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  • ASAP Laboratory SA 2017 SA Small Animal Form .pdf · Species: Owner Name: Breed: Animal ID: Age: Patient Ref No.: Signature Print Name Date Time of collection Sex: E G P L FO C it
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Species: Owner Name: Breed: Animal ID: Age: Patient Ref No.: n o i t c e l l o c f o e m i T e t a D e m a N t n i r P e r u t a n g i S : x e S E G P L FO Sbl U Sm Fl Tfo Tfr Swab F t i C Other Previous Lab No: VETERINARIAN / CLINIC DETAILS CLINICAL HISTORY: (including description of any gross skin or mass lesions and any recent therapy): OTHERS: (PLEASE SPECIFY) Property ID (if applicable) 27143 ASAP 2017 SA Small Animal Form SNAP® No PO Box Office Use ONLY: ASAP Laboratory PHONE: 1300 VET LAB (1300 838 522) FAX 9562 0055. EMAIL: [email protected] www.asaplab.com.au SA SMALL ANIMAL Do not run Regionally. Send directly to ASAP BARCODE No: (Office Use) RECOMMENDED PROFILES HAEMATOLOGY / COAGULATION 101 FBE 614 CBC Uninterpreted 107 PT+APTT 106 APTT 105 PT n o i t a l u g a o C l l u F 3 1 6 URINALYSIS Method of collection;____________________ 301 Urinalysis 303 Urinalysis + C+S 305 Urine C+S ONLY 307 Comprehensive urinalysis 308 Urine Protein: Creatinine Ratio MICROBIOLOGY 351 MC & S Tick to pool samples Number of sites ......... 359 Fungal wet mount and culture 375 Fungal and Bacterial culture BIOCHEMISTRY 201 Full Screen 202 Liver 203 Renal 207 Paired Bile acids / 208 Single 211 Fructosamine 205 1-5 Biochemistries (list required tests) CYTOLOGY 401 Routine cytology 352 Add M+C 407 CSF 404 BAL/TTW 405 Bone marrow (incl. FBE) 403 Body Fluid Analysis 402 Additional Site FAECAL EXAMINATION 901 Comprehensive 902 Basic 903 Faecal float 904 Occult blood ENDOCRINOLOGY / THERAPEUTIC 701 Total T4 705 cTSH 216 Phenobarbitone 217 Potassium Bromide 712 Progesterone 708 ACTH stimulation test 709 LDDST 732 AMH SEROLOGY AND MOLECULAR 801 FIV/FeLV (ELISA) 803 Cryptococcus (LCAT) 805 Heartworm antigen 808 Toxoplasma IgG +IgM 809 Neospora serology Neurological PCR HISTOPATHOLOGY 502 Histopathology 2-3 tissues 503 Histopathology 4-6 tissues 504 Histopathology 7-10 tissues Margin check required? Respiratory PCR Full Body Function Body Function + Urinalysis Body Function + T4 Body Function +T4 + Urinalysis + MCS Sick Dog / Cat Profile Basic Health Basic Health + Urinalysis Basic Health + SNAP ® cPL ™ /fPL ™ Wellness Profile (Basic Health + T4) Wellness Profile + Urinalysis Wellness Profile + Urinalysis + MCS Wellness Profile + SNAP ® cPL ™ /fPL ™ 1054 Respiratory Mycoplasma PCR 1055 Haemotropic Mycoplasma PCR 501 Histopathology 1 tissue SAMPLES BLOOD EDTA Citrate Plain FI Ox Lith Hep Gel SMEARS Blood Other URINE Sterile Method Container ___________ FLUID EDTA Plain SWAB Gel Dry TISSUE In Formalin Fresh FAECES ___________ __________ OTHER ___________ __________ Add Ons TT4 FIV/FeLV Urine C+S ONLY Faecal Multiplex PCR

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Page 1: ASAP Laboratory SA 2017 SA Small Animal Form .pdf · Species: Owner Name: Breed: Animal ID: Age: Patient Ref No.: Signature Print Name Date Time of collection Sex: E G P L FO C it

Species:

Owner Name:

Breed:

Animal ID:

Age:

Patient Ref No.:

noitcelloc fo emiTetaDemaN tnirPerutangiS

:xeS

E G P L FO Sbl U Sm Fl Tfo Tfr Swab F tiC Other

Previous Lab No:

VETERINARIAN / CLINICDETAILS

CLINICAL HISTORY: (including description of any gross skin or mass lesions and any recent therapy):

OTHERS: (PLEASE SPECIFY)

Property ID (if applicable)

2714

3 A

SA

P 2

017

SA

Sm

all A

nim

al F

orm

SN

AP

® N

o P

O B

ox

Office Use ONLY:

ASAP LaboratoryPHONE: 1300 VET LAB (1300 838 522) FAX 9562 0055.EMAIL: [email protected]

www.asaplab.com.auSASMALL ANIMAL

Do not run Regionally. Send directly to ASAP

BARCODE No:(Office Use)

RECOMMENDED PROFILES

HAEMATOLOGY / COAGULATION

101 FBE 614 CBC Uninterpreted107 PT+APTT 106 APTT 105 PT noitalugaoC lluF 316

URINALYSIS

Method of collection;____________________301 Urinalysis 303 Urinalysis + C+S305 Urine C+S ONLY307 Comprehensive urinalysis308 Urine Protein: Creatinine Ratio

MICROBIOLOGY

351 MC & S

Tick to pool samplesNumber of sites .........

359 Fungal wet mount and culture375 Fungal and Bacterial culture

BIOCHEMISTRY201 Full Screen 202 Liver 203 Renal207 Paired Bile acids / 208 Single 211 Fructosamine205 1-5 Biochemistries (list required tests)

CYTOLOGY

401 Routine cytology 352 Add M+C

407 CSF 404 BAL/TTW405 Bone marrow (incl. FBE)403 Body Fluid Analysis

402 Additional Site

FAECAL EXAMINATION

901 Comprehensive 902 Basic903 Faecal float 904 Occult blood

ENDOCRINOLOGY / THERAPEUTIC

701 Total T4 705 cTSH

216 Phenobarbitone217 Potassium Bromide

712 Progesterone708 ACTH stimulation test709 LDDST

732 AMH

SEROLOGY AND MOLECULAR801 FIV/FeLV (ELISA)803 Cryptococcus (LCAT)805 Heartworm antigen808 Toxoplasma IgG +IgM809 Neospora serology

Neurological PCR

HISTOPATHOLOGY

502 Histopathology 2-3 tissues503 Histopathology 4-6 tissues504 Histopathology 7-10 tissuesMargin check required?

Respiratory PCR

Full Body Function Body Function + UrinalysisBody Function + T4Body Function +T4 + Urinalysis + MCSSick Dog / Cat ProfileBasic HealthBasic Health + UrinalysisBasic Health + SNAP® cPL™/fPL™

Wellness Profile (Basic Health + T4)Wellness Profile + UrinalysisWellness Profile + Urinalysis + MCSWellness Profile + SNAP® cPL™/fPL™

1054 Respiratory Mycoplasma PCR1055 Haemotropic Mycoplasma PCR

501 Histopathology 1 tissue

SAMPLES

BLOOD EDTA CitratePlain FI OxLith Hep Gel

SMEARS Blood OtherURINE Sterile Method Container ___________FLUID EDTA PlainSWAB Gel DryTISSUE In Formalin Fresh

FAECES ___________ __________

OTHER ___________ __________

Add OnsTT4 FIV/FeLV Urine C+S ONLY

Faecal Multiplex PCR

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