Idexx Snapshot dx Manual

IDEXX SNAPshot Dx*

Analyzer

Operator’s Guide

Proprietary Rights Notice

Information in this document is subject to change without notice. Companies, names, and data used in

examples are fictitious unless otherwise noted. No part of this document may be reproduced or transmitted

in any form or by any means, electronic, mechanical, or otherwise, for any purpose, without the express

written permission of IDEXX Laboratories. IDEXX Laboratories may have patents or pending patent

applications, trademarks, copyrights, or other intellectual or industrial property rights covering this document

or subject matter in this document. The furnishing of this document does not give a license to these property

rights except as expressly provided in any written license agreement from IDEXX Laboratories.

*IDEXX VetLab, SNAPshot Dx, Catalyst, SNAP, SNAP cPL, SNAP fPL, 4Dx, VetStat, and IDEXX SmartService are

trademarks or registered trademarks of IDEXX Laboratories, Inc. in the United States and/or other countries.

Lysodren is a registered trademark of Bristol-Myers Squibb Company. All other product and company names

and logos are trademarks of their respective holders.

iii

Contents

Preface ....................................................................................................................................................v

Safety Precautions....................................................................................................................................... v

International Symbol Descriptions.............................................................................................................. vi

Other Symbols........................................................................................................................................... vii

A Getting Started.............................................................................................................................. A-1

Introduction.............................................................................................................................................. A-1

SNAPshot Dx Analyzer Components....................................................................................................... A-2

Installing the SNAPshot Dx Analyzer ....................................................................................................... A-2

Powering On the Analyzer ....................................................................................................................... A-4

Shutting Down the Analyzer..................................................................................................................... A-4

Connecting/Disconnecting the Power Cord............................................................................................ A-4

Printing Test Results................................................................................................................................. A-4

BUsing the SNAPshot Dx*Analyzer ...............................................................................................B-1

Overview .................................................................................................................................................. B-1

Using the Touch Screen........................................................................................................................... B-1

Loading a SNAP*Test............................................................................................................................. B-1

Running a SNAP*Test ............................................................................................................................ B-1

Viewing Test Results ............................................................................................................................... B-2

CSNAP* Test Procedures................................................................................................................C-1

Overview ..................................................................................................................................................C-1

SNAP* Total T4.........................................................................................................................................C-2

SNAP* Cortisol ........................................................................................................................................C-5

SNAP* Bile Acids.....................................................................................................................................C-9

SNAP* fPL*............................................................................................................................................C-11

SNAP* cPL*...........................................................................................................................................C-12

SNAP* 4Dx* Plus...................................................................................................................................C-13

SNAP* FIV/FeLV Combo .......................................................................................................................C-14

SNAP* Heartworm RT ...........................................................................................................................C-15

SNAP* Feline proBNP ...........................................................................................................................C-16

DModifying the Settings on the Analyzer.......................................................................................D-1

Overview ..................................................................................................................................................D-1

Changing the Language/Local Settings..................................................................................................D-1

Adjusting the Volume of the Analyzer......................................................................................................D-2

Deleting a Patient from the Pending or In Process List...........................................................................D-2

ESample Preparation and Storage................................................................................................. E-1

Overview .................................................................................................................................................. E-1

IDEXX Quality Sample Preparation.......................................................................................................... E-2

Sample Collection Order ......................................................................................................................... E-3

Centrifuged Sample Inspection............................................................................................................... E-3

Sample Storage....................................................................................................................................... E-4

FMaintenance.................................................................................................................................. F-1

Overview .................................................................................................................................................. F-1

Upgrading the Software........................................................................................................................... F-1

Cleaning the Case ................................................................................................................................... F-1

Cleaning the SNAP Ports......................................................................................................................... F-1

Cleaning the Screen ................................................................................................................................ F-1

Cleaning the Incubator Wells................................................................................................................... F-1

Calibration................................................................................................................................................ F-1

G Troubleshooting ............................................................................................................................G-1

Differences in Results..............................................................................................................................G-1

Wrong SNAP* Device Removed .............................................................................................................G-1

Touch Screen Not Responsive ................................................................................................................G-1

SNAP Bar Code Cannot Be Read ...........................................................................................................G-1

Viewing the Event Log .............................................................................................................................G-2

Other Problems with Your Analyzer .........................................................................................................G-2

Sending Your Analyzer to IDEXX .............................................................................................................G-3

Frequently Asked Questions ...................................................................................................................G-3

HAppendices ...................................................................................................................................H-1

Technical Specifications ..........................................................................................................................H-1

IDEXX Technical Support Contact Information........................................................................................H-2

Preface

Safety Precautions

• The IDEXX SNAPshot Dx* Analyzer contains no user-serviceable components. DO NOT

disassemble. Call IDEXX Technical Support for any service issues.

• Do not insert anything in the SNAP* ports except devices approved for use with the SNAPshot

Dx Analyzer.

• Do not insert anything in the incubator wells except for the plastic sample tubes provided in

the SNAP test kits.

• DO NOT stack other equipment or containers on top of the analyzer.

• Keep analyzer away from sources of heat or flames.

• DO NOT place or operate the analyzer near x-ray equipment, photocopiers, or other devices

that generate static or magnetic fields.

• PROTECT your equipment from damp conditions or wet weather.

• Take care not to spill water or other fluids on the analyzer.

• DO NOT use any of the following liquids, abrasives, or aerosol sprays on or near the analyzer,

as they may damage the outer case and may influence the results:

– Organic solvents

– Ammonia-based cleaners

– Ink markers

– Sprays containing volatile liquids

– Insecticides

– Disinfectant

– Polish

– Room freshener

• Line voltage for the SNAPshot Dx Analyzer power supply is 100–240 V AC, 50–60 Hz.

Be sure to plug all equipment into properly grounded electrical outlets.

• Use only the power cable supplied.

• Disconnect the power cable from the AC power outlet:

– If the power cable becomes frayed or otherwise damaged.

– If anything is spilled onto the equipment.

– If your equipment is exposed to excessive moisture.

– If your equipment is dropped or the case has been damaged.

– If you suspect that your analyzer needs service or repair.

– Whenever you clean the case.

• If the equipment is used in a manner other than specified, the protection provided by the

equipment may be impaired.

International Symbol Descriptions

International symbols are often used on packaging to provide a pictorial representation of particular

information related to the product (such as expiration date, temperature limitations, batch code,

etc.). IDEXX Laboratories has adopted the use of international symbols on our analyzers, product

boxes, labels, inserts, and manuals in an effort to provide our users with

easy-to-read information.

Symbol Description Symbol Description

Use by

A utiliser avant

Verwendbar bis

Usare entro

Usar antes de

使用期限

Temperature limitation

Température limite

Zulässiger Temperaturbereich

Temperatura limite

Limitación de temperatura

保存温度（下限）

Batch Code (Lot)

Code de lot (Lot)

Chargenbezeichnung (Partie)

Codice del lotto (partita)

Código de lote (Lote)

ロット番号

Upper limit of temperature

Limite supérieure de température

Temperaturobergrenze

Limite superiore di temperatura

Limite superior de temperatura

保存温度（上限）

Serial Number

Numéro de série

Seriennummer

Numero di serie

Número de serie

シリアル番号

Consult instructions for use

Consulter la notice d’utilisation

Gebrauchsanweisung beachten

Consultare le istruzioni per l’uso

Consultar las instrucciones de uso

取扱説明書をご参照ください。

Catalog Number

Numéro catalogue

Bestellnummer

Numero di catalogo

Número de catálogo

製品番号

Keep away from sunlight

Conserver à l’abri de la lumière

Vor direkter Sonneneinstrahlung

schützen

Mantener alejado de la luz solar

Tenere lontano dalla luce diretta del

sole

遮光してください。

Authorized Representative in the

European Community

Représentant agréé pour la C.E.E.

Autorisierte EG-Vertretung

Rappresentante autorizzato nella

Comunitá Europea

Representante autorizado en la

Comunidad Europea

EC内の正規販売代理店

WEEE Directive 2002/96/EC

Directive 2002/96/CE (DEEE)

WEEE-Richtlinie 2002/96/EG

Directiva 2002/96/CE RAEE

Direttiva RAEE 2002/96/CE

廃電気電子機器指令（WEEE Directive

2002/96/EC）

Preface

vii

Symbol Description Symbol Description

Manufacturer

Fabricant

Hersteller

Ditta produttrice

Fabricante

製造元

Biological Risks

Risques biologiques

Biogefährlich

Rischi biologici

Riesgos biológicos

生物学的リスク

Caution, consult accompanying

documents

Attention, consulter les documents

joints

Achtung, Begleitdokumente beachten

Attenzione, consultare la

documentazione allegata

Precaución, consultar la

documentación adjunta

注意、添付文書をご参照ください。

Do Not Reuse

Usage unique

Nicht wiederverwenden

No reutilizarw

Non riutilizzare

再利用しないでください。

Other Symbols

Symbol Description Symbol Description

USB symbol Ethernet/network symbol

Preface

A-1

A Getting Started

Introduction

The IDEXX SNAPshot Dx* Analyzer is an assay reader designed for use with certain IDEXX SNAP*

consumables, such as SNAP* Total T4and SNAP* 4Dx* Plus Tests. By using the SNAPshot Dx

Analyzer, you can keep a record of your patient’s SNAP test history as well as add tests to an

existing patient’s record.

The analyzer’s touch-screen interface provides easy-to-follow instructions to help you navigate the

system, specify testing information, and more.

The SNAPshot Dx Analyzer is for veterinary use only.

IDEXX VetLab* Station Connectivity

The SNAPshot Dx Analyzer is part of the IDEXX VetLab* suite of analyzers, all of which connect

to the IDEXX VetLab Station (IDEXX’s laboratory information management system). Connecting

multiple analyzers to the IDEXX VetLab Station allows you to view a comprehensive picture of

your patient’s health, with the ability to view test results from multiple analyzers on a single report,

determine disease progression with parameter-trending capabilities, and more.

By connecting the SNAPshot Dx Analyzer to the IDEXX VetLab Station, you can:

• Automatically review patients’ prior results on every printout for easy comparison.

• Improve client communications with illustrated diagnostic or treatment progress printouts.

• Link to expert descriptions and common causes of abnormal values.

• Print information to help explain the significance of results to your clients.

• Allow new staff to train independently.

• View educational on-screen guides and videos, such as how to properly prepare a plasma

sample.

• Learn proper protocols and tips for best techniques.

How It Works

The SNAPshot Dx Analyzer is a digital imaging system

that records and interprets the colorimetric response

of enzymes immobilized on the surface of a SNAP test.

During operation, the analyzer records digital images of

each SNAP device and uses test-specific algorithms to

calculate the results. All SNAP tests that are loaded into

the SNAPshot Dx Analyzer must have a bar code on the

top of the device so that the analyzer can confirm the

SNAP test type.

A-2

SNAPshot Dx Analyzer Components

Installing the SNAPshot Dx Analyzer

The SNAPshot Dx Analyzer must be connected to the IDEXX VetLab Station (to be used in

conjunction with the IDEXX VetLab suite of analyzers).

To Install the SNAPshot Dx Analyzer

1. Before you unpack the analyzer, choose an optimum location for the analyzer. The analyzer

should be placed on a level surface with at least 4 inches (10 cm) of clearance above

the analyzer. The area underneath the analyzer should remain clean and clear. Choose a

well-ventilated area away from obvious sources of heat, direct sunlight, cold, humidity, or

vibrations. For optimum results, room temperature should be 19°C–27°C

(66°F–81°F) and relative humidity should be 30%–85%.

2. Unpack the analyzer using the following steps:

a. Remove the analyzer, power supply, and Ethernet cable from the box and then from the

bag.

b. Position the analyzer so the power switch can be accessed and the analyzer can be

unplugged.

3. Connect the power cord using the following steps:

a. Plug the round power connector into the receptacle on the back of the analyzer.

b. Plug the power cord into a wall outlet or power strip.

Note: Do not power on the analyzer at this time.

To Install the IDEXX VetLab Station Connectivity Router

Note: If you already have a network router connected directly to the IDEXX VetLab Station computer,

you can skip this section and move to the “To Connect the SNAPshot Dx Analyzer to the IDEXX

VetLab Station” section on page A-3.

Getting Started

A-3

1. Connect the AC power adapter to the power port on the back of the network router supplied

by IDEXX Laboratories.

2. Plug the AC power adapter into an electrical outlet.

3. Connect one end of the Ethernet cable (provided with the router) into any available port on the

router.

IMPORTANT: Do not connect the IDEXX VetLab Station directly to the Internet port on

the router.

4. Connect the other end of the Ethernet cable (from step 3)

into the IDEXX VetLab Station computer’s Ethernet port, which

is located near the center panel on the back of

the computer.

Note: If this Ethernet port on the IDEXX VetLab Station

computer is currently being used to connect the IDEXX VetStat*

Electrolyte and Blood Gas Analyzer (red Ethernet cable) to

your IDEXX VetLab Station, disconnect the red Ethernet cable.

Then complete step 4 above. The “To Reconnect the VetStat

Analyzer” section, found at the bottom of this page, explains

how to reconnect the VetStat analyzer after the router is

installed.

To Connect the SNAPshot Dx Analyzer to the IDEXX VetLab Station

1. Connect the Ethernet cable provided with the SNAPshot Dx Analyzer to the next available port

on the back of the router.

IMPORTANT: Do not connect the SNAPshot Dx Analyzer directly to the Internet port

on the router.

2. Connect the other end of the Ethernet cable (from Step 1) to the Ethernet port on the back of

the SNAPshot Dx Analyzer.

3. Power on the IDEXX VetLab Station. Once the IDEXX VetLab Station is at its Home screen,

power on the SNAPshot Dx Analyzer. Once both systems have completed their initialization

process, the IDEXX VetLab Station will establish connectivity with the SNAPshot Dx Analyzer.

When the SNAPshot Dx icon appears on the IDEXX VetLab Station Home screen, your

connections are complete.

Note: If the SNAPshot Dx icon does not appear on the IDEXX VetLab Station Home screen

within 3 minutes, contact IDEXX Technical Support for assistance.

To Reconnect the VetStat* Analyzer

IMPORTANT: The direct connection between the VetStat analyzer and the IDEXX VetLab Station

uses a standard Ethernet cable with a light purple cross-over adapter. This light purple cross-over

adapter, which is located on one end of the cable, must be removed before connecting the

Ethernet cable to the router.

1. Ensure the light purple cross-over adapter has been removed from the VetStat Ethernet cable.

2. Connect one end of the VetStat Ethernet cable to the VetStat analyzer and the other end to the

next available port on the router.

IMPORTANT: Do not connect the VetStat analyzer directly to the Internet port on the

router.

3. On the VetStat Home screen, tap System Manager and then tap Setup.

4. Use the alphanumeric keypad to enter the setup password, 207, and tap OK.

Ethernet port on the back panel of the

IDEXX VetLab Station computer’s CPU

Getting Started

A-4

5. From the Setup screen, tap Hardware and then tap the Ethernet tab.

6. Select Dynamic as the network setting and then tap OK to save the change.

7. Turn off the VetStat analyzer by toggling the power switch to OFF. Then, turn on the analyzer.

After the VetStat analyzer returns to the Home screen, the VetStat icon will appear at the

bottom of the IDEXX VetLab Station Home screen.

Note: If the VetStat icon does not appear on the IDEXX VetLab Station Home screen within 3

minutes, contact IDEXX Technical Support for assistance.

Powering On the Analyzer

To turn on the analyzer, press the power switch on the back of the analyzer. The analyzer will take

several minutes to warm up. It is ready for use when the Home screen appears.

Shutting Down the Analyzer

To Shut Down the SNAPshot Dx Analyzer

1. Tap Tools.

2. Tap Shutdown and then tap Yes to confirm that you want to shut down the analyzer.

3. When the analyzer indicates it is okay to do so, press the power switch on the back of the

analyzer to power the analyzer off.

Important: If you need to unplug the analyzer, ensure you disconnect the power cord from

the wall outlet/power strip BEFORE you disconnect it from the analyzer.

Connecting/Disconnecting the Power Cord

It is important that you follow these instructions carefully as improper connection/disconnection

could result in the hazard of an electrical shock.

To Connect the Power Cord

1. Ensure the analyzer is powered off.

2. Plug the round power connector into the receptacle on the back of the analyzer.

3. Plug the power cord into a wall outlet or power strip.

4. Press the power switch on the back of the analyzer to the on (I) position.

To Disconnect the Power Cord

1. Shut down the analyzer (see “Shutting Down the Analyzer” above).

2. Press the power switch on the back of the analyzer to the off (O) position.

3. Unplug the power cord from the wall outlet or power strip.

4. Unplug the round connector from the receptacle on the back of the analyzer.

Printing Test Results

The SNAPshot Dx Analyzer is connected to the IDEXX VetLab Station. Therefore, you print your

SNAPshot Dx Analyzer test results using the print settings on the IDEXX VetLab Station (compatible

printer required). For more information on printing while connected to the IDEXX VetLab Station, see

the IDEXX VetLab Station Operator’s Guide.

Getting Started

B-1

BUsing the SNAPshot Dx*Analyzer

Overview

The SNAPshot Dx Analyzer is controlled via a touch-screen monitor on the front of the analyzer and

by the IDEXX VetLab* Station.

Using the Touch Screen

To get the best results when using the touch screen:

• Do not rest your hand on the touch screen. The screen is sensitive to touch; pressure from

your hand prevents the touch screen from functioning properly.

• Tap the screen firmly.

• Never tap the touch screen with a sharp or abrasive object.

The touch screen is on whenever the analyzer is on.

Loading a SNAP*Test

The proper way to load a SNAP test device into the analyzer is horizontally, sample well end first. Do

not insert the SNAP device into the SNAPshot Dx Analyzer until the SNAPshot Dx Analyzer is ready

to process the device.

Important: Do not remove a SNAP test from the analyzer during analysis—removing the device

prematurely may result in loss of the run. Analysis is complete when the patient’s name is moved

from the In Process list to the Results list.

Running a SNAP*Test

For detailed instructions on running a specific SNAP test, see the “SNAP Test Procedures” chapter

in this guide.

IMPORTANT: Do not load a SNAP device until prompted by the analyzer.

To Run a SNAP Test

1. Enter the patient information on the IDEXX VetLab Station (for more information, see the

“Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen, tap

the patient’s name and then tap Select.

3. Follow the on-screen instructions for preparing, incubating (SNAP Total T4and Cortisol only),

and loading the SNAP test.

When analysis is complete, the patient’s name moves from the In Process list to the Results

list (you may also receive a “New Results” alert message and/or hear a beep on the IDEXX

VetLab Station, depending on the option(s) you selected in the New Results Alert tab on the

IDEXX VetLab Station’s Settings screen). You can then remove the SNAP device from the

analyzer by gently pushing the SNAP device until you hear a click. The device will slide out of

the port.

B-2

Viewing Test Results

To View the Test Results on the SNAPshot Dx Analyzer

1. Tap the Results list.

2. Tap the patient whose test results you want to view.

Note: If you do not see the patient’s name in the Results list, tap the page up and page

down arrows to view additional patient names.

3. Tap View Results to display the Test Results screen.

To View the Test Results on the IDEXX VetLab Station

See the IDEXX VetLab Station Operator’s Guide for detailed instructions on viewing test results.

Using the SNAPshot Dx* Analyzer

C-1

CSNAP* Test Procedures

Overview

This chapter includes detailed information for each of the SNAP tests that the SNAPshot Dx*

Analyzer supports. You can use the information in this section to:

• Read a description of each SNAP test.

• Learn how to prepare each test for analysis (the process varies by test type).

For more information about SNAP test diagnosis, management, and interpretations, visit idexx.com.

C-2

SNAP* Total T4

Test Description

An enzyme-linked immunosorbent assay (ELISA) for the quantitative measurement of total T4

(thyroxine) in canine, feline, and equine patients. With a SNAP Total T4Test, you can assess thyroid

function, provide comprehensive one-visit screening for feline hyperthyroidism, presumptive

hyperthyroidism and canine or equine hypothyroidism, as well as monitor response to treatment and

adjust dosages immediately.

Preparing and Running a SNAP Total T4Test

Important: Allow the SNAP Total T4Test to equilibrate in its sealed foil package at room temperature

for at least 15 minutes. Do not heat. It is not necessary to equilibrate the conjugate solution at room

temperature.

1. Enter the patient information on the IDEXX VetLab* Station (for more information, see the

“Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen, tap the

patient’s name and then tap Select. The Identify Sample screen appears.

3. Select Total T4as the SNAP Test Type.

4. Select the applicable sample type.

Note: Plasma from the Catalyst* whole blood separator may be used.

5. Tap Next.

6. If you are running a diluted sample, tap the Dilution or arrows to specify the parts diluent

(see the “Total T4Dilution Guidelines” section on page C-3).

Note: T4dilutions have not been validated for equine samples.

Important: Before performing a dilution, always run an undiluted patient sample first.

Samples should only be diluted when the undiluted sample result is >7.0 μg/dL (90.1 nmol/L).

7. Tap Next and follow the on-screen instructions to properly prepare the sample.

a. Use the purple handheld pipette to transfer 65 μL of sample into a disposable sample tube.

b. Use the 300-μL pipette to transfer 300 μL of conjugate into the same sample tube.

c. Cap the sample tube and gently invert it 4–5 times to mix.

d. Place the sample tube into an available incubator well.

e. Tap to start the incubation timer that corresponds to the well you selected (left or right).

The incubation timer displays with the patient information in the Pending list on the Home

screen (the timer counts down in 10-second intervals).

8. When incubation is complete (the patient information in the Pending list changes from

“Incubating” to “Ready,” the text turns red, and the analyzer beeps), tap to select the patient in

the Pending list.

9. Tap Next and follow the on-screen instructions to properly prepare the SNAP test:

a. Place the device on a horizontal surface.

b. Add the entire contents of the sample tube to the sample well, being careful not to

splash the contents outside of the sample well. The sample will flow across the result

window, reaching the activation circle in 30–60 seconds. Some sample may remain in

the sample well.

c. When color FIRST appears in the activation circle, press the activator firmly until it is

flush with the device body.

SNAP Test Procedures

C-3

10. Insert the SNAP device into the SNAPshot Dx Analyzer immediately. The SNAPshot Dx

Analyzer automatically begins to process the patient sample and the Home screen displays.

The patient’s name moves from the Pending list to the In Process list.

When analysis is complete, the patient’s name will move from the In Process list to the Results

list (you may also receive a “New Results” alert message and/or hear a beep on the IDEXX

VetLab Station, depending on the option(s) you selected in the New Results Alert tab on the

IDEXX VetLab Station’s Settings screen). You can then remove the SNAP device from the

analyzer by gently pushing the SNAP device until you hear a click. The device will slide out of

the port.

Total T4Dilution Guidelines

The SNAPshot Dx Analyzer allows you to dilute canine and feline Total T4samples that initially report

>7.0 μg/dL (90.1 nmol/L). Total T4dilutions have not been validated on equine samples.

To Ensure that You Receive the Most Accurate Results

• Only perform a dilution when the undiluted sample result is >7.0 μg/dL (90.1 nmol/L).

• Use the lowest dilution factor possible.

• Use only normal saline as the diluent.

Note: Conjugate volume remains at 300 μL even if you are running a diluted sample.

Preparing a 1:2 Dilution (1 part sample, 1 part saline)

1. Using the purple handheld pipette, dispense 65 μL of sample (serum or plasma) into a

disposable sample tube (e.g., a disposable tube from the SNAP Total T4Test Kit).

2. Using the purple handheld pipette, add 65 μL of normal saline to the tube.

3. Cap the tube and gently invert 4–5 times to mix the sample and saline.

4. Using the purple handheld pipette, aspirate 65 μL of the diluted sample and run the SNAP

Total T4Test as normal.

Note: When prompted, select 1in the Dilution drop-down list.

Preparing a 1:4 Dilution (1 part sample, 3 parts saline)

Important: A 1:4 dilution is only recommended if the result of a 1:2 diluted sample is

>14.0 μg/dL (180.2 nmol/L).

1. Using the purple handheld pipette, dispense 65 μL of sample (serum or plasma) into a

disposable sample tube (e.g., a disposable tube from the SNAP Total T4Test Kit).

2. Using the purple handheld pipette, add 65 μL of normal saline to the tube 3 times.

3. Cap the tube and gently invert 4–5 times to mix the sample and saline.

4. Using the purple handheld pipette, aspirate 65 μL of the sample/saline combination and

dispense it into a new disposable sample tube.

5. Using the diluted sample, prepare and run the SNAP Total T4Test as normal.

Note: When prompted, select 3in the Dilution drop-down list.

SNAP Test Procedures

C-4

Interpreting Test Results

The recommendations below are intended to provide general guidance only. As with any diagnosis,

you should use clinical discretion with each patient based on a complete evaluation of the patient,

including history, physical examination, and complete laboratory profile.

Species Results

U.S. Units (µg/dL) S.I. Units (nmol/L)

Canine†<1.0 Low <13 Low

1.0–2.0 Low Normal 13–26 Low Normal

1.0–4.0 Normal 13–51 Normal

>4.0 High >51 High

2.1–5.4 Therapeutic 27–69 Therapeutic

Feline‡<0.8 Subnormal <10 Subnormal

0.8–4.7 Normal 10–60 Normal

2.3–4.7 Gray zone in old or

symptomatic cats

30–60 Gray zone in old or

symptomatic cats

>4.7 Consistent with

hyperthyroidism

>60 Consistent with

hyperthyroidism

Equine <1.0 Low <13 Low

1.0–3.8 Normal 13–49 Normal

>3.8 High >49 High

†Canine Screening

• Dogs with a low total T4(T4) and evidence of nonthyroidal illness (NTI) should have their NTI addressed.

• Dogs with T4results in the low normal range may be hypothyroid.

• In dogs with low or low normal T4 results and with consistent clinical signs, consider free T4 (fT4) and

endogenous thyroid-stimulating hormone (TSH) and possibly thyroglobulin autoantibodies (TgAA) to aid in

confirming hypothyroidism.

Hypothyroidism Therapeutic Monitoring

For dogs on thyroid supplement, acceptable 4–6-hour post-pill T4values will generally fall in the upper end of

the reference range or slightly above.

‡Feline Screening

Cats with consistent clinical signs and total T4(T4) values in the borderline high range (gray zone) may have

early hyperthyroidism or a concurrent nonthyroidal illness (NTI). In these cases, consider a free T4(fT4), a T3

suppression test or radionuclide thyroid imaging to aid in confirming the diagnosis.

Hyperthyroidism Therapeutic Monitoring

Following treatment with methimazole, T4values will generally fall within the lower to midportion of the

reference range.

SNAP Test Procedures

C-5

SNAP* Cortisol

Test Description

An enzyme-linked immunosorbent assay (ELISA) for the quantitative measurement of cortisol in

canine patients. With the SNAP Cortisol Test (when used in conjunction with accepted protocols

for ACTH stimulation and low-dose dexamethasone suppression tests), you can screen for

Addison’s disease and Cushing’s syndrome. You can also monitor response to treatment and make

adjustments to medications for patients diagnosed with Cushing’s syndrome.

Important: DO NOT use the SNAP Cortisol Test if the patient has received:

• Dexamethasone (doses >0.1 mg/kg) in the last 7 days.

• Prednisone or other corticosteriods in the past 4 weeks.

Preparing and Running a SNAP Cortisol Test

Important: Allow the SNAP Cortisol Test to equilibrate in its sealed foil package at room temperature

for at least 10 minutes. Do not heat. It is not necessary to equilibrate the conjugate solution at room

temperature.

1. Enter the patient information on the IDEXX VetLab Station (for more information, see the

“Analyzing Samples” chapter of the IDEXX VetLab Station Operator’s Guide).

2. Once the patient’s name appears in the Pending list on the SNAPshot Dx Home screen, tap the

patient’s name and then tap Select. The Identify Sample screen appears.

3. Select Cortisol as the SNAP Test Type (the sample type is chosen automatically).

4. Tap Next.

5. In the Protocol drop-down list, tap ACTH Stim, LDDST, or HDDST.

Note: Take care not to exceed 0.1 mg/kg of dexamethasone.

6. In the Protocol Step drop-down list, tap the applicable protocol step. The options that are

available vary based on the Protocol option that was selected in step 6.

7. Tap Next and follow the on-screen instructions to properly prepare the sample.

a. Using the appropriate handheld pipette (provided in the SNAPshot Dx sample prep kit),

transfer the sample and conjugate into a disposable sample tube (see volumes below).

Protocol/Protocol Step

Sample

Volume

Pipette

Color

Conjugate

Volume

Range†

Baseline Cortisol

100 µL Gray 300 µL

0.5–10.0 µg/dL

(13.8–276.0

nmol/L)

Dexamethasone Suppression

Cortisol (low- or high-dose) 100 µL Gray 300 µL

0.5–10.0 µg/dL

(13.8–276.0

nmol/L)

ACTH Stim Cortisol: Cushing’s

Suspected 25 µL Blue 300 µL

2.5–30.0 µg/dL

(69.0–828.0

nmol/L)

ACTH Stim Cortisol: Addison’s

Suspected 100 µL Gray 300 µL

0.5–10.0 µg/dL

(13.8–276.0

nmol/L)

SNAP Test Procedures

C-6

Protocol/Protocol Step

Sample

Volume

Pipette

Color

Conjugate

Volume

Range†

ACTH Stim Cortisol: Therapeutic

Monitoring 100 µL Gray 300 µL

0.5–10.0 µg/dL

(13.8–276.0

nmol/L)

ACTH Stim Cortisol: Therapeutic

Monitoring >10 µg/dL 25 µL Blue 300 µL

2.5–30.0 µg/dL

(69.0–828.0

nmol/L)

†“Range” refers to the test result range for a particular test’s protocol. When a test result falls outside of this

range, it will be reported as either “>” (greater than the upper limit) or “<” (less than the lower limit).

b. Cap the sample tube and gently invert it 4–5 times to mix.

c. Place the sample tube into an available incubator well.

d. Tap to start the incubation timer that corresponds to the well you selected (left or right).