Best Practices

Submission Information

Whether you are filling out a paper form or submitting to us online (online is our preference),
PLEASE always include 3 things:

Who?

1. Patient’s full signalment
(species, breed, sex, age)

What?

2. Pertinent medical history
(please do not send the entire medical record)

Where?

3. Full description of the lesion
(anatomic location, size, depth, gross description, ultrasound appearance, etc).

Cytology Preparation

Specimens can be obtained using aspiration and non-aspiration/woodpecker techniques depending on your preference. Once the specimen has been obtained, there are 2 vital steps that should be followed quickly to produce an optimal cytologic specimen:

1.

Using an air-filled syringe, force the specimen on a glass slide(s) and quickly create a monolayer. Cells of interest that are not in a monolayer cannot be easily assessed or interpreted.

2.

Facilitate rapid drying of the created cytologic specimen by blowing, waving, or adding very mild heat (hair dryer, not a flame). Cells of interest that dry slowly are often disrupted and destroyed.

We prefer to stain the slides with our automated stainer. However, we do not want to discourage our veterinary clients from looking at their own cytologies. If five slides are obtained from a lesion, consider staining 1-2 with your in-house staining method, and sending the additional 3-4 slides unstained.

Submitting Fluid Analysis

Fluid analysis includes a total protein level and cell count, in addition to cytologic evaluation. Fluid analysis is only performed on fluids from effusions (pleural, peritoneal, pericardial), joints or spinal fluid. Fluid collected from other sources (such as from masses/cysts, bronchial washes, etc, can still be sent for evaluation, but these are processed as cytology only, and will not include a cell count or protein level.
Fluids should ideally be collected into an EDTA tube (purple top), to prevent clotting.

Always prepare a few direct smears of the fluid and send them along with the vacutainer of fluid (label them as “direct” so we can interpret the cell volume correctly).
If enough fluid can be collected and it is not hemorrhagic or viscous, centrifuge a few milliliters, pour off the supernatant and make a few smears of the concentrated cells (be sure to label the slides as “concentrated”) and send these along with the direct smears and the fluid. This allows us to get the best possible look at any cells within the fluid before they begin to degrade over time.
Keep the fluid refrigerated. If sending via FedEx, include a small ice pack (our fluid analysis kits are great for this) and send overnight. If sending via courier, place an ice pack in the courier box unless overnight temperatures are below freezing.

Ask about our EVP ﬂuid submission kits that include an ice pack, EDTA tube, foam insulation, and a slide container.

Submitting Blood Smears

When sending in a blood smear cytology evaluation, it is critical that you provide us with a current CBC report for this patient.
When sending these samples, please send 2-3 blood smear slides that include a feathered edge, as well as a purple top vacutainer of whole blood so we can make additional slides. These samples should be sent with overnight shipping and a small ice pack (our fluid analysis kits come with perfectly sized ice packs and boxes!)

Submitting Urine or
Prostatic Washes for Cytology

Since urine is very acidic and will rapidly degrade cells, we have a few recommendations for getting the most from a urine/prostatic wash cytology.

If enough urine can be collected (3-6ml), immediately centrifuge a large aliquot of the urine. Pour off the supernatant and make several smears (blood smear style) of the precipitate. Allow these slides to quickly air dry.
Also, send a few milliliters of uncentrifuged urine along with the slides. Urine can be sent in a urine collection tube or plain white top vacutainer.
If enough fluid can be collected and it is not hemorrhagic or viscous, centrifuge a few milliliters, pour off the supernatant and make a few smears of the concentrated cells (be sure to label the slides as “concentrated”) and send these along with the direct smears and the fluid. This allows us to get the best possible look at any cells within the fluid before they begin to degrade over time.
Keep the urine refrigerated. If sending via FedEx, include a small ice pack (our fluid analysis kits are great for this) and send overnight. If sending via courier, place an ice pack in the courier box unless overnight temperatures are below freezing.

1. Fresh urine sample

2. Spin down as soon as possible

3. Pour off the supernatant

4. Gently mix to reconstitute the sample

5. Transfer the reconstituted sample to glass slides and make blood smear-type smears, and promote fast air drying

Submitting Liver Biopsy for
Copper Quantification

If you suspect that the liver biopsy you collect may need to be sent for copper quantification, please note the following guidelines:

Samples may be submitted in formalin. There is no need to send in saline.
The copper quantification requires at least 10 grams of liver tissue. Because of this, trucut samples often are not sufficient. A wedge biopsy is recommended if you anticipate needing the copper quantification

Packaging and Shipping Samples

For those utilizing FedEx for sample delivery, please review our recommended packaging guidelines.

Cytology

Cytology slides should be labeled with pencil and placed inside the plastic slide container.
The ideal way to send your slide containers is with a piece of medical tape over the lid (to secure it shut) and down the side, with the patient name written on the tape.

Slide container should be placed in baggie with submission form and placed inside the brown padded envelope.
We recommend putting each case in its own brown envelope, and then placing all the envelopes into the same FedEx LabPak envelope. This keeps the specimens safe and reduces shipping costs.

Biopsy

All samples MUST BE IN FORMALIN
All biopsy samples MUST be placed in a BOX. This not only keeps your specimens safe, but keeps all persons coming in contact with your package in transit safe from formalin leakage.
Ensure jar lids are tightly sealed, and place them inside a baggie, and then inside the box. If utilizing our white boxes, please places these boxes inside the FedEx LabPak envelope

If you have multiple samples from the day or if they do not fit easily into the small white boxes we provide, you are welcome to package the sealed, bagged formalin jars in any appropriately sized box. Please utilize some light weight packaging material around the sample to protect them in transit.

If sending a tissue sample that does not fit easily into a formalin jar we suggest using gallon sized Ziplock bags instead of very large formalin jars. Simply wrap the specimen in lap sponges and place in the gallon sized ziplock bag (the freezer strength ones work best). Pour the contents of a formalin jar or two over it. The goal is to have the lap sponges saturated and 1-2 inches of formalin in the bottom of the bag. This can then be double or triple bagged, and packaged in a box. This minimizes the risk of those large, heavy formalin containers breaking or spilling, while also keeping the samples preserved and safe during transit.

Please Combine Shipments

When sending out multiple samples on the same day, we strongly encourage you to put them in the same package and send with one shipping label.
Formalin fumes can impact cytology slides if not packaged appropriately
- Never put cytology slide containers in the same ziplock as a formalin jar
- Package cytology samples into their brown padded envelope and biopsy samples into their boxes. Then place both into the FedEx LabPak envelope (or into appropriately sized box if they do not fit well in the envelope).