Have you ever checked the sample requirements for a full chemistry panel only to find the minimum requirements ask for more than the patient has to give?
When we designed Moichor's service offerings, we asked ourselves: Does it make sense to run the same chemistry panel for every animal? And what would happen if we tailored our chemistry so that the analytes were best suited to what we know about each class? Better yet, what about each order?
The obvious impact of these questions was that we could set a much smaller minimum sample requirement. But the more subtle benefit was that it would remove unnecessary ambiguity from clinicians' interpretations of the data they received from their blood work.
Every single analyte on the chemistry panel requires a certain volume of serum or plasma to be run. If you tried running a canine patient or feline patient blood chemistry panel on a bird, you would be looking at 27 analytes. That would require a very large blood sample.
In effect, you'd need to draw 1mL of blood from that bird to get the serum requirement to run all of those analytes. This volume requirement would be too prohibitive; obtaining 1mL of blood from many of the exotic species we work with is not possible in one venipuncture event.
By first tailoring our analytes by class, you're not wasting your sample. You're focusing on what's clinically relevant.
That being the case, our sample requirements have been designed to require less blood. We accept 50uL of plasma for birds and reptiles as an absolute minimum to get the most meaningful chemistries. For small mammals, it's 85uL of serum.
By focusing on these class-specific chemistries in a way that only includes analytes demonstrated in the literature to be effective, we're removing the distracting analytes without a framework for interpretation and improving accurate delivery of chemistry results.
Applying pathologist and clinical insights to a curated list of tailored analytes makes it easier to interpret results, avoid misleading distractions in patient treatment planning, and enhance veterinary care.
Most of the clinically supported chemistry analytes measured today are tailored specifically to mammals. That is primarily because historically, our understanding of blood chemistry began with humans and was later translated into dogs, cats rabbits, and rodents.
As a result, many vets make the natural leap, inferring the same analytes act equivalently to a wide range of animal patients whether they're birds, reptiles, or mammals.
When it comes to chemistry, we talk about “class” because we don't have the granularity of insight to speak of species-specific chemistry yet.
But because there is a certain amount of conserved anatomy and physiology within each of the different classes, as you go further down into the more detailed taxonomy, the evaluation of something like bile acids for a bird, whether it's an ostrich or a budgie, is still applicable.
However, those same parameters cannot be directly translated into reptiles because reptiles have their own conserved anatomy and physiology. For that reason, we can tailor our biochemical understanding of what their bodies are doing and how it's unique to the various orders of reptiles.
Even among mammalian orders, although there are similarities, the anatomy and physiology differs as organism organization becomes more tailored.
For example, alkaline phosphatase (ALP) is commonly present in the circulating bloodstream of a dog or a cat for a multitude of reasons, and significant elevations are often due to liver dysfunction. But for birds, ALP is not present in the liver in appreciable quantities.2 Because of the different physiology between all of the orders, ALP is not clinically applicable in the avian patient.
Other parameters to consider are the enzyme half-life and the potential for multiple situations for analyte increase. For instance, LDH in birds is in the bloodstream for less than one hour.2 Elevations can be noted during both liver disease and muscle damage. Additionally, marked elevations can be seen due to sample hemolysis alone.2 So if it's going up and down every hour, and your chemistry is capturing a single moment in time, how relevant is that insight to your patient's clinical picture?
These parameters are different for mammals. As a result, it becomes a potentially more informative tool for the clinical state of a mammalian patient.
Therefore, at the core, the conserved physiology in each of the orders dictates what values or what analytes are appropriate, can be measured, and can be clinically applied.
Therefore, if you look at blood work being done a hundred years ago, they were measuring some of the same analytes measured today. We just are measuring them with a higher degree of accuracy and a better understanding of how they move throughout the body, what elevations and decreases mean clinically, and how those changes are associated with disease.
Over the past 30 years, avian and reptile clinicians started by taking everything from the mammal side and saying: What about this in birds? What about reptiles?3
As the data grew and became more avian or reptile specific, so did the analytes that are in each class-specific chemistry panel that we use for complete blood counts, testing for elevated levels of white blood cells, and more. These are based on an accumulation of data and knowledge from the scientific literature that supports their interpretation in that order.
At Moichor, we're looking at classes and asking: How can we eventually tailor these to an order or even species-specific level?
By organizing our animal panels in this way, we believe this will make it easier to obtain a diagnostic sample from your patient and provide you with results that have cut out the extra noise. This way, you'll only be presented with analytes that are scientifically supported and clinically applicable.
Over the next several months, you can expect to see a new column in the newsletter profiling individual analytes. We will talk about indications, what’s been demonstrated through research, when an analyte is applicable for a particular class or order, when they’re inappropriate, and why we’ve prioritized them. Let us know if there’s an analyte you’d like us to discuss! Write firstname.lastname@example.org with the subject Analyte of the Month and we’ll explore it.
When it comes to dogs and cats, while chemistry values and indications are well understood in the research, we’re going to be diving into the current state of the research to offer a refresher on what’s currently known about each of the analytes. So whether you’re a new practitioner or a seasoned one, we hope this will provide a useful refresher on the current best practices with each of these analytes. What are your thoughts? We'd love to hear from you.
You can view our chemistry profile breakdowns here . If you have a particularly small sample, you can prioritize analytes in the notes section when submitting a sample on the portal.
If you have questions about available analytes contact email@example.com