Tuesday, June 26, 2007

Student Internship Programme(SIP)

Subject Title: CCHEM/ HAEM/ LMQA/ MMIC
Topic : SIP

Hi all

In case you are wondering what am I actually doing at my SIP, no I am not bathing for the horses, not drawing blood or any other body fluid from the horses(done by Vet, Vet nurses, or the horse's traininer themselves. In this hospital for horses, there is a clinical lab of it's own that also runs Haematology(Full Blood Count, Fibrinogen test etc.). I currently work in this laboratory that runs these tests.

There is a seperate lab that test for any performance drugs administered to the horse to prevent cheating.

In the Hospital, there is a X-ray room, Radioactivity room, patient stables(not ward for humans =P) and even a operation theater for the horse! Big operating tables and another big room where horse is given anaesthesia then a crane is used to put the horse onto the operating table. Today(second day of work), there is a surgery for a lame horse and the doctor sent a urgent blood tube to our lab.

My lab is a seperate building from the hospital. This is because there are new instrument boughted by company for clinical test and needed more space to house this equipment. Hence, my supervisor and I have to take a 5 minutes buggy ride to and fro the hospital at least 4 times a day to check if any sample are sent for testing. In my laboratory, the Haemotology is done by the CELL-DYN 3700 from ABBOTT, and clinical tests are done by the OLYMPUS AU400. The Olympus is the new instrument that is bought recently. My supervisor has just finished evaluating the machine and has just switched from the old instrument to this new one. However, there are still several problems and uncertainty that requires trouble-shooting. As the Olympus AU400 is still not stable, and that it is a very sensitive and complicated machine, I will first learn to use the CELL-DYN 3700.

Today, I did the Daily Maintanence. This includes the daily start-up(priming machine and doing background checks), running the Control samples (3-level: Low, High, Normal), Auto-cleaning(cleaning probe and wash block, auto-clean with enzymatic), Daily Shutdown. I also did the FBC for 2 of the samples.

An account in the LIS is created for me so that I can access and order test and record/retrieve results when necessary. I also learn about filling up Laboratory Request Form(LRF) and procedures(who sign who validate results, which copy of LRF to who, lab report out must have who to sign etc.). I also learnt to change reagent for the CELL-DYN3700.

Driving the buggy around the Club needs experience. Some horses are naughty and easily agitated so overtaking them or sudden movement startle them and may cause them to respone vigourously or even violently. Extra care have to be given and observation of the horses' movement and action allows you to tell if the horse is a naughty one or a tame one.

Hope to hear about some of your experience soon too.

Yew Long Jie, Douglas


  • At June 26, 2007 at 11:01 PM , Blogger BloodBank.MedMic.Haematology said...

    Hey douglas,

    thanks for sharing your experience! it sounds fun.

    have a question to ask you ah. is there any difference between the horse blood and ours in terms of blood cells? or is it the same?

    boon ching.

  • At June 30, 2007 at 9:51 PM , Blogger Kent said...

    Hi! Glad to know that you're having an enriching and enjoyable time at STF. I'm just curious to know what kinds of diseases horses normally suffer from (surely they don't get kidney and liver failure?), and how the CBC and clinical tests can help in the diagnosis of these disease states?


  • At June 30, 2007 at 10:49 PM , Blogger BloodBank.MedMic.Haematology said...


    sounds so COOL yeah.

    ask you smth. do horses have different blood groups like humans? A+, B+, etc.


  • At July 1, 2007 at 1:23 AM , Blogger first6weeks said...

    Hahaha hello douglas, everyone's flooding you with questions and i guess it won't make much difference with another!

    Are PBFs(blood smears) required for screening of any anomalies in diagnosing diseases for horses? If yes, is differential count performed?

    Looking forward to your reply. :) Thanks.

    - Alex

  • At July 1, 2007 at 4:14 PM , Blogger Star team said...

    Hey Douglas! Thanks for sharing..It sounds very interesting working in Turf Club. Anyway I have some qns. how did u use the CELL-DYN 3700? Is it the same as the Cell-Dyn 3000 which is used in school. What are the adv of using CELL-DYN 3700 in the turf club for horses? & what is the composition of WBC, RBC, platlets in horses? (ie monocytes for human is 8-12%. Is that the same in horses)& do horses have the same type of RBC abnormalities (in terms of shape)(do they have ovalocytes etc. or different from humans)

    Look forward in hearing from you

    Eugene Wong TG02

  • At July 1, 2007 at 5:52 PM , Blogger BloodBank.MedMic.Haematology said...

    Hey,what an exciting experience you had. Thanks for sharing with us:)

    I would like to ask u about the running of control samples, do you usually run for once or twice a day? And what are some of the tests you can order for the horses using LIS?

    Ci Liang

  • At July 2, 2007 at 1:25 AM , Blogger VASTYJ said...

    hihi.. nice experience.. juz wondering.. besides using FBC for diagnosis for certain diseases similar to humans like anaemia.. are there other horse diseases that also can be pre-determined by performing FBC tests? hmm.. and juz wondering.. if are there are differences notably between human and horse blood besides the antigens present.. thanks..

    Jia Hao

  • At July 2, 2007 at 10:51 PM , Blogger royal physicians said...

    Hi douglas,

    look like you are having a great experience there. Just a few question to ask,you mention that blood samples were taken from the horse'patients' so wat type of blood are they taking(eg. venous, arterial or blood gases)and from which part of the horse?And is there any spare blood for emergency?


  • At July 2, 2007 at 10:52 PM , Blogger royal physicians said...

    This comment has been removed by the author.

  • At July 2, 2007 at 11:03 PM , Blogger VASTYJ said...

    yoyo! wow, seems like u're enjoying yourself there. the transport time to turf club might be very long, but i can see that u are making full use of the learning experience! good job, keep up the good work!

    okay time for some qn.
    1)How much blood is usually taken from the horse?
    2)Is the needle of the syringe thicker than the one we use?
    3)A lame question. Do u collect urine smaples from horse? If yes, how do u go about collecting it?

    hope to hear from u soon! do check my blog for upcoming new post!

    Chaur lee TG01

  • At July 2, 2007 at 11:10 PM , Blogger Star team said...

    hello! looks like you are having fun there.

    Anyway, what are some of the clinical test you do there? Is it similar to the labs in hospital (for example, ferritin, blood gases,etc)? and do the lab recieve alot of samples every day? What other kind of samples to the lab recieve?

    Jo-anne Loh

  • At July 2, 2007 at 11:12 PM , Blogger royal physicians said...

    Hey douglas

    Just wanted to ask whether the horses are sent for routine checkups where they withdraw blood and urine samples or only before runs will they do a full checkup. and besides taking urine samples and blood from horses what other tests can be done?

    Johanna TG02

  • At July 3, 2007 at 9:55 PM , Blogger VASTYJ said...

    HIHI ~! thanks 4 sharing . It sounds very interesting and different from what the rest of us are doing . anyway .. u said a horse's movement should be observe to see if it is naughthy or violent rights ? So what are the kinds of movements or behaviours that should be looked out for ? thanks ~!
    valerie =)

  • At July 3, 2007 at 10:27 PM , Blogger The Lab Freaks said...

    hi! your attachment sounds very interesting!
    anyway..i would like to know what are the vaious tests that are run in the clinical labs, are the tests run for the horses same as those that are run for humans?also, what is the significant difference between the horse FBC and human FBC resuts?

    charmaine yeo, TG 01

  • At July 3, 2007 at 11:16 PM , Blogger J.A.M.M.Y.S said...

    Hey, I see you're having FUN with the horses

    Anyways,since im in question is...

    Do they culture the samples to check for infections or do you just do routine clinical testing using machines?

    Azhar TG01

  • At July 3, 2007 at 11:38 PM , Blogger MedBankers said...

    I think everyone is interested in your job scope. quick share more with us! Any cheating incident discovered by you?

    Pei Shan, TG02

  • At July 4, 2007 at 8:56 PM , Blogger first6weeks said...

    HiHi! seems like u're having loads of fun! a few ques for u: how do u carry out the fibrinogen test and wad do u mean by background check? i'm attached to histo lab. other than bld samples are collected for diagnosis, r tissue samples collected as well?
    June. TG02

  • At July 5, 2007 at 7:21 PM , Blogger BloodBank.MedMic.Haematology said...

    thanks for sharing! it appears that you are having fun at STF!
    btw, can i ask you some questions? do horse donate blood to another horse..? do they have a blood bank...? if so, where are the source of blood donor?

    Wing Fat

  • At July 6, 2007 at 10:57 PM , Blogger Distinction in Disaster! said...

    hey HOrse Expert,

    having fun with the horse out in Turf Club?? haha.. kk.. talking abt work now, can i know how the horses are distinguished from one another and how many blood grp system do they have?

    Aitee- 0503160D

  • At July 8, 2007 at 7:39 PM , Blogger ALsubs said...

    This comment has been removed by the author.

  • At July 8, 2007 at 7:54 PM , Blogger ALsubs said...

    Hey its so excitig when am hearing that you can even do a FBC for horse.gosh..Alrite anywayz my quest. is.. the reference range for the horse's blood is it the same as for humans or different? And the difference in referance range btw sex? male and female horse has differant referance range just like humans??


  • At July 8, 2007 at 11:37 PM , Blogger BloodBank.MedMic.Haematology said...

    Boon Ching-
    Horse blood is much thicker/viscous compared to human at gross examination level. Blood cells classification is the same as human blood. RBC, Retics, WBCs- Neutrophils, Basophils, Monocyte etc.

    Eh they actually do get kidney and liver failure. =) However, many a times this is a secondary illness. The most comman disease should be myopathy, damage to muscles tissue. When massive and prolonged damage is suffered, there will be a tremendous rise is AST and CK(muscle enzymes). They are present in large amounts in muscles. Damage caused leaking into blood. Excretion of these are carried out by the kidney. If this is prolonged, kidney may fail in that case.

    What is CBC? It's STC(Singapore Turf Club) by the way. =)

    Not sure. I think should have. I will ask and reply you again.

    Yes PBF is done. Exactly as how we did in the school lab. no "areoplane-take-off" slides. Yes differential count is done as some immatured cells are not properly identified by the machine.

    Eh, I have not used the one in school before so I cannot really compare. From what I know, 3700 measures by both optical(scattering light) and by impedence. Blood composition I gotta get the list. I have yet to remember it. Yes ovalocytes does happen to them as well. The blood abnormalities are very similar. another example is high Reticulocytes(slow maturation rate). However I have yet to heard anything about horse haveing a target cell or sickled cell. But I believe it may happen to them.

    Ci Liang-
    I run the 3-level control once a day, at the start of everyday. Something to note is that the company does not provide a horse blood control sample. Hence, when running the controls, I actually swtich the machine to human mode as the controls are human blood. Any test that is available in the lab connected to the LIS can be ordered. My supervisor has already set the profle test required because the routine test everyday follows a few certain profiles. Surgery blood always only require a FBC. Another proflie are the standard tests in our biochemistry(AST, Bicarbonate, etc.) selective individual test can also be ordered separately.

    low RBC is actually almost never seen before by me YET. normally RBC is normal or higher as the horses in the turf club are trained to race. "sporty horse" =)
    From what I see in the PBF, not much difference. just that counts of cells such as Basophils are more easily seen. (higher percentage I suppose.)

    blood are not only taken from patients. Trainers also uses the haem and biochem tests to check on their horse diet, training etc. Venous blood is taken from a large vein on the left neck of the horse. Not sure about the name of the Blood vessel. No emergency blood is stored. Many a times the horses are shot down to feed the lions in the zoo. =) these are those that cannot race no more.

    Chaur Lee-
    a 9ml plain tube and 3ml EDTA tube is taken for normal routine test. Lithium Heparin tubes are also used for pre-race blood. to test for any prohibited drugs. This drug testing is done by another lab in STC. Urine, not a lame question. They do take urine after the race to test for prohibited drugs. Urine test done by the other STC lab. They use a big container about 2 litres big, to collect and put into this smaller container about 250ml and send for testing. I haven really had the chance to see a close up on how to get the urine samples. Will update again if i get to see it. =)

    P.S. The rest of the questions I will answer again when I am free ASAP okay!! sorry very tired now liao.. =D

  • At July 9, 2007 at 10:09 AM , Blogger BloodBank.MedMic.Haematology said...

    Jo-anne Loh-
    I never do any ferritin, blood gas test. Test done only on the biochemistry and the electrolyte(Sodium Potassium Cloride) by the olyumpus lor.. per day sample is much less compare to you guys in hospital. Daily sample can be as low as 3 to about 30 to 40 samples. Sample kinds- Blood samples (EDTA and Plain tubes), Trechea Wash, Hair scrape.

    How often the horses are checked depends solely on the trainer during non-race period. If the trainer decides to check if his training for the horse is too much or too little, if the the diet of the horse is well, he will send blood for checkup. For race-day, there will be a compulsory blood test to be done before and after the race. Urine test is done after the race. Blood is drawn from the horses 2 hours before their race, and post-race urine and blood is collected straight after their race. Other test done are for trechea wash and hair samples where we test for microbs presence. Sensitivity test is also done to check if the microbs present in these sick horses are resistant or supceptible to the antibiotics.

    Hahas... When approaching the horses with a buggy from far away, observation should already start. This is because some horses get very disturbed by buggy going around. Sometimes the sound of the engines will startle them. In cases of sudden noises that shocked them, they will start jumping and kicking their hind legs. Example of some behaviors to look out for is that when approaching them, "naughty" horses will start to swing their head from side to side, they start to dun walk calmly/peacefully(wanting to move side to side). Extra attention must be given to horses with jockey on them as they do not like people to ride on them as well as we do. hahas.. horses with jockey on them will tend to be more easily disturbed. However, the more experienced jockey would be able to control the horses even if they are very "naughty". Some young jockey are not able to tame the horse and it could be quite dangerous if the horse is very "naughty". Hahas..

    Test run are the same. FBC results are similar just that reference range of the cell sizes are different.

    Yes they do. When horses fall sick, they do cell culture on Mueller Hinton agar, blood agar, Mac Conkey plates, depending on the sample type. Sensitivity testing is subsequently done.

    Pei Shan-
    What do you mean by cheating!!! Hahas.. you mean like changing of results??? or doing short cuts that yo are NOT suppose to do if you follow your lab accredidation regulations?

    Currently the fibrinogen test is done manually. =( machine has yet to come. There is this special pipette to draw EDTA blood into the capillary tube and a "cap" at the end of the tube. then you insert this "float" from the other end and you centrifuge the capillary tube. Then you incubate then you spin again and you read with the Idexx analyser. tissue I never do before. Only seen a skin scraping sample done for mircobiology.

  • At July 9, 2007 at 3:54 PM , Blogger BloodBank.MedMic.Haematology said...

    Wing Fat-
    It's STC(Singapore Turf Club), not STF. Blood donation is not done in the Equine Hospital. There is no blood bank here.

    Hey... Don't anyhow say, what expert. There is this MRA number that works like IC number that we have. Their MRA number can be seen on their left shoulder. Not sure about blood grouping in horses.

    Reference range for horse's is definitely different from that of human. The set of reference range that I am using is for both sexes of the animal. I will post the reference range for Haemotology soon.

  • At July 9, 2007 at 9:58 PM , Blogger VASTYJ said...

    hey douglas ~!
    hahas thx 4 the interesting reply on the horses behaviour ~!!
    vaLerie XD

  • At July 10, 2007 at 11:40 PM , Blogger Kent said...

    Wow. So horses do suffer from kidney failure too! Thanks for taking time to answer my questions!

    Kent TG01

  • At July 17, 2007 at 10:03 AM , Blogger BloodBank.MedMic.Haematology said...

    Sorry I missed this part out. Background check is a test run to check that there is no sample/cells "stuck" in the tubings in the machine. Ensuring that background check is near zero, accuracy of FBC is increased.

    Jo-anne Loh-
    Another sample type I received is the Bronchoalveolar Lavage(BAL). It is another sample type(other than transtracheal wash) obtained from lower respiratory tract.


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