Laboratory

Clinical
Veterinarian

Chapter I
Introduction to the Laboratory
Veterinary Clinic

Deepening Elective I

Yonairo Herrera Benavides

2019
 VETERINARY CLINICAL LABORATORY

Clinical Pathology, Clinical Analysis or in simpler words, the

Clinical Laboratory; it is nothing more than the application of methods of
laboratory and the use of the results in solving problems
clinical (Medway et al. 1973).

In recent years, the use of Clinical Laboratory has been growing.

as a diagnostic tool to assist the clinician. The correlation
from the laboratory results, along with those from the clinical history of the
patients allow the clinician to reach a more accurate diagnosis, and to make
consider the different variables to adopt the best therapy for
response to what affects our patient (Messeguer et al. 1992).

The disciplines involved are varied, but generally include everything

laboratory procedure applied to the study of diseases in
living beings. In the diagnosis of the disease, therefore, the Clinician and
the Clinical Pathologist should be considered as a unit (Medwayet
al. 1973).

It is a perfectly established fact that, in the current moments, the

The clinician cannot, or at least should not, do without the laboratory. If
it is true that a well done anamnesis makes things much easier for the
time to issue a diagnosis and that the so-called 'Clinical Eye' allows
Some diagnose a process after a superficial examination, but it is not.
less, as the use of the laboratory allows to ratify, or if applicable, to rectify,
that diagnosis which, after exhaustive examination, the clinician had intuited.
It would be a luxury that could sometimes be paid for with serious mistakes, not having.
consider that such an important source of information is represented by the
clinical analysis (Messeguer et al. 1992).

Among the main indications for conducting examinations of

the laboratory stands out: 1) the confirmation of the presence or the cause
of an illness,
the determination of a more accurate forecast,
3) the evaluation of the functional alterations of any organic system,
4) the assessment of the treatment response,
5) the monitoring of disease progression, 6) the evaluation of
immune status of an animal or a herd (Jardonet et al. 2003).

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 According to Bush (1999), currently the use of the clinical laboratory has not
integrated as a routine into medical practice, due to reasons
countless; among the most common are:

In many cases, it is not necessary to perform laboratory tests, since

that clinically one can reach the diagnosis or solve the problem.
2. Inexperience, which translates to minimal or no employment of
laboratory.
3. Medical negligence, whether by Veterinarians or by
Owner.
The owner does not have financial resources.
5. Laboratories are unreliable if they do not have a Pathologist.
Clinician who maintains an acceptable quality control and interaction
with the doctors.
6. Late delivery of results, this is a very important cause of
abandonment of the laboratory; so that the results are useful for the
case solutions must be obtained quickly, sometimes not
more than 24 hours.
7. There is no access to nearby laboratories. This makes it difficult to practice the
veterinary medicine; although it develops more clinical skills.

The most serious limitations to the full utilization of the data of

the laboratory is in the interpretation phase and it is essential to recognize that
Such data only gains significance when interpreted.
correctly by the clinician and the pathologist. That is why for the
interpretation of results must always pay attention to the species
animal examined considering the different particularities within
these, from the systemic response to the different diseases,
up to the reference physiological values, considered 'normal' for
each species (Medway et al. 1973).

The Laboratory Diagnosis can and should play its role as

diagnostic tool for the clinician, among many it must always be
keep in mind that the complementary exams must be requested
after an exhaustive clinical examination of the patient and the formulation of
the possible diagnostic hypotheses (Jardon et al. 2003).

The lack of instruments for diagnosis will often be the barrier

between the precise and the intuitive, although it is also necessary to consider that the
the laboratory does not have to be a panacea, it should be used when
required, when indicated, not when requested by the owner (Bush
1999).

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 CHAPTER I

1. INTRODUCTION TO THE VETERINARY CLINICAL LABORATORY

1.3.GENERALS

The Clinical Laboratory is the physical space where a large number of

diversity of medical, scientific, technical, etc. procedures that in
set represents a valuable resource of the clinic by documenting the
health status (Preventive Medicine) or disease (Medicine
Curative). There is only one reason why the veterinarian sends the
Show to the laboratory, and this is that needs information to take
appropriate decisions; since the clinician only observes in the patient a
series of clinical manifestations, such as signs, symptoms and/or syndromes,
that cannot be quantified as they must be translated into concrete data
(Terres, 2009).

The various Clinical Laboratories can be classified into:

Reference Laboratories: laboratory of recognized level of

scientific and diagnostic training concerning a
specific animal disease or diseases and/or to
testing methodology; includes the ability to describe and
evaluate the reagents, among others.
Dependent laboratory: the one that from the point of view
institucional, patrimonial, administrativo, laboral, técnico, científico,
budgetary and financial; constitutes an integrated unit with the
institution or company to which it belongs.
Private Laboratory: one that has its own assets and
independent, administrative autonomy, budgetary and
financial; has an autonomous direction and orientation, and that
provides its services to the general public, to the institution or company
that requests it.
Registered Laboratory: any natural or legal person with
address in the country, that carries out diagnostic activity
veterinarian or for zoosanitary research purposes.

The primary function of the Clinical Laboratory is to 'carry out

qualitative and quantitative analytical determinations of liquids
organic materials, such as: blood, urine, cerebrospinal fluid, etc.; as well as
feces and other substances". With specific objectives to: detect
asymptomatic diseases, confirm the diagnosis, establish the
forecast, evaluate the treatment, provide statistical information

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 epidemiological, detection, management and control of public health problems,
among others.

1.2. LABORATORY INFRASTRUCTURE

The facilities must be located, designated, constructed,

adapted and maintained in such a way that they are appropriate for the
tests or laboratory techniques stipulated by the laboratory. It is
it is necessary for these facilities to allow for adequate cleaning and
maintenance of order, in order to avoid cross-contamination, dust,
dirt and generally any condition that could represent a risk of
contamination.

With the aim of minimizing biological risk or contamination

Crusades must have independent and autonomous facilities;
which have their own design requirements depending on the
Laboratory safety level, always promoting biosecurity.
Therefore, a type of classification for the areas that make up a
laboratory, they can be the following:

Reception Area: it is the place where the reception takes place.

the patients and exam requests; as well as the
receiving the samples sent from other places, is responsible
from the delivery of the results and the payment for the services
provided.
Administrative Area: The one where all activities are carried out.
activities administrative (accounting, planning of
activities, etc.) as well as the main storage place and
safeguarding of Documentation (guides, manuals, job profiles,
resumes and contracts, inventory, agreements, among others.
Sample Collection Area: Area where the extraction is performed
from the sample for the requested exam, as well as all the
materials and means necessary to carry out the extraction of the
different types of samples.
Sample Processing Area: These are all those
designated areas for carrying out the processing of the
different samples, equipped with the equipment, materials,
solutions and reagents needed for that purpose. According to the analyses
and show what is worked on, they can be divided into different areas,
such as the following: Hematology, Urinalysis, Microbiology
Blood Biochemistry, Serology, Enzymology, Parasitology, Ex.
Miscellaneous, among others.
Storage Area: It is the designated area for safeguarding
of reagents, solutions, materials, and supplies; as well as

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 a section of this area can be designated for the
storage of defective equipment or that will be given
maintenance or repair.
Sterilization and Disinfection Area: Designated place for the
cleaning and disinfection of laboratory materials, as well as
the sterilization and disposal of waste and pollutants.
Accessory Areas: Those that specifically include the
Staff area (changing clothes, storage of items)
personal, among others), Staff break area (room
common, kitchen, etc.), hygienic services, area for items
cleaning staff, Waiting Room, etc.

The facilities can also be classified into: Main Areas (Area

Administrative, Sample Extraction Area, Processing Area
of Samples, Sterilization and Disinfection Area, Area of
Storage) and Accessory Areas (Staff Area, Area of
staff break, Hygiene Services, Reception and Waiting Area.
These areas have their own parameters regarding security and
installations and that must be respected, thus achieving a minimum of
biological risk, cross-contamination, and the proper functioning of
laboratory in the activities and procedures it performs.

Every laboratory, regardless of the area and/or activity being carried out, must
have the following basic requirements:

Adequate lighting and emergency lamps.

Ceilings, walls, and floors; they must be smooth and
non-slip.
Corridors with a free space not less than 120 cm.
Furniture suitable for the activity or procedure that is
they carry out.
Always have sinks with running water, Area of
washing (of hands and eyes).
Fire Extinguishers and Pictograms.

All areas and subdivisions of the laboratory must be maintained.

organized, clean and free of materials unrelated to work.
Office or cleaning materials must be cleared from the areas of
work during the development of the tests and be for the exclusive use of these
areas.

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 1.3. GOOD LABORATORY PRACTICES

Good Laboratory Practices are defined as the set of rules,

operational procedures, practices established and enacted by
certain organizations; considered mandatory
to ensure the quality and integrity of the data produced in
certain laboratory processes, in order to standardize protocols,
information and documentation of the Operating Procedures
Standardized.

It is of utmost importance that all laboratory professionals

get to know:

The laboratory equipment.

The work methodology of the laboratory.
The agents, substances, and hazardous products that exist in
the laboratory.
The measures to take in case of emergency.

The Laboratory Supervisor is responsible for ensuring compliance with the

rules and regulations that ensure the protection of personnel; but everything
the staff is responsible not only for their own safety but also for the
of his coworkers and the environment.

When an accident occurs, it is essential to conduct an analysis of

its causes and corrective measures are taken to prevent its recurrence. The
biological accidents usually occur due to: aerosols,
Accidental inoculation, spills and splashes, injuries caused by
sharp or cutting objects.

1.3.1. Security Levels

The Biosafety Levels represent those conditions under the

which agent can commonly be safely manipulated. It
they describe four levels of biosafety, consisting of combinations
of practices and laboratory techniques, safety equipment and facilities
of the laboratory; with the laboratory director being the specific person and
main responsible for assessing risks and applying them appropriately
recommended biosafety levels.

Biosafety Level I: The practices, safety equipment,

design and construction of the Level I Biosafety facility

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 are suitable for laboratories intended for education or
secondary or university training, and for other laboratories in
which work with defined and characterized strains of
viable microorganisms that are not known as generators
systematic diseases. Biosafety Level I
represents a basic level of containment based on practices
of standard biosafety without any primary or secondary barrier
especially recommended.
Biosafety Level II: The practices, equipment, design and
construction of facilities of Biosafety Level II are
applicable to educational, diagnostic, clinical laboratories or others
laboratories where a wide spectrum of agents is worked with
of moderate risk that are present in the community
and associated with human disease of varying severity. The Level
Biosecurity II is appropriate when working with blood.
body fluids or tissues; as the primary risks of
staff working with these agents are related to
accidental exposures of mucous membranes or percutaneous,
or ingestion of infectious materials.
Biosafety Level III: The practices, safety equipment and
the design and construction of the facilities of the Level of
Biosecurity Level III can be applied to clinical facilities,
production, research, education or diagnosis, where it
work with exotic agents with transmission potential
respiratory, and that can cause a serious infection and
potentially lethal. The primary risks to the staff working
these agents are associated with auto-inoculation, ingestion
and exposure to infectious aerosols.
Biosafety Level IV: The practices, safety equipment, the
design and construction of Biosafety Level facilities
IV are applicable to work with dangerous or toxic agents that
represent a high individual risk of diseases that pose
endangering life, and that can be transmitted through aerosols
and for which there are no vaccines or therapies available. The
the main risks for personnel are respiratory exposure to
infectious aerosols, exposure of mucous membranes or skin
infectious droplets and self-inoculation. In general,
The installation of Biosafety Level IV is a separate building.
or a totally isolated area with waste management systems
specialized and complex ventilation requirements to prevent
the release of viable agents into the environment.