Blog by Dr. Lindsay Riddick
Happy spring to all of the wonderful PAZ pet parents (PEACE TO ALL!) The sun is shining, the birds are singing and the trees have been pollinating! As some of you know, it’s been a rough allergy season for some of our furry friends. If you’ve had to come and see us lately for your pet’s skin or ear issues you are not alone! We’ve been seeing lots of dermatology issues this spring (as usual) and I wanted to explain some of the tests we do here to help treat our pets as quickly and efficiently as possible and get them back to feeling great and frolicking in the haze of spring time pollen.
LOTS of pets have allergies and by now I’m sure you have learned (from our expert staff members that always seem to be lecturing 🙂 that there are some really great tools out there to help prevent reoccurring infections: special diets, shampoos, medications, fish oils, supplements etc. However, the other realization you’ve probably had is that inevitably, dogs and cats with this chronic condition will at some point, succumb to an active infection despite our best efforts.
The first step in resolving these infections is a consultation for us to look (and even smell)! Looking and sniffing is often accompanied by a quick and easy test called cell-cytology. Cytology is a brief look at CELLS on a slide. They are not cut away but rather aspirated or smeared from a subject.
This is quick, easy, painless and takes about 5 to 10 minutes and is performed in clinic. It’s a basic description of CELL TYPES but not always specific strains of organisms. We can tell white blood cells, rod bacteria, cocci bacteria, yeast, tumor cells and basic morphology but not always SPECIFIC. This is why it cost less than a BIOPSY which might have full thickness cuts and special stains… its also around $200 where as cytology is around $60.
Based on basic microscopic appearance, we can categorize infections can into fairly basic types: either yeast, “cocci shaped” bacteria or “rod shaped” bacteria. Identifying the shape of bacteria and/or finding yeast is what leads us to select a specific medication or medications to treat the current infection. A lot of the time, the buck stops here and the infection goes away. But occasionally we have to take the diagnostics to the next level and perform a…
CULTURE AND SENSITIVITY
We normally reserve this test for instances when our first line of treatments didn’t work as effectively as expected or when infections return shortly after finishing a round of medication. With this test, the sample is sent out to a diagnostic lab where it will be grown in a petri dish for several days and then evaluated by a pathologist. This test goes beyond identifying shapes and very specifically identifies the strain of bacteria present as will as the specific medication needed to knock out the infection at the appropriate DOSE.
Sounds simple right? Normally it is! But there are some instances when our culture will come back with…”No organisms found.” While this may sound like really good news it usually leads to another round of investigating. With skin lesions, If we don’t have any bacterial growth we will usually submit a sample for fungal testing or possibly even take a biopsy. With these tests, we are ruling out things like dermatophytes and auto-immune disorders like lupus.
The good news about skin and ear infections is that we can get a pretty good handle on things quickly and usually only have to battle them a few times a year. We know these chronic conditions will test your patience, but with good team-work and SOLID communication, happy pets will prevail!
CYTOLOGY- can be FNA or fine-needle aspirated, Skin Smear, Impression Smear or SWABBED from a lesion. It’s a baseline starting point and can sometimes be HIGH YIELD but typically under 50% confidence on average. It is lowest cost at around $60. If the Cytology is a great sample it can also be reviewed by a pathologist for around $200.
CULTURE/SENSITIVITY- great if you have a nasty infection and you need to identify the bug specifically b/c its in a sensitive location or if it has not been treated successfully. It can take 3-5 days and can cost upwards of around $200. Commonly used in UTI’s and Ear infections. Can also be used to identify FUNGAL cultures which can be hard to stabilize and identify.
BIOPSY FULL THICKNESS OR CUT- taking a small portion of tissue from a site and identifying micro slices. Somewhat invasive and costly. The procedure alone can cost $300-500 depending on level of anesthesia and thickness of cut. In addition, the pathologist will charge $200 to identify. VERY HIGH YIELD, typically over 90% accuracy and very supportive evidence when it comes to tumor identification, skin lesion, and dermal identification. Reserved for critical cases or when other diagnostics have been exhausted. If it is a small skin tumor- you can sometimes locally anesthetize and remove at low cost but pathologist will still request a charge for stain and identification.