SAMPLE SUBMISSION FORM Veterinary Diagnostic Laboratory

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SAMPLE SUBMISSION FORM Veterinary Diagnostic Laboratory
Veterinary Diagnostic Laboratory
SAMPLE
SUBMISSION FORM
VDL Profiles Guide
Fee
(ex GST)
PATHOLOGIST
INTERPRETATION
HAEMATOLOGY
FBC
Fibrinogen
Serum Amyloid A
Platelet Count
PT & APTT
CHEMISTRIES
Albumin
ALP
ALT
Amylase
Anion gap
AST
Betahydroxybutyrate
Bicarbonate
Bilirubin
Calcium
Cholesterol
Chloride
Creatinine
CK
GGT
GLDH
Globulin
Glucose
Lipase
Magnesium
Phosphate
Potassium
Sodium
Total Protein
Triglycerides
Urea
Uric Acid
(Fees are current for 2012 and are subject to change thereafter)
CANINE
Complete Profile
$75.00
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Health Profile1
$45.00
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$45.00
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Greyhound Racing
Profile
FELINE
Complete Profile
$75.00
Health Profile1
EQUINE
$45.00
Complete Profile2
$71.50
Racing Profile
$42.00
Inflammatory Profile
$55.00
Respiratory Profile3
RUMINANT
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$175.00
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Complete Profile
$71.00
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Health Profile
$60.00
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Downer Cow Profile
AVIAN/REPTILE
$48.00
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Complete Profile
GENERAL
$72.00
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Coagulation Profile
$85.00
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Pre-anaesthetic
Screen
$50.00
Kidney Profile
$62.00
Liver Profile
Pancreas Profile
1. Also includes T4
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$45.00
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$55.00
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2. Choice of fibrinogen or SAA
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3. Equine complete profile plus TW & BAL cytology, TW culture.
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Complete Profile
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Health Profile
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Health Profile
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Greyhound Racing Profile
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Downer Cow Profile
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Complete Profile
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Health Profile
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Fl. Oxalate
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Citrate
Plain
Complete Profile
CANINE
Li Hep
EDTA
Fl. Oxalate
Citrate
Li Hep
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Blood Collection Guide for Profiles
Plain
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EDTA
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RUMINANT
FELINE
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AVIAN/REPTILE
EQUINE
Complete Profile
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GENERAL
Complete Profile
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Pre-anaesthetic Screen
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Racing Profile
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Kidney Profile
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Inflammatory Profile
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Liver Profile
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Respiratory Profile
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Pancreas Profile
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Coagulation Profile
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VETERINARY DIAGNOSTIC LABORATORY
Building 295, Nathan Cobb Drive
Wagga Wagga NSW 2650
SAMPLE SUBMISSION FORM
Veterinarian:
Animal ID:
Address:
Species:
Breed:
Ph:
Age:
Gender:
Fax:
Owner’s name:
Email:
Invoice (tick )
submitter
CSU code:
Owner’s address:
Copy Report (s) to:
HISTORY, SIGNS, LESIONS:
DIFFERENTIAL DIAGNOSIS: 1.
SAMPLES
SUBMITTED
(tick )
2.
3.
Blood, clotted
Blood, EDTA
Blood, Li hep
Fluid
Blood, citrate
Blood, fl/ox
Slide
Faeces COLLECTION TIME:
TESTS REQUESTED (tick )
Profiles
Canine complete
Feline complete
Canine/feline health
Greyhound racing
Equine complete
Equine racing
Equine inflammatory
Equine respiratory
Ruminant complete
Ruminant health
Downer cow
Avian & reptile complete
Coagulation
Pre-anaesthetic
Liver
Kidney
Pancreas
Add to profile:
Cytology
Fine needle aspirate
Cavity fluid
Joint fluid
BAL
TTW
CSF
Other (specify sample):
plus culture & sensitivity
Swab
Haematology
Full blood count
Fibrinogen
Serum amyloid A
Reticulocyte count (no FBC)
Platelet count (only)
Prothrombin time
APTT
Coomb’s test
Cross match
Tissue, unfixed
Microbiology/virology
Aerobic (only) culture
Aerobic & anaerobic culture
Blood culture
Equine uterine
Equine clitoral
Milk culture & sensitivity
Faecal (specify panel):
Sensitivity
Biochemistry
Fungal, wet mount & culture
Canine complete panel
PBFD (HA, serology & PCR)
Feline complete panel
Equine complete panel
Parasitology
Ruminant complete panel
Faecal floatation
Avian/reptile complete panel
Worm egg count, individual
Equine muscle enzyme panel
Worm egg count, pooled
Electrolyte panel
Larval culture
Eye fluid panel
Fluke egg count, individual
Add to panel:
Fluke egg count, pooled
Liver fluke antigen ELISA
Total worm count
Urinalysis
Urinalysis & sediment exam
plus stained cytology
plus culture & sensitivity
Urine protein: creatinine
I authorise Charles Sturt University to use the samples that I have
submitted and the results of the tests that I have requested for
teaching and research purposes.
Tissue, fixed
Other:
DATE:
Endocrinology
Canine ACTH
Equine ACTH
Canine insulin
Equine insulin
Cortisol
Urine cortisol:creatinine
ACTH stim
LDDT
HDDT
Equine O/N dex supp. test
Total T4
Canine TSH
Progesterone
Testosterone
Biopsy/necropsy
Histopathology
Necropsy, routine
Necropsy, legal/insurance
Serology for:
Other tests:
SIGNATURE:
DATE:
Laboratory Details
Opening Hours
Monday - Friday, 8.30 am - 5.00 pm, except public holidays.
For all enquiries, please contact the laboratory by phone/fax, (02) 6933 4000, or by email to [email protected]
Courier Service
The VDL courier picks up from veterinary clinics and hospitals in Wagga Wagga at 11.30am - 12.30pm and 4.30 5.30pm, Monday to Friday. Clinics are also welcome to deliver specimens to the VDL during its opening hours.
Our preferred courier from other centres is Toll Priority. For a pick-up, phone 131531 and consign on account
291133. For pre-addressed consignment notes, simply phone the VDL. Samples submitted by courier should be
packed to IATA Packing Instruction 650, which can be found at www.iata.com
The VDL courier address is: The VDL postal address is:
Veterinary Diagnostic Laboratory (Bldg 295)
Veterinary Diagnostic Laboratory
Nathan Cobb Drive
School of Animal & Veterinary Sciences
Charles Sturt University
Locked Bag 588, Boorooma Street
WAGGA WAGGA NSW 2650
WAGGA WAGGA NSW 2678
Submission of Samples
Samples must be submitted in biohazard bags (provided on request), together with a Sample Submission form
(also provided). All samples must be correctly identified and labelled, and Sample Submission forms must be fully
filled out.
The ‘TESTS REQUESTED’ section of the Sample Submission form lists only the VDL’s more frequently requested
tests. Its full range of tests is in its Services & Fee Schedule handbook. Use the ‘Other tests’ section of the
form to request tests that are not listed on the form or in the handbook.
The VDL does not accept samples submitted in a syringe with needle attached. These samples should be
submitted in sterile, screw-capped containers for the safety of couriers and laboratory staff. Faeces should not be
submitted in plastic bags.
Turn-around Times
Listed below are our turn-around times for various services. These are from receipt at the laboratory, and are for
tests performed in-house (including all routine clinical and anatomical pathology).
•
Haematology, biochemistry, cytology and urinalysis: 4 working hours.
•
Biopsies and post-mortem histopathology: 2-3 working days unless processing necessitates a
delay, e.g. inadequately fixed, large samples, or tissue requiring decalcification; the VDL will inform the
submitting veterinarian of any such delay. Large animals’ brains may take longer. The results of special
stains may be reported later.
•
Post-mortems, gross findings: 1 working day, except insurance and legal post-mortems, which may
take longer. The timing of further reports depends on the submitter’s requirement for additional testing.
•
Microbiology: preliminary results within 1 working day. Follow up results depend on the type of organism,
rapidity of growth, etc.
•
Parasitology: simple tests, e.g. FEC, within 1 working day. Other tests depend on the complexity of
requirements.
Some specialised tests are out-sourced. Their turn-around times are dependent on the laboratory to which the
tests are referred.
For any extra advice regarding specimen collection and transport to the VDL,
and for all general enquiries, please contact the lab.
Phone/Fax: 02 6933 4000
Email: [email protected]
Website: www.csu.edu.au/vetservices/vdl
Charles Sturt University
Building 295, Nathan Cobb Drive
Veterinary Diagnostic Laboratory
Director: John Boulton
Phone/Fax: +61 2 6933 4000
Laboratory Manager: Lori Blechynden
ABN 83 878 708 55
Wagga Wagga NSW 2650
Email: [email protected]
Website: www.csu.edu.au/vetservices/vdl