External labs

Re: External labs

Richard Fox — Sat, 14 Jul 2012 12:28:36 GMT

That's a bit of a contentious issue whether an individual cytopathologist will give a definitive diagnosis on a cytology of lymphoma IME - For a while now we have started at least saying this is a cytological diagnosis/interpretation and in the comment that the cell harvest in conjunction with a history compatible with lymphoma (esp if high grade type) would be compatible. I always suggest a biopsy to gain more info is its going for expensive chemo however :)

But there are instances where a definitive dx can be made on cyto i.e. MCT, spindle cell tumours, certain infections etc :)

Re: External labs

Peter Graham — Fri, 13 Jul 2012 13:55:01 GMT

As Graham has pointed out NVS has provided a sample pick up service for NationWide Laboratories (now Dechra Laboratory Services) at the time of supplies delivery for many years. However, that is not the only mechanism of secure sample collection and transport that we offer. Depending where you are in the country you could have a same day service or an overnight lock-box service with early-mid morning results. If you are where I think you are, overnight lock-box collection is the most likely option.

Dechra Laboratory Services have on-site, in-house cytopathlogists and histoptahologists with relevant qualifications (FRCPath, DipECVCP) and experience. If you need any further information on NWL/Dechra Labs from us, don't hesitate to give us a call.

Peter Graham BVMS PhD CertVR DipECVCP MRCVS

Managing Director, Dechra Laboratory Services, www.dechralabs.co.uk

Re: External labs

Rob Loxley — Fri, 13 Jul 2012 13:49:16 GMT

[quote user="Alan Tevendale"]they don't offer a courier service in our area[/quote]

We don't have an Idexx courier from them, but they send a daily Parcelforce collection

Re: External labs

HMC — Fri, 13 Jul 2012 12:16:19 GMT

[quote user="Richard Fox"]

I think it boils down to what is most important - price, discount or a courier or sent it separately to different labs depending on personal reasons or specialisation?

[/quote]

Most important for me with cytopathology = not sitting on the fence with a definitive diagnosis! (Underlying criticism not aimed at you Richard!).

I had an inconclusive result from a lab for FNA of a lymphoma even though I sent sufficient sample on the slide. Then sent bloods to CSLS for their pyridine kinase test and the dog's result was off the scale!

Or the time when the report (Idexx this time) described the cells and made it sound exactly like whichever leukaemia it was but didn't actually give the diagnosis- until calling and speaking to the pathologist.

Having said that, I like Idexx.

Re: External labs

Anthony Todd — Thu, 12 Jul 2012 16:57:02 GMT

[quote user="Richard Fox"]I think it boils down to what is most important - price, discount or a courier[/quote]

Next morning results would be top of my list and my vets; lunch-time collects not so good 'cos you miss the evening samples.

Also I'll bet the night bikers flash around the country at illegal speeds with little traffic and it's cooler for the samples [providing the nurses remember to put them in the box...]

Re: External labs

Richard Fox — Thu, 12 Jul 2012 14:36:16 GMT

Thank you for the nice comments about Abbey - We do strive to give good VFM and accurate results but obviously on the discounts side, compared with IDEXX, we do not have so much clinpath coming in at present. We have just acquired another lab in Leeds (CAPL) (with a regional courier service) and this is going well and we are expanding and improving our services at this sister company (www.capl.co.uk). Therefore any cyto or histo sample (sent to or picked up for CAPL) will come to us for reading.

I think it boils down to what is most important - price, discount or a courier or sent it separately to different labs depending on personal reasons or specialisation?

Re: External labs

Martin Atkinson — Thu, 12 Jul 2012 11:37:14 GMT

I recently changed to Axiom having been a loyal Idexx customer for many years, although because I'm a member of a buying group that has negotiated discounts with Idexx I send some core tests there still and also use them for some of their speciality tests like Cardiovet and specCPL. I use some other labs for specialised tests as and when necessary. Axiom negotiated on prices so most of their charges are less than Idexx but their trump card is their courier who comes midday and I have the results by late afternoon (this of course may depend on where you're based - we're near Heathrow). I'm not on Idexx's daytime courier route and their evening drop-box collection is no advantage to me. If you like Finn for histology - Axion use them. I've tried NWL and found their interpretive reporting poor and the NVS driver pick-up is unreliable even though he comes every day. Idexx just about trump everyone on the quality of their interpretive reporting and access to someone to discuss the case with but Axiom come very very close. Only downside to Axiom is that if I miss the courier and post stuff it can be delayed whereas stuff posted to Idexx gets there next day 95% of the time - this is of course nothing to do with the labs its the post and considering we're equal distance from York and Devon may be surprising or maybe not!

Re: External labs

Graham Bilbrough — Thu, 12 Jul 2012 08:36:38 GMT

Hi, Alan

I think we should be able to get you onto one of our courier routes--we serve other practices in your area with this service. Have you spoken to one of the regional team?

As for collection by the NVS drivers, that is a service offered by (the recently relabelled) Nationwide Labs as they are owned by the same parent company: Dechra.

If I can be of any help, please let me know.

All best wishes

Graham

Re: External labs

Alan Tevendale — Wed, 11 Jul 2012 23:38:18 GMT

Part of the reason we're looking at moving away from Idexx is that they don't offer a courier service in our area. They can get the samples picked up by the NVS driver but as ours comes first thing in the morning this is of little use to us.

Re: External labs

Rob Loxley — Wed, 11 Jul 2012 22:54:24 GMT

[quote user="Iain McAllister"]Like a lot of others I like to send samples to different places for different stuff[/quote]

Agree; I send histo to Finn and cytology to DWR who I think give good, helpful answers, some hormones to CSLS who offer these tests, and the bulk of the rest to IDEXX where a good price and quick turnaround and a courier collection are important.

Re: External labs

Iain McAllister — Wed, 11 Jul 2012 16:56:59 GMT

Like a lot of others I like to send samples to different places for different stuff - quite frustrated now as a locum I often have to go down the line of "We send everything to Lab X " aka "We love a discount "

Histo and cytology are always the ones where you can get a big difference in abilities - I always rated the histopatholgists at the AHT and Liz Villers at DWR is a genius at cytology - brilliant on tumour FNA's

Re: External labs

Rob Loxley — Wed, 04 Jul 2012 13:50:16 GMT

[quote user="Alan Tevendale"]Any thoughts?[/quote]

What is wrong with your current lab; what would you like to see in/from a new lab?

Re: External labs

Stephen Putnam — Wed, 04 Jul 2012 11:11:51 GMT

We have been using Abbey for histopath for many years and would not change.

For our other samples we use TDDS (part of the same group as CTDS) and would not be keen to change this either. Both labs are very helpful and, despite the fact that both would like all of our business, we will continue to divide it in this way.

We have been approached by other labs offering big discounts, but the service and reliability are too good to change.

Re: External labs

Rajat — Tue, 03 Jul 2012 23:02:44 GMT

Cytopath for cytology histopath and haematology analysis - excellent service including calls on the complex/sl weird cases

What I like is they will give you opinions on what they think it is (i.e ddx XYZ, but given history and signalment in my opinion this is consistent with lymphoma..)

We use Axiom for the rest (biochem, routine bloods and histology 50% of the time) who also provide a good service

Axiom used to send histo to Finn not sure if they still do and apart from the odd glitch (i.e. we see something inhouse on cytology or impression smear which they miss, about once a year) good service and good reports

Give Cytopath a try if for nothing else at least cytology. Chris Belford is fantastic and has a great team.

Re: External labs

Julian Earl — Tue, 03 Jul 2012 19:30:59 GMT

We've always found Finn's to be fast, reliable and efficient and all three of those are now improved since we took on theeir courier service. Dick White's are also extremely helpful if ever you need advice (having sent the samples there first of course!). We tend to use both, depending.

Re: External labs

Anthony Todd — Tue, 03 Jul 2012 16:57:01 GMT

[quote user="Malcolm Ness"]

We use CTDS for bloods etc and Abbey for Histopath - have done for 25 years or so. Trevor Whitbread (the boss at Abbey) is the most sensible, helpful and reliable pathologist I have come across and he has surrounded himself with like-minded people - give them a try.

[/quote]

Can't beat the silver bodgie for path.!

Re: External labs

Bob Russell — Tue, 03 Jul 2012 16:49:49 GMT

TDDS Ringwood and/or Exeter for us!

(probably interchangable with CTDS depending on the area of the country).

Re: External labs

Malcolm Ness — Tue, 03 Jul 2012 16:43:28 GMT

Re: External labs

Anthony Todd — Tue, 03 Jul 2012 16:25:21 GMT

Depends where you, are but the game has changed in London, with outside lockable pick-up boxes, so samples are picked up after 7pm and you get the results by 10ish next morning which virtually obviates the need for in-house facilities.

Re: External labs

Ian Mostyn — Tue, 03 Jul 2012 16:20:54 GMT

[quote user="plantagenet"]

I would recommend CTDS

[/quote]

Re: External labs

plantagenet — Tue, 03 Jul 2012 16:17:08 GMT

I would recommend CTDS

Re: External labs

Jo Cobbett — Tue, 03 Jul 2012 16:01:19 GMT

Whereabouts are you? We use Dick White Laboratories near Newmarket. They do a courier service if you are in the area, and their back up is exceptional. They are always happy to discuss the case and offer advice Although their prices are slightly higher than, for example, Idexx, the personal touch is worth its weight in gold!