Objective—To determine sensitivity and specificity of
cytologic examination used in a clinical setting.
Animals—216 dogs, 44 cats, 4 horses, 2 ferrets, 1
llama, 1 rat, and 1 mouse.
Procedure—Records were reviewed of cases in
which a cytologic diagnosis was followed by a surgical
biopsy or postmortem examination within 3 days
with subsequent histopathologic diagnosis.
Diagnoses were compared for agreement at various
levels, including complete agreement, partial agreement,
no agreement, or no comparison possible
because of insufficient or incorrect cytologic specimen.
Levels of agreement were compared for different
categories of lesions, including neoplastic, inflammatory,
dysplastic-hyperplastic-other, and normal tissue.
Additionally, levels of agreement for neoplastic
lesions were categorized with regard to cell type,
degree of malignancy, and location. Sensitivity and
specificity of cytologic examination were calculated.
Results—At the level of general agreement (complete
and partial agreement), the sensitivity of cytologic
examination ranged from 33.3 to 66.1%,
depending on the location of the lesion. Cytologic
examination was most accurate when used to diagnose
cutaneous and subcutaneous lesions and least
accurate for diagnosis of liver lesions. Cytologic
examination was most effective in diagnosis of neoplastic
disease and least effective in diagnosis of dysplastic
or hyperplastic conditions.
Conclusions and Clinical Relevance—Cytologic
examination is a valuable diagnostic tool, although our
results indicated lower accuracy than previously
reported. False-negative results (missing a diagnosis)
were far more common than false-positive results
(categorizing a healthy animal as diseased); therefore,
if the clinical index of suspicion is high, cytologic
examination should be repeated or another technique
should be selected to rule out the suspected condition.
(J Am Vet Med Assoc 2003;222:964–967)
As efforts to reduce the overpopulation and euthanasia of unwanted and unowned dogs and cats have increased, greater attention has been focused on spay-neuter programs throughout the United States. Because of the wide range of geographic and demographic needs, a wide variety of programs have been developed to increase delivery of spay-neuter services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, feral cat programs, and services provided through private practitioners. In an effort to ensure a consistent level of care, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. The guidelines consist of recommendations for preoperative care (eg, patient transport and housing, patient selection, client communication, record keeping, and medical considerations), anesthetic management (eg, equipment, monitoring, perioperative considerations, anesthetic protocols, and emergency preparedness), surgical care (eg, operating-area environment; surgical-pack preparation; patient preparation; surgeon preparation; surgical procedures for pediatric, juvenile, and adult patients; and identification of neutered animals), and postoperative care (eg, analgesia, recovery, and release). These guidelines are based on current principles of anesthesiology, critical care medicine, microbiology, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs.
As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs.