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IDEXX VetTest* Chemistry Analyzer. Operator s Manual



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IDEXX VetTest* Chemistry Analyzer Operator s Manual Proprietary Rights Notice Information in this document is subject to change without notice. Companies, names, and data used in examples are fictitious
IDEXX VetTest* Chemistry Analyzer Operator s Manual Proprietary Rights Notice Information in this document is subject to change without notice. Companies, names, and data used in examples are fictitious unless otherwise noted. No part of this document may be reproduced or transmitted in any form or by any means, electronic, mechanical, or otherwise, for any purpose, without the express written permission of IDEXX Laboratories. IDEXX Laboratories may have patents or pending patent applications, trademarks, copyrights, or other intellectual or industrial property rights covering this document or subject matter in this document. The furnishing of this document does not give a license to these property rights except as expressly provided in any written license agreement from IDEXX Laboratories IDEXX Laboratories, Inc. All rights reserved *VetTest, VetTrol, Cornerstone, and SNAP are trademarks or registered trademarks of IDEXX Laboratories, Inc. or its affiliates in the United States and other countries. All other product and company names and logos are trademarks of their respective holders. One IDEXX Drive Westbrook, Maine USA idexx.com Contents Preface... ix About this Guide... ix IDEXX Technical Support Contact Information... xi International Symbol Descriptions... xii General Safety Summary... xiv Safety Symbols on the Product... xiv Connection to a Power Source... xiv Personal Safety... xiv A Important Things to Know About the VetTest* Analyzer...A 1 Overview... A 1 Slide Packaging and Storage... A 1 Profile Interpretation (Canine and Feline only)... A 1 Star Reference System... A 2 Your Participation in Reference-Range Data Collection... A 2 Software Updates... A 2 VetTest Chemistries... A 3 VetTest Species... A 4 B System Overview and Installation...B 1 Choosing the Analyzer Location... B 1 Handling... B 1 Precautions... B 2 Important Electrical Safety Precautions... B 2 Unpacking the Analyzer... B 2 VetTest Analyzer Components (Front and Back Views)... B 3 Accessing Components Inside the Right-side Cover... B 4 Connecting the VetTest Pipettor... B 5 Inserting the Paper Roll... B 6 Inserting the VetTest Software Disk... B 6 Connecting the Power Cord and Turning On the Analyzer... B 7 Adjusting Initial Settings... B 7 Connecting Your Printer... B 8 Connecting an External Keyboard... B 8 Connecting an IDEXX SnaP* Reader Analyzer... B 9 C Sample Collection and Preparation...C 1 Plasma and Serum Collection and Preparation... C 1 Plasma and Serum Sample Volumes... C 1 General Blood Sample Collection Precautions... C 1 Serum Sample Preparation... C 2 Plasma Sample Preparation... C 2 Centrifuged Sample Inspection... C 3 Urine Sample Collection and Preparation... C 3 Urine Sample Volumes... C 4 Urine Sample Preparation... C 4 v Sample Storage... C 4 Storing Serum or Plasma Samples... C 4 Storing Urine Samples... C 5 Analysis of Stored Samples... C 5 Combined Chemistry and Hematology Sample Preparation... C 5 D Basic System Operation...D 1 Prepare Your Materials and Information... D 1 Specify a Sample from the Main Menu... D 1 Enter Patient Species... D 1 Enter Patient Identification (ID)... D 2 Insert slides... D 2 Reading the Bar Codes... D 2 Preparing the Pipettor for a Sample... D 3 Sample Analysis Display... D 3 Postanalysis Steps... D 4 Results... D 4 E Advanced Operations...E 1 Out-of-Linearity Range Samples... E 1 Analyzer Linearity Range... E 1 Dilution Protocols... E 2 Plasma and Serum Dilutions... E 2 Urine Dilutions... E 3 Running a Dilution on the VetTest Analyzer... E 4 Patient Monitoring... E 5 Combining Results on the Same Sample... E 5 F Quality Control... F 1 Quality Control Materials...F 1 IDEXX VetTrol* Control...F 1 VetTest Quality Control Panel...F 2 IDEXX UPRO Control...F 3 Preparing the VetTrol Quality Control Fluid...F 3 Preparing the UPRO Control...F 3 Performing the Quality Control Procedure on the VetTest Analyzer...F 4 Documenting Quality Control Results...F 5 Performing the Ca Offset Procedure...F 5 G Other Maintenance... G 1 General Upkeep and Cleaning...G 1 Case Cleaning...G 1 Screen Cleaning...G 1 Dust and Animal Hair...G 1 Disk Drive Protection...G 1 Right Side Cover and Rotor Cleaning...G 1 Pipettor Cleaning...G 2 Pipettor Collar Cleaning...G 2 Used Slide Drawer...G 2 Temperature Control...G 2 vi UV Lamp Replacement...G 2 Autocalibration...G 2 Autocalibration Kit...G 2 H Chemistry Description and Guide...H 1 Introduction to Biochemical Profiling... H 1 Enzymes...H 1 Enzymes as Indicators of Organ Damage... H 1 Enzyme Half-lives... H 2 Albumin/ALB... H 3 Alkaline phosphatase/alkp... H 4 Alanine aminotransferase/alt (SGPT)... H 5 Amylase/AMYL...H 6 Aspartate aminotransferase/ast (SGOT)... H 7 Calcium/Ca H 8 Cholesterol/CHOL...H 9 Creatine kinase/ck... H 10 Creatinine/CREA...H 11 Gamma-glutamyltransferase/GGT... H 12 Glucose/GLU... H 13 Lactic Acid (LAC)... H 14 Lactate dehydrogenase/ldh... H 15 Lipase/LIPA... H 16 Magnesium/Mg H 17 Ammonia/NH 3... H 18 Inorganic phosphate/phos... H 19 Total bilirubin/tbil... H 20 Total protein/tp... H 21 Triglycerides/TRIG... H 22 Urea/UREA/BUN...H 23 Uric acid/uric...h 24 Urine Creatinine... H 25 Urine Protein/UPRO... H 26 UPC Protocol... H 27 I Self-Help Guide... I 1 Analyzer Power and Function...I 1 Screen Failure Messages...I 4 Temperature Warnings...I 9 Miscellaneous...I 10 J Specifications and Warnings... J 1 Power Input...J 1 Warnings...J 1 Interference with Radio Communications...J 1 K Appendix: Differences in Results...K 1 With a Commercial Laboratory or Other Instrument... K 1 With Your Own Expectations... K 1 vii L Appendix: Reference Ranges... L 1 Canine Puppies...L 1 Canine Adults...L 2 Canine Geriatric...L 3 Feline Kittens...L 4 Feline Adults...L 5 Feline Geriatric...L 6 Equine Yearlings...L 7 Equine Foals...L 8 Equine Adults...L 9 Equine Mares at Stud...L 10 Dairy Cows...L 11 Beef Cattle...L 12 Llama...L 13 Sea Turtles...L 14 Provisional Reference Ranges...L 15 Avian Parrots...L 15 Avian Cockatoos...L 16 Avian Budgerigar...L 17 Avian Cockatiel, Canary, Conure...L 18 Avian Macaws...L 19 Ferret...L 20 Goat...L 21 Monkey...L 22 Mouse...L 23 Pig...L 24 Rabbit...L 25 Rat...L 26 Sheep...L 27 Snake...L 28 Tortoise...L 29 Lizard...L 30 M Appendix: Unit Conversion... M 1 Conversion Factors...M 1 viii Preface About this Guide Use This Section... A Important Things to Know About the VetTest* Analyzer B System Overview and Installation C Sample Collection and Preparation D Basic System Operations E Advanced Operations F Monthly QC Procedure G Other Maintenance H Chemistry Description and Guide To Learn About... How the analyzer works Slide packaging and storage Profile interpretation Star reference system Software updates Available chemistries Choosing a location Handling and safety precautions Installation and setup procedures Plasma and serum collection and preparation Urine collection and preparation Specifying samples Inserting slides Reading bar codes Preparing the pipettor Postanalysis steps Reviewing results Linearity ranges Dilution protocols Patient monitoring processes Combining patient results Quality control materials Preparing the QC materials Performing QC procedures General upkeep and cleaning UV lamp replacement Autocalibration Biochemistry profiling Enzymes Specific chemistries I Self-Help Guide How to troubleshoot problems J Specifications and Warnings Power specifications Instrument warnings Interference with radio communications ix IDEXX VetTest* Chemistry Analyzer Operator s Manual Use This Section... K Appendix: Differences in Results L Appendix: Reference Ranges M Unit Conversions To Learn About... Differences in results from the VetTest analyzer as compared to other analyzers or your expectations Reference ranges for a variety of species Conversion factors (U.S. to S.I.) x Preface IDEXX Technical Support Contact Information United States/Canada/Latin America Toll-free Technical Support Toll-free Fax Europe Toll-free Technical Support Toll-free Fax Australia Toll-free Technical Support Toll-free Fax Japan Toll-free Technical Support Toll-free Fax New Zealand Toll-free Technical Support Asia Toll-free Technical Support ,230 xi IDEXX VetTest* Chemistry Analyzer Operator s Manual International Symbol Descriptions International symbols are often used on packaging to provide a pictorial representation of particular information related to the product (such as use by, temperature limitations, batch code, etc.). IDEXX Laboratories has adopted the use of international symbols on our analyzers, product boxes, labels, inserts, and guides in an effort to provide our users with easy-to-read information. If you are unsure of the meaning for a particular symbol, see the table below for a description of each symbol that can be found on IDEXX Laboratories packaging. Symbol Description Symbol Description Use by A utiliser avant Verwendbar bis Usare entro Usar antes de 使用期限 Batch Code (Lot) Code de lot (Lot) Chargenbezeichnung (Partie) Codice del lotto (partita) Código de lote (Lote) ロット番号 Serial Number Numéro de série Seriennummer Numero di serie Número de serie シリアル番号 Catalog Number Numéro catalogue Bestellnummer Numero di catalogo Número de catálogo 製品番号 Temperature limitation Température limite Zulässiger Temperaturbereich Temperatura limite Limitación de temperatura 保存温度 ( 下限 ) Upper limit of temperature Limite supérieure de température Temperaturobergrenze Limite superiore di temperatura Limite superior de temperatura 保存温度 ( 上限 ) Consult instructions for use Consulter la notice d utilisation Gebrauchsanweisung beachten Consultare le istruzioni per l uso Consultar las instrucciones de uso 取扱説明書をご参照ください Keep away from sunlight Conserver à l abri de la lumière Vor direkter Sonneneinstrahlung schützen Mantener alejado de la luz solar Tenere lontano dalla luce diretta del sole 遮光してください xii Preface Symbol Description Symbol Description Authorized Representative in the European Community Représentant agréé pour la C.E.E. Autorisierte EG-Vertretung Rappresentante autorizzato nella Comunitá Europea Representante autorizado en la Comunidad Europea EC 内の正規販売代理店 Manufacturer Fabricant Hersteller Ditta produttrice Fabricante 製造元 Caution, consult accompanying documents Attention, consulter les documents joints Achtung, Begleitdokumente beachten Attenzione, consultare la documentazione allegata Precaución, consultar la documentación adjunta 注意 添付文書をご参照ください 2 WEEE Directive 2002/96/EC Directive 2002/96/CE (DEEE) WEEE-Richtlinie 2002/96/EG Directiva 2002/96/CE RAEE Direttiva RAEE 2002/96/CE 廃電気電子機器指令 (WEEE Directive 2002/96/EC) Biological Risks Risques biologiques Biogefährlich Rischi biologici Riesgos biológicos 生物学的リスク Do Not Reuse Usage unique Nicht wiederverwenden No reutilizarw Non riutilizzare 再利用しないでください xiii IDEXX VetTest* Chemistry Analyzer Operator s Manual General Safety Summary Please review the precautions on this page and on the analyzer to avoid personal injury, fire hazard, or damage to the product. Use of the equipment in a manner not specified by the manufacturer may impair the equipment s safety features. Safety Symbols on the Product Caution Protective Ground Earth Terminal Connection to a Power Source Use the correct power cord. Use only the power cord specified for this product and certified for the country of use. Use only a grounded cord, and be sure that the grounding conductor is connected to the earth ground. Position the equipment so the power cord is easily accessible. Use only 2A 250V 5 x 20 slow blow fuse for replacement. Personal Safety A pinch point exists between the sample rotor and bridge. Keep your fingers and any loose clothing away from the rotor if you are running the analyzer with the rotor cover removed. xiv A Important Things to Know About the VetTest* Analyzer Overview The VetTest* Chemistry Analyzer is a blood and urine testing instrument that analyzes up to 12 biochemical tests simultaneously, using a single sample of either serum, plasma, or urine, in about six minutes. The VetTest analyzer prompts you through a series of steps offering short beeps at each prompt that help you prepare the pipettor, introduce the sample and initiate analysis. After drawing enough total sample, the pipettor dispenses 10 microliters onto each slide in succession. The sample spreads over the top layer of the slide and is absorbed. As the sample filters through the layers, biochemical reactions take place that produce progressive color changes. The VetTest analyzer s optical system measures the colors and their intensity. The analyzer uses three reflectometers operating at six wavelengths to perform both end-point and rate measurements. The analyzer converts these measurements into values that are displayed on the analyzer screen and the paper printout. The analyzer s software disk contains the calibration data for the various lots of slides. IDEXX provides free software updates that contain new calibration data for new slide lots so that you do not have to worry about calibrating them. Slide Packaging and Storage Chemistry slides are supplied in cartons and are packaged individually in sealed foil. Important: Store green boxes in the refrigerator and purple boxes in the freezer. For convenience, you can store all the boxes in the freezer. Slides can be used directly from the freezer or refrigerator. You do not need to bring them to room temperature before using them on the VetTest analyzer. You can cycle the slides you use most often from cold storage to room temperature and back on a daily basis up to five times (or one week) without hindering slide performance. For slides used less often, do not cycle the entire box; just remove several slides from the box, or remove the slides from storage as needed. Important: Open the foil package only when you re ready to run a test. Slides removed from the foil must be used within 15 minutes or be discarded. Profile Interpretation (Canine and Feline only) The VetTest analyzer has been set to automatically provide an interpretation of results. If you do not want the diagnostic interpretation to print automatically, disable it by choosing Settings at the Main Menu. Press Printer Settings, then press Print Interpretations, and then 0 to disable (see Adjusting Initial Settings, page B-7, for more information.) Important: The VetTest Profile Interpretation is a software algorithm that is based solely on results of the specific chemistries run. The more chemistries run, the more specific the interpretation. The VetTest analyzer cannot make clinical judgments or diagnoses. A 1 IDEXX VetTest* Chemistry Analyzer Operator s Manual Star Reference System Note: For adult and geriatric canine and adult and geriatric feline patient samples only. In addition to providing Profile Interpretation, the VetTest analyzer provides users with information on the degree of an abnormal result for certain chemistries. The display and printout includes one (*), two (**), or three (***) stars, along with the Hi or Lo indicators, when a test result falls out of the reference range. The stars serve to identify unusual results which may require special attention or further study. For example, a onestar display indicates a slight to moderate increase or decrease in analyte concentration. A two- or three-star display highlights a more significant deviation from the reference range. The particular ranges for the star rating were developed by G. Daniel Boon, DVM, MS, Dipl. ACVP and A.H. Rebar, DVM, PhD, Dipl. ACVP. Both are experienced veterinary clinical pathologists who based their findings on the VetTest analyzer s database and their professional judgement. Stars should be treated as a tool, not to be used alone, but in conjunction with other interpretive information such as physical examination and additional test results. The star system is translated to indicator bars on a full-page printout from an external printer. S/N Ver. X.X 16-Oct :14PM Adult Canine Boots TBIL = 1.64 mg/dl HI*** ( ) Example of Hi result with 3 stars Your Participation in Reference-Range Data Collection Reference ranges for clinical chemistry analyses are important guidelines used by veterinarians to determine an animal's health. Reference ranges are typically established by testing samples from a large group of healthy animals and creating a statistical distribution of results. In establishing the initial reference ranges for the VetTest analyzer, IDEXX relied on historical, established normal ranges. An important priority for IDEXX is to continuously improve the accuracy of these ranges, and we have that unique ability with each new set of returned software diskettes we receive from our worldwide user base. You can contribute to this important work each time you run a test by first enabling your VetTest analyzer, then indicating if this animal is sick or questionable, or healthy on the appropriate VetTest analyzer screen display. To do so, first enable the patient Health Screen after installing a new software disk: 1. From the Main Menu, press Settings. 2. Press Health Screen. 3. Press 1 to enable Health Screen. (Press 0 to disable Health Screen.) During analysis, a screen will be displayed after the patient identification is entered. This screen prompts you to indicate if the patient is healthy. Software Updates IDEXX will mail you, at no charge, your new software disk containing updated calibration data for newly produced slides. You should install the new disk promptly in order to run new slide lots. The new disk also will contain additional enhancements to the analyzer, such as new menu features and updated reference or quality control ranges. You will also receive a return mailer for your old software. The returned disk provides IDEXX with important information concerning reference ranges. Note: You do not need to perform a quality control procedure after inserting new software. Keep to your regularly scheduled quality control. A 2 Important Things to Know About Your Analyzer VetTest Chemistries Individual chemistries in 12-test and 25-test packages are available for the VetTest analyzer. These include: Individual Chemistry Individual Chemistry ALB Albumin LAC Lactate ALKP Alkaline phosphatase LDH Lactate dehydrogenase ALT (SGPT) Alanine aminotransferase LIPA Lipase AMYL Amylase Mg 2+ Magnesium AST (SGOT) Aspartate aminotransferase NH 3 Ammonia Ca 2+ Calcium PHOS Inorganic phosphate CHOL Cholesterol TBIL Total bilirubin CK Creatine kinase TP Total protein CREA Creatinine TRIG Triglycerides GGT Gamma-glutamyltransferase UREA/BUN Urea GLU Glucose URIC Uric Acid Note: Globulin is calculated by subtracting albumin from total protein. Several prepackaged panels and profiles are also available for the VetTest analyzer. These include: Profile/Panel Name General Health Profile Preanesthetic Panel Diagnostic Health Profile NSAID Monitoring Panel Urine P:C Ratio Equine Health Panel Avian Health Profile Included Chemistries ALB, ALKP, ALT, AMYL, Ca 2+, CHOL, CREA, GLU, PHOS, TBIL, TP, UREA/BUN, GLOB ALKP, ALT, CREA, GLU, TP, UREA/BUN ALB, ALKP, ALT, AMYL, BUN, Ca 2+, CREA, GGT, GLU, LIPA, TBIL, TP, GLOB ALKP, ALT, AST, BUN, CREA UPRO (urine protein) and UCRE (urine creatinine); to be used with a sample preparation kit ALB, ALKP, AST, Ca 2+, CK, CREA, GGT, GLOB, GLU, LDH, TBIL, TP UREA/BUN ALB, AST, Ca 2+, GLU, TP, URIC, GLOB Quality Control Panel ALB, ALKP, ALT, Ca 2+, GLU, NH 3 A 3 IDEXX VetTest* Chemistry Analyzer Operator s Manual VetTest Species Canine Puppy ( 6 months) Adult Geriatric ( 8 years) Feline Equine Bovine Avian Kitten ( 6 months) Adult Geriatric ( 8 years) Yearling Foal Adult Mare at Stud Beef Cattle Dairy Cow Budgerigar Cockatoos (Grey Cheek, Moluccan, Umbrella) Cockatiel Canary Conure Macaw (Blue and Gold, Hyacinth, Scarlet) Parrots (Amazon Blue, Amazon Yellow, Eclectus, African Grey) Ferret Goat Lizard Llama Monkey Mouse Pig Rabbit Rat Sea Turtles Sheep Snake Tortoise A 4 B System Overview and Installation Choosing the Analyzer L
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