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PCR PANELS IDEXX Reference Laboratories PCR REQUEST FORM IDEXX Reference Laboratories PCR REQUEST FORM - INFECTIOUS DISEASE In order to enable us to process your sample(s) efficiently, please complete all information on this form using black ink. DATE REFERENCE / PIMS NUMBER LAB NUMBER VETERINARY SURGEON OWNER‘S NAME (LAB USE ONLY) ADDRESS STAMP NAME OF ANIMAL VET CODE SPECIES AGE BREED SEX NEUTERED ENTIRE See current Directory of Products and Services and www.vetconnect.co.uk for profile content & sample requirements For a full list of all available test, sample requirements and online ordering please visit www.vetconnectplus.co.uk PCR PANELS SINGLE PCR TESTS RealPCR™ as of 1018 FELINE FELINE CANINE AVIAN – PLEASE SPECIFY EXACT BREED FDPP Diarrhoea Panel BBPC Babesia felis (DNA) CADP Adenovirus type 2 (CADV-2) (DNA) CPCR Chlamydia psittaci (DNA) UK116 FEP1 Eye Panel 1 BHPC Bartonella spp. (DNA) ANPC Anaplasma spp. (DNA) POLY Polyomavirus (DNA) FEPC Eye Panel 1 CALF Calicivirus (RNA) BBPC Babesia spp. (DNA) PBFD Psittacine Beak & Feather Disease plus bacterial culture CPCF Chlamydia felis (DNA) BHPC Bartonella spp. (DNA) Virus (PBFD) (DNA) FP2 Eye Panel 2 FCOP Coronavirus/FIP (RNA) (faeces) DIPC Distemper Virus (CDV) (RNA) OTHER FP2C Eye Panel 2 FIPVP Coronavirus/FIP (RNA) EPCR Ehrlichia canis (DNA) MYCP Mycoplasma spp. (DNA) plus bacterial culture (Fluid or Tissue) EHPC Ehrlichia spp. (DNA) FFURS Gingivitis Profile FEAP Enteritis (Panleucopenia/FPV) ECPC Enteric Coronavirus CECoV (DNA) MPCR Haemotropic Mycoplasma (DNA) HMPC Haemotropic Mycoplasma (DNA) Panel FLVP FeLV (Progenome-DNA) HWPC Heartworm (Dirofilaria spp.) (DNA) FUR1 Upper Respiratory Panel 1 FIVP FIV (Progenome-DNA HEPP Hepatozoon canis (DNA) © 2019 IDEXX Laboratories, Inc. All rights reserved. · FU1C Upper Respiratory Panel 1 and viral RNA) HVPC Canine Herpesvirus CHV-1 (DNA) plus bacterial culture FHV1Q Feline Herpesvirus FHV-1 (DNA) IVPC Influenza Virus (RNA) FUR2 Upper Respiratory Panel 2 LPCR Leishmania spp. (DNA) FU2C Upper Respiratory Panel 2 BPCR Lyme (Borrelia spp.) (DNA) LEPP Leptospira spp. (DNA) plus bacterial culture MPCC Mycoplasma felis (DNA) BPCR Lyme (Borrelia spp.) (DNA) CANINE TOPC Toxoplasma gondii (DNA) PVPC Parainfluenza Virus type 3 (RNA) LUNGWP Canine Lungworm Panel TTFF Tritrichomonas foetus (DNA) CPPC Parvovirus 2 (DNA) CDPP Diarrhoea Panel (CPV-2, CPV-2a, CPV-2b, CPV-2c) CRP1 Upper Respiratory Panel CCPV Respiratory Coronavirus CRPC Upper Respiratory Panel CRCoV (RNA) plus bacterial culture TOPC Toxoplasma gondii (DNA) TRA1 Travel Disease Profile I TRA2 Travel Disease Profile II TRA3 Travel Disease Profile III TIC1 Tick Panel – Blood TIC2 Tick Panel – Tick AVIAN - PLEASE SPECIFY EXACT BREED AVP1 Avian Panel 1 AVP2 Avian Panel 2 AVP3 Avian Panel 3 AVP4 Avian Panel 4 PREVIOUS REF. N° Please provide history to allow for interpretation (please indicate Differential Diagnosis / Disease Suspected / Specific questions you would like answered) o Does the animal originate from a country outside the UK (please state country) o Has the animal recently travelled abroad or been in contact with a non-UK bred animal that has travelled abroad o Please indicate if the sample has been obtained from a patient receiving chemotherapy or radioactive iodine IDEXX considers proper processing of personal data to be of upmost importance and has adopted the privacy policy which can be found onwww.idexx.com/privacy FOR LAB USE ONLY EDTA SEP SERUM UN SPUN GEL HEPARIN E-SWAB UNLABELLED REV SMEAR WHOLE BLOOD PART SPUN GEL HEPARIN PLASMA DRY SWAB LOCK BOX NHS OTHER SPUN GEL PLAIN URINE FRESH TISSUE COURIER IDEXX Laboratories Ltd Tel: UK: +44 (0) 2037887508 · Eire: +353 (0) 15621211 GTD Fax: 01937 544001 · [email protected] · www.idexx.co.uk IDEXX Reference Laboratories PCR REQUEST FORM - GENETIC DISEASE In order to enable us to process your sample(s) efficiently, please complete all information on this form using black ink. To help us process your sample as efficiently as possible, please provide all owner and PATIENT‘S NAME patient information including Kennel Club Registration Number and Microchip number. Please note the expected time for results is up to 8 weeks from receipt of the sample and completed form. KENNEL CLUB NAME DATE REGISTERED BREED LAB NUMBER VETERINARY SURGEON (LAB USE ONLY) DATE OF BIRTH KENNEL CLUB No ADDRESS STAMP SEX NEUTERED MICROCHIP No MR / MRS / MISS OWNER‘S ADDRESS* VET CODE POSTCODE See current Directory of Products and Services and www.vetconnect.co.uk for profile content & sample requirements For a full list of all available test, sample requirements and online ordering please visit www.vetconnectplus.co.uk GD02 Canine malignant hyperthermia GD21 Myopathy (CNM, HMLR, LRM) VONP Von Willebrand-disease GD43 Dry Eye and Curly Coat (genetic predisposition) Labrador Retriever Type 1: Dobermann, Poodle, Manchester Syndrome (CCS) Terrier, Dutch partridge Dog, Papillon, Cavalier King Charles Spaniel GD03 CLAD (Canine leucocyte GD22 Myotonia congenita Coton de Tulear, Kerry Blue Terrier, UK116-0120 adhesion deficiency) Miniature Schnauzer, Chow Chow, Bernese Mountain dog, German Pointer, GD44 Polycystic Kidney Disease Bull Terrier Irish Setter Staffordshire Bull Terrier, Mastiff Welsh Corgi; Type 2: German Wirehaired; GD45 Neuronal Cerod Lipofuscinosis GD08 Collie Eye Anomaly (CEA) GD25 Phosphofructokinase defici- Type 3: Scotch Terrier, Sheltie (NCL) Border Collie, Rough Collie and Smooth ency Australian Shepherd, Border Collie, Collie, Longhaired Whippet, Lancashire PARC Parentage Test (Canine) English Springer Spaniel, American Chihuahua, Chinese Crested, Dachshund, Heeler, Shetland Sheepdog, Australian Cocker Spaniel and their cross breeds GD38 Familial Nephropathy Miniature Long Haired Dachshund, Minia- Shepherd GD39 Degenerative Myopathy/ ture Smooth Haired Dachshund, Miniature GD26 Polycystic Kidney Disease (PKD) Wire Haired Daschund, Standard Wire GD09 Copper storage disease Persian, Himalayan, Siamese cats, degenerative radiculomyelo- Haired Daschund, Standard Smooth Bedlington Terrier Ragdolls, European Shorthair, pathy Haired Daschund,Standard Long Haired American Shorthair, British Shorthair, GD10 Cystinuria Available for all dog breeds - the most com- Daschund, Golden Rretriever, American Exotic Shorthair, Selkirk Rex and (genetic predisposition) mon ones are: American Eskimo, Chesa- Bulldog, English Setter, Tibetan Terrier, Scottish Folds © 2020 IDEXX Laboratories, Inc. All rights reserved. · Newfoundland, Landseer peake Bay Retriever, German Shepherd, American Staffordshire Terrier Golden Retriever, Labrador Retriever, Poodle GD36 Exercise Induced Collapse (EIC) GD27 prcd-PRA (atrophy of the , Nova Scotia Duck Tolling Retriever, Poodle, GD46 Trapped Neutrophil Syndrome Labrador Retriever, Chesapeake Bay retina) Shetland Sheepdog (Sheltie), Pembroke (TNS) Retriever, Curly-coated Retriever, German Australian Shepherd, Miniature Austral- Welsh Corgi, Cardigan Welsh Corgi, Rough Border Collie Wirehaired Pointer, Pembroke Welsh Corgi, ian Shepherd, Australian Cattle Dog, Collie, Smooth Collie, Bernese Mountain Boykin Spaniel American Bichon Poodle, Poochon, Cocker Dog, Airedale Terrier, French Bulldog, Fox PDE/ Encephalitis (PDE)/Necrotizing Spaniel, American Eskimo, Chesapeake Bay Terrier, Boxer , Rhodesian Ridgeback, Jack NME Meningoencephalitis (NME) GD11 Fucosidosis Retriever, Chinese Crested, English Cocker Russell Terrier, Kerry Blue Terrier, Wire Pug English Springer Spaniel Spaniel, Cockerpoo, Golden Retriever, Fox Terrier, Cavalier King Charles Spaniel, AVIAN Golden Doodle, Entlebucher Mountain GD16 HCM Alaskan Malamute, Pug, Borzoi (Russian dog, Karelian Bear Dog, Kuvasz, Lapponian Wolfhound), Hovawart, Soft Coated Wheaten ASEX Avian Sexing N.B. Please (Hypertrophic Cardiomyopathy) Herder, Labrador Retriever, Labradoodle, Terrier, Canaan Dog, Pyrenean Mountain specify EXACT breed Mutation A31P Maine Coon and their Australian Labradoodle, Miniature Poodle, Dog (Great Pyrenees), Lakeland Terrier, Hun- cross breeds, Mutation A74T Maine Coon Nova Scotia Duck Tolling Retriever, garian Pumi, Blood hound, British Timber and their cross breeds, Mutation R820W Portuguese Water dog, Swedish and Dog, Glen of Imaal terrier, Utonagan. Ragdoll and their cross breeds Finnish Lapp dog, Silky Terrier, Australian GD18 L-2-HGA Stumpy Tail Cattle Dog, Toy Poodle, Pumi, GD41 Hyperuricosuria (HUU, SLC) Spanish Water Dog, Markjesje, Moyen poo- Available for all dog breeds, Commonly (L-2-hydroxyglutaric aciduria) dle, Norwegian Elkhound, Yorkshire Terrier found in Dalmatian, Large Munsterlander, Staffordshire Bull Terrier American Bulldog, French Bulldog, Bull- GD28 cord1-PRA MDR1 MDR1 Defect (multi resistance, dog, Black Russian Terrier, Hungarian Wire Miniature long haired and smooth haired Haired Vizsla (Vizslak), Hungarian Vizsla ivomectin hypersensitivity) Dachshund, English Springer Spaniel GD20 Mucopolysaccharidosis VII GD42 Episodic Falling Cavalier King Charles Spaniel German Shepherd PREVIOUS REF. N° Please provide history to allow for interpretation (please indicate Differential Diagnosis / Disease Suspected / Specific questions you would like addressed) o Does the animal originate from a country outside the UK (please state country) o Has the animal recently travelled abroad or been in contact with a non-UK bred animal that has travelled abroad o Please indicate if the sample has been obtained from a patient receiving chemotherapy or radioactive iodine IDEXX handles personal data responsibly and has adopted the privacy policy which can be found at idexx.com/privacy FOR LAB USE ONLY EDTA UNLABELLED REV LOCK BOX NHS OTHER COURIER E-SWAB IDEXX Laboratories Ltd Tel: UK: +44 (0) 2037887508 · Eire: +353 (0) 15621211 GTD Fax: 01937 544001 · [email protected] · www.idexx.co.uk.
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