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Use of cytology as a diagnostic method in veterinary practice and assessment of communication between veterinary practitioners and veterinary clinical pathologists

Mary M. Christopher DVM, PhD, DACVP1, Christine S. Hotz DVM, MS, DACVP2, Sonjia M. Shelly DVM, DACVP3, and Paul D. Pion DVM, DACVIM4
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  • 1 Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 2 Division of Health Informatics, School of Medicine, University of California, Sacramento, CA 95817.
  • | 3 IDEXX Veterinary Services, 2825 KOVR Dr, West Sacramento, CA 95605.
  • | 4 Veterinary Information Network, 777 W Covell Blvd, Davis, CA 95616.

Abstract

Objective—To determine the extent of use of cytology as a diagnostic method in veterinary practice and assess how veterinarians in practice communicate with veterinary clinical pathologists.

Design—Online survey.

Study Population—870 veterinarians.

Procedures—An online survey was made available to members of the Veterinary Information Network from October 1, 2004, through December 1, 2004.

Results—Respondents reported obtaining a median of 7 cytology samples weekly (range, 0 to 100). On average, respondents reported that 48.1% of the samples they collected were evaluated in-house, 29.5% were submitted to a veterinary diagnostic laboratory, and 21.6% were evaluated in-house and then submitted to a diagnostic laboratory. Most respondents (89.2%) reported using cytologic assessments to guide additional testing, and most (80.3%) indicated that they found the comments section of the cytology report to be the most important section. When asked to indicate the importance of various factors in their decision to use cytology as a diagnostic method, respondents overwhelmingly indicated that accuracy was very important. The most common reasons for consulting with a clinical pathologist were to discuss a discrepancy between clinical and cytologic findings, to clarify a diagnosis, and to ascertain the pathologist's confidence in a diagnosis. Respondents expressed more confidence in results when board-certified clinical pathologists were examining cytology samples than when others were.

Conclusions and Clinical Relevance—Results suggested that improving communication between veterinary practitioners and veterinary clinical pathologists could enhance the diagnostic value of cytologic examinations and improve clinical decision-making.

Abstract

Objective—To determine the extent of use of cytology as a diagnostic method in veterinary practice and assess how veterinarians in practice communicate with veterinary clinical pathologists.

Design—Online survey.

Study Population—870 veterinarians.

Procedures—An online survey was made available to members of the Veterinary Information Network from October 1, 2004, through December 1, 2004.

Results—Respondents reported obtaining a median of 7 cytology samples weekly (range, 0 to 100). On average, respondents reported that 48.1% of the samples they collected were evaluated in-house, 29.5% were submitted to a veterinary diagnostic laboratory, and 21.6% were evaluated in-house and then submitted to a diagnostic laboratory. Most respondents (89.2%) reported using cytologic assessments to guide additional testing, and most (80.3%) indicated that they found the comments section of the cytology report to be the most important section. When asked to indicate the importance of various factors in their decision to use cytology as a diagnostic method, respondents overwhelmingly indicated that accuracy was very important. The most common reasons for consulting with a clinical pathologist were to discuss a discrepancy between clinical and cytologic findings, to clarify a diagnosis, and to ascertain the pathologist's confidence in a diagnosis. Respondents expressed more confidence in results when board-certified clinical pathologists were examining cytology samples than when others were.

Conclusions and Clinical Relevance—Results suggested that improving communication between veterinary practitioners and veterinary clinical pathologists could enhance the diagnostic value of cytologic examinations and improve clinical decision-making.

Contributor Notes

Dr. Shelly's present address is VDx, 2019 Anderson Rd, Suite C, Davis, CA 95616.

Presented in part at the 40th Annual Meeting of the American Society for Veterinary Clinical Pathology, Boston, December 2005.

The authors thank Drs. John Steel and Carla Burris for assistance in developing the survey and validating the results.

Address correspondence to Dr. Christopher.