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Check specimens for hemolysis and lipemia Lavender‐top tube (LTT)
• Hemolysis and lipemia will impact complete blood count (CBC) results.
• Many chemistry tests are affected by interfering substances.
• Suitable for hematology, whole blood
• Contains potassium EDTA:
• Fill tube to recommended fill volume.
• After filling, invert gently 8–10 times to mix.
• Run immediately or within 4 hours OR refrigerate; do not
freeze.
Hemolysis grading • Do not harvest plasma for chemistries.
Lipemic grading
Normal to >4+ Normal to >4+
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Serum separator tube (SST) Red‐top tube (RTT)
• Suitable for therapeutic drug monitoring and progesterone
• Can be used for transport of separated plasma or serum and for
• Suitable for chemistry, endocrinology, immunoassay chemistries and endocrinology.
• Contains a gel medium that forms a barrier between serum and • Do not use for transporting urine or fluids for cytology.
the cells: • Tube contains silicone‐coated clot activator:
• Let specimen clot for 30 minutes. • Fill to manufacturer’s recommendations.
• Centrifuge according to manufacturer’s specifications. • Let specimen clot for 30–60 minutes.
• Refrigerate after centrifugation. • Centrifuge according to manufacturer’s specifications.
• Remove serum from clot.
• Refrigerate serum.
3 © 2019 IDEXX Laboratories, Inc. All rights reserved. 4 © 2019 IDEXX Laboratories, Inc. All rights reserved.
Blue‐top tube (BTT) Lithium heparin green‐top tube
• For coagulation testing.
• Contains sodium citrate 3.2%:
• Fill with as much blood as the vacuum allows.
• Invert gently several times to mix. • Can be used for most chemistries.
• Centrifuge immediately at 1,500–2,000 g for 10 minutes or • Plasma must be separated or run within 1 hour.
per specific centrifuge recommendations.
• Remove plasma from cells and transfer to a plastic tube.
• Label tube as citrated plasma and freeze.
5 © 2019 IDEXX Laboratories, Inc. All rights reserved. 6 © 2019 IDEXX Laboratories, Inc. All rights reserved.
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White‐top, no‐additive tube Filling vacuum tubes and tubes with additives
• Avoid forcing clotted Citrate (coagulation tests)
blood into a vacuum
tube.
• Used for urinalysis and urine culture.
• Always fill tubes without Serum (SST—serum separator tube)
• Can be used for transport of separated plasma or serum. additives first.
• Test within 2 hours or refrigerate.
• Fill lavender‐top (EDTA)
• Indicate collection method. or blue‐top (citrate) Heparin
• Avoid exposure to sunlight. tubes as much as
• Place stones in a dry, sterile container. vacuum will allow.
EDTA
• Do not put urine in tubes with clot activator. • Always mix tubes with
additives well
immediately after filling. All others
7 © 2019 IDEXX Laboratories, Inc. All rights reserved.
Chemistry: Chemistry:
Lithium heparin tube Serum separator (red top) tube Urine for urine protein‐creatinine ratio
• Use the appropriate tube • Use an appropriate serum separator • Collect urine from patient through
and collection device. tube and sample collection device. cystocentesis (recommended), a
catheter, or free catch.
• Draw sample gently and • Draw the sample gently and transfer
transfer into tube per into tube—keep manufacturer’s • Transfer urine into a disposable
manufacturer’s fill volume. recommendations re: fill volume top sample tube.
of mind.
• Gently invert sample for • Centrifuge sample.
30 seconds. • Let tube clot for a minimum of 20
• Transfer 0.3 cc of the supernatant into
minutes.
• Centrifuge sample within a Catalyst sample cup.
30 minutes. • Centrifuge sample within 45 minutes
• Dispense 0.3 cc of Catalyst® Urine P:C
of collection.
• Remove 0.3 cc of plasma Diluent into a different Catalyst
and place in Catalyst sample cu.
sample cup.
Hematology: Urine sample handling
• VetCollect® EDTA, 1.3 mL tube, 650 μL tube, or other For best practice, conduct urinalysis in first 30–60 minutes.
tubes that can be secured in the adapter.
• If samples cannot be analyzed within 60 minutes, immediately refrigerate in a
• Fill tubes to manufacturer’s recommendations— clean, sealed container.
EDTA/blood ratio is extremely important:
• Overfilling tubes results in clotting. • Samples should be warmed to room temperature prior to analysis.
• Underfilling alters hematocrit and hemoglobin • Mix thoroughly prior to analysis.
volumes.
• Mix sample by fully inverting 10 times or placing on a
Patient‐side analysis reduces:
blood tube rocker for 30 seconds. oGrowth or death of bacteria.
• Ideal time for testing is within 30 minutes of sample oCell and cast degradation, especially with low
collection. urine specific gravity.
• NOTE: If for any reason the cap is removed from the oFormation of crystals and amorphous material.
EDTA tube, it should be vented by inserting a needle
through the stopper to allow air pressure to equilibrate oBreakdown of bilirubin by sunlight.
before placing it into the instrument.
Sources:
Stockham SL, Scott MA. Urinary system. In: Stockham SL, Scott MA. Fundamentals of Veterinary Clinical Pathology. 2nd ed. Ames, IA: Blackwell; 2008:415–494.
Albasan H, Lulich JP, Osborne CA, Lekcharoensuk C, Ulrich LK, Carpenter KA. Effects of storage time and temperature on pH, specific gravity, and crystal formation in urine samples from dogs and cats. J Am Vet Med A.
2003;222(2):176–179.
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Physical examination components:
Color
Physical examination: Clarity
• Turbidity (cloudiness).
• Normally, urine is clear.
• Urine may become more
Urine color Interpretation opaque with increased
Pale yellow to amber Normal particles in the liquid:
Red to red‐brown HGB, RBCs • Bacteria
Red‐brown to brown Myoglobin, RBCs
• Cells
Orange Bilirubin
• Crystals
• Lipids
Blue, green, purple, etc. Various drugs
• Mucus
Most clinically significant sediment
elements
Blood cells Epithelial cells Bacteria Casts Crystals
o Red blood cells o Squamous o Rods o Hyaline o Struvite
(RBCs) o Nonsquamous o Cocci o Nonhyaline o Calcium oxalate
o White blood cells (including (including cellular dihydrate
(WBCs) transitional cells, casts, granular o Unclassified (all
renal tubular cells) casts) other crystals)
All images from the SediVue Dx® Urine Sediment Analyzer