ANIMAL DISEASE DIAGNOSTIC AND INVESTIGATIVE LABORATORY
Division of Comparative Medicine, Research Animal Resources,
University of Minnesota
| Date |
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Lab No |
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Lab Tech |
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| Signalment |
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Species |
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Prov Dx |
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| Investigator |
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Breed/Strain |
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Dx A. |
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| Department |
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Animal ID # |
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Dx B |
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| Protocol No. |
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Age |
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Dx C |
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| Billing Name |
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Sex |
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RAR Research |
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| Clinician |
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Necropsy # |
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Title |
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| Hematology |
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Serum |
Chemistries |
Fecal |
Examination |
| WBC (103/mm3) |
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BUN (mg/dl) |
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Endoparasites |
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| %Segs |
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Creat (mg/dl) |
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A. |
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| Bands |
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Gluc (mg/dl) |
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__________ |
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| Lymphocytes |
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T Bilirubin |
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B. |
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| Monocytes |
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Amylase |
__________ |
__________ |
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| Eosinophils |
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Chem Panel |
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C. |
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| Basophils |
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Other |
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__________ |
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| nRBC/100 WBC |
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|
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Occult Blood |
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| Reticulocytes |
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Serology |
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| RBC (106/mm3) |
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M. Pulmonis |
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Urinalysis |
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| MCV |
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Sendai |
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Color |
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| MCHC |
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RCV |
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Clarity |
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| HCT (%) |
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MHV |
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Sp Gravity |
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| HB (g/dl) |
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Other |
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pH |
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| M-total protein |
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PVM |
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Protein |
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| Platelets |
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GD VII |
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Glucose |
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| Blood Morphology |
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PCR (indicate test) |
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Ketone |
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| __________ |
__________ |
Parasites |
|
RBC |
__________ |
| __________ |
__________ |
Heartworm |
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Bilirubin |
__________ |
| __________ |
__________ |
Intracellular |
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Micro |
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|
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Ectoparasites |
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KOH Prep |
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| Microbiology |
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| Source (Specimen) |
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Sensitivity |
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| A. |
__________ |
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Organism |
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| B. |
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Amikacin |
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| C. |
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Stain |
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Ampicillin |
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| Routine |
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Gram |
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Amoxi-Clav acid |
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| Anaerobe |
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Giemsa |
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Ceftiofur |
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| Mycoplasma |
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Other |
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Cephalothin |
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| Fungus |
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Stain Interpretation |
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Ciprofloxacin |
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| Salmonella |
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__________ |
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Chloramphenicol |
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| Other |
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Clindamycin |
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| Results |
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Erythromycin |
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| __________ |
__________ |
__________ |
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Gentamicin |
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| __________ |
__________ |
__________ |
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Penicillin |
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| __________ |
__________ |
__________ |
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Sulfa/trimeth |
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| __________ |
__________ |
__________ |
__________ |
Tetracycline |
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| __________ |
__________ |
__________ |
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Ticarcillin |
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revised 6/00