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Appendix E

CBC Parameters and Associated Indications

E-1

CBC Parameters and
Associated
Indications

Complete Blood Count (CBC) parameters are useful in assessing

overall wellness of a patient, as well as identifying and monitor-

ing certain disease states. This appendix outlines the various

CBC parameters and associated clinical indications.

Appendix Contents

E.1 White Blood Cell Parameters and Associated
Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-2

E.2 Red Blood Cell Parameters and Associated
Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-3

E.3 Platelet Parameters and Associated Indications. . . . . . E-4

Summary of Contents for VetScan HM5

Page 1: ...Operator s Manual ...

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Page 3: ...eterinary Use Only Customer and Technical Support For USA 1 800 822 2947 vetsupport abaxis com For Europe 49 6155 780 210 techsupport abaxis de For U K 44 1904 909 500 info abaxis co uk September 2018 PN 790 7013 Rev F Text 2018 Abaxis Inc Union City CA 94587 ...

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Page 5: ...ce Serial number from the back of the unit Date of installation Distributor name and address Abaxis sales representative name Phone Email VetScan is a registered trademark of Abaxis Inc September 2018 PN 790 7013 Rev F Abaxis Inc 3240 Whipple Road Union City CA 94587 USA European Representative Abaxis Europe GmbH Bunsenstr 9 11 64347 Griesheim GERMANY Abaxis UK Limited Chessingham Park Common Road...

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Page 7: ...ample 4 1 4 1 Collecting and Handling Samples 4 2 4 2 Storing Samples 4 3 4 3 Before Performing an Analysis 4 4 4 4 Running a Blank Measurement 4 5 4 5 Running a Sample 4 7 4 6 Adjusting the Lyse Volume 4 9 4 7 Interpreting Results 4 9 Section 5 Quality Control and Calibration 5 1 5 1 Quality Control 5 2 5 2 Calibration 5 10 Section 6 Maintenance Service 6 1 6 1 Preventive Maintenance 6 2 6 2 Auto...

Page 8: ...ell Parameters A 4 A 4 Normal Hematology Ranges A 8 A 5 Veterinary Hematology References A 9 Section B Operating Principles B 1 B 1 Complete Blood Count CBC B 2 B 2 Measurement Methods B 2 B 3 Hemoglobin Determination B 6 B 4 Measured and Calculated Parameters B 7 B 5 Measured and Calculated Values B 8 Section C Potential Sample Interferences C 1 Section D Veterinary Case Studies D 1 D 1 Normal Le...

Page 9: ...ut the Abaxis VetScan HM5 Hematology System Section Contents 1 1 Introduction 1 2 1 1 1 Customer and Technical Support 1 3 1 1 2 Safety Information 1 3 1 2 HM5 System 1 4 1 2 1 Main Components 1 4 1 2 2 Power Supply and Power Cord 1 5 1 2 3 Reagents 1 5 1 2 4 Accessories 1 7 1 3 Touchscreen Icons 1 8 ...

Page 10: ... following components The HM5 hematology analyzer itself with a touchscreen interface and optimized soft ware A reagent pack including five individually bottled solutions Diluent Lyse Lyse 2 Cleaner and Rinse The HM5 provides multiple user friendly features Rapid CBC analyses with full five part differentials A database for up to 5000 records with USB drive backup capability Automated on screen re...

Page 11: ...L CONNECTORS ON THE ABAXIS VETSCAN HM5 ARE SELV SAFETY EXTRA LOW VOLTAGE CONNECTORS TO AVOID THE RISK OF ELECTRICAL SHOCK CONNECT THE INSTRU MENT ONLY TO EXTERNAL DEVICES THAT ARE SELV RATED Note This equipment has been designed and tested to CISPR 11 Class A In a domestic environment it may cause radio interference in which case you may need to take measures to mitigate the interference Note For ...

Page 12: ...1 Front View 1 Built in thermal printer 2 LCD touchscreen 3 Sampling door and rotor 4 USB Type A ports 2 1 2 1 2 Back View 1 Reagent ports inlets 2 Power switch ON OFF 3 Power supply connection 4 USB Type A ports 2 5 Ethernet port 6 USB Type B port 2 4 3 1 3 4 5 6 1 2 ...

Page 13: ...ble 1 1 Reagents and Containers Reagents Descriptions Color Volume Diluent Isotonic saline solution used to dilute whole blood specimens and to rinse the analyzer s fluidic system between analyses Green 9 liters Rinse Used for certain species runs and for certain cleanings White 500 ml Cleaner Used in the fluidic system cleaning process Blue 300 ml Lyse Used to create hemolysate for three part WBC...

Page 14: ...in the reagent bottles Bottle Caps The Bottle Caps setup includes color coded caps with nozzles and attached flexible drop down tubes The bottle caps screw onto the appropriate reagent bottles and are intended for compact locations such as under counter installations In the Bottle Caps setup the reagent tubing connects to the bottle caps 1 2 3 2 Reagent Tubing The reagent tubing includes six color...

Page 15: ...2 ml glass vials 6 for microtainer tubes of 0 6 ml or less Peristaltic Pump Tube In case this tube is damaged a spare is provided See Peristaltic Pump Tubing Replace ment on page 6 13 Thermal Paper Roll Two rolls are included with the analyzer package for use in the built in printer Each reagent pack also includes a new roll Save the paper rolls as printing to the built in printer is often very us...

Page 16: ... guage Maintenance Clean Calibrate run Quality Control and manage Reagent Status Measurement Settings Select units and set normal ranges for species Settings Manage printer testing date time and other analyzer settings Date and Time Change date and time options Exit Select shut down options and log in to user accounts Admin Settings Allows Admin users to edit Reagent Replace settings Schedule Main...

Page 17: ...ve will normally install the VetScan HM5 analyzer If this is not possible however follow the procedures in this section Section Contents 2 1 Choosing a Location 2 2 2 1 1 Environment Requirements 2 2 2 1 2 Electrical Requirements 2 3 2 2 Installation 2 3 2 3 Initializing the VetScan HM5 2 9 ...

Page 18: ...r if this is not possible place the reagent pack below the analyzer so that the top of the reagent pack is no more than 18 in 45 7 cm lower than the bottom of the analyzer Avoid using equipment that can produce electromagnetic emissions nearby refrigerators freezers cen trifuges fans hair dryers etc WARNING MAKE SURE THE ANALYZER AND ALL ACCESSORIES ARE PROPERLY GROUNDED IMPROPER GROUNDING CAN CAU...

Page 19: ...nd out of the box 4 Place the HM5 temporarily on a clean stable counter 5 Remove the plastic wrap from the HM5 6 Use the metal latch to open the door on the right side of the HM5 CAUTION Abaxis recommends using the analyzer with surge protection designed for a computer In addition a battery backup is strongly recommended if the VetScan HM5 will be used in an area prone to electrical surges or powe...

Page 20: ... tubes to the back of the HM5 Match the colors of the reagent tubing with the colors on the rear of the analyzer HM5 Operator s Manual CD Quick Reference Guide Power supply and cord Mini keyboard Four sample tube adapters Thermal paper rolls 2 Tubing kit reagent tubing bottle caps with drop down tubing VetScan HemaClean Kit 1 liter polypropylene flask Peristaltic pump tube Waste bottle and lid wit...

Page 21: ...lyzer 16 Turn the analyzer on using the power switch on the back 17 Allow the analyzer to boot up and initialize 18 On the HM5 s Home screen select Settings Admin Settings CAUTION If the analyzer has been kept at a temperature below 50 ºF 10 ºC allow it to sit for at least an hour at the correct operating tempera ture 59 86 F 15 30 C before using it Note When the analyzer is turned on it first per...

Page 22: ...an 18 in 45 7 cm lower than the bottom of the analyzer 20 Select Schedule Settings Reset Accept to restart maintenance timers from today 21 Pour 200 ml of distilled water into the Abaxis flask 22 Submerge the free ends of the reagent tubes into the water 23 Select Maintenance Reagent Status and then Prime All 24 Run Prime All twice more three times in all until all water is gone from the flask and...

Page 23: ...ellow etc d Pull one of the five dip tubes shown at right out of the accesso ries kit e Insert the dip tube into the matching color coded ring in the QCA frame f When the dip tube touches the bottle seal push the tube through the seal until the end of the tube contacts the bottom of the bottle CAUTION Use the color codes as guides when connecting tubing dip tube heads and reagent bottles If the tu...

Page 24: ...ce the drop down tube into the appropriate color matching bottle then tighten the bottle cap c Thread the long tubes from the back of the HM5 through the punched out hole in the reagent pack lid d Attach the long reagent tubes to the nozzles on the color matching bottle caps 29 Select Next through the steps of the pack change process until the analyzer primes 30 Select Home to return to the Home s...

Page 25: ...Measurement on page 4 5 3 Select Accept if there are no flags and no values highlighted in red indicating that the analyzer blank background level is within specifications The analyzer then displays a sample measurement screen as shown and is now ready to per form an analysis 4 Verify the analyzer s system settings and make any needed changes see Settings on page 3 1 Note You will be notified with...

Page 26: ...2 10 Installing the VetScan HM5 ...

Page 27: ...ings Overview 3 2 3 2 Printer Settings 3 2 3 2 1 Connecting an External USB Printer 3 2 3 3 General Settings 3 3 3 3 1 Screen Saver and Standby Time 3 3 3 4 Measurement Settings 3 4 3 5 Date and Time Settings 3 4 3 6 Communication Settings 3 5 3 6 1 VSx Communication 3 7 3 6 2 Serial USB Connection to a Computer 3 7 3 6 3 Network Communication 3 8 3 6 4 Host Network 3 9 3 7 Admin Settings 3 11 ...

Page 28: ...reagent tubing type maintenance scheduling and user manage ment See page 3 11 3 2 Printer Settings The Abaxis HM5 can print to its built in printer or a connected external printer For a list of compati ble printers contact Abaxis Technical Support The HM5 s printer settings enable users to select specific information to print manage print color and quality modify margins and add a personalized hea...

Page 29: ... format screen saver time and standby 1 From the Home screen select Settings General Settings 2 Select the settings to adjust Sound enables disables sound Language selects the language used in analyzer displays Data Export Format selects the format for exported data Advanced is recommended Screen Saver Time sets the delay time for screen saver activation in minutes Standby Time sets the delay time...

Page 30: ... VetScan HM5 s built in clock and calendar and the format used to dis play the date and time on results Date and Time sets the displayed time and date on the analyzer clock Format sets the date display format Month Day Year Year Month Day or Day Month Year and time display format 12 or 24 hour Note The HM5 software contains three duplicate software profiles called Dog2 Cat2 and Foal that measure w...

Page 31: ...d produces a formatted report that combines the VS2 and HM5 results when a Patient ID match is found in the HM5 database Computer unidirectional Serial USB Cable Communication USB Sends results from the HM5 to a host such as a computer with practice management software through a USB serial COM port See Table 3 2 Computer unidirectional Host PC in Host Network Network Sends results from the HM5 to ...

Page 32: ...etwork Personal Computer PC Inactive PC Automatic Send Disabled Electronic Medical Record EMR Inactive EMR Automatic Send Disabled Communication Setting Name Setting Serial USB Communication Serial USB Link Disabled Serial Automatic Send Disabled Host Network Personal Computer PC Active PC Automatic Send Enabled Electronic Medical Record EMR Inactive EMR Automatic Send Disabled Communications Sett...

Page 33: ...ect the USB A flat end of the cable to a USB A port on the HM5 6 Press Accept 3 6 2 Serial USB Connection to a Computer The VetScan HM5 can connect to practice management software PMS on a computer using a USB A B cable For a list of compatible PMS software visit the Abaxis website at www abaxis com 3 6 2 1 USB A B Cable Connection 1 Connect the B end of the cable into the USB B port on the back o...

Page 34: ...ia DHCP or manually by making a static IP address assignment The method to use depends on a number of factors is best determined by the local network administrator DHCP address assignment is the easiest to configure and is the preferred method when Host EMR communication is not being used When using Host EMR communication a fixed or static address is preferred Contact your system administrator for...

Page 35: ...send order information For a list of compatible software visit the Abaxis website at www abaxis com 3 6 4 1 Personal Computer PC The Host Network Personal Computer PC settings enable the HM5 to send results one way unidirectional to a network enabled Personal Computer PC system or software such as a practice management system In this mode the HM5 cannot accept work list orders bidirectional commun...

Page 36: ...ections on that IP address and port The IP address and port values are provided by the local network administrator or software vendor To configure the HM5 to communicate with an EMR system 1 In the Host Network screen set Electronic Medical Record EMR to Active 2 Enter the EMR Remote IP Address and EMR Remote Port number as provided by your local network administrator or software vendor 3 Enter th...

Page 37: ...minders for mainte nance select Enable 4 Then select Schedule Settings The Interval fields can be used to set the number of days between cleanings Abaxis recommends that Intervals be left at the default values of a 7 day Interval for Wash Head Cleaning and a 14 day Interval for Soak Cleaning Use the Cleaning Day Time fields to set the specific day and time that cleaning is due Users who run fewer ...

Page 38: ...3 12 Settings ...

Page 39: ...ge of the samples Section Contents 4 1 Collecting and Handling Samples 4 2 4 2 Storing Samples 4 3 4 2 1 Remixing Before Running 4 3 4 3 Before Performing an Analysis 4 4 4 3 1 Daily Cleaning 4 4 4 3 2 Check Tubing 4 4 4 4 Running a Blank Measurement 4 5 4 5 Running a Sample 4 7 4 6 Adjusting the Lyse Volume 4 9 4 7 Interpreting Results 4 9 4 7 1 Histograms 4 10 ...

Page 40: ...s can cause platelet clumping and clot formation To achieve proper mixing and prevent clotting immediately mix samples by inverting the tubes 10 15 times 25 30 times with very small samples or in low volume micro tubes Inversion speed should be 2 3 inversions per second Mix thoroughly by hand immediately before analysis by gently inverting the tube 10 15 times CAUTION Use only tubes containing pot...

Page 41: ...om temperature or 8 hours if refrig erated If the samples were refrigerated allow them to warm to room temperature before analy sis by sitting on the counter for 10 15 minutes Samples may also be warmed by slowly rolling the tube in the palms of the hands for 5 10 minutes Do not use a rocker to mix samples smaller than 1 0 ml 4 2 1 Remixing Before Running The HM5 software will display a reminder t...

Page 42: ...width of the tubing or gaps exist clear the affected tubes as follows a Make sure the affected tubes are securely attached at both ends b From the Home screen select Maintenance Reagent Sta tus c Select Prime All to start priming the reagents Confirmation will be required Select Change Pack if you are currently changing the reagent pack or Prime if you only need to clear bubbles in the tubes For d...

Page 43: ...the Home screen select Measure Run 2 If the Blank results are expired screen appears select OK to run a blank If a blank has already been run and accepted for the day this message does not appear To run a new blank select Run Blank 3 When the blank has run if the blank is successful meaning there are no values reported in red with or signs and no warning message displayed the results will appear o...

Page 44: ...rs press OK find the warning flag displayed at the upper right on the screen then go to the section of Trouble shooting on page 9 1 for that flag CAUTION Do not accept an unacceptable blank with high values Note A new blank will be required after the following procedures Reagent Pack Change Soak Cleaning see Soak Cleaning on page 6 6 Deep Cleaning see Deep Cleaning on page 9 18 Self test HM5 Reboo...

Page 45: ...f 0 6 ml or less 3 Place the adapter into the slot in the sample door 4 From the Home screen select Measure Run 5 Select the patient species under Type 6 Enter patient information select the needed fields enter the infor mation then select Enter 7 Make sure the sample tube is at least half full If the tube is not adequately filled see Collecting and Handling Samples on page 4 2 results can be affe...

Page 46: ...as shown at right The sample is taken into the HM5 and analysis begins The CBC process takes approximately 4 minutes for a five part differen tial and 3 minutes for a three part differential When complete results are displayed on the screen and trans mitted to a printer and or the PMS depending on configuration If the analyzer is not set to print results automatically print them by selecting Print...

Page 47: ...e Lyse and rerun the sample 6 If the Lyse tube is in working order from the Home screen select Measure Run 7 Select the Change Lyse field and increase the volume by 0 1 ml 8 Rerun the sample 9 If the L Warning persists increase the Lyse by 0 2 ml then rerun the sample 10 If the L Warning still persists and there are no Lyse issues perform a manual smear or send the sample out 4 7 Interpreting Resu...

Page 48: ...populations sorted by size Cells larger than discriminator 1 are counted as WBCs Blood includes three WBC popula tions Lymphocytes LYM shown by the first peak in the histogram Monocytes MON indicated by the area between the second and third discriminators although the MON region does demon strate a distinctive peak of its own this peak is not always clear in histogram form Granulocytes GRA are the...

Page 49: ... The example PLT histogram at right follows a log normal distribution with a good separation from RBCs The most commonly identified anomaly in platelet histo grams results from aggregated clumped platelets This appears as a flattened lumpy histogram that increases towards the right side see Cat Clumped PLT Increased LYM on page D 10 ...

Page 50: ...4 12 Running a Sample ...

Page 51: ...2 5 1 1 Required Quality Control Sample 5 2 5 1 2 Handling Quality Controls 5 2 5 1 3 Entering Quality Control Values 5 3 5 1 4 Running a Quality Control Sample 5 8 5 1 5 What to Do If QC Values Are Out of Range 5 9 5 2 Calibration 5 10 5 2 1 When to Calibrate 5 10 5 2 2 Required Calibration Materials 5 10 5 2 3 Calibration Procedure 5 11 5 2 4 View Calibration History 5 13 5 2 5 Resetting Calibra...

Page 52: ... regulatory environ ments 5 1 2 Handling Quality Controls When opening new Abaxis HM5 controls always write the open date onto the package insert and the control tube itself Users can then monitor the open date of each tube and avoid using degraded control material After the control is first opened it will be good for up to 14 days if it is properly stored Note Quality control cannot be run if the...

Page 53: ...alues from a USB Drive on page 5 5 Load values through a USB 2D barcode reader see Loading Control Values with a 2D Barcode Reader on page 5 6 5 1 3 1 Entering Values Manually Enter control values manually for one level of control at a time using the HM5 s touchscreen or a USB keyboard 1 From the Home screen select Maintenance Quality Control The Quality control screen includes buttons for QC leve...

Page 54: ... lot number and expiration date of the current control tube in hand are the same as those displayed on screen verify that the on screen target and range values match those on the control package insert then select Accept and proceed to Running a Quality Control Sample on page 5 8 If the lot number and expiration date of the control tube are different than those on screen select New ...

Page 55: ... unzipped folder onto a USB drive See the Abaxis website for more detailed instructions on extracting the files 2 From the Home screen select Maintenance Quality Control 3 Select QC Normal or another level Measure 4 Select Run QC then New 5 Select Load from USB Drive 6 Insert the USB drive containing the unzipped control values files downloaded from www abaxis com 7 Enter the control lot number fr...

Page 56: ...sheet 1 Plug the 2D USB barcode reader into a USB port on the HM5 2 From the Home screen select Maintenance Quality Control 3 Select Scan Barcode then scan the 2D barcode on the HM5 value assignment sheet provided with the control tube Note When scanning the barcode make sure the control sheet is on a flat surface Note Scan Barcode can also be selected after choosing the QC level and selecting New...

Page 57: ...lect Accept 5 Select OK to delete previous QC results and save the new reference ranges 6 If the 2D barcode reader will not scan the barcode check the reader s brand and model For a Motorola Symbol reader Scan Return to Factory Defaults below Then scan the three barcodes below 1 2 then 3 ...

Page 58: ...entered control values see Entering Quality Control Values on page 5 3 2 After accepting the new control values select Run QC 3 Mix well by slowly rolling the tube flat between your hands A and then slowly inverting the tube 10 15 times B 4 Select Run Note Before running a QC sample make sure the control tubes have come to room temperature Remove the controls from the refrigerator at least 15 minu...

Page 59: ...es such as PDWs and BAS do not have ranges so may always report as out of range because of the lack of target and range data If there are any Warning flags refer to the Troubleshooting section of this manual to resolve the cause of the Warning If the RDWc value is two or more points above the target value discard the control and order a new one as this indicates it has frozen or been exposed to to...

Page 60: ...imal performance In certain situations calibration is needed to fine tune the analyzer When quality control measurements show that one or more parameters are consistently out of range and the analyzer has been determined to be clean and the control has been stored and shipped properly After relocating the HM5 5 2 2 Required Calibration Materials The calibration procedure requires the VetScan HM5 H...

Page 61: ...select Maintenance Calibration 2 Select Measure 3 Verify that Prediluted is set to No and that Cal Sampling Depth is set to 2 mm 4 Select Accept Note Allow the normal control to reach room temperature before beginning This takes about 15 minutes Once opened the control has a shelf life of 14 days Do not calibrate with an expired control or a tube that has been opened more than 14 days ...

Page 62: ...ate tube adapter 8 Select Run to begin the first calibration run When the analysis is complete the results will appear on screen 9 Select Run Cal again The analyzer will display a reminder to mix the sample Mix control well by slowly rolling the tube flat between your hands 10 times and then slowly inverting the tube 10 15 times 10 Follow the on screen directions then select Run When the second an...

Page 63: ...ors are saved and can be viewed as follows 1 From the Home screen select Maintenance Calibration His tory 2 Use the on screen arrows to move through the history 5 2 5 Resetting Calibration If calibration fails repeatedly call Abaxis Technical Support If directed use the Reset Calibration function as follows 1 From the Home screen select Maintenance Calibration Reset Calibration 2 Select OK 3 Calib...

Page 64: ...5 14 Quality Control and Calibration ...

Page 65: ...e 6 3 6 1 2 Cleaning the Wash Head 6 4 6 1 3 Soak Cleaning 6 6 6 2 Automatic Self Cleaning 6 8 6 3 Changing the Reagent Pack 6 9 6 3 1 For QCA Tubing Setup 6 10 6 3 2 For Bottle Caps Tubing 6 11 6 3 3 Disposing of Reagent 6 12 6 4 Software Upgrades 6 12 6 5 Auto Maintenance Flush 6 13 6 6 Peristaltic Pump Tubing Replacement 6 13 ...

Page 66: ...yzer displays reminders when the two primary routine cleanings need to be performed If Scheduling is disabled a yellow triangle appears in the upper left corner of the screen when cleaning is due Select the triangle to see details If Scheduling is enabled you can adjust the cleaning fre quency within allowed limits Reminders appear three days two days and one day before cleaning is due You can sel...

Page 67: ...d select the appropriate fields to set the Interval and Cleaning Day and Time for the Wash Head and Soak Cleanings Abaxis recommends these intervals Cleaning the Wash Head 7 days Soak Cleaning 14 days 5 Select Accept for these settings then Accept again to confirm the Scheduling choice Note If your sample run rate will be less than 5 samples per day you may set the Soak Cleaning Interval to 30 day...

Page 68: ... analyzer displays a message that Wash Head cleaning is due select Clean or Next to begin cleaning If running this pro cess manually that is without prompting by a pop up select Maintenance from the Home screen Cleaning Clean the Wash Head The analyzer then displays cleaning instructions as detailed in the following steps Note Do not clean the Wash Head without activating the HM5 s software as des...

Page 69: ...o at right 4 Visually inspect the Wash Head for any salt or blood build up on its bottom surface For best access view from below Refer to the following figures CAUTION Do not touch components inside the instrument except as specifi cally directed Clean Wash Head No salt or blood build up present on Wash Head s bottom surface Wash Head with minor build up Wash Head with heavy build up ...

Page 70: ... it is clean before proceeding 6 When finished close the side door then select Done 6 1 3 Soak Cleaning Soak Cleaning helps dissolve organic build up from all surfaces that contact blood samples inside the analyzer and is the best way to clean the needle the dilution chamber and the aperture The Soak Cleaning process will require a new unused tube of VetScan HemaClean Abaxis recommends a Soak Clea...

Page 71: ... a blank is required to verify that the background counts are within specification The software will automatically prompt the user to run a blank when a measure ment is attempted after a Soak Cleaning From the Home screen select Measure and then Run Note If Soak Cleaning is needed for troubleshooting outside of scheduled maintenance select Maintenance Cleaning Soak Cleaning and follow the on scree...

Page 72: ...sage pops up contact Abaxis Tech nical Support 9 If two out of three Quality Control runs are within target range the analyzer is ready to run blood work If two out of three runs fall out of target range or have any error warnings call Abaxis Technical Support at 844 247 5271 6 2 Automatic Self Cleaning After each measurement the analyzer automatically cleans the measurement area The software also...

Page 73: ...re running low when one or more levels is low When this occurs change the reagent pack as follows 1 Make sure you have the following New reagent pack New HM5 Normal Quality Control 2 Remove the control from the refrigerator so it can warm to room temperature before use 3 Select and follow the appropriate procedure below according to the reagent pack setup Note Abaxis recommends wearing protective ...

Page 74: ...e and reagent pack all match 10 One at a time grasp each dip tube head and push the tube through its white heat seal and into the same colored bottle Repeat until all dip tubes are through the bottle seals and touching the bottom of the bottles 11 Select Next 12 Dispose of the waste per local regulations The original white waste bottle or the emptied Diluent bottle with the red cap that came with ...

Page 75: ... on each cap is not blocked so air can flow freely 9 Empty the waste container or set up the empty Diluent container from the old reagent pack as the new waste container 10 Reconfirm that the colors on the reagent tubes the back of the analyzer the bottle caps and the reagent pack all match Make sure all reagent tubes are firmly attached to the bottle tops and the back of the analyzer and that the...

Page 76: ...ded from www abaxis com and copied to a USB drive Follow the instructions on the Abaxis website Upgrade from the USB drive as follows 1 Power off the analyzer 2 Plug the USB drive containing the software into a USB port on the analyzer 3 Power on the analyzer and select Upgrade 4 When prompted unplug the USB drive and select OK The analyzer then automatically reboots to complete the software upgra...

Page 77: ...ing can become flattened and eventually needs to be massaged back into shape or replaced A spare tube is included in the accessories kit Although replacement is a simple process Abaxis strongly recommends contacting Abaxis Technical Support before beginning They will verify the need for pump tube replacement and provide guidance through the process if necessary Replace the peristaltic pump tube as...

Page 78: ...up 4 Grasp the bottom left tube connector green band and push it to the left The connector slides out freeing the left end of the tube 5 Grasp the bottom right tube connector white band and push it to the right The connector slides out freeing the right end of the tube 6 Slide the gray attachments toward the center of the yellow pump tube ...

Page 79: ...nd to guide the tubing slide one of the gray pieces on the pump tube into the right side of the pump Stretch the yellow pump tube over the top of the pump then slide the remaining gray piece into the left side of the pump until it snaps into place 11 Reconnect the appropriate color tubes to the bottom of the pump 12 Grasp the gray cover and slide it down over the pump 13 Once the notches on the si...

Page 80: ...6 16 Maintenance Service ...

Page 81: ... to provide three different levels of user access to the VetScan HM5 Section Contents 7 1 User Permission Levels 7 2 7 1 1 Basic Level 7 2 7 1 2 Advanced Level 7 2 7 1 3 Admin Level Default 7 2 7 2 Adding Users and Passwords 7 3 7 3 Logging In 7 4 7 4 Automatic Login Set 7 4 ...

Page 82: ...cks Run QC control on previously entered QC lots View print and save CBC results 7 1 2 Advanced Level Advanced users can perform all functions available to Basic Users as well as the following Load new QC lot values Calibrate the analyzer Adjust all settings other than Admin settings schedule maintenance 7 1 3 Admin Level Default Admin users can view and operate all functions in the analyzer and h...

Page 83: ... a login and password Add new users and their passwords as follows 1 From the Home screen select Settings Admin Settings User Management Add New User 2 Select fields and enter the Login Name and Password then Re Enter Password 3 Select User Type until the desired permission level is displayed 4 If desired enter Name Phone and Email 5 Select Accept ...

Page 84: ... and password 4 When the advanced or admin level maintenance is complete be sure to Exit and Log Out again to return the analyzer to its basic mode 7 4 Automatic Login Set Automatic login set allows the VetScan HM5 to revert to a specific user whenever rebooted 1 Select Settings Admin Setting User Management 2 Select Automatic Login Set and select the default user ...

Page 85: ...n This section describes how to shut down the VetScan HM5 analyzer Section Contents 8 1 Shutting Down the Analyzer 8 2 8 1 1 Temporary Shutdown 8 2 8 1 2 Longer Term Shutdown or Storage 8 3 8 1 3 Powering Off for Troubleshooting 8 3 ...

Page 86: ... days shut it down as follows 1 On the Home screen select Exit Shutdown 2 Select OK to confirm 3 When the analyzer displays a message and sounds a tone power it off using the power switch on the rear panel The off position is marked by the O symbol CAUTION Always follow the instructions in this section when turning off the analyzer The analyzer uses an isotonic saline solution in its fluidic syste...

Page 87: ... on the display The procedure drains the reagents from the analyzer and flushes the Diluent from the internal tubing An alarm sounds when it is safe to turn off the analyzer using the power switch on the back panel 8 1 3 Powering Off for Troubleshooting On occasion the analyzer may freeze or require a reboot for troubleshooting In these situations pro ceed as follows 1 Turn the analyzer off using ...

Page 88: ...8 4 Shutdown ...

Page 89: ... Pressure Error 9 9 9 2 4 Vacuum Error 9 11 9 2 5 Needle Motor Errors 9 12 9 2 6 Sample Rotor Errors 9 13 9 2 7 MValve Errors 9 13 9 2 8 MicroDilutor Motor Error 9 14 9 2 9 Diluent and Lyse Dilutor Motor Errors 9 14 9 3 Evaluating Unexpected Results 9 15 9 4 Additional Cleanings and Processes 9 15 9 4 1 Removing and Cleaning the Wash Head 9 15 9 4 2 Deep Cleaning 9 18 9 4 3 Removing and Cleaning t...

Page 90: ...ery 12 hours for 24 hour clinics The blank measures the cleanliness of the analyzer and the purity of the reagents If there are no warning flags and no values highlighted in red accompanied by or accept the blank The analyzer is then ready to run patient samples If there are issues with the blank the warning shown at right appears Click OK to view the actual blank results on the blank results scre...

Page 91: ...g the Wash Head on page 6 4 If the Wash Head has significant accumulation the Wash Head must be removed for cleaning see Removing and Cleaning the Wash Head on page 9 15 While the Wash Head is removed clean the area around the Wash Head mounting point if there is salt build up there If the Wash Head is clean perform a Soak Cleaning see Soak Cleaning on page 6 6 then repeat the blank 2 Check for bl...

Page 92: ...ad is pulled to the right during the cleaning process Rerun the blank 5 For continued X flags check the Lyse 2 orange and Diluent green reagent tubing for bub bles or leaks If either are found attach the tubing more firmly to the analyzer dip head or bottle cap If the attachment is loose cut 3 5 mm off the end of the tube and reattach Then prime Maintenance Reagent Status Prime and select Lyse 2 a...

Page 93: ...Check for moisture salt or blood debris on the HGB head in the side door area circled in red and dry clean if any is found Reboot the HM5 then rerun the blank Run Soak Cleaning or Deep Cleaning then rerun the blank Run a self test from the Home screen select Maintenance Diagnostics Self Test Start If the self test fails call Abaxis Technical Support Flag Meaning Description Recommended action E No...

Page 94: ... exist perform a manual smear to verify the WBC count If the M flag persists and the manual smear does not indicate a high WBC count call Abaxis Technical Support c C q Analyzer s aperture is clogged Run 2 3 automatic self cleanings see Automatic Self Cleaning on page 6 8 Redraw a sample making sure to transfer the sample into the tube immediately and mix well then rerun If visible clots are seen ...

Page 95: ...e clogging or insufficient Lyse 2 delivered If the Y flag is accom panied by many other warnings c C E B Y call Abaxis Techni cal Support Make sure the Lyse 2 tube orange is connected to the Lyse 2 bottle If not disconnect the incorrectly connected tubes from the analyzer and hold them up so the liquid in them flows back into the bottles Connect tubes to the cor rect connections on the analyzer bo...

Page 96: ...thing such as the foot of the analyzer 5 Make sure the reagent bottle is not empty 6 Prime the reagent tube by pressing the Prime button on the pop up 7 If a second Reagent Supply Error is displayed open the door on the back of the analyzer and check for any loose or disconnected tubes Examine the seven white valves circled in red closely to see if any tubes have detached from them Touch the tubes...

Page 97: ...waste bottle a salt or blood clot or disconnected tubing in the analyzer 1 Check the waste tube red band for pinching or kinks and straighten if necessary Empty the waste bottle if needed 2 Select Drain The analyzer will make a series of clicking noises while it attempts the draining 3 If the pressure error continues touch Re Drain and the analyzer will try again to clear the error by flushing flu...

Page 98: ...tened or is sticking to itself see Peristaltic Pump Tubing Replacement on page 6 13 6 Attempt to run a blank 7 If the screen message indicates that the pressure error has resolved AND the blockage was due to clots in the valves perform Valve Cleaning only in software v2 3 and higher The Valve Cleaning cycle will take about 20 minutes Otherwise select Cancel 8 If the pressure error still persists c...

Page 99: ...Abaxis Technical Support 4 Open the analyzer s side door to see if any liquid has spilled on the floor of the analyzer Wipe up any liquid and power the analyzer off then on to re home the needle Run a blank to verify that the issue is resolved 5 If the issue persists open the analyzer s side door and look for any detached tubing Dry and reconnect if any are found 6 Grasp the measuring tube shown a...

Page 100: ...the needle and move it up and down as far as able 3 4 times to relubricate the guide bars c Turn the analyzer back on and run a blank If the error continues call Abaxis Technical Support 9 2 5 2 Horizontal Needle Motor Errors Try the following in the order shown 1 Examine the area to the right and left of the needle and Wash Head assembly for any block age including salt build up preventing left a...

Page 101: ...ing 4 Select Retry or reboot the analyzer then attempt to run a blank to determine if the issue is resolved 5 If the issue repeats call Abaxis Technical Support 9 2 7 MValve Errors The MValve error occurs when the controlling computer board fails or if a valve is stuck Correct this error as follows 1 Open the analyzer s back and side doors 2 Push the clear button on the front of each of the 12 val...

Page 102: ...k 4 If the blank runs perform an Soak Cleaning 9 2 9 Diluent and Lyse Dilutor Motor Errors These errors refer to the motors that move the syringes in the back of the analyzer Correct this error as follows 1 Check for kinks in the reagent tubing from the analyzer to the bottle caps or dip tube heads 2 If no kinking is found turn the analyzer off open the back door of the analyzer and manually move ...

Page 103: ...Additional Cleanings and Processes on page 9 15 for various cleaning procedures which can be run 4 Run a new blank then rerun the sample to see if results now clinically fit 5 If results are still not supporting the clinical symptoms call Abaxis Technical Support 9 4 Additional Cleanings and Processes 9 4 1 Removing and Cleaning the Wash Head If salt or blood build up on the Wash Head cannot be re...

Page 104: ...s 5 Loosen the thumbscrews solid circle and remove both completely Take care not to drop them into the counting chamber dashed circle 6 Gently pull the Wash Head bracket circled straight down then pull the Wash Head straight down If the needle is pulled down with the Wash Head hold the needle in place from above so it doesn t descend with the Wash Head CAUTION Take care not to bend the needle in t...

Page 105: ... clean the top and bottom surfaces of the Wash Head by wiping thoroughly with a moist lint free tissue to remove all salt residue Large hard salt residues may require longer soaking times 11 Inspect the Wash Head to make sure it is free of salt and blood build up 12 Reconnect the two tubes from the Wash Head bracket 13 Make sure the Wash Head is right side up with the white disk facing upward as s...

Page 106: ...n routine Soak Cleaning has been regularly performed This procedure will per form a more thorough cleaning of the HM5 Call Abaxis Techni cal Support before performing this procedure This procedure requires a lint free cloth moisturized with dis tilled water a new tube of HemaClean and an in date not expired unopened HM5 normal control 1 Open the side door and identify the Wash Head Red Circle and ...

Page 107: ...within target range the analyzer is ready to run blood work If two out of three runs fall out of target range or have any error warnings call Abaxis Technical Support at 844 247 5271 for help in calibrating the instrument 9 4 3 Removing and Cleaning the Aperture The analyzer s aperture may get clogged or collect debris over time If Soak Cleaning or Deep Cleaning does not resolve the problem the ap...

Page 108: ...nnect the black wire from the left side of the mea suring tube assembly by sliding it down and to the left 4 Grasp the measuring tube and pull while slightly twisting left and right until it comes off This is a push fit part so it should pull straight out 5 Disconnect the tubing and pull off the U shaped clip so the two pieces can be separated ...

Page 109: ...r ten minutes 7 Rinse off the bleach with distilled water 8 Put the reference electrode and measuring tube back together and slide the U shaped clip back into place 9 Push the probe back into the body of the dilu tion chamber and reattach tubing 10 Reattach the black wire 11 Run a blank 12 If the blank displays flags and results in red contact Abaxis Technical Support ...

Page 110: ...er on top of the unit or to certain external USB printers Use these suggestions to solve problems with either printer 9 5 1 Built in Printer If the analyzer s built in printer is not printing check the following in this order 1 Is the lid closed properly If the light is blinking one side of the printer lid may not have snapped shut 2 Is the paper roll inserted correctly Make sure to lower the pape...

Page 111: ...s USB instead of the exact printer type try to print a result to trig ger the connection 5 Check that the USB A B cable is securely attached to the analyzer and to the printer Most printers have an Ethernet and a USB B port Make sure the USB B end of the cable is not inserted into the Ethernet port 9 5 2 1 If Results Are Not Combining With the VS2 Try the following in the order shown 1 Check that ...

Page 112: ...9 24 Troubleshooting ...

Page 113: ... 10 1 Specifications This section contains technical specifications for the VetScan HM5 system and lists its linearity ranges Section Contents 10 1 VetScan HM5 Specifications 10 2 10 2 Linearity Ranges 10 3 10 3 Precision 10 4 ...

Page 114: ...culated parameters 16 and 64 day Levy Jennings charts separate QC database Calibration Three measurement automatic calibration of WBC HGB RBC PLT MCV RDWc MPV and EOS absolute Multi user feature Three level multi user operation with selective privilege levels user identification with ID and password Contact Abaxis for more information User interface Easy to use menu driven touchscreen user interfa...

Page 115: ...inear value indicated in the table below predilution is recommended The following tables list the linearity ranges for primary parameters in normal measuring mode and prediluted mode Table 10 1 Linearity Ranges in Normal Measuring Mode Table 10 2 Linearity Ranges for Prediluted Mode Parameter Linearity Ranges Maximum Unit WBC 0 100 150 109 cells liter EOS 0 2 3 0 10 0 109 cells liter RBC 0 15 20 1...

Page 116: ...with ten replicate measurements performed in one day Table 10 3 Control Parameter Precision Parameter Mean SD CV WBC 103 cell μl 8 05 0 15 1 89 RBC 106 cells μl 4 49 0 111 2 44 EOS 103 cell μl 5 00 0 07 1 32 HCT 40 39 1 01 2 51 HGB g L 125 66 1 71 1 36 MCV fL 90 03 0 50 0 56 PLT 103 cell μl 248 36 18 30 7 37 MPV fL 12 69 0 177 1 39 ...

Page 117: ... these concepts will help you better understand the results from the analyzer Appendix Contents A 1 Function of Blood A 2 A 2 Composition of Blood A 3 A 3 Blood Cell Parameters A 4 A 3 1 Red Blood Cells Hemoglobin A 4 A 3 2 White Blood Cells A 5 A 3 3 Automated WBC Classification A 5 A 3 4 Eosinophils A 6 A 3 5 Platelets A 6 A 4 Normal Hematology Ranges A 8 A 5 Veterinary Hematology References A 9...

Page 118: ...epends on the rapid removal of toxic metabolic products CO2 and NH3 from the interstitial fluid environment These waste products are taken up by the plasma and red blood cells and eliminated as the blood passes through the kidneys and lungs Blood also delivers hormones lip ids amino acids salts and vitamins and removes urea and conjugated acids Blood distributes the heat generated by metabolizing ...

Page 119: ... x 109 cells l 100 700 x109 cells l Nucleated No Yes No Sub populations and their percentages RBC 99 9 NRBC Nucleated RBC 0 1 GRAnulocytes 65 NEUtrophil 60 EOSinophil 4 BASophil 1 LYMphocytes 32 MONocytes 3 Shape size Biconcave donut shape diameter 5 7 µm thickness 1 8 2 µm GRAnulocytes 13 16 µm LYMphocytes 8 15 µm MONocytes 15 25 µm Fragments with a diameter of 2 4 µm Volume of cell 30 80 fl 50 1...

Page 120: ...egree of cell size vari ation In a healthy sample RBCs demonstrate a normal Gaussian distribution bell curve as shown at right RDW can be characterized by a standard deviation RDW SD or a coefficient of variation RDW CV repre sented as a percentage Hemoglobin HGB is the main component of RBCs It is a conjugated protein with Fe and its main function is to transport oxygen from the lungs to tissues ...

Page 121: ... the number and relative percentage of lymphocytes LYM LYM monocytes MON MON and granulocytes GRA GRA WBC related parameters are defined as follows WBC LYM MON GRA LYM LYM WBC MON MON WBC GRA GRA WBC NEU GRA EOS BAS WBC EOS EOS WBC BAS BAS WBC Elevated WBC counts can affect other differential parameters It is highly recommended that abnormal WBC and other cell differentials be confirmed by a manua...

Page 122: ...sence of eosin staining red granules A 3 5 Platelets Platelets PLT are non nucleated fragments of the megakaryocyte in mammals Note that plate lets are formed by cellular fragmentation Therefore the platelet histogram normally has a logarithmic shape on the left side and a normal shape on the right side log normal distribution Normal PLT concentrations range from 200 800 x 109 cells l for dogs dep...

Page 123: ...to 30 seconds before analysis The analyzer calculates the volumetric ratio of PLTs in whole blood as follows PCTpercent PLT x MPV 10 PCTabsolute PCTpercent 100 Typically PCT 0 003 0 3 Platelet Distribution Width PDW is a measure of platelet anisocytosis the degree of size vari ation In a healthy sample platelets demonstrate a Log normal distribution PDW can be characterized by a standard deviation...

Page 124: ...0 77 39 55 37 59 40 60 50 68 45 55 71 86 69 87 HGB g l 120 180 80 150 110 190 80 150 100 160 122 162 109 147 120 156 MCH pg 19 5 24 5 12 5 17 5 12 3 19 7 11 17 17 21 11 1 12 7 21 8 26 2 21 4 26 2 MCHC g l 310 390 300 360 310 390 300 360 300 340 223 320 287 323 278 330 PLT 109 cells l 165 500 300 800 100 400 100 800 325 715 200 450 216 502 261 629 MPV fl 3 9 11 1 12 17 6 8 11 6 Parameter Unit Rat R...

Page 125: ...s Reagan William et al Iowa State Press 1998 Veterinary Laboratory Medicine Interpretation Diagnosis 3rd ed Meyer Denny Harvey John Elsevier Press 2004 A Guide to Hematology in Dogs Cats Rebar Alan et al Teton New Media 2002 Automated Blood Counts Differentials A Practical Guide Bessman J David Johns Hopkins University Press 1986 Hematology Techniques Concepts for Veterinary Technicians Voigt Greg...

Page 126: ...A 10 Introduction to Veterinary Hematology ...

Page 127: ...B 1 Complete Blood Count CBC B 2 B 2 Measurement Methods B 2 B 2 1 Volumetric Impedance Method B 2 B 2 2 Three Part Differential Method B 3 B 2 3 Five Part WBC Differential Method B 5 B 3 Hemoglobin Determination B 6 B 3 1 Hemoglobin Determination by Photometry B 6 B 4 Measured and Calculated Parameters B 7 B 5 Measured and Calculated Values B 8 ...

Page 128: ...wing figure illus trates this method The principle of this method is that blood diluted with an isotonic solution Diluent conducts electric current by ionic conduction A counting chamber made of an insulating material plastic holds this diluted blood while a small circular hole aperture in this chamber allows the flow of diluted blood The analyzer aperture diameter and length is 80 µm the optimal ...

Page 129: ... Lysing also releases the hemoglobin stored in the RBCs for direct analysis in the solution Therefore a hemolysing reagent Lyse is used to dissolve cellular membranes thus destroying RBCs and creating a complex solution suitable for photometry of HGB and counting WBCs The following figure shows the changes in blood cell characteristics that occur during three part differ ential hemolysis Although ...

Page 130: ...se reagent this depends on the animal profile selected to destroy red blood cells The remaining solution is suitable for photometric measurements of HGB and counting of WBC After these measurements are done the software is able to determine HGB WBC LYM LYM MON MON total GRA and GRA GRA contains all types of granulocytes GRA NEU EOS BAS and GRA NEU EOS BAS Volume distribution of three part measure ...

Page 131: ...lution a hemo lytic reagent and Diluent to form a 1 200 dilution During the incubation time white blood cells will be differentially hemolysed so that eosinophils will retain a higher cellular volume After counting and sizing the cells the software will interpret all cells above the discriminator as eosinophils The user can observe the distribution of the cells on the EOS histogram The number and ...

Page 132: ...ity of blood The analyzer uses cyanide free lysing reagents to minimize negative effects on user safety and the environment The effect of cyanide free Lyse is very similar to that of Lyse containing cyanide but the chemical reaction is slightly different The figure below illustrates the HGB measurement method HGB is measured by passing light 540 nm through the WBC dilution and measuring the transm...

Page 133: ...obin MCHC mean corpuscular hemoglobin concentration RDWc RDWs std dev red cell distribution width coefficient of variation PLT platelet count PCT platelet crit MPV mean platelet volume PDWc PDW std dev platelet distribution width coefficient of variation The monocyte category consists primarily of monocytes Impedance counters categorize white blood cell types differential according to size and the...

Page 134: ...10 HCTabsolute HCTpercentage 100 Mean Corpuscular Hemoglobin MCH reportable as picogram fmol Average hemoglobin content of erythrocytes calculated from RBC and HGB values MCH HGB RBC Mean Corpuscular Hemoglobin Concen tration MCHC reportable as g dl g l mmol l Calculated from the HGB and HCT values MCHC HGB HCTabsolute Red Cell Distribution Width reportable as RDW SD fl RDW CV absolute Measure of ...

Page 135: ...ils EOS EOS reportable as cells l cell µl Absolute values counted in channels as determined by the EOS discriminator Percentage calculated from the absolute EOS and WBC values Basophils BAS BAS reportable as cells l cells µl BAS is the absolute count of basophils BAS is the percentage of basophils in the total WBC Neutrophils NEU NEU reportable as cells l cells µl NEU is the absolute count of neut...

Page 136: ...B 10 Operating Principles ...

Page 137: ...ial Sample Interferences C 1 Potential Sample Interferences Appendix Contents Table C 1 lists situations in which substances in the samples themselves can interfere with accurate analysis and provides possible solutions ...

Page 138: ...r filled tube Fill tube at least halfway or remove portion of potassium EDTA before filling tube Miscellaneous idiopathic Use alternative anti coagulant as heparin or citrate vortex sample immediately prior to sampling Giant platelets Right side of platelet histogram runs into RBC histogram Decreased PLT decreased MPV Thrombopoiesis feline species Confirm platelet estimate on smear and or manual p...

Page 139: ...igh LYM Low GRA D 4 D 2 3 Dog High PLT D 5 D 2 4 Dog Low PLT Low MPV D 6 D 2 5 Dog Stress Leukogram D 7 D 2 6 Dog Eosinophilia D 8 D 3 Cats D 9 D 3 1 Cat Optimal Sample D 9 D 3 2 Cat Clumped PLT Increased LYM D 10 D 3 3 Cat Eosinophilia and Lymphocytosis D 11 D 4 Horses D 12 D 4 1 Horse Normal Sample D 12 D 4 2 Horse Low LYM High GRA D 13 D 4 3 Horse Low PLT and WBC Leukopenia Lymphopenia D 14 D 4...

Page 140: ...al level control blood run in test mode the con trol results are the same in test mode as in QC mode Note the differences in cell populations human samples and control blood contain larger cells than ani mal blood Samples run under the species Control do not display reference range bars or cell percentages ...

Page 141: ...ells larger than approximately 40 fl are counted as WBCs indicated by discriminator 1 Discriminators 2 and 3 show the MON population The histogram shows well defined LYM and GRA peaks with MON in the valley between them RBC All cells larger than 25 fl are counted as RBCs The RBC histogram follows a normal distribution The MCV is near 68 fl and the RBC is near 7 66 x 1012 cells l PLT PLT cell popul...

Page 142: ...es D 2 2 Dog High LYM Low GRA The following shows a sample that has high LYM LYM is normally near 12 30 for dogs This case shows a lymphocytosis These histograms indicate the following WBC High LYM low NEU RBC Normal PLT Normal ...

Page 143: ... high and the LYM population is much smaller than the GRA population This case demonstrates a thrombocytosis These histograms indicate the following WBC Three part differential curve with good separation between populations EOS Normal EOS count RBC Normal PLT High PLT No sign of PLT clumping ...

Page 144: ...nia These histograms indicate the following WBC Discriminator 1 is at 36 fl which is slightly lower than normal Otherwise the histogram appears to be normal Discriminators 2 and 3 are placed correctly according to the WBC population RBC Normal PLT Low PLT The nicely shaped PLT curve indicates that no clumping has occurred but a manual smear is recommended for confirmation ...

Page 145: ... with an elevated NEU count and a decreased LYM count Dogs that are stressed but otherwise healthy dis play results similar to those shown below These histograms indicate the following WBC Very high total leukocyte count with a pronouncedly shrunken LYM peak and an elevated NEU with suppressed EOS RBC Normal PLT PLT count is normal for this sample ...

Page 146: ...tient These histograms indicate the following WBC The histogram shows a fairly normal WBC profile EOS The absolute count of eosinophils and EOS are above normal The high EOS value indicates a need for a manual blood smear PLT The distinct peak shows a slight thrombocytopenia with no detectable clumping ...

Page 147: ...imize accuracy Some clinics have minimized stress induced platelet aggregation by collection from the saphenous vein Analyzing the sample as close to the time of draw as possible also minimizes PLT clumping Pre analytical vortex mixing up to 30 seconds also helps disaggregate platelets with no deleterious effects D 3 1 Cat Optimal Sample The following shows an optimal normal cat sample These histo...

Page 148: ...f the LYM peak relative to the GRA peak and the high LYM result on a cat sample suggest that the user should examine the PLT histogram The clumped platelets PLT increase the LYM count in this sample and also contribute to cell aggregates shown in the extended tail on the right of the histogram PLT The PLT histogram lacks a defined peak and slopes upward to the right indicat ing the presence of clu...

Page 149: ...ate the following WBC Large increase in LYM with a relative decrease in GRA The large LYM count and uniform shape of the histograms indicate that this is likely a genuine lymphocytosis EOS The EOS histogram shows a single broad peak which causes the high EOS count RBC Normal with normal distribution PLT The PLT curve slopes up and indicates some clumping in this sample ...

Page 150: ...lls l giving an HCT near 40 D 4 1 Horse Normal Sample The following shows a typical normal sample for a horse These histograms indicate the following WBC WBC value is normal the cells are well separated and the discriminators are set accurately RBC Normal Compare dog and horse histograms to see the smaller cells in the horse PLT PLT is correct Note the good separation at the PLT RBC discriminator ...

Page 151: ...orse Low LYM High GRA The following is a typical horse sample with a lymphopenia These histograms indicate the following WBC Low LYM and a high GRA Discriminators are set accurately RBC Normal PLT Normal Note the good separation from RBCs ...

Page 152: ... Leukopenia Lymphopenia In some cases the PLT will be low You can compare the height of the PLT peak to the RBC peak on the RBC histogram These histograms indicate the following WBC Low WBC and LYM with accurately placed discriminators RBC Normal PLT Low PLT ...

Page 153: ...nd from each other These histograms indicate the following WBC This is a well separated WBC histogram showing clear populations and good WBC differentials RBC Low RBC HCT and HGB indicating possible anemia MCV is slightly higher and the RBC histogram is slightly skewed to the larger end indicating the presence of larger perhaps immature RBCs PLT Normal Note the good separation from RBCs ...

Page 154: ...D 16 Veterinary Case Studies ...

Page 155: ... wellness of a patient as well as identifying and monitor ing certain disease states This appendix outlines the various CBC parameters and associated clinical indications Appendix Contents E 1 White Blood Cell Parameters and Associated Indications E 2 E 2 Red Blood Cell Parameters and Associated Indications E 3 E 3 Platelet Parameters and Associated Indications E 4 ...

Page 156: ...ce Granulocytes Neutrophils Left shift Increased numbers of immature neutrophils band cells regenerative up to 50 bands neu trophilia absence of myelocytes metamyelocytes degenerative 10 bands depressed total neutropenia pres ence of myelocytes metamyelo cytes poor prognostic indicator Right shift Increased number of hypermature hyper segmented neu trophils often seen with non infectious inflammat...

Page 157: ...enerative anemia Decrease iron deficiency anemia Normal MCV is consistent with non regen erative anemia often due to chronic dis ease MCV should always be interpreted in light of other clinical data MCH Mean Corpuscular Hemoglobin Calculated HGB concentration of an aver age RBC MCH HGB x 10 RBC in pico grams Increase most commonly the result of hemolysis Decrease hypochromasia common in iron defic...

Page 158: ...ession Autoimmune hemolytic anemia Severe hemorrhage Liver disease Parasites MPV Mean Platelet Volume Indirect evidence of increased bone mar row megakaryocyte response Not an accurate predictor of decreased mega karyocyte response PCT Platelet Hematocrit Volume of platelets expressed as a per centage of whole blood used as a research tool Volume of platelets expressed as a percent age of whole bl...

Page 159: ... 4 shelf life 5 11 Cell discriminators dynamic A 5 in histograms 4 10 Cleaning automatic 6 9 daily 4 4 Complete Blood Count CBC B 2 measured or calculated values B 7 B 8 platelet parameters E 4 red blood cell parameters E 3 white blood cell parameters E 2 Computer connecting to HM5 3 7 Contacting Abaxis 1 3 Control panel 1 4 Customer Support 1 3 D Data export format settings 3 3 Deep cleaning 9 18...

Page 160: ...white blood cell 4 10 I Initial Goods 2 4 Installation 2 1 Bottle cap setup 2 8 choosing a location 2 2 electrical requirements 2 3 environment requirements 2 2 procedure 2 3 QCA setup 2 7 K Keyboard 1 7 USB accessory 1 7 2 5 L L flags 9 7 Language settings 3 3 Leukocytes See White blood cells Linearity ranges 10 3 Logging in 7 4 Lymphocytes E 2 LYM LYM 4 10 B 9 Lyse adjusting volume 4 9 M m flags...

Page 161: ... E 3 in WBC histograms 4 10 mean corpuscular volume MCV B 8 E 3 measured and calculated values B 8 red blood cell RBC histogram 4 10 red blood cell count RBC 4 10 B 8 red cell distribution width RDW A 4 B 8 E 3 References veterinary hematology A 9 Removing cleaning aperture 9 19 Result flags 9 5 Results interpreting 4 9 linearity ranges 10 3 measured and calculated values B 8 printing 4 8 report c...

Page 162: ...B ports Type A 1 4 Type B 1 4 User permission levels admin 7 2 advanced 7 2 basic 7 2 Users adding 7 3 V Vacuum error 9 11 Veterinary hematology references A 9 VS2 results not combining 9 23 W W flags 9 7 Warning indicators flags 9 2 blank flags 9 2 Wash Head cleaning 6 4 removing and cleaning 9 15 White blood cells A 5 classification A 5 GRA GRA differentials 4 10 B 9 in CBC parameters E 2 LYM LY...

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Page 164: ...Road Bunsenstrasse 9 11 Chessingham Park Union City CA 94587 USA 64347 Griesheim GERMANY Common Road Tel 1 510 675 6500 Tel 49 6155 780 210 Dunnington YO19 5SE York UK Tel 1 800 822 2947 Tel 44 1904 909 500 www abaxis com Abaxis and VetScan are registered trademarks of Abaxis Inc 2018 790 7013 Rev F ...

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