# IDEXX LaserCyteTM.

## Presentation on theme: "IDEXX LaserCyteTM."— Presentation transcript:

IDEXX LaserCyteTM

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

LaserCyte™ Parameters
Red blood Cells White blood Cell Platlets

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

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

Red Blood Cells HGB (Hemoglobin)

Red Blood Cells # Retics % Retics

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

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

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

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

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

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

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

The Medical Reasons White Blood Cells WBC NEUTS EOS LYMPHS MONOS
Acute Inflammation Increased Increased Variable Decreased variable Chronic Inflammation Increased/ no change Increased/ no change Variable Increased/ no change Increased With a WBC count alone you can’t diagnose any of these conditions. There is a WBC increase is all. Only with a diff can you tell on from the other. Parasites Increased/ Variable Decreased/ no change Increased Variable Increased/ no change Stress Leukogram Increased Increased Decreased/ no change Decreased Increased/ no change

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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