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What are some cytologys that we can perform and places we would perform them?
FNA, Impression smears, BMA (Bone marrow), Ear, vaginal, Milk, Thoracocentesis, Abdominocentesis, Arhtrocentesis, Tracheal Wash, Prostate
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Why would we perform an ear cytology?
Any Unhealthy Ear and to re-check it
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What are the main things we are looking for in an ear cytology?
Bacteria, yeast, mites, inflammatory cells
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What do we do to our slide that allows us to see the bacteria and yeast?
We use the dif-quick
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What do you want to see on an ear cytology?
Few bacteria/ yeast
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What do we do with an ear cytology slide before we stain it?
We heat fix it
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What are a couple reasons we would perform a vaginal cytology?
To determine what phase of estrus or pyo suspect
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What are the 3 main things to do to prep for a vaginal cytology?
Clean vaginal area, apply a lubricant, and moisten cotton swab
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How do we collect our sample for a vaginal cytology?
Gently roll moistened cotton swab along the vaginal walls then gently roll on to a slide
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What are the 4 stages of the estrus cycle?
Anestrus, Proestrus, Estrus, Diestrus
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Anestrus: how long is it and what are the cells like on cytology
- ~4-5 months (canine)
- ~Non-cornified Squamous Epithelial, Intermediate, Parabasal, No RBC’s and few neutrophils
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Proestrus: how long is it and what are the cells like on cytology
- ~Average 9 days
- ~Transition of non-cornified -> cornified, cytoplasm starts to become eosinophilic, RBC’s in canine, Neutrophils less abundant
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Estrus: how long is it and what are the cells like on cytology
- ~Average 9 days
- ~All epithelial are cornified, pyknotic, No neutrophils, fewer RBC’s, towards end neutrophils increase and RBC’s decrease more
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What does it mean if a cell is pyknotic?
Absent of nucleus
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Diestrus: how long is it and what are the cells like on cytology
- ~About 2-3 months
- ~Looks like Anestrus
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What hormone sets the uterus us for pregnancy, pyometra, or pseudo?
Progesterone
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What stage of estrus do we normally get a pyometra and why?
Diestrus because of the Progesterone increase
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FNA:
Fine Needle aspirate
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What are some reasons to perform a fine needle aspirate?
Any palpable or visible masses, lymph nodes, internal organs
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What are some benefits of a FNA? Down falls?
- ~Cheap, no anesthesia, quick
- ~Small sample size, false negatives, often inconclusive
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What are the 2 ways to perform a FNA?
Aspirate and stab
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What are some possible finding of a FNA and how do you feel about them?
Fat- great news, Inflammatory cells and RBC’s- could be meaningless, Neoplastic cells- further testing needed!
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What are the ups and downs of impression smears?
Cheap, easy, non-invasive, minimal restraint, minimal supplies
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What would expect to see on an impression smear?
RBC’s, some WBC’s, possibly a little bacteria, normal cell types
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What would be some abnormal findings on an impression smear?
Fungal , neoplasia
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What are some neoplastic changes?
Size of cell/ nucleus, cell: nucleus ratio, multiple nucleoli, Nuclei/ nucleoli could be irregular, cytoplasmic inclucions +/or basophilia
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What does neoplasia look like microscopically? Grossly?
- ~Large cell, irregular, Basophilic, multinucleated
- ~Invasive, irregular margins, fast growing, attached
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Why would we perform a thoracocentesis?
Therapeutic and diagnostic
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What do you always want to use when performing a thoracocentesis?
A 3 way stop cock
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What materials will you use for a thoracocentesis and where will you perform this?
~22-18g needle, butterfly catheter, scrub, +/- ~anesthesia/sedation Between the ribs, VENTRAL to the fluid line
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What will we do with the sample from the thoracocentesis?
Save some for sterile sample, some in EDTA tube, make slides and let air dry, stain some and examine immediately, save some un-stained slides to send out if needed, Check Specific Gravity
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What are the big risks of thoracocentesis?
Stress to patient, puncture of important things like lung, heart, or major vessel, and anesthetic risks if used.
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Thoracocentesis is the examination of what?
Pleural Fluid
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Abdominocentesis is the examination of what?
Peritoneal Fluid
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What is the reason we do abdominocentesis?
Diagnostic, not generally for therapeutic reason
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Where do we generally perform abdominocentesis at?
Midline or ‘4 quadrants’ of the abdomen
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What are the 4 types of effusions or fluids?
Transudates, Modified transudates, exudates, and Hemorrage
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What could it mean if you pull transudate fluids?
Hepatic failure, protein losing disease, or hypoproteinemia
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What could it mean if you pull modified transudates?
CHF, chylothorax, neoplasia-carcinoma, lymphosarcoma; color vary- may vary- milky white, brownish, red, or yellow
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What could it mean if you pull Exudates?
Inflammatory- septic or non-septic
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What could it mean if you pull hemorrhage?
Trauma, bleeding or ruptured tumor, postoperative, clotting disease
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What would be a reason to examine joint effusion?
Any swollen joint
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How do you collect fluid?
Sterile surgical scrub, +/- sedation, either syringe and needle or butterfly catheter, and EDTA tube
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When you collect joint fluid, what do you make notes of?
Findings, color, volume
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What are normal protein values in joint fluid?
<2.5 g/dl
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Turbidity and Viscosity with joint fluid
- ~Turbidity- none in normal fluid
- ~Very viscous due to hyaluronic acid
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Why is joint fluid very viscous?
It’s due to hyaluronic acid
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A decrease in viscosity of joint fluid could indicate what?
Inflammatory processes
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Normal joint cellularity is what? In horses?
- <1500 nucleated cell/ul
- <500 cell/ul
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On examination what are the similarities and differences between Septic Arhtritis and Immune mediated polyarhtritis?
- ~Both painful swollen joints and have inflammatory cells
- ~Dif: septic will have bacteria; poly will not, septic treat with antibiotics; poly treat with steroids
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Why would you perform a milk evaluation?
Detection of Mastitis
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Where do we take a sample from when testing milk?
Take a sample from each quadrant
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What 2 things do you want to do before catching a milk sample?
Clean the teat and discard the first few squirts
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How much milk do you collect and for what tests?
7ml total: 2 for Californian Mastitis Test and 5 for culture or more specific bacterial test
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What does the tests look for in milk?
Either nucleated cells or actual bacteria
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When do you expect to see the highest cell counts in milk?
Beginning and end of lactation cycle
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Normal Finding in Milk: Cell Count, Neutrophil %, and pH
- ~Cell count <300,000-500,000/ml
- ~<10%neutrophils
- ~pH 6.5-6.8
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What are the 2 forms of mastitis contraction?
Contagious or environmental
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Why do we test milk?
- Because of human consumption
- $$$$$$$$$$$$$
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What are the specific reagents in the California Mastitis Test
Alkyl arylsulfonate and bromcresol purple as pH indicator
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What tests are similar to the California Mastitis Test?
Whiteside test and Michigan Mastitis Test
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CSF: what is it and why do we test it?
- ~Cerebrospinal Fluid
- ~Complete Neurological work-up, any undiagnosed neurological disease, seizures
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What are the major risked involved with collection of CSF?
Damage to CNS, infection, risk associated with anesthesia
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How do you collect CSF?
Under general anesthesia, collect from lumbo-sacral space or the atlantooccipital space, allow fluid to flow freely, collect in both an EDTA tube and a red top, and evaluate within 15 minutes
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What is normal CSF: color, RBC, protein and nucleated cell counts, CK, glucose
- ~Clear and color-less
- ~0 RBC’s
- ~<25 nucleated cells/ul
- ~10-50mg/dl
- ~CK- usually low, activity in nervous tissue can be high, so is used as an indicator of damage
- ~Glucose- 60-80% of blood glucose
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What would a yellow CSF be?
Xanthochromia- generally secondary to hemolysis, elevated bilirubin content, older hemmerage
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How is chronicity distinguished?
Phagocytosis of RBC’s, lack of platelet clumping, yellow rather than red
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What are some reasons we would do a tracheal wash?
Chronic, severe or non-responsive respiratory condition in any species
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What are the major risks with a tracheal wash?
Tracheal damage, aspiration with irritation to lung tissue
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What are the 3 basic Tracheal wash techniques?
Orotracheal, Nasotracheal, and Transtracheal
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With each type technique of tracheal wash, where do we perform it and what state is the animal in?
- ~Orotracheal- general anesthesia and place ET tube and catheter through that
- ~Nasotracheal- awake/ lightly sedated, pass through the nasal passage into trachea
- ~Transtracheal- surgical prep, actually cut through skin and trachea bypassing the pharynx
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What do you do with the material collected from a tracheal wash?
Can be kept in sterile syringe, red top, or if delay is expect EDTA tube
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How do we evaluate the prostate?
- ~Catheterization+prostate massage
- ~Needle biopsy/ FNA
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What do you normally find in the prostate?
Consistent size and shape, 0-few leukocytes, high nucleus to cytoplasm ratio
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Abnormal prostate findings are rare in all species except what?
Canine
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What would you expect to see with protatitis?
Many leukocytes (neutrophils and monocytes, may isolate bacteria
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What is expected to be noticed with Prostate Metaplasia?
Change in cell morphology, often precursor to neoplasia, calls have low nucleus: cytoplasm ratio
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