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InFocus

Examining patients inside and out

DAVID WILKINS and ALISON EDGINGTON of Siemens Healthcare review the firm’s range of ‘integrated healthcare innovations’

WHILST the idea of the patient as a consumer is something gaining momentum in the NHS, this has always been of importance in the veterinary world, as owners look to provide the best possible care for their animals.

With this in mind, it is important that veterinary practices continually innovate offerings for a high quality, consumer-friendly service. Many have installed or are selecting advanced in vivo imaging equipment to explore structure and tissue and in vitro laboratory-based diagnostic solutions.

This ranges from ultrasound systems for general body imaging evaluation through to high-end CT and MRI systems that look inside tissue and vital organs. Practitioners are also looking towards laboratory diagnostics and the advantages of conducting blood and immunoassay tests in-house.

Magnetic resonance imaging (MRI) is already offered at a number of UK veterinary practices, with many sites opting for mobile services one day a week or month. In recent times, MRI has become more affordable and presents a “one stop shop” solution to diagnostic needs.

Although the cost of a single scan is more than the cost of a standard test, MRI is often able to give a high level of information in just one examination. This means animal patients spend less time under anaesthetic and the time to treatment can be reduced.

Fitzpatrick Referrals, a specialist practice for domestic pets in Surrey, uses a Magnetom Symphony from Siemens for rapid and accurate diagnosis in both routine and potentially life-threatening conditions.

Expansion

“The Siemens MRI has allowed us to expand the orthopaedic and neurology service we offer and enhance the standard of care provided by our specialist referral centre,” states Noel Fitzpatrick, director at Fitzpatrick Referrals.

“We are proud that this collaboration with Siemens allows us to provide one of the most responsive services in the world – for example, from admission to scan to surgical recovery for a standard spinal disc herniation takes only one hour on average.”

Computed tomography (CT) scanning is making inroads into the veterinary market as a valuable tool for looking beyond structure into soft tissue, including organs.

With 3D reconstruction software, images can be manipulated to achieve a new level of accuracy helping to pinpoint disease.

Ultrasound also has numerous benefits in the veterinary field as compact units mitigate space constraints and the cost effective options assure high image quality yet ease-of-use. Furthermore, portable systems such as Siemens’ laptop-based Acuson P50 and hand-held, pocketsized Acuson P10 can be taken out of the traditional practice setting to diagnose at the point of need.

Key to diagnosis

“Relatively few vets have access to MRI or CT so ultrasound is key to veterinary diagnosis that would not be possible otherwise,” states Chris Lamb, senior lecturer in radiology at the Royal Veterinary College. “Ultrasound has even been used to diagnose pelvic fractures in large animals where radiographic diagnosis would be impractical.”

Laboratory diagnostics

As well as imaging, in vitro solutions and assays in chemistry, haematology and immunology are all vital tools for tackling illness in animals. Quantitative tests and analysers with veterinary specific applications assist in the diagnosis, monitoring and management of animal conditions.

This can include full blood counts, hormone and protein testing which can assist in identifying the correct clinical diagnosis and course of treatment.

Because of workload restrictions, many veterinary practices have to send samples to external sites for testing. Analysers such as the Advia 2120i Haematology system from Siemens can help to keep services within the practice base, providing a fast turnaround time and potential cost savings. This enables effective and timely remedies for many conditions and makes clinical practice more effective.

The Clinical Pathology Laboratory at the University of Glasgow offers testing to practitioners using an Immulite system from Siemens as part of its veterinary diagnostic service.

“It provides a quick turnaround of accurate results. This is especially appreciated by our veterinary surgeons as it allows faster diagnostic decisions to enable appropriate therapy,” says James Harvie from the laboratory.

Therapeutic monitoring

“Examples of this include therapeutic monitoring of phenobarbital and thyroxine levels where adjustments are able to be made quickly. We are considering expanding the test menu that we run to satisfy existing and future demands.”

In haematology, systems such as the latest Advia 2120i Haematology Analyser can provide rapid and accurate results, with full blood counts and complete differentials for 21 defined species, from companion to farmyard animals.

The Goddard Veterinary Group uses an Advia 120 from the same analyser range for species-specific interpretation and diagnosis. “The system is easy-to-use and with appropriate training it is the ideal haematology analyser for us in the interpretation of results, especially cats and dogs, using the dedicated multispecies software,” says James Cummings, the group’s lab manager.

Handling difficult samples

“The superior technology enables us to deal with difficult samples, including low platelet counts in dogs and cat differentials. It enables us to perform all the haematology for the whole group and all our external practice clients.”

By gaining a more comprehensive understanding of animal patients through advanced imaging methods and laboratory diagnostics, practitioners can help to reduce the need for exploratory surgery in diagnosis, saving animals a traumatic and unnecessary interventional procedure. This means that the best possible treatment can be offered for a speedier recovery.

If veterinary practices have the provisions available for extensive diagnostic tests, owners can feel confident that the decisions taken regarding their pets’ health are based on the best information available to them and their veterinary practitioner.

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