Information on sample requirements and shipping guidelines
How much serum do I need to submit?
How to ship from within the USA or from overseas?
What test should I use?
How can I obtain my results as fast as possible? What are my User ID and password?
Does giving glucocorticoids (prednisone or dexamethasone) to a dog/cat affect the results of the TLI/PLI?
Does the serum for TLI, PLI or Cobalamin/Folate assays need to be cooled or frozen during transport?
Should I send samples overnight or by regular mail?
Will the results be affected if samples are hemolyzed?
Can I get some more information on cobalamin supplementation?
Will pancreatic enzyme supplementation affect the TLI results?
How should I store my sample if I am not going to send it to the lab right away?
How should I ship samples for PCR testing?
What address do I use to send the sample?
Does Lipemia interfere with the assays?
Shipping From Within The USA
We strongly recommend the use of a secondary carrier service, such as DHL, FedEx, or UPS for submission of samples to the Gastrointestinal Laboratory. Please do not use the US Mail service, as we have experienced excess delays with this carrier. Please note that the GI Laboratory does not accept packages shipped “Bill Receiver”. If we are paying for sample shipping in one of our studies, we will supply airway bills for sample submission. Unfortunately, we have to refuse packages arriving at the GI Lab marked “Bill Receiver”, and we are not liable for any resultant delays.
Shipping From Overseas To The USA
We strongly recommend the use of a multinational carrier, such as UPS or FedEx, for submission of samples from overseas to the Gastrointestinal Laboratory. These carriers have inhouse customs agents that can handle the importation paperwork. Samples delayed in customs may be stored in suboptimal conditions and experience considerable delays. Please attach to the outside of the box, and include a copy within the box, a signed letter on your official letterhead that states the following:
“This shipment contains only canine/feline serum, urine or fecal samples (word as appropriate) for diagnostic testing. These samples are not contagious or infectious, and have not been derived from animals exposed to agents of agricultural concern. This shipment has no commercial value”
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What test should I use?
Veterinarians often ask which tests we recommend for dogs and cats with clinical signs of gastrointestinal disease. While every patient is different, there are some guidelines we use to determine a systematic diagnostic approach. For dogs and cats with chronic diarrhea we first recommend evaluation for parasitic infestation. Even if fecal smears and flotation are negative, the patient should still be treated with a broad-spectrum anthelmintic agent. If diarrhea continues or in patients with chronic vomiting we recommend ruling out secondary causes of chronic diarrhea and/or vomiting by performing a complete blood count, serum chemistry profile, urinalysis, and in cats above 6 years of age a total serum T4 concentration. If no specific abnormalities are determined a reasonable next step is to evaluate the exocrine pancreas and the small intestine. In dogs with chronic diarrhea and weight loss we recommend starting
out with a serum cTLI concentration to rule out EPI and serum cobalamin and folate concentrations to rule out chronic intestinal disease, such as small intestinal bacterial overgrowth or malabsorptive disorders. If the clinical picture includes anorexia, vomiting, or abdominal pain the initial work-up should also include measurement of serum cPLI concentration to rule out pancreatitis. As pancreatitis in cats usually leads to rather non-specific signs we would recommend the measurement of serum fTLI, fPLI, cobalamin, and folate concentrations in all cats with chronic signs of gastrointestinal disease. We have recently found that hyperthyroid cats appear to be at increased risk for presenting with low serum cobalamin, low serum folate, or both. Thus, we recommend measurement of cobalamin and folate in all hyperthyroid cats, to screen for subclinical small intestinal disease.
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How can I obtain my results as fast as possible? What are my User ID and password?
If your practice does not have an email address registered with the GI Lab, please consider doing so. Our database system allows you to access results over the internet as soon as the assays are completed. Results are available via our lab webpage immediately, and a full report is emailed each day. A follow up fax or hard copy by US mail will follow later. So please be sure to enter an e-mail address on your accession forms to ensure the earliest possible reporting of results. Your e-mail address is your username. On our result reports, your clinic ID number is given in the upper left corner of the page, directly below the email address we have recorded for your clinic. The clinic ID number is your password.
Does giving glucocorticoids (prednisone or dexamethasone) to a dog/cat affect the results of the TLI/PLI?
We have no evidence that the administration of prednisone, prednisolone
or dexamethasone alters the serum concentrations of TLI or PLI in a clinically
significant manner in clinically healthy animals. Thus the administration of
glucocorticoids is highly unlikely to lead to either increases or decreases
in serum TLI or PLI concentrations that would alter your clinical diagnosis.
If the animal has a disease causing malabsorption or increased release
of pancreatic enzymes, and if the disease is glucocorticoid responsive, then
abnormal values may become more normal or even normal when glucocorticoids
are given. This
may influence your interpretation, and you should consider the possibility
that
a high normal
or only moderately increased TLI or PLI, in an animal with clinical signs of
pancreatic disease that is receiving glucocorticoid therapy, may have been
higher in the absence of the glucocorticoids.The serum vitamins, cobalamin
and folate, usually do not show any change with prednisolone therapy alone,even
if the diarrhea or weight loss improves. Typically you have to give vitamin
supplements to make things normal, as we have described on our page regarding
cobalamin therapy.
If you suspect that glucocorticoid administration has altered the clinical interpretation of TLI/PLI results, it may be worthwhile to draw a new sample after withdrawing the glucocorticoid therapy, assuming that the withdrawal of glucocorticoids is not contraindicated and consistent with the ongoing care of the patient.We would suggest waiting for at least 10 days after complete withdrawal of glucocorticoids before collecting a new serum sample.
Does the serum for TLI, PLI or Cobalamin/Folate assays need to be cooled or frozen during transport?
While the listed analytes are stable at ambient temperatures for
up to 2 weeks we highly recommend including a gel icepack. Especially in summer, temperatures in Texas can get very high and a frozen gel icepack will keep the sample at ambient temperatures during the shipment.
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Should I send samples overnight or by regular mail?
We recommend that you send your sample with Fed-Ex, UPS, or DHL. This does not have to be sent overnight, unless the test requested is a fecal alpha1-Proteinase Inhibitor test (see special shipping guidelines). Otherwise the sample may be shipped 2nd day or Ground depending on when the actual assay is run (serum samples for TLI, PLI, cobalamin, and folate are stable for up to 2 weeks at room temperature). Please note that there is NO Saturday delivery at Texas A&M University. Note: Due to delivery procedures at such a large university, packages sent with the US Postal Service can often be delayed or even lost within departments. Please DO NOT use the US Postal Service as a carrier.
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Will the results be affected if samples are hemolyzed?
Hemolysis will cause an increase in serum folate concentrations (because
RBC's contain a much higher concentration of folate than serum) and a false
decrease in serum bile acids concentrations (an artifact because of the methods
that we use).
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Can I get some more information on cobalamin supplementation?
We often recommend supplementation of cobalamin (Vitamin B12) in animals with gastrointestinal disease. Further information on the importance of cobalamin in the treatment of gastrointestinal disease can be obtained by clicking here. If an animal is receiving cobalamin supplementation, it will dramatically
elevate the serum cobalamin concentration, this should be considered when requesting
the cobalamin and folate assay.
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Will pancreatic enzyme supplementation affect the TLI results?
No. The TLI assays are absolutely species specific. Most pancreatic
supplements are made from porcine or bovine pancreatic tissue and thus are
not detected
by
our TLI assays.
Furthermore, intact pancreatic enzymes are not absorbed across the intestine
to any significant extent and so would not interfere with the TLI assay even
if
there were some cross-reactivity between different species.
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How should I store my sample if I am not going to send it to the lab right away?
If you are going to store it for only a day or two, then refrigeration is
adequate for serum samples; however, for longer periods it is preferable to store the serum
frozen. Fecal samples should always be stored frozen.
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Shipping information for PCR testing
We need approximately 0.5 gram of fecal material. The sample should be taken from the abnormal loose stool and must be free of cat litter.
For storage and shipping, add approximately an equal amount of rubbing alcohol (isopropyl alcohol) to the tube. This way, no refrigeration or freezing is necessary during the shipment. If no alcohol is available, place the sample in the freezer, and ship with a frozen gel ice pack.
Our stability studies have shown that DNA in fecal samples is stable for up to 72 hours under refrigeration and for at least four weeks when frozen at -20°C.
What address do I use to send samples?
Our complete address is at the top of the submission form. No street address
is needed.
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Does Lipemia interfere with the assays?
Lipemia has the potential to affect the bile acid, canine and
feline TLI and PLI assays. Severe lipemia interferes with the assay methods
that we use, and can lead to spuriously high or low results. Mild lipemia (the
serum
looks cloudy/opalescent but you can see through it) is usually not a great
problem, we will attempt to centrifuge out the lipids before starting the assays.
If we receive a sample that we judge is too severely lipemic to give accurate
results we will attempt to contact you before running the assay, to see if
a redraw of serum is possible.
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