the Test Results on the SNAPshot Dx Analyzer

1. Tap the Results list.

2. Tap the patient whose test results you want to view.

Note: If you do not see the patient’s name in the Results list, tap the page up  and page down  arrows to view additional patient names.

3. Tap View Results to display the Test Results screen.

To View the Test Results on the IDEXX VetLab Station

See the IDEXX VetLab Station Operator’s Guide for detailed instructions on viewing test results.

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C SNAP* Test Procedures

Overview

This chapter includes detailed information for each of the SNAP tests that the SNAPshot Dx* Analyzer supports. You can use the information in this section to:

• Read a description of each SNAP test.

• Learn how to prepare each test for analysis (the process varies by test type).

For more information about SNAP test diagnosis, management, and interpretations, visit idexx.com.

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SNAP Test Procedures

SNAP* Total T

Test Description

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

Preparing and Running a SNAP Total T4 Test

Important: Allow the SNAP Total T4 Test to equilibrate in its sealed foil package at room temperature for at least 15 minutes. Do not heat. It is not necessary to equilibrate the conjugate solution at room temperature.

1. Enter the patient information on the IDEXX VetLab* Station (for more information, see the “Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen, tap the patient’s name and then tap Select. The Identify Sample screen appears.

3. Select Total T4 as the SNAP Test Type.

4. Select the applicable sample type.

Note: Plasma from the Catalyst* whole blood separator may be used.

5. Tap Next.

6. If you are running a diluted sample, tap the Dilution  or  arrows to specify the parts diluent (see the “Total T4 Dilution Guidelines” section on page C-3).

Note: T4 dilutions have not been validated for equine samples.

Important: Before performing a dilution, always run an undiluted patient sample first.

Samples should only be diluted when the undiluted sample result is >7.0 μg/dL (90.1 nmol/L).

7. Tap Next and follow the on-screen instructions to properly prepare the sample.

a. Use the purple handheld pipette to transfer 65 μL of sample into a disposable sample tube.

b. Use the 300-μL pipette to transfer 300 μL of conjugate into the same sample tube.

c. Cap the sample tube and gently invert it 4–5 times to mix.

d. Place the sample tube into an available incubator well.

e. Tap to start the incubation timer that corresponds to the well you selected (left or right).

8. When incubation is complete (the patient information in the Pending list changes from “Incubating” to “Ready,” the text turns red, and the analyzer beeps), tap to select the patient in the Pending list.

9. Tap Next and follow the on-screen instructions to properly prepare the SNAP test:

a. Place the device on a horizontal surface.

b. Add the entire contents of the sample tube to the sample well, being careful not to

c. When color FIRST appears in the activation circle, press the activator firmly until it is

The incubation timer displays with the patient information in the Pending list on the Home screen (the timer counts down in 10-second intervals).

splash the contents outside of the sample well. The sample will flow across the result window, reaching the activation circle in 30–60 seconds. Some sample may remain in the sample well.

flush with the device body.

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SNAP Test Procedures

10. Insert the SNAP device into the SNAPshot Dx Analyzer immediately. The SNAPshot Dx Analyzer automatically begins to process the patient sample and the Home screen displays. The patient’s name moves from the Pending list to the In Process list.

When analysis is complete, the patient’s name will move from the In Process list to the Results list (you may also receive a “New Results” alert message and/or hear a beep on the IDEXX VetLab Station, depending on the option(s) you selected in the New Results Alert tab on the IDEXX VetLab Station’s Settings screen). You can then remove the SNAP device from the analyzer by gently pushing the SNAP device until you hear a click. The device will slide out of the port.

Total T4 Dilution Guidelines

The SNAPshot Dx Analyzer allows you to dilute canine and feline Total T4 samples that initially report >7.0 μg/dL (90.1 nmol/L). Total T4 dilutions have not been validated on equine samples.

To Ensure that You Receive the Most Accurate Results

• Only perform a dilution when the undiluted sample result is >7.0 μg/dL (90.1 nmol/L).

• Use the lowest dilution factor possible.

• Use only normal saline as the diluent.

Note: Conjugate volume remains at 300 μL even if you are running a diluted sample.

Preparing a 1:2 Dilution (1 part sample, 1 part saline)

1. Using the purple handheld pipette, dispense 65 μL of sample (serum or plasma) into a disposable sample tube (e.g., a disposable tube from the SNAP Total T4 Test Kit).

2. Using the purple handheld pipette, add 65 μL of normal saline to the tube.

3. Cap the tube and gently invert 4–5 times to mix the sample and saline.

4. Using the purple handheld pipette, aspirate 65 μL of the diluted sample and run the SNAP Total T4 Test as normal.

Note: When prompted, select 1 in the Dilution drop-down list.

Preparing a 1:4 Dilution (1 part sample, 3 parts saline)

Important: A 1:4 dilution is only recommended if the result of a 1:2 diluted sample is >14.0 μg/dL (180.2 nmol/L).

1. Using the purple handheld pipette, dispense 65 μL of sample (serum or plasma) into a disposable sample tube (e.g., a disposable tube from the SNAP Total T4 Test Kit).

2. Using the purple handheld pipette, add 65 μL of normal saline to the tube 3 times.

3. Cap the tube and gently invert 4–5 times to mix the sample and saline.

4. Using the purple handheld pipette, aspirate 65 μL of the sample/saline combination and dispense it into a new disposable sample tube.

5. Using the diluted sample, prepare and run the SNAP Total T

Note: When prompted, select 3 in the Dilution drop-down list.

Test as normal.

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SNAP Test Procedures

Interpreting Test Results

The recommendations below are intended to provide general guidance only. As with any diagnosis, you should use clinical discretion with each patient based on a complete evaluation of the patient, including history, physical examination, and complete laboratory profile.

Species Results

Canine

Feline

Equine <1.0 Low <13 Low

†

‡

U.S. Units (µg/dL) S.I. Units (nmol/L)

<1.0 Low <13 Low

1.0–2.0 Low Normal 13–26 Low Normal

1.0–4.0 Normal 13–51 Normal

>4.0 High >51 High

2.1–5.4 Therapeutic 27–69 Therapeutic

<0.8 Subnormal <10 Subnormal

0.8–4.7 Normal 10–60 Normal

2.3–4.7 Gray zone in old or symptomatic cats

>4.7 Consistent with

hyperthyroidism

1.0–3.8 Normal 13–49 Normal

>3.8 High >49 High

30–60 Gray zone in old or

symptomatic cats

>60 Consistent with

hyperthyroidism

†

Canine Screening

• Dogs with a low total T

• Dogs with T

• In dogs with low or low normal T endogenous thyroid-stimulating hormone (TSH) and possibly thyroglobulin autoantibodies (TgAA) to aid in confirming hypothyroidism.

Hypothyroidism Therapeutic Monitoring

For dogs on thyroid supplement, acceptable 4–6-hour post-pill T the reference range or slightly above.

‡

Feline Screening

Cats with consistent clinical signs and total T early hyperthyroidism or a concurrent nonthyroidal illness (NTI). In these cases, consider a free T suppression test or radionuclide thyroid imaging to aid in confirming the diagnosis.

Hyperthyroidism Therapeutic Monitoring

Following treatment with methimazole, T reference range.

results in the low normal range may be hypothyroid.

(T4) and evidence of nonthyroidal illness (NTI) should have their NTI addressed.

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

values will generally fall in the upper end of

(T4) values in the borderline high range (gray zone) may have

(fT4), a T3

values will generally fall within the lower to midportion of the

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SNAP Test Procedures

SNAP* Cortisol

Test Description

An enzyme-linked immunosorbent assay (ELISA) for the quantitative measurement of cortisol in canine patients. With the SNAP Cortisol Test (when used in conjunction with accepted protocols for ACTH stimulation and low-dose dexamethasone suppression tests), you can screen for Addison’s disease and Cushing’s syndrome. You can also monitor response to treatment and make adjustments to medications for patients diagnosed with Cushing’s syndrome.

Important: DO NOT use the SNAP Cortisol Test if the patient has received:

• Dexamethasone (doses >0.1 mg/kg) in the last 7 days. OR

• Prednisone or other corticosteriods in the past 4 weeks.

Preparing and Running a SNAP Cortisol Test

Important: Allow the SNAP Cortisol Test to equilibrate in its sealed foil package at room temperature for at least 10 minutes. Do not heat. It is not necessary to equilibrate the conjugate solution at room temperature.

1. Enter the patient information on the IDEXX VetLab Station (for more information, see the “Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen, tap the patient’s name and then tap Select. The Identify Sample screen appears.

3. Select Cortisol as the SNAP Test Type (the sample type is chosen automatically).

4. Tap Next.

5. In the Protocol drop-down list, tap ACTH Stim, LDDST, or HDDST.

Note: Take care not to exceed 0.1 mg/kg of dexamethasone.

6. In the Protocol Step drop-down list, tap the applicable protocol step. The options that are available vary based on the Protocol option that was selected in step 6.

7. Tap Next and follow the on-screen instructions to properly prepare the sample.

a. Using the appropriate handheld pipette (provided in the SNAPshot Dx sample prep kit),

transfer the sample and conjugate into a disposable sample tube (see volumes below).

Protocol/Protocol Step

Baseline Cortisol

Dexamethasone Suppression Cortisol (low- or high-dose) 100 µL Gray 300 µL

ACTH Stim Cortisol: Cushing’s Suspected 25 µL Blue 300 µL

ACTH Stim Cortisol: Addison’s Suspected 100 µL Gray 300 µL

Sample Volume

100 µL Gray 300 µL

Pipette Color

Conjugate Volume

Range

0.5–10.0 µg/dL (13.8–276.0 nmol/L)

2.5–30.0 µg/dL (69.0–828.0 nmol/L)

0.5–10.0 µg/dL (13.8–276.0 nmol/L)

†

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SNAP Test Procedures

Protocol/Protocol Step

ACTH Stim Cortisol: Therapeutic Monitoring 100 µL Gray 300 µL

Sample Volume

Pipette Color

Conjugate Volume

Range

†

0.5–10.0 µg/dL (13.8–276.0 nmol/L)

ACTH Stim Cortisol: Therapeutic Monitoring >10 µg/dL 25 µL Blue 300 µL

2.5–30.0 µg/dL (69.0–828.0 nmol/L)

†

“Range” refers to the test result range for a particular test’s protocol. When a test result falls outside of this

range, it will be reported as either “>” (greater than the upper limit) or “<” (less than the lower limit).

b. Cap the sample tube and gently invert it 4–5 times to mix.

c. Place the sample tube into an available incubator well.

d. Tap to start the incubation timer that corresponds to the well you selected (left or right).

The incubation timer displays with the patient information in the Pending list on the Home screen (the timer counts down in 10-second intervals).

9. Tap Next and follow the on-screen instructions to properly prepare the SNAP test:

a. Place the device on a horizontal surface.

b. Add the entire contents of the sample tube to the sample well, being careful not to

splash the contents outside of the sample well. The sample will flow across the result window, reaching the activation circle in 30–60 seconds. Some sample may remain in the sample well.

c. When color FIRST appears in the activation circle, press the activator firmly until it is

flush with the device body.

Interpreting Test Results

The recommendations below are intended to provide general guidance only. In all cases, it is important to exercise clinical judgement in interpreting cortisol results in the context of the patient’s history, clinical signs, physical status, and other laboratory data.

Note: Dexamethasone (doses >0.1 mg/kg), prednisone, and other corticosteroids are expected to artificially increase the reported result.

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SNAP Test Procedures

A. ACTH Stimulation Test

Pre-ACTH Interpretation

<2 μg/dL (55.2 nmol/L)

2–6 μg/dL (55.2–165.6 nmol/L)

>22 μg/dL (607.2 nmol/L)

Post-ACTH Interpretation

<2 μg/dL (55.2 nmol/L)

2–6 μg/dL (55.2–165.6 nmol/L)

6–18 μg/dL (165.6–496.8 nmol/L)

18–22 μg/dL (496.8–607.2 nmol/L)

>22 μg/dL (607.2 nmol/L)

Must evaluate in conjunction with post-ACTH result. If both results are <2 μg/dL (55.2 nmol/L), results are consistent with hypoadrenocorticism. Begin treatment with mineralocorticoid and/or glucocorticoid as appropriate.

Normal

Consistent with Cushing’s syndrome; perform high-dose dexamethasone suppression test.

Ideally, should be evaluated in conjunction with pre-ACTH result. If both results are <2 μg/dL hypoadrenocorticism. Begin treatment with mineralocorticoid and/or glucocorticoid as appropriate.

Inconclusive

Normal

Equivocal; Cushing’s syndrome possible

Consistent with Cushing’s syndrome; perform high-dose dexamethasone suppression test to discriminate between PDH and ATH, ACTH level, and/or abdominal ultrasound.

(55.2 nmol/L), results are consistent with

B. Low-Dose Dexamethasone Suppression Test

4-Hour Cortisol Level 8-Hour Cortisol Level Interpretation

<1 μg/dL (27.6 nmol/L) <1 μg/dL (27.6 nmol/L) Normal

1–1.5 μg/dL (27.6–41.4 nmol/L)

>1.5 μg/dL (41.4 nmol/L) and >50% of baseline

<1.5 μg/dL (41.4 nmol/L) or <50% of baseline

>1.5 μg/dL (41.4 nmol/L) and >50% of baseline

1–1.5 μg/dL (27.6–41.4 nmol/L)

>1.5 μg/dL (41.4 nmol/L) and >50% of baseline

>1.5 μg/dL (41.4 nmol/L) and <50% of baseline

Inconclusive; consider repeating in 6–8 weeks.

Consistent with Cushing’s syndrome; perform high-dose dexamethasone suppression test, endogenous ACTH concentration test, and/or abdominal ultrasound to discriminate between PDH and ATH.

Consistent with PDH

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SNAP Test Procedures

C. High-Dose Dexamethasone Suppression Test

4-Hour Cortisol Level 8-Hour Cortisol Level Interpretation

<1.5 μg/dL (41.4 nmol/L) or <50% of baseline

>1.5 μg/dL (41.4 nmol/L) and >50% of baseline

<1.5 μg/dL (41.4 nmol/L) or <50% of baseline

>1.5 μg/dL (41.4 nmol/L) and >50% of baseline

D. Post-ACTH Stimulation Mitotane (Lysodren*) Monitoring

>1.5 μg/dL (41.4 nmol/L) and >50% of baseline

<1.5 μg/dL (41.4 nmol/L) or <50% of baseline

>1.5 μg/dL (41.4 nmol/L) and >50% of baseline

Consistent with PDH

Additional testing required to differentiate PDH from ATH; consider measuring plasma ACTH levels and/or performing an abdominal ultrasound.

Loading Dose Interpretation

<1 μg/dL (27.6 nmol/L)

1–5 μg/dL (27.6–138.0 nmol/L)

>5 μg/dL (138.0 nmol/L)

Note: 1 μg/dL = 27.6 nmol/L

Discontinue mitotane. If dog is listless or ill, administer maintenance prednisone in tapering dose for 2 weeks. If dog is clinically healthy, do not start prednisone, but start low maintenance dose of mitotane in 2 weeks.

Begin maintenance mitotane dosing (25–50 mg/kg per week with food in divided doses); repeat ACTH stimulation test in one month.

Continue mitotane loading dose for 3–7 days; recheck 3–7 days; observe for adverse reaction.

Maintenance Dose Interpretation

<1 μg/dL (27.6 nmol/L)

1–5 μg/dL (27.6–138.0 nmol/L)

>5 μg/dL (138.0 nmol/L)

Discontinue mitotane. If dog is listless or ill, administer maintenance prednisone in tapering dose for 2 weeks. If dog is clinically healthy, do not start prednisone. Restart mitotane maintenance therapy in 2 weeks, but reduce dose by 25%.

Maintain current dosage; repeat ACTH stimulation test every 3–4 months.

Increase weekly dose or repeat loading dose for 3–7 days; observe for adverse reaction and then increase weekly maintenance dose.

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SNAP Test Procedures

SNAP* Bile Acids

Test Description

An enzyme-linked immunosorbent assay (ELISA) for the quantitative measurement of bile acids in canine and feline patients. The SNAP Bile Acids Test may be used as an initial screen to establish a baseline level for hepatic function or as a bile acids stimulation test where standard protocols are adhered to. Abnormal results obtained from the SNAP Bile Acids Test indicate hepatic dysfunction ranging from mild, as with nonspecific hepatopathy, to severe, as with portosystemic shunts. Bile acids may also be useful for monitoring the effects of therapeutic drugs on hepatic function and screening for occult liver dysfunction when enzyme levels are normal.

Preparing and Running a SNAP Bile Acids Test

Important: Allow the SNAP Bile Acids Test and conjugate solution to equilibrate at room temperature for at least 30 minutes. Do not heat. Keep the SNAP test in its sealed foil package until ready to use.

1. Enter the patient information on the IDEXX VetLab Station (for more information, see the “Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen, tap the patient’s name and then tap Select. The Identify Sample screen appears.

3. Select Bile Acids as the SNAP Test Type.

4. Select the applicable sample type.

5. Tap Next.

6. In the Protocol drop-down list, tap Preprandial, Postprandial, or Other.

7. Tap Next and follow the on-screen instructions to properly prepare the sample.

a. Use the gray handheld pipette (provided in the SNAPshot Dx sample prep kit) to transfer

100 μL of sample into a disposable sample tube.

b. Use the 300-μL pipette to transfer 300 μL of conjugate into the same sample tube.

c. Cap the sample tube and gently invert it 4–5 times to mix.

8. Tap Next and follow the on-screen instructions to properly prepare the SNAP test:

a. Place the device on a horizontal surface.

b. Add the entire contents of the sample tube to the sample well, being careful not to

splash the contents outside of the sample well. The sample will flow across the result window, reaching the activation circle in 30–60 seconds. Some sample may remain in the sample well.

c. When color FIRST appears in the activation circle, press the activator firmly until it is

flush with the device body.

9. Insert the SNAP device into the SNAPshot Dx Analyzer immediately. The SNAPshot Dx Analyzer automatically begins to process the patient sample and the Home screen displays. The patient’s name moves from the Pending list to the In Process list.

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SNAP Test Procedures

Interpreting Test Results

The recommendations below are intended to provide general guidance only. In all cases, it is important to exercise clinical judgement in interpreting bile acid results in the context of the patient’s history, clinical signs, physical status, and other laboratory data.

<12 µmol/L

12–25 µmol/L

>25 µmol/L

Preprandial Result

Postprandial Result

<12 µmol/L 12–25 µmol/L >25 µmol/L

Normal; consistent with sufficient hepatic function

Retest at a later time (days to weeks) if liver dysfunction is

Consistent with decreased hepatic function

still suspected and

†

Consistent with decreased hepatic function

†

Consistent with decreased hepatic function

†

Retest at a later time (days to weeks) if liver dysfunction is still suspected and patient is anicteric

Decreased hepatic function possible

Retest at a later time (days to weeks) if liver

patient is anicteric

Retest at a later time (days to weeks) if liver dysfunction is still suspected and patient is anicteric

†

Retest at a later time (days to weeks) if liver dysfunction is still suspected and patient is anicteric

dysfunction is still suspected and patient is anicteric

†

Inadequate fast possible

†

Preprandial values will occasionally exceed postprandial values. This is usually attributed to spontaneous gall bladder contraction or preprandial specimen obtained prior to a sufficient fast. When preprandial values exceed the postprandial values, always check that preand postprandial samples are properly identified.

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SNAP Test Procedures

SNAP* fPL*

Test Description

The SNAP fPL Test is an in vitro test for the determination of pancreas-specific lipase levels in feline serum.

Preparing and Running a SNAP fPL Test

Important: Allow all SNAP fPL test components to equilibrate at room temperature for at least

30 minutes. Do not heat.

1. Enter the patient information on the IDEXX VetLab Station (for more information, see the

“Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen,

tap the patient’s name and then tap Select. The Identify Sample screen appears.

3. Select fPL as the SNAP Test Type (the sample type is selected automatically).

4. Tap Optional Prep Instructions if you would like to view on-screen sample preparation

instructions.

a. Hold the provided pipette vertically and dispense 3 drops of sample into a

b. Holding the bottle vertically, add 4 drops of conjugate to the sample tube.

c. Cap the sample tube and invert it 4–5 times to mix.

5. Tap Next and follow the on-screen instructions to properly prepare the SNAP test:

Note: Some samples may not flow to the activation circle within 60 seconds. In this case, press the activator after the sample has flowed across the result window.

6. Insert the SNAP device into the SNAPshot Dx Analyzer immediately. The SNAPshot Dx

Analyzer automatically begins to process the patient sample and the Home screen displays. The patient’s name moves from the Pending list to the In Process list.

disposable sample tube.

a. Place the device on a horizontal surface.

b. Add the entire contents of the sample tube to the sample well, being careful not

to splash the contents outside of the sample well. The sample will flow across the result window, reaching the activation circle in 30–60 seconds. Some sample may remain in the sample well.

c. When color FIRST appears in the activation circle, press the activator firmly until it is

flush with the device body.

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SNAP Test Procedures

SNAP* cPL*

Test Description

The SNAP cPL Test is an in vitro test for the determination of pancreas-specific lipase levels in canine serum.

Preparing and Running a SNAP cPL Test

Important: Allow all SNAP cPL test components to equilibrate at room temperature for at least 30 minutes. Do not heat.

1. Enter the patient information on the IDEXX VetLab Station (for more information, see the “Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen, tap the patient’s name and then tap Select. The Identify Sample screen appears.

3. Select cPL as the SNAP Test Type (the sample type is selected automatically).

4. Tap Optional Prep Instructions if you would like to view on-screen sample preparation instructions.

a. Hold the provided pipette vertically and dispense 3 drops of sample into a disposable

b. Holding the bottle vertically, add 4 drops of conjugate to the sample tube.

c. Cap the sample tube and invert it 4–5 times to mix.

5. Tap Next and follow the on-screen instructions to properly prepare the SNAP test:

a. Place the device on a horizontal surface.

b. Add the entire contents of the sample tube to the sample well, being careful not to

c. When color FIRST appears in the activation circle, press the activator firmly until it is

Note: Some samples may not flow to the activation circle within 60 seconds. In this case, press the activator after the sample has flowed across the result window.

6. Insert the SNAP device into the SNAPshot Dx Analyzer immediately. The SNAPshot Dx Analyzer automatically begins to process the patient sample and the Home screen displays. The patient’s name moves from the Pending list to the In Process list.

sample tube.

splash the contents outside of the sample well. The sample will flow across the result window, reaching the activation circle in 30–60 seconds. Some sample may remain in the sample well.

flush with the device body.

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SNAP Test Procedures

SNAP* 4Dx* Plus

Test Description

The SNAP 4Dx Plus Test is an in vitro test for the detection of Dirofilaria immitis antigen, antibody to Anaplasma phagocytophilum, antibody to Anaplasma platys, antibody to Borrelia burgdorferi, antibody to Ehrlichia canis, and antibody to Ehrlichia ewingii in canine serum, plasma, or whole blood.

Note:

Any color development in the sample spots on a SNAP 4Dx Plus Test indicates a positive test

result.

Preparing and Running a SNAP 4Dx Plus Test

Important: Allow all SNAP 4Dx Plus test components to equilibrate at room temperature for at least 30 minutes. Do not heat.

1. Enter the patient information on the IDEXX VetLab Station (for more information, see the “Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen, tap the patient’s name and then tap Select. The Identify Sample screen appears.

3. Select 4Dx Plus as the SNAP Test Type.

4. Select the applicable sample type.

5. Tap Optional Prep Instructions if you would like to view on-screen sample preparation instructions.

a. Hold the provided pipette vertically and dispense 3 drops of sample into a disposable

sample tube.

b. Holding the bottle vertically, add 4 drops of conjugate to the sample tube.

c. Cap the sample tube and invert it 4–5 times to mix.

6. Tap Next and follow the on-screen instructions to properly prepare the SNAP test:

a. Place the device on a horizontal surface.

b. Add the entire contents of the sample tube to the sample well, being careful not to

splash the contents outside of the sample well. The sample will flow across the result window, reaching the activation circle in 30–60 seconds. Some sample may remain in the sample well.

c. When color FIRST appears in the activation circle, press the activator firmly until it is

flush with the device body.

Note: Some samples may not flow to the activation circle within 60 seconds. In this case, press the activator after the sample has flowed across the result window.

7. Insert the SNAP device into the SNAPshot Dx Analyzer immediately. The SNAPshot Dx Analyzer automatically begins to process the patient sample and the Home screen displays. The patient’s name moves from the Pending list to the In Process list.

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SNAP Test Procedures

SNAP* FIV/FeLV Combo

Test Description

The SNAP FIV/FeLV Combo Test is a rapid immunoassay for simultaneous detection of feline leukemia virus (FeLV) antigen and antibody to feline immunodeficiency virus (FIV) in feline serum, plasma or whole blood. The presence of FeLV p27 antigen is diagnostic for FeLV infection, and the presence of specific antibodies to FIV indicates that a cat has been exposed to FIV and may have an active FIV infection.

Note:

Any color development in the sample spots on a SNAP FIV/FeLV Combo Test indicates a

positive test result.

Preparing and Running the SNAP FIV/FeLV Combo Test

Important: Allow all SNAP FIV/FeLV Combo test components to equilibrate at room temperature for at least 30 minutes. Do not heat.

1. Enter the patient information on the IDEXX VetLab Station (for more information, see the “Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen, tap the patient’s name and then tap Select. The Identify Sample screen appears.

3. Select Combo FeLV/FIV as the SNAP Test Type.

4. Select the applicable sample type.

5. Tap Optional Prep Instructions if you would like to view on-screen sample preparation instructions.

a. Hold the provided pipette vertically and dispense 3 drops of sample into a disposable

sample tube.

b. Holding the bottle vertically, add 4 drops of conjugate to the sample tube.

c. Cap the sample tube and invert it 4–5 times to mix.

6. Tap Next and follow the on-screen instructions to properly prepare the SNAP test:

a. Place the device on a horizontal surface.

b. Add the entire contents of the sample tube to the sample well, being careful not to

splash the contents outside of the sample well. The sample will flow across the result window, reaching the activation circle in 30–60 seconds. Some sample may remain in the sample well.

c. When color FIRST appears in the activation circle, press the activator firmly until it is

flush with the device body.

Note: Some samples may not flow to the activation circle within 60 seconds. In this case, press the activator after the sample has flowed across the result window.

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SNAP Test Procedures

SNAP* Heartworm RT

Test Description

The SNAP Heartworm RT Test is an in vitro diagnostic test for the semiquantitative detection of Dirofilaria immitis (D. immitis) antigen in canine and feline whole blood, serum, or plasma.

IMPORTANT: SNAPshot Dx supports the SNAP Heartworm RT Test with canine samples only—tests with feline samples must be read visually.

Note:

Any color development in the sample spots on a SNAP Heartworm RT indicates a positive test

result.

Preparing and Running the SNAP Heartworm RT Test

Important: Allow all SNAP Heartworm RT test components to equilibrate at room temperature for at least 30 minutes. Do not heat.

1. Enter the patient information on the IDEXX VetLab Station (for more information, see the “Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen, tap the patient’s name and then tap Select. The Identify Sample screen appears.

3. Select Heartworm RT as the SNAP Test Type.

4. Select the applicable sample type.

5. Tap Optional Prep Instructions if you would like to view on-screen sample preparation instructions.

a. Hold the provided pipette vertically and dispense 3 drops of sample into a disposable

sample tube.

b. Holding the bottle vertically, add 4 drops of conjugate to the sample tube.

c. Cap the sample tube and invert it 4–5 times to mix.

6. Tap Next and follow the on-screen instructions to properly prepare the SNAP test:

a. Place the device on a horizontal surface.

b. Add the entire contents of the sample tube to the sample well, being careful not to

splash the contents outside of the sample well. The sample will flow across the result window, reaching the activation circle in 30–60 seconds. Some sample may remain in the sample well.

c. When color FIRST appears in the activation circle, press the activator firmly until it is

flush with the device body.

Note: Some samples may not flow to the activation circle within 60 seconds. In this case, press the activator after the sample has flowed across the result window.

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SNAP Test Procedures

SNAP* Feline proBNP

Test Description

The SNAP* Feline proBNP Test is a rapid immunoassay to assess the level of NTproBNP (N-terminal pro-brain natriuretic peptide) in Feline serum or EDTA plasma samples. NTproBNP is released by the myocardium in response to stress and stretch. A normal result indicates that moderate to severe heart disease is unlikely at the time of testing. An abnormal result indicates increased stretch and stress on the heart muscle. As NTproBNP levels may be increased in other conditions, such as hyperthyroidism, hypertension or severe azotemia, an abnormal result should be evaluated in the context of laboratory profile

Note: If the color intensity of the sample spot is equal to or darker than the color intensity of the reference spot, the NTproBNP level is abnormal than the color intensity of the reference spot, the NTproBNP level is normal.

Preparing and Running the SNAP Feline proBNP Test

Important: Allow all SNAP Feline proBNP test components to equilibrate at room temperature for at least 30 minutes. Do not heat.

1. Enter the patient information on the IDEXX VetLab Station (for more information, see the

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen, tap

3. Select fBNP as the SNAP Test Type.

4. Select the applicable sample type.

5. Tap Optional Prep Instructions if you would like to view on-screen sample preparation

6. Tap Next and follow the on-screen instructions to properly prepare the SNAP test:

7. Insert the SNAP device into the SNAPshot Dx Analyzer immediately. The SNAPshot Dx

complete evaluation of the patient, including history, physical examination, and complete

“Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

the patient’s name and then tap Select. The Identify Sample screen appears.

instructions.

a. Hold the provided pipette vertically and dispense 3 drops of sample into a disposable

sample tube.

b. Holding the bottle vertically, add 5 drops of green conjugate to the sample tube.

c. Cap the sample tube and invert it 4–5 times to mix.

a. Place the device on a horizontal surface.

b. Add the entire contents of the sample tube to the sample well, being careful not to

splash the contents outside of the sample well. The sample will flow across the result window, reaching the activation circle in 30–60 seconds. Some sample may remain in the sample well.

c. When color FIRST appears in the activation circle, press the activator firmly until it is

flush with the device body.

Note: Some samples may not flow to the activation circle within 60 seconds. In this case, press the activator after the sample has flowed across the result window.

Analyzer automatically begins to process the patient sample and the Home screen displays. The patient’s name moves from the Pending list to the In Process list.

. If the color intensity of the sample spot is lighter

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D Modifying the Settings on the Analyzer

Overview

Some of the Settings and Tools screen features allow you to customize the analyzer, such as selecting a time/date format and editing the In Process and Pending lists on the Home screen. This chapter describes how to use those features.

Changing the Language/Local Settings

Tapping the Language/Local option on the Settings screen allows you to modify the analyzer’s language, name format, unit system, time, and/or date.

Notes:

• This option is unavailable when the SNAPshot Dx* Analyzer is processing a sample run.

• The analyzer will prompt you to restart it whenever the language/local settings are changed. You must restart the analyzer in order for the changes to take effect.

To Change the Language/Local Settings

1. Tap Settings on the SNAPshot Dx Home screen.

2. Tap Language/Local.

3. Select the desired language from the Language drop-down list. When a language is chosen, the Unit System and Name Format default settings change.

4. If desired, select a different Name Format option (last name, first name or last name first name).

5. If desired, select a different Unit System option (US, SI, or French SI).

6. Tap Next.

7. If desired, update the time settings:

a. Tap the arrows above or below the hour/minutes text boxes to increase or decrease the

hours/minutes incrementally.

b. Select the AM or PM option for your system time.

c. Select a time format (hh:mm in 12-hour format or hh:mm in 24-hour format).

8. If desired, update the date settings:

a. Select a date format (mm/dd/yyyy or dd/mm/yyyy). The left and right date fields

(above the date format options) vary depending on the date format you choose. For example, if you choose the date format mm/dd/yyyy, the month field is the left-most field, the day field is the middle field, and the year field is the right-most field. If you choose dd/mm/yyyy, the day field is the left-most field, the month field is the middle field, and the year field is the right-most field.

b. To change the month, tap the arrow above/below the current month selection to change

the month incrementally.

c. To change the day, tap the arrow above/below the day to increase/decrease the day

incrementally.

d. To change the year, tap the arrow above/below the year to increase/decrease the year

incrementally.

9. Tap Save. When prompted, tap Ye s to restart your analyzer and save the new settings.

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Modifying the Settings on the Analyzer

Adjusting the Volume of the Analyzer

The Sound feature on the Settings screen allows you to adjust the volume of the sounds the analyzer emits.

Note: If you do not wish to hear any analyzer sounds, select the Mute check box.

To Adjust the Volume

1. Tap Settings on the SNAPshot Dx Home screen.

2. Tap Sound.

3. Tap the left arrow to decrease the volume or the right arrow to increase the volume. The analyzer plays a sample of that particular volume upon each tap.

4. Tap Save.

Deleting a Patient from the Pending or In Process List

The Tools screen is available from the Home screen and provides options for editing the Pending and In Process lists. You can edit these lists by deleting a patient from the list.

To Delete a Patient from the Pending List

1. Tap Tools.

2. Tap Edit Pending.

3. Tap to select the patient you want to remove from the Pending list.

4. Tap Delete in the Delete From Pending box.

To Delete a Patient from the In Process List

You can also delete a patient from the In Process list by selecting the patient in the In Process list (on the SNAPshot Dx Home screen) and then tapping Stop Run in the Home screen’s center display area.

1. Tap Tools.

2. Tap Edit In Process.

3. Tap to select the patient you want to remove from the In Process list.

4. Tap Delete in the Delete From In Process box.

5. Remove the SNAP device from the applicable port. If you accidentally remove the wrong SNAP device, you will need to run a new SNAP Test for that patient.

Note: The IDEXX VetLab* Station displays the “New Results” alert even though no results exist for the deleted patient run (this message only displays if you’ve selected to receive a message with new results in the New Results Alert tab on the IDEXX VetLab Station’s Settings screen).

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E Sample Preparation and Storage

Overview

The quality of your reference laboratory and in-house testing results is impacted by the quality of the sample you provide the lab/analyzer. Therefore, it is important that you always prepare samples properly. This chapter provides instructions for preparing quality samples, the recommended order of draw, and more.

See the table on pages E-2–E-4 for a list of the different sample types that each IDEXX VetLab* analyzer is capable of running. The table provides the sample volume required for each sample type as well as how to prepare the sample. It also lists the sample type and volume for each SNAP* test type.

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Sample Preparation and Storage

IDEXX Quality Sample Preparation

Sample

Test

SNAP* Total T

Test 65 μL

Volume Required

Serum

 

Plasma

Anticoagulated Whole

Blood

serum: allow to clot for 20 minutes plasma: gently invert collection tube for 30

seconds Note: Plasma recovered from a Catalyst*

lithium heparin whole blood separator may be used.

Sample Preparation

Centrifuge

(time/speed)

serum/plasma: 120 seconds at a minimum of 12,000 RCF

SNAP* Cortisol Test

SNAP* Bile Acids Test

SNAP* fPL* Test 3 drops

SNAP* cPL* Test 3 drops

SNAP* 4Dx* Plus Test 3 drops

SNAP* FIV/FeLV Combo Test

SNAP* Heartworm RT 3 drops

SNAP* Feline proBNP 3 drops

25 μL or 100 μL

100 μL

3 drops



  

 

serum: allow to clot for 20 minutes

serum: allow to clot for 20 minutes plasma: gently invert collection tube for 30

seconds whole blood: gently invert collection tube for

30 seconds

serum: allow to clot for 20 minutes plasma: gently invert collection tube for 30

seconds whole blood: gently invert collection tube for

30 seconds

serum: allow to clot for 20 minutes plasma: gently invert collection tube for 30

seconds whole blood: gently invert collection tube for

30 seconds

serum: allow to clot for 20 minutes plasma: gently invert collection tube for 30

seconds

serum: 120 seconds at a minimum of 12,000 RCF

serum/plasma: 120 seconds at a minimum of 12,000 RCF

whole blood: none

serum/plasma: 120 seconds at

a minimum of 12,000 RCF

whole blood: none

serum/plasma: 120 seconds at

a minimum of 12,000 RCF

whole blood: none

serum/plasma: 120 seconds at

a minimum of 12,000 RCF

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Sample Preparation and Storage

Sample Collection Order

In order to prevent coagulation and contamination, blood should be drawn into the collection tubes in a specific order.

Note: While the following orders are recommended by the various tube manufacturers, always follow your clinic’s protocol for order of draw.

Order for Evacuated Collection Tubes

The following is the recommended order of draw when using evacuated tubes:

1. Blood cultures

2. Citrate

Note: If drawing citrate first, it is important to draw and discard a small volume of blood before dispensing the sample into a citrate tube.

3. Serum (with or without gel)

4. Plasma/lithium heparin (with or without gel)

5. EDTA

6. Fluoride

Order for Nonevacuated/Micro Collection Tubes

The following is the recommended order of draw when using nonevacuated/micro collection tubes:

1. Blood cultures

2. Citrate

Note: If drawing citrate first, it is important to draw and discard a small volume of blood before dispensing the sample into a citrate tube.

3. EDTA

4. Plasma/lithium heparin (with or without gel)

5. Fluoride

6. Serum (with or without gel)

Centrifuged Sample Inspection

It is good practice to examine the sample carefully following centrifugation. 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 also want to modify your test panel based on the following visual observations.

Hemolysis

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

Indications: Damage to red 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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Sample Preparation and Storage

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.

• Serum, plasma, and anti-coagulated whole blood (e.g., EDTA, heparin) can be stored in the refrigerator for up to one week (the storage temperature guidelines can be found in the SNAP test package insert(s)).

• For longer storage, serum or plasma can be frozen (-20°C or colder) and then recentrifuged before use.

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 (18°C–25°C/64°F–77°F).

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

• Centrifuge the samples to remove any fibrin particles that may have formed during storage.

• Analyze the samples immediately after centrifugation.

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F Maintenance

Overview

To ensure optimum performance of your SNAPshot Dx* Analyzer, IDEXX recommends that you clean the case, screen, and the SNAP* ports often.

Upgrading the Software

IDEXX will provide you, on a periodic basis and at no charge, updated instrument software that may include new features. Be sure to read the software notes contained with each new release.

For detailed upgrading instructions, see the insert included with the upgrade disc.

Note: If you have IDEXX SmartService* Solutions enabled on your IDEXX VetLab* Station, software upgrades will be sent to the SNAPshot Dx Analyzer automatically.

Cleaning the Case

Always disconnect the power cable before cleaning the analyzer.

Clean the outside of the analyzer with a damp, lint-free cloth. A mild liquid soap will remove grease. Do not use any of the following near the analyzer: organic solvents, ammonia-based cleaners, 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.

Cleaning the SNAP Ports

Dust and animal hair can lead to analyzer failures. Keep dust and animal hair from entering the analyzer by keeping the SNAP insertion area clean and dust-free.

If anything is spilled in a port, wipe it immediately with a damp, lint-free cloth. Confine wiping and cleaning of the ports to the bottom, side, and rear surfaces. If any fluid cannot be reached, call IDEXX Technical Support for service.

Cleaning the Screen

If the screen gets dirty, apply an antistatic screen cleaning agent (NOT ammonia-based) to a clean cloth or paper towel and wipe the screen. Do not spray the cleaner directly onto the screen as liquid can run inside the case and damage electrical circuits. Take care not to scratch the screen.

Cleaning the Incubator Wells

The incubator wells can be cleaned with a damp, lint-free cloth.

Note: There are holes in the bottom of the incubator wells. If liquid is spilled inside of a well, you may need to move your SNAPshot Dx Analyzer slightly to clean the counter underneath the analyzer.

Calibration

The SNAPshot Dx Analyzer requires no user intervention for calibration. It performs a self-check at the beginning of each test as well as an automatic systems check each time the analyzer is powered on.

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G Troubleshooting

Differences in Results

Every commercial laboratory must establish its own species reference ranges for the equipment and methodology used. 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 which has been “split,” stored under like conditions, and tested at approximately the same time. Comparisons of values must take into account differences in the corresponding reference ranges and technology.

If you receive results that are not what you expected for a particular patient, consider the following:

• Was the correct handheld pipette used (SNAP* Total T correct volume of sample and conjugate aspirated?

• Was the sample incubated for 5 minutes? (SNAP* Total T

• Was the device activated as soon as the sample reached the activation circle?

• Are there any abnormalities on the SNAP* device (e.g., streaking or high background color)?

• For SNAP tests that can also be read visually (e.g., SNAP* 4Dx Plus), the SNAPshot Dx* Analyzer was developed to read any color in the sample spots as positive, as outlined in the product insert.

• Do other clinical findings support the results?

• What other tests or procedures might be used to confirm or reject this result?

All laboratory results should be interpreted in light of the case history, the clinical signs, and the results of ancillary tests.

Cortisol and Bile Acids only) and the

and Cortisol only)

Wrong SNAP* Device Removed

If you remove the wrong SNAP device from a port on the analyzer, do not reinsert the SNAP device. You must run a new SNAP test for that patient.

Touch Screen Not Responsive

If you notice a decline in the responsiveness of the touch screen, it may be because the analyzer has not been shut down for a long period of time. Shut down the analyzer and then power on the analyzer (for instructions, see page A-4). If you still do not notice an increase in responsiveness, contact IDEXX Technical Support.

SNAP Bar Code Cannot Be Read

There is a small bar code located on top of all SNAP devices. When you place a SNAP device inside of the SNAPshot Dx Analyzer, the analyzer reads that bar code.

When the analyzer cannot read the bar code, a SNAP Status Event dialog box appears on the SNAPshot Dx Analyzer screen, prompting you to enter the bar code information manually or to confirm the SNAP test.

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Troubleshooting

To Enter the Code Manually (SNAP Total T4, Cortisol, or Bile Acids only)

1. Select the SNAP test type from the drop-down list.

2. Use the keypad in the dialog box to enter the STD CURVE number found on the SNAP foil bag.

Note: Tapping the Back button removes the last digit entered with the keypad.

3. Tap Start Run.

To Confirm the SNAP Test

When prompted, tap OK to confirm that you are running the SNAP test listed in the dialog box. The SNAP test will continue processing normally.

If you are unable to confirm that the SNAP test listed in the dialog box is the same SNAP test that was inserted, tap Cancel and delete the run.

Viewing the Event Log

Any issues that the analyzer has experienced are recorded in the analyzer’s event log. These issues are expressed as codes which are used by IDEXX Technical Support to diagnose problems with the analyzer.

To View the Event Log

1. Tap Tools.

2. Tap Event Log. The analyzer’s software version, serial number, IVLS status, and IP address are listed at the top of the screen. The date and time that each issue occurred are listed in the center of the screen.

Idexx SNAPshot Dx Operator's Manual

Specifications and Main Features

Frequently Asked Questions

User Manual