FAQ
Shipping From Within The USA
NEW: Discounted shipping
available
We strongly recommend the use of a secondary carrier service,
such as 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."
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.
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?
The various analytes have different stability in serum. Serum
TLI and PLI are stable for up to 2 weeks at room temperature.
However, serum folate shows limited stability at room temperature.
Therefore, serum samples for folate analysis should be kept at 4ºC
for not longer than 48 hours, but freezing is preferred.
Furthermore, folate is light sensitive and samples should be stored
in the dark or wrapped in foil. We recommend that samples for serum
cobalamin/folate analysis are shipped overnight either frozen or at
least with included ice packs to keep them cooled during
shipment.
Should I send samples overnight or by regular mail?
We recommend that you send your sample with Fed-Ex or UPS. Fecal
samples for fecal
alpha1-Proteinase Inhibitor need to arrive frozen at the
laboratory. We highly recommend shipping such samples overnight on
dry ice.
Serum TLI and PLI are stable for up to 2 weeks at room
temperature. We recommend that samples for serum cobalamin/folate
analysis are shipped overnight either frozen or at least with
included ice packs to keep them cooled during shipment.
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.
We also offer a Fed Ex discounted shipping
program through our website. Contact the lab for your username
and password.
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). Hemolysis will also
affect C-reactive protein concentrations.
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.
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.
How should I store my sample if I am not going to send it to
the lab right away?
The various analytes have different stability in serum. Serum
TLI and PLI are stable for up to 2 weeks at room temperature.
However, serum folate shows limited stability at room temperature.
Therefore, serum samples for folate analysis should be kept at 4ºC
for not longer than 48 hours, but freezing is preferred.
Furthermore, folate is light sensitive and samples should be stored
in the dark or wrapped in foil.
Shipping information for PCR testing
We need approximately 0.5 to 1 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, please collect the sample and store in
the refrigerator for up to one week before shipping. Fresh samples
are ideal. Please ship overnight with a frozen gel ice pack.
What address do I use to send samples?
Our complete address is at the top of the submission form. No
street address is needed.
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.