September / October 2009

Welcome to the September/October issue of VetCom broughtto you by Abaxis.

Our goal at Abaxis® is to be a leader in delivering superior quality products andworld-class customer service that meet Veterinary practice requirements every time.

In a recent Abaxis VetScan® customer survey, 97% of respondents were happywith how easy VetScan products are to use and were quoted with comments like“The small amount of tech time to set up and run samples is valuable in mybusy practice” and “Very easy to use, even the vets can work it!! LOVE IT!!”99% of respondents agree that Abaxis Products make their practice more efficient.

Thank you for your valuable feedback and thank you for your business.

In this issue (see page 6) Abaxis is also pleased to announce the theVetScan i-STAT® 1 with a full range of diagnostic applications in minutesand the point-of-care. The VetScan i-STAT 1 delivers accurate blood gas,electrolyte, chemistry and hematology results in minutes from two dropsof whole blood. Please note: Abaxis is servicing and supporting ALLi-STAT customers. Should you have questions regarding the i-STAT or i-STAT 1, please call 1.800.822.2947.

As always, Abaxis remains committed to Innovation that you can Trust.

Sincerely,

Valerie Goodwin – AdamsDirector, Marketing – Animal HealthEditor, VetCom Publications

Special Look:

Viral MarketingA lesson from industry applied tothe veterinary hospital

ARF and Abaxis Team UpAbaxis donates equipment to ARF

The Black-footed FerretVetScan assists in conservation efforts

Equine Metabolic Syndromeand Insulin Resistance

Project Report from Kruger National Park, South Africa

Abaxis Expands Warehouse

Case Studies:

African Grey ParrotAvian/Reptilian Profile Plus rotor

German ShepherdRetired Military Canine

Authorized Distributors

Conference Calendar

Editorial Staff

888-9300-REV T

Highlights Welcome

September / October 2009

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An Abaxis Publication For The Veterinary Community

About Abaxis, Inc.

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The Abaxis Animal Health point-of-care product portfolio consists of the VetScan VS2chemistry, electrolyte and immunoassay analyzer, the VetScan VSpro, a coagulationanalyzer with a combination PT/aPTT test cartridge, the VetScan i-STAT 1, a portableclinical analyzer, the VetScan HM2 (3-part differential), and the VetScan HM5 (5-part differential) hematology analyzer.

Abaxis has also introduced VetScan Canine Heartworm Rapid Test.

Special Look: Viral Marketing

At Abaxis, the economic downturn so far has been aboom to our business and is as well an opportunity forthe veterinary practice. We attribute much of our success to word of mouth (WOM) or what we call ‘viral’marketing. The veterinary community is a very tightknit social marketplace, and so is the pet owner market-place…they too share information by WOM, at theshopping center, in the park and among family andfriends.

Today, more than ever, veterinarians are re-evaluatinghow they stack up to the local competition as it relatesto services provided and the total client experience.Practice owners are also carefully reconsidering theiractual costs associated with those services, or maybecosts to the business associated with certain servicesthat they don’t offer but are offered by their competitorsin the community.

Abaxis strives to provide exceptional service and support,and our goal is to provide that support instantaneously.The motto in the building and in the field is “whateverit takes” or what we call “WIT”, and trust me; it is notjust a slogan, it is an embedded behavior and an integralpart of our company wide culture.

The animal hospital offering all clients low cost routinelaboratory testing (annual wellness for example) with results discussed in minutes is certainly spoken of differently by pet owners at the park than another hospital that selectively offers testing and then call’sthe client later that day or worse, a day or two later,because this testing is still being sent out to a commerciallaboratory or possibly the equipment used is outdated,slow or not reliable. This not only fails to impress theclient, and certainly inconveniences the client, but canoften adversely impact outcomes as well. If the hospitaldoes provide testing in house, and has a state of the artlaboratory on the premises, they should advertise thatthey do.

Abaxis continues to invest in capital expenditures allowing us to keep our costs down, and in turn ourreagents pricing (our customers’ operating costs) significantly lower than the competition. Over theyears we have ‘retired’ millions of dollars of factoryequipment investing in more efficient, more reliablelower operating cost equipment saving Abaxis overtime as much as 10X the initial capital investment orour net cost of financing, and we continue to do so.

The veterinary hospital discarding equipment with highoperating cost and/or poor performance and investingin or financing more efficient and economical instru-ments by Abaxis will allow it to actually reduce clientcharges for routine annual blood work if they like. Thisin turn increases testing compliance and testing volume,allowing for a greater likelihood of early disease detection.This all leads to increased revenue from treatment andprocedures and most importantly, better outcomes. Yourclients will be impressed and in turn will tell their familyand friends about your clinic and the services that youprovide. Traffic to your clinic will increase by WOM referrals and the cycle repeats itself.

So what do we do now with all these new profits? Theseincremental profits the business might consider reinvesting in still more services not widely offered locally,being certain to advertise same. If in your locality clientvisits are down, it may be time to ‘put on your gameface”. It is called getting a bigger slice of a smaller pie.Get competitive.

Finally, relying solely on the wholesalers’ recommendationsin this economic environment is passé. In the animalhealth industry, manufacturers often restrict distributorsto one product line in a category, and distributors typicallyacquiesce. (Abaxis though does not impose such restric-tions). At Abaxis we of course have solid relationshipswith suppliers and wholesalers, but at the end of theday, we do our own homework.

Viral marketing…A lesson from industry applied to the veterinary hospital

September / October 2009 • 2

Abaxis North American Animal Health Business up 32% (Nasdaq: ABAX)

Author: Martin Mulroy, Vice President, Marketing and SalesNorth American Animal HealthAbaxis, Inc.

Tony La Russa’s Animal Rescue Foundation (ARF) isvery pleased to announce a new partnership with Abaxis,Inc., a Union City, California manufacturer of point of careblood laboratory systems for medical and veterinary use.Abaxis has generously provided ARF’s Clinic with the use of aVetScan VS2 blood chemistry, electrolyte and immunoassayanalyzer and VetScan HM2 hematology analyzer with addi-tional support for related supplies. The equipment was re-cently installed with free training provided for ARF’s ClinicStaff and volunteers. The VetScan system can be operatedwith minimal training and perform multiple tests on wholeblood, serum or plasma at a greatly reduced cost, with preciseand accurate test results in minutes.

ARF’s Medical Director, Heather Coburn, DVM states “This equipment allows ARF to quickly obtain verycost-effective blood work when needed for ARF’s shelter animals and to provide more services to local lowincome clients served through ARF’s Emergency Medical Fund, enabling these families to receive criticallyneeded test results for their pets quickly and inexpensively”.

In these challenging economic times, demands for ARF’s programs and services increasedaily. Your support will help ARF make a difference in the lives of animals and people.Please visit http://www.arf.net/how-you-can-help/donate/ to make a donation.

People rescuing animals … animals rescuing people®.


Special Look: Viral Marketing continued

Abaxis Sales Representative training on theVetScan VS2 and VetScan HM2.

Abaxis’ North American Animal Health business lastquarter generated record revenues growing 32% versusyear ago while our competitors, including those providingcommercial lab services, were generally flat or down. Weattribute much of this continued success to the fact thatjust as we work hard (“Whatever It Takes”) in customersatisfaction and converting clients from the competitionto Abaxis the veterinary hospital management mustalso work hard to retain the existing client base and attract new ones every day. Just as our products andservices have a “Wow” factor, the veterinary hospitalshould strive to their level of service having a “Wow”factor and capitalize on the viral marketing opportunityboth Abaxis and its clients share.

Abaxis, should the practice owner invite us in, can provideproducts and services which will enable new and sus-tainable growth for the business: increased customersatisfaction, increased traffic, more services providedand procedures rendered, often better outcomes and increased recurring revenue and profits. 7,000+ ofyour peers are experiencing today the benefits of theirpartnering with Abaxis. You can “take that to the bank”.

Tony La Russa’s Animal Rescue Foundation Teams Up With Abaxis, Inc.


Distributors

United StatesAmerican Veterinary Supply 800-869-2510

DVM Resources877-828-1026

Great Western Animal Supply800-888-7247

Hawaii Mega-Cor, Inc.800-369-7711

IVESCO800-457-0118

Lextron, Inc.800-333-0853

Merritt Veterinary Supply800-845-0411

Nelson Laboratories800-843-3322

North East Veterinary Supply Co. 866-638-7265

Penn Vet Supply800-233-0210

TW Medical 888-787-4483

Western Medical Supply800-242-4415

VWR International, LLC800-932-5000

CanadaAssociated Vet Purchasing, Co.604-856-2146

CDMV450-771-2368

MidWest Drug204-233-8155

VetNovations866-382-6937

Vie et Sante418-650-7888

Western Drug & Distribution877-329-9332

VetScan Assists in Conservation Efforts: TheBlack-footed FerretContributing Authors: Heather Branvold MS, DVM

Julie Kreeger DVM, PhD

The black-footed ferret is one of threeferret species in the world, and the onlyone native to North America. The otherferret species include the Siberianpolecat and the European ferret, fromwhich the domestic ferret is descended.Black-footed ferrets have acharacteristic black mask, black feet,and black-tipped tail. The average lifespan in captivity is 4-6 years, and 1-3years in the wild.

Black-footed ferrets depend almost exclusively on prairie dogs for food andfor shelter in underground burrows. They once occurred across the GreatPlains wherever their prairie dog prey existed, from southern Canada tonorthern Mexico. Over the past century prairie dog populations, andferrets by extension, have been vastly reduced by conversion of nativeprairie to cropland, by poisoning of prairie dogs to reduce foragecompetition with domestic livestock, and by a non-native disease- sylvaticplague. Prairie dog numbers have been reduced by over 95%, and they nolonger occur in large, unbroken colonies extending for miles.

Black-footed ferrets were considered extinct in the 1960s, until apopulation was discovered in South Dakota in the mid-1970s. Some of thispopulation was brought into captivity, but breeding efforts wereunsuccessful. The wild South Dakota population died out due to disease,and when the last captive animal died in 1979 the ferret was presumed tobe extinct- again.

However, in 1981 a wild population wasdiscovered near Meeteetse, Wyoming.Unfortunately, this last known, non-reintroduced wild population alsosuccumbed to disease in the mid-1980s,but not before it provided 18 animals tostart a successful captive breedingeffort. Six facilities now maintaincaptive ferret populations. These are theNational Black-footed FerretConservation Center, the National Zoo’sConservation and Research Center,

Cheyenne Mountain Zoo, Louisville Zoological Gardens, the Phoenix Zoo,and the Toronto Zoo. To date, over 6100 ferrets have been produced incaptivity. The captive population now totals approximately 280 animals,which ensures the survival of the species and provides animals forreintroduction.

Special Look: Conservation Efforts


The National Black-footed Ferret Conservation Center (FCC), located innorthern Colorado, houses the majority of the captive ferrets. Ferrets incaptivity are susceptible to a wide variety of infectious and non-infectiousdiseases. Some common diseases include renal failure and various cancers inolder animals, and coccidia and other intestinal pathogens in young and oldanimals. Physical exams are performed biannually and bloodwork is doneroutinely at the FCC. Since ferrets are small animals, weighing only 600-1100g,it is preferable to take the smallest amount of blood necessary for analysis,especially if the animal is ill. The Abaxis VetScan chemistry analyzerrequires only small amounts of whole blood or serum/plasma, and istherefore used at the FCC for routine bloodwork and for helping to diagnosediseases in sick ferrets. It is important that each captive ferret remainshealthy, since they will be released into the wild or remain in captivity toproduce young for reintroduction.

Since 1991, over 2100 ferrets have been reintroduced into the wild at 18 sites across the western United Statesand Mexico. At present, ferret numbers in the wild are estimated to be 800-1,000 individuals. Althoughsignificant progress has occurred to support ferret recovery, the species will not be recovered until largernumbers of ferrets exist in the wild and routine reintroduction efforts are no longer necessary.

Currently, the most challenging obstacle limiting ferret recovery is providing a sufficient quantity and quality ofprairie dog habitat to support larger number of ferrets in the wild. Prairie dogs are considered a pest species andare subjected to routine poisoning which thereby reduces or eliminates potential ferret habitat. Additionally, thequality of potential ferret habitat is limited by disease. Sylvatic plague is lethal to both prairie dogs and ferrets.The recent development of several management tools, including a vaccine for ferrets, to ameliorate the impact ofthis disease has been useful in maintaining some reintroduced ferret populations. More research and fieldtesting of these techniques is underway.

Despite the radically altered nature of the environment which reintroduced ferrets face today, the recovery of thisspecies is within reach.

Special Look: Conservation Efforts continued

Customer Sampling

Medical & Research UniversitiesVeterinary Facilities

IMMEDIATE RESULTS, WHERE AND WHEN YOU NEED THEM THE MOST

With the VetScan laboratory and the addition of VetScan i-STAT® 1, you can

now get a full range of diagnostic applications in minutes at the point-of-care.

The Vetscan i-STAT 1 delivers accurate blood gas, electrolyte, chemistry and

hematology results in minutes from two drops of whole blood.

The VetScan i-STAT 1 is the ideal solution for critical care situations, hospital

operating room monitoring, exotic animals, research or for diagnostic and

specialty testing needs at the point-of-care.

Most importantly, the VetScan i-STAT 1 provides the additional information

needed to monitor chronic disease patients, evaluate pre-anesthetic patients

and provide diagnostic information for the ill patient in the exam room or

treatment room.

The VetScan i-STAT 1 uses disposable single use cartridges that contain the

necessary reagents to provide reference lab quality results while improving

efficiency throughout the animal health continuum of care.

HANDHELD ANALYZER

• Small sample size - 95 μl or less

• Most results in 2 minutes

• Accurate and reliable results

• Low maintenance

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• Ergonomic design, handheld versatility, battery operated

• Stores up to 5,000 tests

• Rapid infrared printing through a convenient mini-printer (optional)

• Integrated barcode reader

• On board glucose strip reader

• Features a Cardiac Troponin I Cartridge

BENEFITS

• Perfect for either the anemic kitten or fractious cat

• Neither your client or you have to wait for results

• Allows you to make quick and confident treatment decisions

• Enhances usability in every clinical situation

• Prior patient results available in the exam room or in the field

• Simple, easy, convenient

• Quick general or emergency assessment with one cartridge

FEATURES

The addition of the VetScan i-STAT 1

to my practice provides me the ability

to monitor and correct acid-base

abnormalities in my patients with

renal disease, ketoacidosis, etc. This

is a vital component of the treatment

protocol as well as being recom-

mended by the AAFP guidelines. The

VetScan i-STAT 1, along with my

VetScan laboratory, allows me to

perform these tests while my patients

and clients are still in the exam room

allowing treatment and medication

changes to be discussed face to face,

improving my customer service and

patient compliance in the most cost

effective manner possible.”

–Gary D. Norsworthy, DVM, DABVP

“

Point of care analyzers have become an integral part of veterinary medicine. Exotic pets, inparticular, often present in critical condition, and accurate data is immediately needed inorder to diagnose and treat the patient appropriately.

On June 3, 2008, a 5 year old male African Grey parrot was referred from another veterinaryhospital with tentative diagnosis of Proventricular Dilatation Disease. The diagnosis wasbased on the fact that the bird was demonstrating crop stasis, and radiographs revealed anenlarged, (but not gas filled), proventriculus. No other diagnostics were performed. Thebird was deteriorating rapidly, and the referring clinic wanted the bird examined at afacility that had point-of-care diagnostics available.

Upon examination, I determined that the bird was severely polydipsic, (which I believed explained the distendedcrop), and polyuric. Radiographs taken here at the time of presentation appeared normal. During physical examthe bird appeared slightly underweight, (404 grams with a full crop), was moderately sluggish, a little unsteady,and had a crop quite distended with water. The owner indicated that she was having to refill the bird’s (“large”)water bowl at least once a day. The owner also indicated that the bird seemed to have a ravenous appetite. Atthat point, my primary differentials were diabetes mellitus or renal failure. Knowing that it’s never appropriateto jump to conclusions when definitive data is readily available, I chose to simply perform the appropriatelaboratory diagnostics, knowing that within a few minutes I would have concrete data that would most likelyexplain the reasons for the bird’s clinical signs. As I do 99.999999973% of the time, I collected blood for a CBCand chemistry panel. The results were as follows:

At this point, my primarydifferentials were shot to hell.The uric acid and the blood glucosewere both perfectly normal. Theprofound hyperkalemia wassomething I had never seen beforein an avian patient. Addison’sdisease came to mind, but neverhaving dealt with it in avianspecies, I decided to discuss thecase with colleagues who hadexperience treating this disease indomestic animals. No one I spokewith had any experience with

Addison’s in birds, and there were no reports of such found in the literature. The consensus was to treat the birdand use response to therapy as confirmation of the tentative diagnosis. A biopsy of the adrenal gland wascontemplated but, while technically not that challenging, the owners elected to use the “response to therapy”approach.

The bird was started on Florinef, .01mg/ml, 0.2cc BID, (.005mg/kg BID). Prednisone was considered, but it wasdecided that conservative treatment at first might be the safer approach. The owners, for financial reasons,preferred to treat the bird at home and return every 3-5 days, (in spite of the fact that they lived 3 hours away),for follow-up.


Case Study: African Grey Parrot

African Grey Parrot: VetScan Helps in Diagnosis Contributing Author: Don Harris, DVM

WBC 15,760Hets 88%Lymphs 12%PCV 34wbc toxicity 0polychromasia 2+

Chems AST 1772Bile Acids 35CK above analyzer rangeUA 1.6Glu 234Ca 8.7Phos 2.8K+ 10.8Na+ 138


Case Study: African Grey Parrot continued

Within 24 hours, the bird “felt better”. He was less sluggish, more vocal, more alert, etc. The polydipsia lessened,but didn’t resolve. On the 3rd day, the owners, on my direction, increased the dose of Florinef to 0.3cc Bid. Withthat, the polydipsia was all but eliminated, and the bird “seemed perfectly normal”. On the 6th day the birdreturned for follow-up.

Follow-up labwork was almost perfectly normal. The K+ was now 4.7, AST 185,CK 400, and the PCV of 34 was up to 42. The bird’s weight was up to 436 grams,with an EMPTY crop.

Three weeks later the patient returned for an additional follow-up. This time, alllaboratory parameters were within normal limits, and the bird, according to theowners, was “his old self”. Six months later a telephone call revealed that the birdwas still doing perfectly well on the Florinef, but he has not returned for re-examination.

The most important points this case demonstrates is the need to remain open minded in the face of any clinicalpresentation and the importance of obtaining accurate laboratory data as soon as possible. In some cases, minutescount. Rarely is it acceptable with avian patients to wait a day or two to retrieve clinical data that directly influencesthe therapy. Many times, the patient will expire while waiting to labwork to materialize. To make matters worse,a patients demise can be accelerated by administering inappropriate therapy, directed by clinical signs only.

The Abaxis VetScan VS2 Chemistry Analyzer is God’s gift to avian medicine in the sense that it provides the mostdata for the least sample size, rendering it ideal in the exploration of health in even the smallest avian patients.

Aug. 28-31 CVC CentralKansas City, MOwww.cvccentral.com

Sep. 10-12 CVC EastBaltimore, MDwww.thecvc.com

Sep. 10-12 IVECCSChicago, ILwww.iveccs.org

Sep. 12-13 San Diego VMASan Diego, CAwww/sdvma.org

Sep. 18-20 New England VMAPortland, MEwww.newvma.org

Sep. 18-19 Colorado VMAKeystone Convention Centerwww.colovma.org

Sep. 22-25 NEAEPLedyard, CTwww.neaep.net

Sep. 23-25 Purdue Annual Fall ConferenceWest Lafayette, INwww.vet.purdue.edu

Sep. 24-27 Veterinary Hospital Manager’s AssociationPortland, ORwww.vhma.org

Sep. 25-27 Southwest Vet SymposiumSan Antonio, TXwww.swvs.org

Oct. 1-3 Florida Equine Promoting Exellence SymposiumMarco Island, FLwww.faep.net

Oct. 2-4 Alaska VMAAnchorage, AKwww.akvma.org

Oct. 7-10 American College of Veterinary SurgeonsWashington, DCwww.acvs.prg

Oct. 8-10 Wisconsin VMAMadison, WIwww.wvma.org

Oct. 12-15 Atlantic Coast Vet Conf.Atlantic City,NJwww.acvc.org

Oct. 14-18 Wild West Vet ConferenceReno, NVwww.wildwestvc.com

Oct. 16-19 Veterinary Cancer SocietyAustin, TXwww.vetcancersociety.org

2009 Veterinary Conferences


It is difficult to discuss EMS with talking about IR as they seem intimately associated or occur concurrently. Some feelthat EMS is an early manifestation of pituitary pars intermedia dysfunction (PPID) also referred to as Equine Cushing’sSyndrome. It may be more likely that horses and ponies with EMS and IR are predisposed to PPID, but the jury is stillout on this.

WHAT IS EMS?EMS is a term used to describe a group of clinical signs that may accompany pasture-associated laminitis (founder).It is defined by evidence of insulin resistance, obesity or regional fat deposition, and previous or existing laminitis. Inthe past signs of EMS were attributed to hypothyroidism, but it is now recognized that low resting thyroid levelsaccompany extrathyroidal illness in the horse.

WHAT IS IR?Broadly defined, IR is a decreased response of tissues to circulating insulin, resulting in decreased uptake of glucoseby skeletal muscle, adipose, and liver tissues. Both compensated and uncompensated IR exists in the horse.Compensated (the most common type) IR may be due to reduction in the density of insulin receptors on cell surfaces,malfunction of those cellular receptors, defective internal signaling pathways, or interference with the translocation orfunction of glucose transporter proteins. Uncompensated IR is thought to develop as a result of compensated IR ifpancreatic insufficiency develops.

CLINICAL FEATURES:EMS has been identified in many breeds of horses, including the Miniature horses, Morgan, Paso Fino, NorwegianFjord, Arabian, Quarter Horse, American Saddlebred, Tennessee Walking Horse, Thoroughbred, and Warmbloods. It hasalso been documented in ponies and donkeys. Most horses are 5 – 15 years of age when laminitis first occurs. Obesitycan develop at an earlier age. Physical characteristics include generalized obesity or development of regional fatdeposits (cresty neck, fat deposition over the tailhead, prepuce or random distribution of subcutaneous fat over thetrunk), or both and laminitis. These horses may be at greater risk to colic due to pedunculated lipomas.

Equine Metabolic Syndrome (EMS) andInsulin Resistance (IR)

Author: Dr. Terry Gerros


OBESITY - EMS - IRObese horses with EMS are described as easy keepers because they require fewer calories to maintain body weight.This may suggest that there is some genetic susceptibility and these particular animals are more efficient at convertingpoorer quality forages into energy. Factors that may contribute to the development of EMS included grazing on lushpasture, feeding concentrates and interference with seasonal weight loss. Overfeeding horses promotes obesity. Someconcentrates (sweet feeds) induce weight gain and also exacerbate IR. These feeds, rich in starches and simple sugars,create a glycemic response that can be difficult for the IR horse to accommodate. And like beauty, obesity is in the eyeof the beholder and breed associations.

The grass consumed on pasture may provide too many calories for those horses predisposed to EMS. Pasture grass can berich in hydrolysable carbohydrates (CHO) such as sugars that are digested and absorbed in the small intestine and fermentablecarbohydrates that are primarily digested within the large intestine. Many horses and ponies with EMS remain obeseand insulin resistant as long as they free graze on pasture, even when concentrates and hay are eliminated from the diet.

In the wild, horses would be expected to lose weight in the winter months when forages are scarce and of poor quality.Our horses today are now fed through the winter to offset any normal weight loss. The relationship between obesityand IR is complex because obese horses and ponies are more likely to be IR, but not all obese horses are IR and insulinresistance can occur without obesity. It is likely though that obese horses are predisposed to IR. Laminitis and Insulin Resistance

Laminitis and IR are likely related through three mechanisms:1) Impaired glucose delivery to hoof keratinocytes.2) Altered blood flow or endothelial cell function within the hoof vessels,3) Proinflammatory or pro-oxidative states associated with chronic IR and obesity.

WHAT TRIGGERS LAMINITIS IN HORSES WITH IR?Currently it is suggested that excessive hydrolysable CHO exacerbate IR as it does in humans with type II diabetesmellitus; secondly an alteration in bacterial flora occurs in the large intestine. The change in bacterial populationsincreases the production of factors inducing laminitis: exotoxins, endotoxins, and vasoactive amines.

Therefore we think of IR as a factor that predisposes these animals to pasture-associated laminitis, whereas the diseaseitself is triggered by the GI disturbance cause by the pasture grass composition. Sugars in the grass increase the gutpermeability and allow those factors causing laminitis to be more easily absorbed.

TESTING FOR IRResting serum insulin concentrations:Hyperinsulinemia is a common feature of IR in horses therefore serum insulin concentration is a useful screening test. Whileserum insulin levels are elevated with compensated IR, it has limited value in horses with mild IR or with noncompensateddisease (pancreatic disease as a result of chronic IR). Blood samples are drawn after horses have been withheld from pastureand fed hay overnight. A resting serum insulin concentration greater than 30 microU/ml is diagnostic for IR.

Combined Glucose-Insulin Test:This test is particularly useful for detecting mild or uncompensated IR. The horse is stalled overnight, before testing,and fed free choice hay that night and during the test. An IV catheter should be placed to facilitate administration ofglucose and sampling. A baseline blood sample is obtained and the horse given 150 mg/kg body weight (BW) of 50%dextrose, immediately followed by 0.10 units/kg BW of regular insulin. Blood is collected at 1, 5, 15, 25, 35, 45, 60,75, 90, 105, 120, 135 and 150 minutes after infusion. For field use, the intervals can be adjusted to 0, 15, 30, 45and 60 minutes.


IR is defined by maintaining blood glucose concentrations above baselinefor 45 minutes or longer. A handheld glucometer is used to measureglucose levels. If blood glucose drops below 40 mg/dl, administer 120ml of 50% dextrose to treat insulin induced hypoglycemia.

MANAGING OBESITYEasier said than done. Simply put, limit caloric intake and eliminateaccess to pasture until satisfied with the horses body condition.Concentrates should be eliminated and hay limited to 1.5% of currentbody weight (i.e. 15# hay for a 1000# horse), lowering it gradually to1.5% of the ideal body weight over several weeks time. The hay fedshould contain less than 12% nonstructural CHO (simple sugars, starch,and fructans) for obese IR horses. For hay greater than 12% NSC you cansoak the hay for 30 minutes, drain off the water, then feed that hay.There are now commercially available feeds (Purina Mills) for IR horses.Weighing the hay ensures accurate feeding. Horses should be fed 1000IU vitamin E because access to green pasture is restricted. Those horseswith laminitis should not be exercised until the hoof has stabilized.Otherwise horses with EMS should be exercised daily.

MANAGING INSULIN RESISTANCEIR can be managed by controlling weight, routine exercise and avoiding

feeds that exacerbate the condition. Access to pasture is the most difficult component of the diet to control; thereforeturnout on pasture must be restricted. Most horses will only need to be withheld from pasture for a few weeks ormonths although some must be permanently removed. Horses and ponies can have pasture access if limiting grazingtime to 1-2 hours per day, turn out in a small grass paddock or with a grazing muzzle.

Other supplements which have been used include cinnamon, chromium, magnesium and L-carnitine, but there are nopublished reports to their efficacy in managing IR or laminitis in horses. Some horses are lean but still exhibit regionfat deposition. This can sometimes be the situation when horses are managed through regular exercise or when horsesdevelop PPID.

Feeding strategies include:1) A diet consisting of hay with less than 12% NSC content, a pelleted specialty feed for IR horses (Purina

Mills), a balanced vitamin and mineral supplement, and 0.5 cup corn oil, twice daily.2) Same diet as #1 with molasses-free beet pulp substituted for the pelleted specialty feed,3) Either of the two diets listed above substituting rice bran for oil.4) A pelleted specialty feed (Purina Mills) for geriatric horses when the horse is over 20 years old.

Use of thyroid supplement:Levothyroxine can be used to induce weight loss and improve insulin sensitivity in horses. It should be used in horseswhen the animal cannot be exercised or laminitis threatens to cause permanent damage to the hoof tissues. A dosageof 48 mg/day for 3 to 6 months is fed. At this dose, it acts as a metabolic stimulant and induces weight loss withoutnegatively impacting general health. When levothyroxine treatment is discontinued, the dosage should be lowered to24 mg/day for 2 weeks and then 12 mg/day for 2 weeks. The benefits of treating horses with lower doses for extendedperiods have not been evaluated scientifically.

Chang, a 9 year old neuter male German shepherd presented for acute onset vomiting.Chang, a retired military dog, had a history of degenerative joint disease in the coxofemoraljoints and multiple other injuries, all having resolved. The patient had been evaluated oneweek earlier for an area of moist dermatitis at another veterinary facility. Chang was some-what aggressive to that veterinarian and he was not fully evaluated. He was placed oncarprofen and released with instructions to keep the area clean and to use antihistaminesalong with the carprofen.

Physical exam was not difficult and revealed a somewhat thin patient (BCS 4/9). The area ofmoist dermatitis was resolving with now only mild alopecia in the area. The owner indicateda rawhide had been given several days earlier and they were still giving the carprofen. The

CBC showed a mild eosinophilia consistent with an allergic condition causing the moist dermatitis as well as a mildrelative monocytosis. Chemistry results indicated significant elevation in ALT and ALP indicating some hepatic issue.

Initial rule-outs included a reaction to the NSAID, non-specifichepatopothy or neoplasia. Paired bile acids, radiology andultrasound were recommended but due to limited funds, onlybile acids were accepted. This was the most logical choice basedon the recent history of NSAID administration and no previoushistory of liver enzyme elevations (a panel had been performed6 months earlier with no abnormalities noted). Since the patient had been fed that morning, a paired bile acid study was scheduled for the following day.

Bile acid results were within normal limits both pre- and post-prandial (Pre-prandial 9, post-prandial <1, normal 0-25 for both).GGT was also fond to be significantly elevated (31, normal 0-7).These results indicated adequate hepatocellular perfusion, noshunting of any sort and adequate hepatic bile flow. A presumptivediagnosis of acute hepatic necrosis or hepatopa thy secondary toNSAID administration was made. The NSAIDs were removed

and the patient placed on Amoxicillin triydrate/clavulanatepotassium at 375mg b.i.d., Denamarin s.i.d. and a hepatic diet.A recheck at 12 days indicated normal bile acids,ALP and GGT. ALT was slightly high at 122 (normal 10-118) but was also considered resolved. All CBC valuesalso returned to normal. At 3 months post-incident, all values remained completely normal.

There are several important lessons from this case. First, we had no idea as to the internal status of the patientprior to the administration of the NSAID. Since the values returned to normal quickly after withdrawal of themedication, we can assume the liver was normal prior to giving the drug, but the lack of that information madediagnosis far more difficult. It is vital to have pre-medication blood values for any medication, but especially thosewith a known ability to cause idiosyncratic or other type reactions. Lack of blood tests also created liability for theoriginal veterinarian as the NSAID could have been prescribed to a patient with a pre-existing condition.

The ability to perform bile acid analysis in the office rather than waiting for commercial lab results allowed a detailed discussion with the client in the exam room. This greatly improved client communication in a potentiallylitigious situation.


Case Study: German Shepherd

WBC 8.59LYM 1.40 17.3%MON 0.34 4.1%NEU 5.31 65.6%EOS 0.92 11.4%BAS 0.12 1.5%

RBC 6.3HGB 16.2HCT 41.88MCV 72MCH 23.3MCHC 32.5RDWc 15.8%PLT 207

ALB 2.9ALP 559ALT 1073AMY 502TBIL 0.5BUN 14CA++ 10.7PHOS 5.8CRE 0.8GLU 88NA+ 144K+ 4.8TP 6.7GLOB 3.8

German Shepherd: VetScan Helps out an Old VetContributing Author: Craig Tockman, DVM

Paying too much to run your lab is like airconditioning your house with the windows open.

I N N OVAT I O N YO U C A N T R U STWho says that good medicine and smart business can’t work together?At Abaxis, we’re just as committed to helping you run your practice aswe are to devolping reliable, leading edge technology, tools and services that support the highest quality health care. Our VetScan Laboratoryand rapid tests provide reference lab quality results, in-clinic, in minutes; all for significantly less cost than competing lab alternatives. If you’re getting blown away by laboratory expenses, take a closer look at the VetScan Laboratory System.

Save money every day with the lower operatingcosts of the VetScan Laboratory System.

Call us today to schedule a live, on-site demonstration and cost analysis.

Tel: 510.675.6500 800.822.2947 www.abaxis.com/adcostsavings/Abaxis and VetScan are registered trademarks of Abaxis. © 2009 Abaxis, Inc.


PROJECT REPORT: DETERMINATION OF BASELINE HEMATOLOGICALAND BIOCHEMICAL VALUES FOR FREE-RANGING ELEPHANT ANDRHINOCEROS IN KRUGER NATIONAL PARK, SOUTH AFRICA

Overview of progress achieved during work with Kruger National Park Veterinary Wildlife Services staff January 23-February 26, 2009.

Senior Researchers and Co-Investigators: Michele Miller, DVM, PhD;Dr. Peter Buss; Dr. Markus Hofmeyr; Jenny Joubert; Khosi Maseko

Project Objectives:The proposed project addresses antemortem diagnostic testing to assess the healthstatus of free-ranging rhinoceros and elephants to provide a baseline, and furtherevaluate rhinos that are confined in bomas to determine if there are changes thatare associated with health problems. Specific goals will be to develop a betterunderstanding of basic physiological values in free-ranging wildlife in order to havea baseline from which to make comparisons with 1) diseased animals; 2)physiological changes that may occur during captivity and other stresses such astranslocation; and 3) examine the differences between and within different free-ranging populations due to environmental changes (i.e., seasonal effects, habitatdifferences, etc.).

Work Procedure:Sera or heparinized plasma samples were used fromstored banked samples. All sample collection wasperformed opportunistically during immobilizations onrhinos and elephants that have been scheduled fortranslocations, horn transmitter placement, emergency

procedures, or other projects. CBC and chemistry panels were performed at the KNP lab. Theveterinary technicians have been trained to perform estimated white blood cell counts from bloodsmears and differential cells counts. All analyses were performed by the same individual to maintainproject continuity. A portable blood chemistry analyzer is available (Abaxis VetScan VS2) that has been field tested on wildungulates, including white rhino and elephant, and can provide biochemical profile results on serum or plasma within 12minutes. The VetScan Large Animal rotor was used on both elephants and rhinoceros for analyses.

RESULTS:Samples analyzed from the white rhinos were collected during the 2008 capture season. Chemistry panels were performedon 81 white rhinos and repeated on 25 of these individuals that were boma-confined at the time of release. Hematologicalanalyses were available for 66 individual rhinos. Only chemistry panels were available for the elephant samples since thesewere opportunistically collected between 2004 and 2008. A total of 71 samples were processed. Data has been entered intoa spreadsheet along with demographic data and is in the process of statistical analyses.

Future Directions:White rhino data will be compared with previous data analyzed during the 2006 and 2007 capture seasons. This will providea larger database especially for investigating gender and age-specific values. In addition, paired sample analyses for boma-confined individuals will be assessed for potential biomarkers of change that occur during captivity due to stress, diet, or othermanagement changes.

The elephant data will also be evaluated in a similar manner to develop a general database of normal values. These valueswill also be compared to zoo-based values for these species. Eventually, it is the goal of the study to determine if there mightbe seasonal, age or gender related differences that could be used to examine changes in the ecosystem such as effects ofdrought on habitat quality, etc. and those created by manipulations such as capture, confinement, and translocation.

Field work using VetScan products in Kruger National Park, South Africa

Editorial Staff

Valerie Goodwin - AdamsDirecto,r Marketing - AnimalHealthVetCom [email protected]

Terry C. Gerros, DVM, MS, Diplomate, ACVIM (LA)Abaxis Advisory Board MemberEquine [email protected]

Craig M. Tockman, DVMDirector of Professional Services, Abaxis, Inc. 800-822-2947, ext. [email protected]

Kent Adams, DVMAbaxis Advisory Board MemberEquine/Large Animal [email protected]

Don J. Harris, DVMAbaxis Advisory Board MemberAvian/Exotic [email protected]


Kate An Hunter, DVMAbaxis Advisory Board MemberCompanion Animal [email protected]

Baerbel KoehlerAbaxis Sales and MarketingManager for Europe, Africaand the Middle EastDarmstadt, Germany+49 6151 350 79 [email protected]

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Special Look: Warehouse Expansion

Despite a slower global economy, Abaxis has experienced a 110% increasein our shipping volume over the past several months, as a result Abaxis isexpanding our shipping operations to assure our customers experience thesame great level of service in the future. Our new location is dedicated tohandle our customer shipping volume only and will house our finishedgoods inventory to assure prompt shipment on time every time. Our newfacility will include a new expanded cold room operation that has been updated to better serve you.

Some highlights of our new facility are:

• 28% overall facitity increase from 91,124 sq ft. to 116,824 sq. ft.• 233% increase in shipping space from 7,70 sq. ft. to 25,700 sq. ft.• Walk-in cooler capacity increased to 167,200 cu. ft from 30,000 cu. ft.• Cold Room Storage capacity increased from 750,000 rotors to 2.5

million rotors

Abaxis Expands Warehouse

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Get the Most Out of Your VetScan Chemistry Analyzer

Comprehensive Diagnostic ProfileIdeal For: Providing a complete diagnostic analysis for pre-anesthetic testing, general health profile, ill patient diagnos-tics, geriatric testing, and wellness testing.

Analytes Include: ALB, ALP, ALT, AMY, BUN, CA, CRE, GLOB,GLU, K+, NA+, PHOS, TBIL, TP

Used For: Wellness testing, pre-anesthetic testing, criticalcases, diagnostic testing and ill patient examinations, re-check examination for chronic disease.

Critical Care PlusIdeal For: Serial testing, re-checks, and monitoring hospital-ized patients. An alternative panel to the Prep II rotor for pre-anesthetic testing.

Analytes Include: ALT, BUN, CL-, CRE, GLU, K+, NA+, tCO2

Used For: Hospitalized patient monitoring, re-checks (forhyperadrenocorticism, diabetes, renal disease) and pre-anesthetic evaluation.

Prep Profile IIIdeal For: Determining of basic health values for youngerhealthy patients, a basic re-check panel for some diseasestates and as a low cost pre-anesthetic evaluation.

Analytes Include: ALP, ALT, BUN, CRE, GLU, TP

Used For: Routine wellness screening for younger patients,lower cost pre-anesthetic screen for younger, apparentlyhealthy patients, monitor and recheck for disease statessuch as diabetes mellitus and renal disease.

T4/CholesterolIdeal For: Routine screening of hypothyroidism in dogsand diagnostic for hyperthyroidism in cats. Titratingand monitoring patients on thyroid hormone replacementtherapy or patients being treated for hyperthyroid disease.

Analytes Include: CHOL, T4

Used For: Screening for hypothyroidism in dogs,diagnosis of hyperthyroidism in cats, monitoring drug,I131 or thyroidectomy therapy.

Mammalian Liver ProfileIdeal For: Obtaining baseline values prior to administrationof and concurrent with the use of NSAIDS as well asmonitoring hepatic function and diagnosing liver disease.

Analytes Include: ALB, ALP, ALT, BA, BUN, CHOL, GGT, TBIL

Used For: Diagnosis and monitoring of liver disease, obtainingbaseline values prior to administration of NSAIDS, andmonitoring patients concurrent with the use of NSAIDS.

Avian/Reptilian Profile PlusIdeal For: Measuring analytes that represent the mostimportant area of concern in avian and reptilian patients.

Analytes Include: ALB, AST, BA, CA, CK, GLOB, GLU, K+, NA+,PHOS, TP, UA

Used For: Ill patient diagnostics, wellness testing, evaluateliver integrity and function, evaluate renal status, measureelectrolyte status.

Equine Profile PlusIdeal For: Routine equine checkups, wellness testing, illpatient diagnostics and pre-purchase examinations.

Analytes Include: ALB, AST, BUN, CA, CK, CRE, GLU, GGT,GLOB, K+, NA+, TBIL, tCO2 , TP

Used For: Ill patient diagnostics, wellness examinations,patient monitoring, fluid therapy, and re-check examinations.Ideal for both equine ambulatory practitioners and criticalcare units.

Large Animal ProfileIdeal For: Health assessment, prognostic indicator and a diag-nostic tool for beef and dairy cattle.

Analytes Include: ALB, ALP, AST, BUN, CA, CK, GGT, GLOB, MG,PHOS, TP

Used For: Accurate diagnosis and prognosis, aid in the choiceof therapeutics.

September / October 2009

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Transcript of September / October 2009