Latest news from the lab

More news from the lab

We’ve published another podcast – how to navigate the diagnosis of PPID during the late summer and autumn

How does the seasonal influence on the pituitary gland influence the diagnosis of PPID at this time of the year?  And how does it impact follow-up blood samples in cases that were previously under control?  What happens if you try to start pergolide treatment in July or August?

Let us take the stress out of managing your PPID cases – download our latest (free) podcast with Victoria South and Andy Durham who discuss what happens to our basal ACTH reference intervals at this time of the year, and chat through some common case scenarios that are affected by the pituitary hyperactivity observed at this time of the year – Seasonal PPID Podcast

 

 

 

LEH Laboratory lead the field in equine endocrinology with our new Immulite 2000 xpi machines

We have upgraded our Endocrinology Analysers and are proud to introduce the Immulite 2000 xpi System.

Our driving ethos at Liphook has always been to stay ahead of the game and offer the latest and best to all of our laboratory users. Thus, we have recently purchased two Siemens Immulite 2000 xpi analysers, the newest and most proficient chemiluminescent immunoassay system available in this format which supersedes the older Immulite 1000 system used by most other labs.  These new analysers allow greater precision, accuracy and throughput and, given that we have duplicate machines, this means that we can guarantee uninterrupted output of results even in the unlikely event of a machine malfunction.

It is well recognised that different assays and analysers generally return different results, and even the change from Immulite 1000 to Immulite 2000 xpi is no different in this respect. We have spent the past 6 months validating the new analysers and re-establishing appropriate cutoffs for diagnostic use and so you will see slight differences on forthcoming laboratory reports.

We apologise as I’m sure we’d all prefer to stay with our previous familiar values, but this change not only improves test reliability, but will in time be inevitable as the old Immulite 1000 system is withdrawn. We felt that as reference intervals (for ACTH at least) are about to change with the season in any case, this was the best time to implement this change. Should you require any assistance with interpretation or comparison with previous results then don’t hesitate to contact us to discuss.

Effects on ACTH reporting

As a general guideline the newly generated ACTH values will be slightly lower than previously (by around -10%) meaning lower cutoffs. In general terms this means a cutoff between 23-26 pg/mL for most of the year, rising slowly from July to a peak of 50 pg/mL in late September and returning to baseline by mid-November. Liphook Equine hospital remains the only laboratory internationally with valid ACTH reference ranges available for every week of the year, allowing greater accuracy of interpretation.

Effects on Insulin reporting

As a general guideline the newly generated insulin values will be higher than previously (by around +30%) meaning higher cutoffs. Resting insulin values in normal horses are expected to be no higher than 30-50 mU/L depending on the diet, and the response to 0.45 mL/kg Karo Light Corn Syrup should be no higher than 63 mU/L between 60-90 mins post-dosing.

Karo Light Challenge Test

We appreciate that is can be tricky to keep in touch with the latest publications on endocrinopathic laminitis especially those relevant to the diagnostic tests that we use in practice. We have produced this handy summary of the best evidence-based protocol for the Karo Light Challenge Test. Please click here to view the protocol.

 

 

 

Outbreaks of Hepatopathy

We are all now recognising that most cases of liver disease that we encounter are part of a wider outbreak amongst herd-mates, even if the others appear externally healthy. This suggests a common toxin or infectious aetiology. It is useful to rule out “old favourites” such as ragwort by biopsy. Fluke is rare and almost impossible to rule out as no antemortem tests are reliable.

Work performed at Liphook over the last few years has identified fumonisin B1 contamination of forage as a possible cause of some outbreaks and international work looking at various causes of viral hepatitis in horses has identified a number of candidates including equine Hepacivirus, equine Pegivirus, Theiler’s disease associated virus and equine Parvovirus.

 

See Cornell University Laboratory website:

https://ahdc.vet.cornell.edu/news/equinehepatitis.cfm

 

and recent publication describing equine Parvovirus: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5782890/pdf/17-1031.pdf

 

Continued work at Liphook has identified equine Parvovirus in some horses with liver disease and we hope to offer this, and other, new PCR assays shortly.

Liphook Equine Hospital Laboratory Easter 2018 Opening Hours

New Podcast on Tendinopathy with Victoria South and Russell Parker

Here’s our latest podcast – something to download to your phones and listen to as you drive round in the snowy weather this week!

 

https://victoriasouth.podbean.com/e/acute-tendinopathy-in-the-horse-with-victoria-south-in-discussion-with-russell-parker/

Equine Veterinary CPD Wednesday 21st March 2018

Liphook Equine Hospital are pleased to announce the date of our first Equine Veterinary CPD of 2018.

The event will take place on Wednesday 21st March at The Petersfield School, Petersfield, and is very kindly sponsored by Dechra.

To book your FREE place, please contact our hospital reception team on: 01428 727200, or via email to tasha.wilson@theleh.co.uk

Liphook Equine Hospital Laboratory team move into their new building!

We thought you might like to take a look at our new purpose built Laboratory building – our team moved in over Christmas.  We have plenty of space, and the team love their wonderful views of the Hospital’s paddocks, menage, and the beautiful Common in the distance.  Here’s a video to show a bird’s eye view of the new Laboratory building.

The number of LEH Podcast downloads tips over 600!

We are so pleased to report that we have now reached more than 600 podcast downloads!  Vets tell us they love downloading them to listen to whilst driving between calls on the road.  Our latest Podcast discussion on Strangles was published just before Christmas – take a look at this link to Podbean where you can download the podcasts and subscribe if you like what you hear:

Liphook Equine Hospital Strangles Podcast

Here’s a link to a recent publication that is discussed in the Strangles podcast:

Comparison of nasopharangeal and guttural pouch specimens shows guttural pouch washes to be 51 times more likely to be positive for Strep equi subs equi than nasopharangeal swabs and washes in convalescent horses: Boyle et al (2017) 10.1186/s12917-017-0989-4

Latest Podcast on equine Cushing’s disease with Andy Durham and Victoria South

Please see the Liphook Equine Hospital Podcast page to download our latest podcast on equine Cushing’s disease with Victoria South in discussion with Professor Andy Durham.  They discuss the clinical manifestation of equine Cushing’s disease, review the diagnostic options year-round and finally they work through some treatment and monitoring scenarios.

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What our clients say

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The Liphook Equine Hospital has provided us with fantastic service for our competition horses for the past 30 years. The team’s depth of experience offers a 5 star level of care for any situation and we have really put them to the test over the years! From the day to day routine treatments to the ” never been seen before ” emergencies they offer knowledgeable and realistic advice.

— Mrs. Elaine Wilson, Milland, Hampshire