hm2 hematology system - abaxis uk · vetscan® hm2 hematology system for veterinary use only...

VetScan® HM2Hematology System

For Veterinary Use OnlyCustomer and Technical Support

1-800-822-2947

November 2006

PN: 760-7003 Rev. A AssyPN: 760-7013 Rev. A Text© 2006, Abaxis, Inc.Union City, CA 94587

IMPORTANT: READ BEFORE USING THE VETSCAN® HM2 ANALYZER FOR THE FIRST TIME

To get started quickly, please refer to the Quick Reference Guide in the pocket of this Operator’s Manual.

Fill in this information for future reference

Serial number (from the back of the unit): .....................................................................................

Date of installation: ............................................................................................................................

Distributor name and address: .........................................................................................................

..........................................................................................................

..........................................................................................................

Abaxis sales representative name: ....................................................................................................

Phone: ....................................................................................................

Email: .....................................................................................................

November 2006

PN: 760-7013 Rev. A©2006, Abaxis, Inc.

Union City, CA94587

THANK YOU FOR PURCHASING THE VETSCAN® HM2!Please fill out the Abaxis Product Warranty and Registration Card located in the front pocket of this Operator's Manual and send it to Abaxis soon to get your benefits started.

Table of Contents

Section 1: General Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-21.2 Customer and Technical Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-21.3 Symbols Used in Labeling and Hazard Identification. . . . . . . . . . . . . . . . . . . . . . 1-3

Section 2: System Overview and Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1

2.1 VetScan HM2 System Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-22.2 Unpacking the System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-162.3 Selecting a Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-182.4 Installing the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-202.5 Turning the Analyzer On and Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-282.6 Initializing the VetScan HM2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-312.7 Standby Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-32

Section 3: Configuring the VetScan HM2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1

3.1 Printer Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-23.2 Operational Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-93.3 Date and Time Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-153.4 Fluid Sensor Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16

Section 4: Test Procedure and Interpreting Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1

4.1 Collecting and Preparing Samples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-24.2 Before Performing an Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-44.3 Analyzing a Sample. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-74.4 Adjusting the Needle Height . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-104.5 Adjusting the Lyse Volume. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-114.6 Interpreting Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-124.7 Printing and Exporting Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-154.8 Combining Chemistry and Hematology Results . . . . . . . . . . . . . . . . . . . . . . . . . . 4-164.9 Using Prediluted Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-214.10 Interpreting CBC Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-23

Section 5: Calibration and Quality Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1

5.1 Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-25.2 Performing Quality Control. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6

Section 6: Managing the Database . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1

6.1 Database Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-26.2 Database Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-26.3 Navigating the Database System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3

Table of Contents TOC-1

Section 7: Maintenance & Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1

7.1 Periodic Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-27.2 Cleaning the Aperture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-57.3 Bleach-Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-57.4 Shut-Down Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-77.5 Changing the Reagent Pack. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-87.6 Running the Self Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-107.7 Replacing the Peristaltic Pump Tube Assembly . . . . . . . . . . . . . . . . . . . . . . . . . . 7-11

Section 8: Special Functions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1

8.1 Viewing the Software Version . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-28.2 Viewing Status Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-28.3 Updating the Software. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-38.4 Customizing the User-Defined Species Profile. . . . . . . . . . . . . . . . . . . . . . . . . . . 8-38.5 Customizing and Printing the Normal Range . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-4

Section 9: Troubleshooting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1

9.1 Warning Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-29.2 Error Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-49.3 Evaluating Unexpected Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-59.4 Preparing the Analyzer for Shipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-10

Section 10: Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1

10.1 VetScan HM2 Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-210.2 Linearity Ranges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3

Section A: Introduction to Veterinary Hematology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1

A.1 Function of Blood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2A.2 Composition of Blood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3A.3 Blood Cell Parameters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-4A.4 Normal Hematology Ranges (Dog, Cat, Horse, and Others) . . . . . . . . . . . . . . . . A-7A.5 Veterinary Hematology References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-8

Section B: Operating Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1

B.1 Complete Blood Count (CBC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-2B.2 Measurement Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-2B.3 Hemoglobin Determination. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-5B.4 Measured and Calculated Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-6B.5 Measured and Calculated Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-7

TOC-2 Table of Contents

Section C: Potential Sample Interferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1

Section D: Veterinary Case Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-1

D.1 Human Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-2D.2 Dogs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-3D.3 Cats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-10D.4 Horses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-15

Section E: Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-1

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I-1

VetScan HM2 Updates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . following Index

Table of Contents TOC-3

TOC-4 Table of Contents

Section 1
General InformationThis section provides general information about the Abaxis VetScan®
HM2 Hematology System.

Section Contents

1.1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2

1.2 Customer and Technical Support . . . . . . . . . . . . . . . . . . . . . . . . 1-2

1.3 Symbols Used in Labeling and Hazard Identification. . . . . . . . 1-3

General Information 1-1

1.1 Introduction

The VetScan® HM2 Hematology System is an impedance-based hematology system designed spe-

cifically for veterinary in vitro diagnostic use.

The VetScan HM2 provides a fully automated complete blood count (CBC) analysis of white blood

cells, red blood cells, and platelets in whole blood in a veterinary setting. The system offers an

18-parameter CBC analysis, including a three-part WBC differential, and three cellular histograms.

The VetScan HM2 is calibrated to analyze multiple veterinary species. Check the list of species on

the HM2 itself (see page 4-8), or contact Abaxis Technical Support for the full list of available spe-

cies. Additional species may be added to the analyzer software from time to time by means of a

simple CD-ROM upgrade, provided to HM2 customers at no charge.

The HM2 system features the following components:

■ the hematology analyzer itself, including a keypad, display, and internal printer

■ an external keyboard that can be connected to the analyzer if needed

■ a reagent pack, including a diluent, lyse agent, cleaner, and rinse solution, each in its

own container. The diluent container can also be used as a waste container for the

next reagent pack.

For added convenience, the HM2 can be connected to a VetScan or VetScan2 Chemistry Analyzer

so that results from both instruments can be consolidated and printed on a single, standard-size

page. In addition, the two analyzers can be connected in tandem to a computer for use with veteri-

nary data management systems. The HM2 alone will also interface directly with an external com-

puter.

1.2 Customer and Technical Support

Abaxis Technical Support personnel can answer your questions regarding the VetScan HM2

Hematology Analyzer, or the combined VetScan HM2/VS2 system.

■ Telephone: 800-822-2947

Beginning January 1, 2007, Abaxis Technical Support will be available seven days a

week from 5:00 a.m. to 5:00 p.m. (PST), except on major U.S. holidays.

Prior to January 1, 2007, Abaxis Technical Support is available 5:00 a.m. to

5:00 p.m. (PST) Monday through Friday, and 7:00 a.m. to 1:00 p.m. Saturday.

■ Email: [email protected]

■ Web: www.abaxis.com

■ Fax: 877-900-9333

1-2 General Information

1.3 Symbols Used in Labeling and Hazard Identification

The VetScan HM2 uses safety features to protect the operator from injury, prevent damage to the

HM2, and to alert the operator of problems with results. Symbols used in labeling and through this

manual are shown below.

Note: Abaxis contact information is also available in the HM2’s software.

To view the information, press the Utilities key on the instru-

ment’s front panel, then press 6 to select Service.

Computer connection. Use only a recommended computer interface cable.

Fragile. Use caution when handling. Do not drop.

Keyboard connection. Use the keyboard provided.

Up. Always store with the arrow facing up.

Printer connection. Use only printers recommended and validated by Abaxis. Use only the recommended printer cable.

Warning: Alerts the operator of hazardous conditions that can cause injury or damage the analyzer. Read all warning statements carefully, and proceed with caution.

Sunlight. Keep out of direct sunlight.

Caution: Procedures that must be followed to avoid damaging the analyzer. Read all caution statements carefully. The Product Warranty can be voided if caution statements are not followed.

Storage temperature. Store only at temperatures within the indicated range.

Note: Important, helpful information

General Information 1-3

1-4 General Information

Section 2
System Overview and InstallationThis section includes an overview of the VetScan HM2: its features, func-
tionality, main components, reagent pack, and available accessories. The

section also provides complete installation instructions.

Section Contents

2.1 VetScan HM2 System Overview . . . . . . . . . . . . . . . . . . . . . . . . 2-2

2.1.1 Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2

2.1.2 Main Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3

2.1.3 Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-5

2.1.4 Reagents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8

2.1.5 Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-9

2.1.6 Subsystems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11

2.1.7 Menu/Command Listing . . . . . . . . . . . . . . . . . . . . . . . . 2-12

2.2 Unpacking the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16

2.3 Selecting a Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18

2.3.1 Space Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18

2.3.2 Environmental Requirements . . . . . . . . . . . . . . . . . . . . 2-19

2.3.3 Electrical Requirements . . . . . . . . . . . . . . . . . . . . . . . . . 2-19

2.4 Installing the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-20

2.4.1 Connecting an External Keyboard (Optional) . . . . . . . 2-20

2.4.2 Connecting the Power Supply . . . . . . . . . . . . . . . . . . . . 2-20

2.4.3 Installing Paper into the Built-In Printer . . . . . . . . . . . 2-20

2.4.4 Connecting an External Printer (Optional) . . . . . . . . . 2-21

2.4.5 Connecting a VetScan Chemistry Analyzer (Optional) 2-22

2.4.6 Connecting the HM2 to a Computer . . . . . . . . . . . . . . . 2-23

2.4.7 Connecting the Reagent Pack . . . . . . . . . . . . . . . . . . . . 2-25

2.5 Turning the Analyzer On and Off . . . . . . . . . . . . . . . . . . . . . 2-28

2.5.1 Turning the Analyzer On . . . . . . . . . . . . . . . . . . . . . . . . 2-28

2.5.2 Turning the Analyzer Off . . . . . . . . . . . . . . . . . . . . . . . . 2-28

2.6 Initializing the VetScan HM2 . . . . . . . . . . . . . . . . . . . . . . . . . 2-31

2.7 Standby Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-32

System Overview and Installation 2-1

2.1 VetScan HM2 System Overview

The following pages provide an overview of the VetScan HM2.

2.1.1 Features

■ Small sample size requirement: consumes approximately 25 µl of EDTA-preserved

whole blood per CBC measurement.

■ Rapid test turnaround: only 2–3 minutes to results.

■ Advanced, integrated self-cleaning system for optimized performance with very mini-

mal maintenance — expanded automatic aperture cleaning after every run.

■ Simple, intuitive, and easy-to-use software interface makes the analyzer very user-

friendly, and requires only a short learning curve.

■ Accurate results for out-of-range values: automatic calculations are provided for external

1:5 dilutions in cases of extremely high values or very small sample volumes.

■ Simple, flexible database with large storage capacity:

❑ Automatically saves up to 1,000 test records.

❑ Data can be downloaded to a USB flash drive or a compatible data-management sys-

tem.

❑ Quality control (QC) results (including Levy-Jennings charts) are stored in the

instrument’s QC database for viewing and management.

■ User reminders for replacing the reagent pack and performing simple maintenance tasks.

■ Integrated laboratory results: the HM2 can be connected to a VetScan Chemistry Ana-

lyzer for integrated results reporting.

■ Advanced user features: Multi user mode, customizable normal range, and adjustable

lysing strength.

2-2 System Overview and Installation

2.1.2 Main Components

The following pages show the main functional components of the VetScan HM2 analyzer.

Front View

1 Control panel with high-contrast liquid crystal display (LCD) — see page 2-5

2 CD-ROM drive

3 USB Type A port 4 Built-in thermal paper printer — see page 2-4

5 Interchangeable sample tube adapter 6 Sampling rotor

2

3

5

4

6

1


Back View

Built-in Thermal Paper Printer

The analyzer includes an internal printer that outputs test

results on thermal paper.

1 Reagent tubing connections 2 Power On/Off switch

3 12 VDC external power supply input 4 USB Type A port

5 USB Type A port 6 Serial (RS-232) port

7 USB Type B port 8 PS/2 keyboard port

2

1

3

4

5

6

7

8


2.1.3 Control Panel

The analyzer’s control panel features an LCD display, a keypad, six “hard-function” keys, six

“soft-function” keys, a Start button, and a status LED indicator.

■ Start button

Press and release to begin an analysis cycle.

■ Status indicator

This LED (above the Start button) indicates the instrument’s status, as follows.

Table 2-1: Status LED Color Indications

LED color HM2 status

Green The instrument is in ready state (analysis can begin).

Red The instrument is performing an analysis. No new analysis can be started.

Orange The instrument is performing a maintenance process, or is in power-saving standby mode (see “Standby Mode” on page 2-32).

LCD display

Start button

Status LED

Soft-functionkeys

Hard-function keys

Keypad

Start button

Status LED


■ Keypad — The analyzer’s control keypad includes the following:

❑ Alpha-numeric keys for entering data and selecting menu items.

❑ Decimal point ( . ) key.

❑ del key for deleting characters.

❑ Cursor control keys: and for moving between items displayed on the screen,

and and for moving between items on the screen or menu levels.

❑ OK key for confirming data, and for moving through items on the screen.

■ Hard-function keys — single-function

keys on the instrument’s front panel

above the LCD display, each of which

opens a menu of commands for that function.

Table 2-2: Hard-Function Keys

Press this key.... To use this function....

Information/Help

Measurement/Analysis — press to begin analysis.

Database — press to view stored results.

Utilities — press to perform quality control, calibration, mainte-nance, or setting functions, or to check reagent status.

Print

Exit — press to shut down the instrument.

Note: See “Menu/Command Listing” on page 2-12 for a list of the menus

and commands that are available through the hard-function keys.


■ Soft-function keys — a row of unlabeled

keys just below the LCD display:

The functions of these keys depend on

the current menu, and are displayed on

the screen immediately above the

keys, as shown in this example.

To use a displayed function, press the soft-function key below it. The following table

lists the various soft-function keys that appear on the instrument.

Table 2-3: Soft-Function Keys

Accepts the results or changes made.

Leaves the current menu without saving changes.

Exits the current menu or action.

Displays histograms of the selected result.

Displays table of values for the selected result.

Opens the local menu for the functions displayed.

Enters or modifies patient data.

Repeats the previous action.

Move through results displayed on multiple pages.

Move through screens with multiple pages.

Change the scaling of Levey-Jennings chart (16 or 64 days).

When completing a bleach-cleaning, select NEW to use a new reagent pack, OLD to continue using the current reagent pack, or to STOP to shut down the instrument.

Resets the status of the reagent pack.

Displays reference ranges for selected species.

Checks the printer status if an error occurs.

Attempts to print again after a printer error has been corrected.

Resets the printer if an error occurs.

Stops the current process.

ACCEPT

CANCEL

EXIT

GRAPH

TABLE

MENU

PT.ID

REPEAT

PREVIOUS NEXT

PGUP PGDN

---16--- ---64---

NEW OLD STOP

CHANGE

LIMITS

CHKSTA

CONTINUE

RESET

ABORT


2.1.4 Reagents

VetScan HM2 Reagent Pack

The HM2 reagent pack (PN 750-9000) consists of bottles containing diluent, cleaner, lyse, and

rinse solutions.

The following table lists the reagents volumes and bottle sizes in the reagent pack.

Table 2-4: Reagents and Containers

Cat, Dog, and Human Controls

Before you can perform analyses, the instrument must first be calibrated using the Human Calibra-

tor1, and quality control procedures must then be performed using Cat and Dog Control materials.

These control materials are not included with the analyzer, but can be ordered from your distributor

or directly from Abaxis. If you order from Abaxis, please use these part numbers:

■ 700-9003, Dog Control, 2 cc vial (1)

■ 700-9004, Cat Control, 2 cc vial (1)

■ 700-9005, Human Calibrator, 2 cc vial (1)

Note: To ensure accurate test results, use only the reagents supplied by

Abaxis.

Reagents Descriptions Color Code Volume Bottle Size

Diluent Isotonic saline solution used to dilute whole blood specimens, and to rinse the ana-lyzer’s fluidic system between analyses.

Green 6200 ml 8 liters

Rinse Used with diluent to prevent salt built-up on aperture.

White 500 ml 500 ml

Cleaner Used in the fluidic system cleaning pro-cess.

Blue 250 ml 250 ml

Lyse Used to create hemolysate for three-part WBC differential, and for total WBC and HGB.

Yellow 270 ml 500 ml

1. The Human Calibrator is derived from human sources. Observe universal safety precautions when handling the Calibrator. See “Calibration and Quality Control” on page 5-1.


2.1.5 Accessories

This section describes the accessories that are included with the analyzer. To order replacements,

contact your distributor or Abaxis.

External Mini-Keyboard

You can connect the external mini-keyboard to the instrument through its PS/2 keyboard port or

one of its USB ports (see “Back View” on page 2-4). The mini-keyboard provides a convenient

way to enter patient and clinic information.

The mini-keyboard’s function keys F1 through F6 function as equivalent to the analyzer’s soft-

function keys (from left to right: see page 2-7), and keys F7 through F12 function as equivalent to

the analyzer’s hard-function keys (see page 2-6):

■ F7 — Information/Help key

■ F8 — Measurement/Analysis key

■ F9 — Database key

■ F10 — Utilities key

■ F11 — Print key

■ F12 — Exit key

Power Supply and Power Cord

The analyzer uses an external 12 VDC power supply that

can operate from a 230 or 110 V main outlet. The power

supply’s input socket is a standard power cable connec-

tion, and its output is a special locking socket.

CAUTION: Abaxis recommends using the analyzer with a surge protector

designed for a computer.

In addition, an uninterruptable power supply (UPS) is strongly rec-

ommended if the HM2 will be used in an area prone to electrical

surges or power outages.

An appropriate power supply is vital for the integrity of the sys-

tem.


Reagent Tubing Kit

The reagent tubing kit (Abaxis Part No. 750-9002)

includes the color-coded reagent tubes used to connect

the HM2 with the containers in the reagent pack.

The kit also include the reagent bottle caps with connec-

tors and drop-down tubes, as shown.

Cleaning Tube Kit

The cleaning tube kit is needed for bleach-cleaning the instrument,

as described in “Bleach-Cleaning” on page 7-5.

Sample Tube Adapters

The instrument includes the following sample tube adapters, for use as shown in “Analyzing a

Sample” on page 4-7.

Table 2-5: Sample Tube Adapters

Peristaltic Pump Tube Assembly

As part of routine yearly preventive maintenance, the HM2’s peristaltic pump tube must be

inspected, and replaced if needed (see “Periodic Maintenance” on page 7-2). The HM2 is shipped

with one replacement peristaltic pump tube.

Tube Adapter Part Number Sample Tube Size

3–5 ml Tube Adapter 750-9008 3–5 ml

Microtainer Tube Adapter 750-9009 1–2 ml

Vacutainer Adapter 750-9014 400 µl

Control Vial Adapter 750-9010 2 ml control vial


Thermal Paper Roll

Two thermal paper rolls are included for the instrument’s internal printer, to provide quick, conve-

nient printed results.

2.1.6 Subsystems

The VetScan HM2 has two primary subsystems.

■ Fluidic system: Performs sampling, diluting, mixing, lysing, and rinsing functions.

Generates the regulated vacuum used for moving cells through the aperture during the

counting process.

■ Data processing system: Counts, measures, and calculates blood parameters, generates

and stores numerical results and histograms.

Note: Thermal paper printouts only last about a year. If you need to keep

a record for longer than a year, make a photocopy of the printout.

Diluent

Lyse

Cleaner

Waste Rinse reagent

Diluent solution Waste container

Lyse

so

lutio

n

Cle

aner

so

lutio

n

Rin

se

reag

ent


2.1.7 Menu/Command Listing

The following charts outline the instrument’s menu functions and commands.

Information / Help Displays help for the current screen.

MENU

Analysis / Measurement

1 – Repeat last sample Repeats last sample tested (HM2

2 – Measure blank Performs blank measurement.

assigns new sample ID, all other

3 – Prediluted mode Enters automatic calculation for 1:5 externally diluted sample (“1:5” appears in upper RH screen corner).

4 – WBC only Analyzes WBC only with next test.

PT.ID

Sample ID HM2 assigns automatically (cannot

Opens dialog for entering patient information.

Doctor

Species

Patient ID

Name

Age

Sex

LIMITS Displays reference ranges for selected species (can be modified).

patient information is unchanged).

be modified).

5 – Needle Height Setting Adjusts sampling depth.

6 – Lyse Volume Adjusts lyse reagent volumeby +/– 0.2 mL.


Database

MENU 1 – Go to specified record Selects one record by time/date,

2 – Selection

3 – Change sort order

4 – Manage selected records

5 – View external Reads stored records from USB drive

6 – Backup one day Backs up all results from a specifieddate to a USB drive (insert a USB

1 – Select by date, Selects one or more records by

2 – Select all Selects all records.

time and ID range of times/dates, sample IDs,

3 – Deselect all Deselects all records.

1 – Unsorted Lists records in the order entered

2 – Sort by time Lists records by measurement time

3 – Sort by sample ID Lists records by sample ID (highest

4 – Sort by patient ID Lists records by patient ID (highest

1 – Send selected Sends selected records to a connected

2 – Delete selected Deletes selected records from the

3 – Backup selected Saves selected records to a USB drive.

sample ID, and/or patient ID

and/or patient IDs.

to lowest).

to lowest).

(oldest to most recent).

(most recent to oldest).

computer.

instrument’s database.

(more criteria narrows search).

GRAPH

Toggle between graph and table display of selected results. TABLE

PT.ID Opens dialog for viewing/modifying patient information (sample IDand patient type cannot be changed).

Sample IDDoctorSpeciesPatient ID

records

records

records

(insert a USB drive containing savedHM2 data into one of the instrument’s

drive with sufficient space into one ofthe instrument’s USB ports).

AgeSex

Name

USB ports).


Utilities

1 – Maintenance

2 – Calibration

1 – Cleaning

2 – Priming Primes reagent lines (use after

1 – Prime diluent Primes diluent line (green connector).

2 – Prime lyse Primes lyse line (yellow connector).

3 – Prime rinse Primes rinse line (blue connector).

4 – Prime cleaner Primes cleaner line (white connector).

5 – Prime all Primes all reagent lines.

3 – Drain chamber Drains aperture chamber (use before

4 – Reagent status Displays reagent installation date,

5 – Bleaching Bleaches internal lines (perform witheach change of reagent pack).

1 – Run Calibrator Performs calibration.

2 – View Calibration History Displays previous calibrations.

replacing reagent).

moving the instrument).

usage, and remaining life.

3 – Quality control

1 – Set QC reference ranges Updates QC ranges for current QC

1 – Whole blood Calibrates using Abaxis calibrator

2 – Prediluted blood (1:5) Calibrates using externally diluted

lot number.

2 – Run QC Runs QC analysis.

3 – View table of QC measures Displays previous QC measures.

4 – View QC diagram Displays previous QC measures as

5 – Select QC typeLevey-Jennings curve.

1 – Dog

2 – Cat

3 – Human(continued)

material.

Abaxis calibrator material to ensure proper calibration of predilutedsamples.

6 – Software upgrade Prompts for software upgrade diskand restarts system.

1 – Auto self-cleaning Runs cleaning cycle to remove build-

2 – Clean the wash head Moves wash head to cleaning position,

up from instrument’s aperture.

provides cleaning instructions.


Utilities (continued)

5 – Settings

1 – Printer settings Dialog for viewing/modifying

3 – Date and time Dialog for setting date/time & format.

printer settings.

1 – Single user mode

2 – Multi user mode Each user has unique user name and

Dialog for setting unit preferences.

4 – Fluid sensors Enables and disables reagent sensors.

1 – Diluent & Cleaner

2 – Lyse

Calibrates reagent sensors.

3 – Rinse

4 – Calibrate sensors

Dialog for laboratory information(used in report header).

4 – User modes

password.

6 – Service Displays contact information fortechnical service.

Printing Prints selected test results.

Exit Information/Help function.

1 – Shut down Shuts off the HM2 (use if the unit

2 – Preparing for shipment Drains and shuts off the HM2 (use

will not be used for over 72 hours).

if the unit will be unused for morethan 10 days, or if it will beshipped).

2 – Customize

1 – General Settings

2 – Units

Selects Single or Multi user mode.

3 – Laboratory

Dialog for setting screensaver delay,VetScan date format, and printingcombined VetScan/HM2 results.

4 – Diagnostics

1 – Device information Shows model, S/N, software version.

2 – Statistics Displays operation statistics.

3 – Self test Tests the analyzer’s internal systems.


2.2 Unpacking the System

Follow these directions for unpacking the HM2 analyzer from its shipping container.

Refer to the diagram at right.

1. Open the shipping carton box, and remove the

Thank-You Letter (A) and Unpacking Instruc-

tions (B). Follow the instructions on the Unpack-

ing Instructions (B).

2. Slide the accessory box (D) — located at the

back of the packaging box — up and out of the

shipping carton.

3. Pull the Foam Cap (C) off of the analyzer.

4. Place both hands in the box on opposite sides of

the analyzer, and carefully lift it out of the carton

as shown.

5. Place the instrument temporarily on a clean, level

surface that is free of animal hair, dust, and other

contaminants.

Note: Save the shipping box, accessory box, and packaging materials in

case you need to use them later.

CAUTION: Place the analyzer in upright position only. Do not place the unit

on its back, side, or top, or you could cause severe damage.


6. Use the latch to open the side door on the unit, as

shown.

7. Inspect the unit for any visible signs of damage.

8. Remove the foam above the needle XYZ

moving assembly, and remove the tape

from the top of the counting chamber, as

shown.

9. Open the accessory box, and use this list to make sure you received all components of

the HM2 system:

❑ VetScan HM2 Analyzer

❑ HM2 Operator's Manual (this document)

❑ HM2 Quick Reference Guide

❑ HM2 analyzer external power supply and power cord

❑ HM2 mini-keyboard

❑ Four sample tube adapters

❑ HM2 reagent tubing kit (with color-coded connectors)

❑ Caps for reagent containers (with color-coded connectors)

❑ HM2 cleaning tube kit

❑ Thermal paper rolls (two)

❑ Warranty card (inside the HM2 Operator's Manual)

❑ Spare peristaltic pump tube assembly (store in a convenient location)


2.3 Selecting a Location

The analyzer must be installed in a suitable location. A poor location can adversely affect its

performance. To ensure the accuracy and precision of the instrument, and to maintain a high level

of operational safety for lab personnel, the environmental and electrical requirements in this sec-

tion must be met. Be sure to thoroughly consider all the following requirements in selecting a per-

manent location for the analyzer.

2.3.1 Space Requirements

■ The location should be flat, level, sturdy, vibration-free, and as dust-free as possible.

■ Leave at least 20 inches (about 0.5 m) of clearance on all sides of the instrument to allow

for adequate airflow and access to connectors.

■ Maintain a minimum of 8 inches (0.2 m) behind the analyzer’s rear panel to allow for

heat dissipation and tube clearance.

■ Leave enough space for the reagent pack (see “Connecting the Reagent Pack” on

page 2-25 for details).

Note: The HM2 requires a reagent pack to operate. A reagent pack

(Abaxis Part No. 750-9000) must be ordered for installation.

Note: To start the warranty on the HM2, make sure to complete the war-

ranty card and mail it to Abaxis, Inc. within 10 days of system

installation. Customers who submit the warranty card are automat-

ically placed on the Abaxis customer list, and are entitled free of

charge to all the benefits that Abaxis offers, such as software

upgrades, on-line training, education materials, and promotions.

WARNING: MAKE SURE THE ANALYZER AND ALL ACCESSORIES ARE PROPERLY

GROUNDED. IMPROPER GROUNDING CAN CAUSE INJURY, AND WILL

VOID THE WARRANTY.


2.3.2 Environmental Requirements

■ Make sure the location is well ventilated.

■ Make sure the location is away from devices that can emit radio frequencies, such as a

radio or TV, radar, centrifuge, X-ray device, or fan. Such devices can interfere with the

HM2’s operation.

■ Operating the HM2 at an altitude above 10,000 ft (3000 m) is not recommended.

2.3.3 Electrical Requirements

■ The HM2 is powered by a standard wall outlet, and requires a power supply of

100–240 VAC, 47–63 Hz, 2 A (this is provided with the analyzer).

■ To avoid power surges or drain, DO NOT plug the analyzer’s power supply (provided)

into a circuit that includes a centrifuge or other high-current device.

CAUTION: Make sure the location stays at an ambient temperature of 59–86 °F

(15–30 °C), and a relative humidity of 65% ± 20%. The optimal

operating temperature is 77 °F (25 °C).

CAUTION: Make sure the area is not exposed to open windows, heat sources,

air conditioners, temperature extremes, or direct sunlight.

CAUTION: Abaxis recommends using the analyzer with a surge protector

designed for a computer.

In addition, an uninterruptable power supply (UPS) is strongly rec-

ommended if the analyzer will be used in an area prone to electri-

cal surges or power outages.

An appropriate power supply is vital for the integrity of the sys-

tem.


2.4 Installing the System

Once you’ve selected a location, install the analyzer system as follows.

2.4.1 Connecting an External Keyboard (Optional)

■ You can use an external keyboard with either a PS/2 connector or a USB connector. Con-

nect either cable to the correct port on the rear of the analyzer.

2.4.2 Connecting the Power Supply

1. Plug the power cord from the power supply into the connector on the analyzer’s rear

panel.

2. Plug the other end of the cord into a properly grounded AC outlet (110–230 VAC).

2.4.3 Installing Paper into the Built-In Printer

If you plan to print results using the analyzer’s built-in printer, install the thermal paper roll as fol-

lows.

1. Remove any tape from the roll of thermal paper, and cut the end of the roll to a point.

CAUTION: Make sure all settings are in the off position before proceeding or

before connecting the analyzer to the power supply or to any ancil-

lary devices (such as an external printer, external keyboard, or

computer).

WARNING: USE ONLY THE POWER SUPPLY PROVIDED WITH THE HM2. USING

ANY OTHER POWER SUPPLY CAN DAMAGE THE INSTRUMENT, AND

WILL VOID THE WARRANTY.

Note: Store thermal paper away from direct light and humidity.


2. Open the paper compartment by pressing

the button on top of the analyzer.

3. Insert the paper roll into the compart-

ment so that the paper unrolls beneath

the roll and toward the front of the

instrument.

4. Make sure the free end of the roll

extends out of the front of the compart-

ment.

5. Press the compartment door closed.

2.4.4 Connecting an External Printer (Optional)

1. Set up the external printer according to the instructions included with it.

2. Attach the USB printer cable to a USB port on the rear of the analyzer, and to the printer.

3. Plug the printer’s power cord into a grounded outlet.

4. Make sure the analyzer is configured for use with the printer — see “Configuring Printer

Settings” on page 3-2.

5. Turn the printer on before turning on the analyzer.

Note: When the roll is running out, a red mark appears on the paper.

Note: Any diskettes or CDs included with the printer are not required for

use with the analyzer, but should be saved in case they are needed

another time.

press to open compartment

paper must unroll in this direction


2.4.5 Connecting a VetScan Chemistry Analyzer (Optional)

Connecting the VetScan HM2 with the VetScan Classic Chemistry Analyzer

1. Make sure the HM2 and the VetScan Classic are both turned off.

2. Connect an RS-232

null modem cable

(Abaxis Part No.

752-0006) to the serial

port on the back of the

HM2, and to the

serial (1) port on the

back of the VetScan

Classic.

3. Turn on the HM2 and

the VetScan Classic.

HM2 VetScan Classic

serial portRS-232cable

serial port


Connecting the VetScan HM2 with the VetScan VS2 Analyzer

1. Make sure the HM2 and the VS2 are both turned off.

2. Connect a USB Type A-B

cable (Abaxis Part No.

1980-0026) to a USB Type A

port on the back of HM2, and

to a USB Type B port on the

back of the VS2.

3. Turn on the HM2 and the VS2.

2.4.6 Connecting the HM2 to a Computer

Using a Serial Cable

Connect the analyzer to a serial port on the computer using an RS-232 null modem cable, or a

serial cable and a null modem adapter.

Note: To print VetScan Chemistry Analyzer results on the HM2, the HM2

must be configured to receive data from the VetScan analyzer. For

instructions, see “Combining Chemistry and Hematology Results”

on page 4-16.

The HM2 can be connected to a computer using either a serial cable or USB Type

A-B cable. This enables you to send information from the analyzer for use by a

practice management application or other applications on the computer.

HM2 VetScan VS2

USB ports(Type A on HM2, Type B on VS2)

USBcable


Using a USB Type A-B Cable

The analyzer can be connected to a computer using the USB Type B port on the back of the ana-

lyzer. A software driver must also be installed on the computer to enable communication with the

analyzer.

The following are required to enable the analyzer to communicate with a computer:

■ PC computer with Windows XP and a USB port

■ USB Type A-B cable (Abaxis Part No. 1980-0026)

■ Abaxis VetScan HM2 software CD, version 2.74 or higher (includes the USB driver)

Step 1 — Installing the HM2 USB Driver

1. Insert the VetScan HM2 software CD (version 2.74 or higher) into the computer’s CD

drive. The installation program then starts automatically.

2. Click Next on the first dialog box that appears on screen, then click Finish on the sec-

ond dialog. Driver installation is then complete.

Step 2 — Connecting the USB Type A-B Cable

■ Connect a USB Type A-B cable to the USB Type B port on the back of the analyzer, and

to a USB Type A port on the computer.

Step 3 — Configuring the USB Driver

The analyzer appears on the computer as a virtual communications port. You will need to use the

computer’s Device Manager to redefine that port’s properties.

1. Click Start > Control Panel.

2. Double-click System.

3. Click the Hardware tab, then click Device Manager.

4. Click the “+” mark next to Ports (COM and LPT).

5. Right-click USB Serial Port (COMx), then select Properties.

Note: Do not connect the USB cable until directed to do so.

Note: For current information on the availability of the USB driver for

other operating systems, contact Abaxis Technical Support — see

“Customer and Technical Support” on page 1-2.


6. Click the Port Settings tab, then click Advanced.

7. Select the appropriate COM port from the drop-down list. You may want to make sure

this port matches the COM port used by or selected in your practice management appli-

cation or other software.

8. Click OK.

9. If a warning states that this modification may interfere with current port settings, consult

Abaxis Technical Support or your system administrator before proceeding. If no devices

are connected to the relevant port on the computer, you can confirm this message. Other-

wise, make sure this won't interfere with your computer settings.

Step 4 — Configuring the Analyzer to Communicate with a PC

You can now configure the analyzer to communicate with an interfaced practice management soft-

ware application that runs on the computer. Make sure the selected port for the application matches

the port selected in the above procedure. For detailed configuration information, see “General Set-

tings” on page 3-9.

2.4.7 Connecting the Reagent Pack

When installing the analyzer in its permanent location, place the reagent pack according to these

guidelines.

■ Place the reagent pack near the analyzer, either beside or behind the instrument.

■ For best results, place the reagent pack at the same level as the analyzer. If you have to

place the reagent pack on a lower level, make sure that it is no more than 30 inches

(0.75 m) below the level of the analyzer’s reagent inlets, as measured from the bottom of

the reagent pack to the bottom of the analyzer.

Note: During transportation, microbubbles can form in the reagent solu-

tions. These bubbles will affect test results. Before connecting a

reagent pack to the analyzer, allow the pack to stand undisturbed

for 24 to 36 hours to eliminate any bubbles.

CAUTION: If the analyzer has been kept at a temperature below 50 ºF (10 ºC),

allow it to sit for an hour at the correct operating temperature

(59–86 °F, 15–30 °C) before using it.


Connect the reagent pack as follows.

1. Open the plastic bag located in the accessory box, and take out the five color-coded

reagent tubes and caps with drop-down tubes.

2. Locate the color-coded reagent intake valves on the back

of the instrument, as shown.

❑ Green = Diluent

❑ Yellow = Lyse

❑ Blue: = Cleaner

❑ Red = Waste

❑ White = Rinse

3. Remove the protective caps from the intake valves. Save the caps for later use.

4. Insert the capped ends of the reagent tubes into the corresponding color-coded reagent

intake valves. Finger-tighten the colored caps securely.

CAUTION: Do not overtighten the caps, or you could damage the threads on the connectors.

This will cause the reagents to leak and damage the instrument.

WARNING: DO NOT PLACE THE REAGENT PACK ABOVE THE ANALYZER (SUCH

AS ON A SHELF).

DO NOT DROP THE REAGENT PACK — THIS CAN CAUSE MICROBUB-

BLES TO FORM.

CAUTION: When working with the reagent tubing, make sure the tubing does

not become pinched or kinked and is not trapped between or

beneath objects. The reagents must be able to flow through the

tubes freely and without obstruction, or the instrument will not

operate properly.

Note: The protective valve caps will be needed whenever the analyzer is

moved, to prevent reagents from leaking.


5. Open the reagent pack box. Open each reagent container (lyse, rinse, cleaner, and dilu-

ent) by unscrewing the container caps.

6. Re-cap each container using the bottle cap with the appropriate color-coded connector

and drop-down tube.

7. Using the color codes as guides, attach the free end of each reagent tube to the bottle cap

connector on the appropriate container. Press each tube onto its connector as far as it will

go.

Note: Be sure to save the original reagent caps so you can re-cap the con-

tainers when the reagent pack is used up.

Note: The analyzer is shipped with a flexible waste container, to be used

with the first reagent pack. The diluent bottle included with each

reagent pack is designed to be used as the waste container for the

subsequent reagent pack.

CAUTION: Make sure the small air vent on each container cap is not blocked,

and that free airflow is maintained at all times.

Do not touch the drop-down tubes with your hands, or you could

contaminate the reagents. If you must handle the drop-down tubes,

be sure to wear gloves.

CAUTION: Make sure each tube runs from the reagent intake valve to its corre-

sponding reagent bottle. Use the color codes as guides. If the tubes

are not connected correctly, the instrument will not produce accu-

rate results.

If you let the reagent tubes pass through the openings on the

reagent pack, make sure the top of the reagent pack does not kink

or pinch the tubing.


2.5 Turning the Analyzer On and Off

2.5.1 Turning the Analyzer On

1. If you have an external printer or a computer connected to the analyzer, turn on the

power to the printer/computer before starting the analyzer.

2. Turn on the analyzer on using the power switch on

the upper left of its rear panel. The on position is

marked by the I symbol.

The analyzer then displays several screens while it

runs its software start-up procedure.

2.5.2 Turning the Analyzer Off

CAUTION: If the analyzer has been kept at a temperature below 50 ºF (10 ºC),

allow it to sit for an hour at the correct operating temperature

(59–86 °F, 15–30 °C) before using it.

Note: To initialize the analyzer, see “Initializing the VetScan HM2” on

page 2-31.

CAUTION: Never switch the analyzer by simply pressing the power switch on

the rear panel, unless an emergency exists, or if you will turn the

instrument on again in only a few minutes.

CAUTION: When the analyzer is shut down properly as described below, it

rinses its fluidic system. Since the analyzer uses isotonic saline

solution, the salt from the solution may not be rinsed out properly if

you simply turn off the power. This could lead to salt build-up in the

system. Therefore, always follow the instructions in this section

when turning off the analyzer.

CAUTION: If an emergency occurs, turn off the analyzer using the power

switch on the back of the instrument, and unplug the power cord

from its outlet.


If the Analyzer Will Not Be Used for 72 Hours or More

Shut down the instrument as follows.

1. Press the Exit key on the front panel.

2. Select Shut down, then press the soft-

function key when asked to confirm.

The analyzer displays a message and sounds a

tone when it’s safe to shut it off.

3. Turn off the analyzer using the power switch on

the rear panel. The off position is marked by the

O symbol.

If the Analyzer Will Not Be Used for 10 Days Or More, or Will Be Shipped

Shut down and prepare the instrument as follows. You will need the cleaning tube kit (shown on

page 2-10) and 100 ml of distilled water for this procedure.

1. Press the Exit key on the front panel.

2. Select Preparing for shipment, then press the

soft-function key when asked to con-

firm.

The display then shows “Pneumatic system is

initializing. Please wait.”

3. Follow the instructions that appear on the dis-

play. When prompted, remove the four reagent

tubing connectors (green, yellow, blue, and

white) from the reagent tubing intake valves,

but leave the waste tubing connected.

Note: If you perform fewer than ten CBC samples a week, Abaxis strongly

recommends that you shut down the analyzer once a week. This

will prevent salt from building up in the system, and increase the

instrument’s efficiency.

YES

YES


4. When prompted, connect the cleaning tube kit to the reagent

connectors, as shown.

5. Submerge the free end in a bottle containing at least 100ml of

distilled water.

6. Press . The analyzer then flushes any remaining reagents

into the waste container.

7. When prompted, remove the cleaning tube kit.

Press .

8. When the analyzer displays “Now it is safe to turn off the instrument,” turn off the ana-

lyzer using the power switch on its rear panel.

9. Disconnect the waste tubing. The analyzer is now ready for shipment or extended non-

use.

10. If you need to prepare the analyzer for shipment, continue with the instructions in “Pre-

paring the Analyzer for Shipment” on page 9-10.

ACCEPT

ACCEPT


2.6 Initializing the VetScan HM2

Use this procedure to initialize the HM2 after installation, or after it has been turned back on after

an extended shut-down.

1. Press the Measurement/Analysis key. The

analyzer then initializes its pneumatic system

and runs a blank measurement. When the pro-

cess is complete, the instrument displays the

result of the blank measurement.

2. When the blank measurement is OK, press

to accept the results.

The analyzer then displays a sample measure-

ment screen, as shown, and is now ready to per-

form an analysis.

3. Verify the HM2’s system settings, and make any needed changes — see “Configuring

the VetScan HM2” on page 3-1.

4. If you are installing a new system, or have moved the analyzer or its reagent pack to new

locations, recalibrate the fluid sensors to maximize the number of tests performed per

reagent pack on your system — see “Fluid Sensor Settings” on page 3-16.

5. Allow the analyzer and its reagents to fully reach room temperature (usually about five

minutes) before beginning an analysis. This will avoid damage from condensation

caused by rapid temperature changes, as well as interference and background “noise”

caused by microbubbles in the reagents during installation.

Note: You will be notified if the blank does not fall within specifications

(these are listed on page 4-6). If this occurs, run one to three clean-

ing cycles (see “Cleaning the Aperture” on page 7-5), and re-run

the blank as needed until it falls in range (no flags, and “Blank

OK” is displayed on the screen). If the problem persists, call

Abaxis Technical Support — see “Customer and Technical Sup-

port” on page 1-2.

ACCEPT


2.7 Standby Mode

The analyzer automatically enters a power-saving

standby mode after a period of standing idle. When in

standby mode, the analyzer displays a “Ready” screen as

shown at right, with rotating information at the bottom of

the screen showing available user functions.

The analyzer can remain in standby for up to 72 hours.

To bring the analyzer out of standby, simply press any key.


Section 3
Configuring the VetScan HM2This section describes how to configure the VetScan HM2 for optimal
performance and to meet your particular lab requirements.

Section Contents

3.1 Printer Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2

3.1.1 Configuring Printer Settings . . . . . . . . . . . . . . . . . . . . . . 3-2

3.1.2 Printout Examples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6

3.1.3 Troubleshooting Printer Settings . . . . . . . . . . . . . . . . . . . 3-8

3.2 Operational Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9

3.2.1 General Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9

3.2.2 Unit Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11

3.2.3 Laboratory Information Settings . . . . . . . . . . . . . . . . . . 3-12

3.2.4 User Mode Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13

3.3 Date and Time Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-15

3.4 Fluid Sensor Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16

Configuring the VetScan HM2 3-1

3.1 Printer Settings

3.1.1 Configuring Printer Settings

Before using a printer, whether the analyzer’s built-in printer or an external printer, you must con-

figure the analyzer for the printer and its requirements, as follows.

1. Press the key, then select Settings.

2. Select Printer settings.

3. Use the and keys to set Printer to the

printer you’ll use (the default is Seiko LPTH245

Built in).

4. Press the soft key to accept the printer set-

tings.

The following table lists the available printer selections, along with the printer language and spe-

cific printer models corresponding to each.

Table 3-1: Compatible Printers

Printer Selection Printer Language Supported Printer Models

Seiko LPTH245 Built in Special printer lan-guage

HM2 built-in thermal printer

Epson ESC/P Raster Epson ESC/P Raster Epson Stylus series (select models onlya)

a. For more information, contact Abaxis Technical Support — see “Customer and Technical Support” on page 1-2.

Canon BJC in 9-pin mode, Canon BJC

Canon BJC Canon BJ and BJC series (select models onlya)

Canon i 70 Canon Canon i series (select models onlya)

Seiko DPU414 Special printer lan-guage

Seiko DPU414 printer

Epson 24-pin in 9-pin mode, Epson 24-pin

ESC/P2 Epson 24-pin dot matrix series (LQ-580, Epson 440, etc.)

Epson 9-pin ESC/P Epson 9-pin dot matrix series (FX-980, etc.)

HP LaserJet PCL4 HP LaserJet series and compatibles (LJ1100, etc.)

HP DeskJet PCL4 HP DeskJet series (select models onlya)

ACCEPT

3-2 Configuring the VetScan HM2

5. Configure the remaining settings as follows.

❑ Use the and keys to change the settings, and the keypad or external

keyboard to enter text or numbers.

❑ Use the and soft keys and the and keys to move

through the settings.

❑ Use and to move between page of settings.

■ When using the analyzer's built-in printer, these settings are recommended:

❑ Printout format: Narrow full (with

histograms)

❑ Table format: Normal or Narrow

❑ Printer cable: COM2

❑ Paper: RollPaper

❑ Units: inch or cm

❑ Paper size: 2.24 x 50.00

❑ Left margin: 0.00

❑ Top margin: 0.00

❑ Printing mode: Normal

❑ Physical margin: Normal

❑ One result per page: No

❑ Rollpaper: Yes

❑ Vertical spacing: 0.50

Note: Although the HM2 can be connected to any printer compatible with

any of the above printer languages, printout sizes and fonts may

vary depending on manufacturer and printer settings. Abaxis car-

ries printers that have been tested and validated specifically for use

with the HM2. For best results, Abaxis highly recommends using

only printers validated by Abaxis. For a current list and further

information, contact Abaxis Technical Support — see “Customer

and Technical Support” on page 1-2.

PGUP PGDN

PGUP PGDN


❑ Autoprint: Yes (Yes prints results automatically after each analysis; No

requires you to press the Print key .)

❑ Limits format: L Graph H

❑ Print flags: Yes

❑ Print warning flags: Yes

❑ Clogging report: No

❑ Serial number on result: Yes

■ When using an external printer, the following default settings are recommended:

❑ Printout format: Full with histograms

❑ Printer cable: USB

❑ Paper: select as appropriate for your printer (Note: Never select Rollpaper

for an HP LaserJet.)

❑ Left and top margins: 1.00

❑ Rollpaper: No (especially for HP LaserJets)

6. Configure any other settings as needed. See Table 3-2 for a complete list.

Table 3-2: Printer Settings

Setting Description

Printer Printer used with the HM2 — see Table 3-1 on page 3-2.

Printout format Overall format used for printouts. Available selections depend on the selected Printer. (See page 3-6 for examples.)

Table format Printed width of tables included in the printouts.

Printer cable Interface used for an external printer: USB.

Paper Paper type used in the selected Printer.

UnitsPaper sizeLeft marginTop margin

Default units of measure, paper size, and print margins for the selected Paper. These may be customized when using a non-standard paper.Left and top margins control the position of printed results on the page.

Printing mode Overall printout size (Mini, Small, Normal, Enhanced, or Large), width (Wide or Narrow), and print speed (Fast). The available modes depend on the selected Printer.

Physical margin Margin correction for printers that have smaller printable areas than usual. Use Normal unless the right edge of the printed text is missing or appears in the next line.


7. Press the soft key to accept the settings.

One result per page Select Yes to print each analysis on a separate page.

Rollpaper Select Yes if using the built-in printer.

Vertical spacing The vertical distance between printed results when multiple reports are printed on each page.

Autoprint Select Yes to print all results automatically after each analysis.

Limits format The format for printing reference ranges:• To print numeric values, select the displayed range (for example,

[4.51…5.64]).• None prints no range values.• Graphical prints a graph showing where the results falls within the range.• L-H Graph prints the low and high limits of the range, followed by a graph

showing where the result falls within the range.• Graph L-H prints a graph showing where the result falls within the range,

followed by the low and high limits of the range.• L Graph H prints the low limit of the range, a graph showing where the

result falls within the range, and the high limit of the range.

Print flags Select Yes to include in the printout any measured values that fell outside the reference range, as well as any errors during analysis.

Print warning flags Select Yes to include all warning flags in the printouts.

Clogging report Select Yes to include information on aperture clogging in all printouts.

Serial number on result

Select Yes to include the analyzer’s serial number in all printouts.

Table 3-2: Printer Settings (Continued)

Setting Description

ACCEPT


3.1.2 Printout Examples

Thermal Paper Printout

Patient information

Patient species

Report header

Report dateTest date & time(dates and timesassignedautomatically)

HM2 serial number

Sample ID (assignedautomatically)

Test parameters

Test result units

Test results

Reference ranges

lowerlimit

shows location of

upperlimit

test results withinreference range limits

WBC histogram

RBC histogram

PLT histogram


8 x 11.5 Letter Printout

Patient

Report date

Sample ID(assigned automatically)

Test

Test result

Reference ranges

lowerlimit

shows location of

upperlimit

test results withinreference range limits

Patientinformation

Reportheader

information

(assignedPatient

speciesautomatically)

and HM2serial number

parameters

Test results

units

WBC histogram

RBC histogram

PLT histogram


3.1.3 Troubleshooting Printer Settings

Use this table to solve problems related to printer settings.

Table 3-3: Troubleshooting Printer Settings

Problem Possible Causes / Solutions

Incorrect characters appear on the printout. Selected printer type does not match your printer. Select the correct type in Printer.

Right side of the printed report is missing or appears on the next line.

• Decrease the Left margin and Top margin.• Try using a smaller Printout format.

Printed report is too small, with excess space on the paper.

Try using a larger Printout format.

End of the printout appears on the next page. • Enter the correct Paper size.• Try decreasing the Left margin and Top margin.

Another patient report could fit on the page. • Enter the correct Paper size.• Try increasing the Left margin, Top margin, and

Vertical spacing.

Printed result is not centered horizontally. Modify the Left margin.

Printed result is not centered vertically. Modify the Top margin.

Results are printed too close together or too far apart.

Modify the Vertical spacing.


3.2 Operational Settings

Use the Customize menu to set the language and date format used by the HM2, along with the

screensaver delay, and the date range used for printing combined results from the HM2 and a con-

nected VetScan analyzer.

3.2.1 General Settings

1. Press the Utilities key .

2. Select Settings.

3. Select Customize.

4. Select General Settings.


5. Configure the settings as needed.

■ Use the and keys to move through

the settings.

■ Use the and keys to change the set-

tings, and the keypad or an external key-

board to enter text or numbers.

■ Use the on-screen and

soft keys to move between pages of set-

tings.

Table 3-4 describes the available settings.

Table 3-4: General Settings

Screensaver wait time 0 to 30 minutes (0 = screensaver off).

Language English. International customers: please contact your distributor for information about available languages.

PC Link Offline, USB, Baud rate (150 to 115200). Protocol used by the ana-lyzer to communicate with a connected computer.– If the analyzer is not connected to a computer, choose Offline.– If the analyzer is connected to a computer using a USB cable, choose USB.– If the analyzer is connected to a computer through serial cable, 9600 is correct for most cases, or you can contact Abaxis Technical Support for the correct setting — see “Customer and Technical Support” on page 1-2.

Serial Protocol Version 1.0, 1.7, 2.20, 2.23, 3.0, or 3.1. Protocol versions used by practice management software to interface with the analyzer. Contact Abaxis Technical Support (see page 1-2) or your practice management soft-ware provider for the proper selection. (Newer versions have higher numbers.)

Serial’s Decimal Dot Dot (period), slash, comma, or lang def (as defined by language).

VSx Link Offline, USB, or RS232. Protocol used by the HM2 to communicate with a connected VetScan Classic or VS2 for combining results.– If the HM2 is not connected to a VetScan Classic or VS2, choose Offline.– If the HM2 is connected to a VetScan VS2 through a USB cable, choose USB.– If the HM2 is connected to VetScan Classic through a serial cable, choose RS232.

Date format of VetScan When printing combined HM2 and VetScan results, the date format used by the VetScan: MM/DD/YY or DD/MM/YY (DD = date, MM = month, YY = year). Set both instruments to the same format.

PGUP PGDN


6. Press the soft key to accept the settings.

3.2.2 Unit Settings

Use the Units menu to set the measurement units the HM2 will use.


2. Select Settings.


4. Select Units.

VetScan-HM2 combining within

365, 90, 60, 30, 15, 8, 5, 3, 1 day, Same day, Don’t care. When print-ing combined results from the HM2 and VetScan Classic or VS2, defines the time range within which HM2 and VetScan hematology results will be paired: HM2 Patient ID number is paired with the Patient Number on the VetScan Classic, or with the Sample ID on the VS2.For example, if the clinic uses the same patient ID numbers each day, so that a given number may be assigned to more than one patient, select Same day to avoid inadvertently pairing results from different patients. Chemistry and hematology results using the same patient ID number will then only be paired if run in the same day.If this is not a requirement, use Don’t care. The HM2 then matches the most recent results on the VetScan Classic or VS2.

Table 3-4: General Settings (Continued)

ACCEPT


5. Set the units as needed:

■ Use the and keys to select a unit.

■ Use the and keys to select a setting

for that unit.

Table 3-5 lists the available unit settings.

6. Press the soft-key to save the settings.

3.2.3 Laboratory Information Settings

Enter your clinic or laboratory information as follows, to be printed automatically on report head-

ers. You can also use this procedure to edit or change this information.


2. Select Settings.


Table 3-5: Unit Settings

Count unit cells/liter (cells/l), cells/µl (cells/µl). Prec. displays a more pre-cise value.

HGB unit grams/liter (g/l), grams/deciliter (g/dl), millimols/liter (mmol/l)

PCT, HCT unit percentage (%), absolute (abs)

RDW, PDW mode standard deviation (sd), coefficient of variation (cv)

ACCEPT


4. Select Laboratory.

5. Enter the name and address of your clinic or

laboratory. Press OK to move to the next line.

You can enter up to 40 characters in each line.

6. Press to accept the setting.

3.2.4 User Mode Settings

If you want to require users to log in and enter passwords to use the HM2, and to be able to track

individual usage of the unit, you can enable the HM2’s Multi user mode. This will require each

user to have a unique user ID and password.


2. Select Settings.

Note: In general, Single user mode is recommended unless the specific

features enabled by Multi user mode are required.

ACCEPT



4. Select User modes.

5. Follow the on-screen instructions to enable

Multi user mode, to add or modify users, or to

change a user’s password.

CAUTION: Write down user names and passwords and store them in a secure

location. If this information is lost, you will need to contact Abaxis

Technical Support (see page 1-2) to reset the HM2.


3.3 Date and Time Settings

The date and time of each analysis is stored with the results. Use the Date and Time menu to set the

HM2’s built-in clock and calendar, and the format used to display the date.

1. Press the Utilities key , then select Settings.

2. Select Date and time.

3. Select Set date and time.

4. Type in the date and time (use the and

keys to select AM or PM), then press .

5. Select formats for displaying the date (item 2, 3,

or 4) and time (item 5 or 6), then press .

6. Press to accept the settings.

ACCEPT

EXIT

ACCEPT


3.4 Fluid Sensor Settings

The fluid sensors allow the HM2 to monitor reagent consumption correctly. To maximize the life

of the reagent pack, recalibrate the fluid sensors in the following situations:

■ on installation

■ when the instrument is moved to a new location

■ if the reagent pack is moved relative to the instrument (changed distance or height of the

pack relative to the instrument)

Recalibrate the fluid sensors as follows.

1. Press the Utilities key , then select Settings.

2. Select Fluid Sensors.

3. Make sure all fluid sensors are on (checked).

To turn on a sensor, select it and press OK so

that its box is checked.

4. If a message indicates that one or more fluid

sensors are disabled, turn those sensors on, then

select Calibrate sensors.


Section 4
Test Procedure and Interpreting ResultsThis section describes how to prepare and analyze samples with the
HM2, as well as how to interpret and print results.

Section Contents

4.1 Collecting and Preparing Samples . . . . . . . . . . . . . . . . . . . . . . 4-2

4.1.1 Sample Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2

4.1.2 Storing Samples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3

4.2 Before Performing an Analysis . . . . . . . . . . . . . . . . . . . . . . . . 4-4

4.2.1 Daily Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4

4.2.2 Check Reagent Status and Tubing . . . . . . . . . . . . . . . . . 4-4

4.2.3 Run a Blank Measurement . . . . . . . . . . . . . . . . . . . . . . . 4-5

4.3 Analyzing a Sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-7

4.4 Adjusting the Needle Height . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10

4.5 Adjusting the Lyse Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-11

4.6 Interpreting Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-12

4.6.1 CBC Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-13

4.6.2 Histograms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-13

4.7 Printing and Exporting Results . . . . . . . . . . . . . . . . . . . . . . . 4-15

4.7.1 Printing Saved Results . . . . . . . . . . . . . . . . . . . . . . . . . . 4-15

4.7.2 Exporting Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-15

4.8 Combining Chemistry and Hematology Results . . . . . . . . . . 4-16

4.8.1 Combining Previously Saved Results . . . . . . . . . . . . . . 4-16

4.8.2 Combining Results During Testing . . . . . . . . . . . . . . . . 4-17

4.8.3 Printout Examples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-18

4.9 Using Prediluted Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-21

4.10 Interpreting CBC Parameters . . . . . . . . . . . . . . . . . . . . . . . . 4-23

Test Procedure and Interpreting Results 4-1

4.1 Collecting and Preparing Samples

Because sample integrity is essential for accurate test results, always follow the optimal sample

collection and proper sample handling techniques described in this section.

4.1.1 Sample Quality

The quality of the blood sample will directly affect the quality of the analysis results. Follow the

recommendations below for optimal results.

■ Selecting an anti-coagulant: Use manufactured EDTA lavender-top tubes for blood

storage.

■ Discarding the first portion of the blood sample: To prevent hair and skin pieces from

getting into the sample, discard the first few drops of blood after collection.

■ Filling blood tubes correctly:

❑ Each tube must be filled at least half full to avoid inaccuracy due to improper dilu-

tion of EDTA.

❑ When using homemade containers pre-dosed with EDTA, the final concentration of

EDTA in the blood should not exceed 3 mg/ml.

■ Mixing samples thoroughly:

❑ Even the most minute blood clots can adversely affect results. To avoid clotting,

thoroughly mix each sample immediately after filling the tube by gently inverting

the filled EDTA sample tube by hand 10 to 15 times.

❑ If testing is delayed and the sample was placed on a rocker, be sure to mix it thor-

oughly again before analysis by gently inverting the tube 10 to 15 times. This

ensures the homogeneity of the sample.

■ Discarding clotted samples: Before analysis, visually check all samples for clots while

rocking the sample tube in your fingers. This is especially important for difficult sample

draws. If you suspect a clot, swirl a wooden applicator stick through the sample: if you

see clots or fibrin strands, discard the sample, and collect a fresh sample.

Note: For multiple tube draws, always fill in this order: 1) red top,

2) green top, 3) lavender top.

CAUTION: Use tubes containing EDTA only for CBC analysis.

4-2 Test Procedure and Interpreting Results

4.1.2 Storing Samples

Analysis is best performed with a fresh, anti-coagulated sample. Always use proper sample han-

dling technique, and make sure the sample is well mixed. If analysis is to take place more than

4 hours after the sample is obtained, refrigerate the sample at 36–46 ºF (2–8 ºC), and test the sam-

ple within 8 hours.

Note: Do not shake samples! Doing so can damage the blood cells, and

can form microbubbles that will cause inaccurate results.

Note: Never use a rocker for samples smaller than 1.0 ml.

Note: Rockers do not mix samples. Each sample must be inverted by hand

10 to 15 times immediately after drawing, and then 10 to 15 times

again before running the sample.

Note: Feline samples frequently demonstrate platelet aggregation

(clumps). Vortex mixing for up to 30 seconds can disaggregate

these clumps with no adverse effect on the sample. Some practitio-

ners find that collecting blood from the medial saphenous vein

using a vacutainer minimizes platelet clumping.

Note: When analyzing a refrigerated sample, be sure to warm the sample

to room temperature before analysis. Roll the sample tube between

your palms to speed up warming. This also helps mix the sample. If

the sample is not mixed correctly, PLTs and WBCs can form

clumps, causing erroneous results. Mix the sample thoroughly

again before analysis.


4.2 Before Performing an Analysis

The HM2 automatically goes into standby mode after a period of standing idle. Press any button to

bring the analyzer out of standby.

4.2.1 Daily Cleaning

1. Wipe up any spills on the sample rotor.

2. Keep the instrument and immediate sur-

roundings as clean as possible.

4.2.2 Check Reagent Status and Tubing

1. Check the status of the reagent pack to make sure enough reagent is available for sample

analysis for the day — see “Viewing Status Information” on page 8-2.

If any reagent is at a level of 10% or less, change the reagent pack soon to ensure reliable

results. For instructions, see “Changing the Reagent Pack” on page 7-8.

2. Inspect the reagent tubes and connections to make sure the reagents can flow freely.

Make sure the tubes are not pinched, kinked, or trapped between or beneath objects.

CAUTION: If the analyzer has been kept at a temperature below 50 °F (10 °C),

such as during shipment or a power failure, allow it to stand for an

hour at the correct operating temperature before turning it on —

see “Environmental Requirements” on page 2-19.

Note: Each day, before analyzing samples, perform the procedures in this

section to make sure the instrument is in proper operating condi-

tion.

Sample rotor

Sample tubeadapter


3. Check the reagent lines (except the red waste line) for bubbles or air gaps. If any exist,

prime the affected tubes as follows.

a. Press the Utilities key , then select Maintenance.

b. Select Priming.

c. Select the line to prime.

d. Repeat as needed until all air gaps

are removed.

4.2.3 Run a Blank Measurement

A blank measurement checks the cleanliness of the HM2’s fluidic system, and is used to establish a

baseline for sample measurements. The results of a blank are used to determine if the background

will affect the test results, and whether the HM2 needs cleaning or maintenance.

1. If “BLANK needed” appears on the screensaver,

press the Measurement/Analysis key .

The HM2 then runs a blank measurement, and dis-

plays the results.

Note: Air gaps in the waste line (red) are normal.

Note: A blank must be run every 12 hours. Each blank measurement

remains valid for 12 hours of continuous operation, after which the

HM2 displays “BLANK needed,” and a new blank must be run.


2. Check the displayed results, and make sure the following CBC parameters fall within the

ranges shown for an acceptable blank:

Table 4-1: Acceptable Blank Parameters

■ If the values are within the allowed ranges: proceed to step 3, below.

■ If the values are not within the allowed ranges (the message “UNSUCCESSFUL

BLANK MEASURE” is displayed):

a. Repeat the measurement by pressing the

soft key.

b. If the new results are still above the accept-

able ranges, run one to three cleaning

cycles (see “Cleaning the Aperture” on

page 7-5), and re-run the blank (up to sev-

eral times).

c. If the results still do not fall within the acceptable range, run a bleach-clean-

ing — see “Bleach-Cleaning” on page 7-5.

d. If the problem persists, call Abaxis Technical Support — see “Customer and

Technical Support” on page 1-2.

3. When the blank measurement is OK, press to

accept the results. The HM2 is then ready for analy-

sis.

Measurement Allowed range

WBC 0.0 to 0.5x103 cells/µl

RBC 0.0 to 0.05x106 cells/µl

PLT 0 to 25x103 cells/µl

HGB 0 to 10 g/l

Note: To run a blank measurement other than at startup (such as for trou-

bleshooting), press the Measurement/Analysis key , then

press the soft key, then select Measure blank.

REPEAT

ACCEPT

MENU


4.3 Analyzing a Sample

Use this general procedure to analyze samples with the HM2.

1. Prepare a well-mixed, EDTA-preserved sample — see “Collecting and Preparing Sam-

ples” on page 4-2 for details.

2. Select the appropriate sample tube adapter (see below), and place the adapter into the

sampling rotor.

3. Press the Measurement/Analysis key , and

select PT.ID.

Tube adapter (3 ml) Microtube adapter Controls/calibrator adapter

Vacutainer adapter

Note: Sponge disks are provided

for the microtube adapter. If

you have a very “short”

sample, you can put the

sponge disk into the micro-

tube adapter to raise the

tube height.

Sponge plate for microtainer adapter


4. Enter the species: view the available profiles using the and keys. Press the keypad

OK key to move to the next field.

5. Enter other patient identification data as indicated.

■ Use the OK key and the and keys to move through the settings.

■ Use the and keys to change the settings, and the keypad or external keyboard

to enter text or numbers.

■ Press the soft key to accept the settings.

6. Gently mix the sample by inverting the tube 10 to 15

times. Then remove the cap from the tube and place

the tube into the sample adaptor as shown at right.

7. Begin analysis by pressing the Start button .

Analysis is complete in less than three minutes. All

results and histograms are automatically saved in the

HM2’s database.

Note: When using the HM2 in

conjunction with the

VetScan Classic, make sure

the Patient ID number on

the HM2 is the same as the

Patient Number on the

VetScan Classic.

When using the HM2 with the VetScan VS2, make sure the Patient

ID number on the HM2 is the same as the Sample ID on the VS2.

Otherwise, the results will not print together.

Note: Make sure the species for the sample — displayed in the upper

right corner of the screen — is correct. The sample will be pro-

cessed and tested according to the species selected.

ACCEPT


8. When analysis is complete, a results screen dis-

plays all measured and calculated parameters as

well as the WBC, RBC, and PLT histograms:

You can view the results as follows:

■ Use the and soft keys to move through the results.

■ If the HM2 is not set to print results automatically,

press the Print key to print the results.

(See “Printing and Exporting Results” on page 4-15

for details.)

Results falling outside of the specified species reference

range are marked as follows:

■ Results higher than the species reference range

are highlighted in black and marked with a plus

sign (+).

■ Results falling below the reference range are

highlighted and marked with a minus sign (-).

■ Warnings and errors flags are indicated using upper- and lower-case letters at the bot-

tom.

See “Troubleshooting” on page 9-1 for details about identifying and resolving any identified flags.

For details on results and interpretation, see “Interpreting Results” on page 4-12.

PREV NEXT


4.4 Adjusting the Needle HeightAdjust the HM2’s needle height when you switch from one tube type to another, when you run a

control, or when the sample volume is low enough to require it.

1. Press the Measurement/Analysis key , then press the soft key.

2. Press Needle Height Setting repeatedly to

cycle through the available needle heights:

A:-2mm, B: 0mm, C: 5mm, D: 10mm, and

E: 15mm.

3. When the correct needle height is displayed,

press .

Use this table and diagram as a guide to appropriate needle height settings.

.

Table 5: Needle Heights

Setting and Needle Height Suitable Situations

A:-2mm Measuring control or short sample

B: 0mm Default setting

C: 5mm Using a false-bottom tube

D: 10mm Have plenty of blood sample

E: 15mm Have plenty of blood sample

MENU

ACCEPT

E: 15 mm

D: 10 mm

C: 5 mm

B: 0 mm

A: –2 mm~3–4 mm


4.5 Adjusting the Lyse Volume

The lyse volume generally only needs adjustment if a histogram indicates over- or under-lysing

(this is relatively rare). If you receive such a histogram, contact Abaxis Technical Support before

adjusting the lyse volume — see “Customer and Technical Support” on page 1-2. When needed,

adjust the lyse volume as follows.


2. Press Lyse Volume or OK on the keypad

repeatedly to cycle through the available vol-

umes:

■ 0.50 ml

■ 0.50+0.1 ml

■ 0.50+0.2 ml

■ 0.50-0.1 ml

■ 0.50-0.2 ml

3. When the correct volume is displayed, press .

MENU

ACCEPT


4.6 Interpreting Results

The HM2 produces a printed report containing the patient ID, measurement data, numeric results

with flags (if any), and histograms showing the three different cell populations.

The following graphic shows a set of typical results and histograms:


4.6.1 CBC Parameters

The Complete Blood Count (CBC) parameters included in the results are useful for assessing the

overall health of the patient, as well as identifying and monitoring certain disease states.

For details about CBC parameters and associated clinical indications, see “Interpreting CBC

Parameters” on page 4-23.

4.6.2 Histograms

Histograms display population distributions of each cell type: leukocytes (white blood cells —

WBC), erythrocytes (red blood cells — RBC) and thrombocytes (platelets — PLT). The histo-

grams show the relative frequency (percentage) of cells on the vertical (Y) axis, and cell volume in

femtoliters (fl) on the horizontal (X) axis.

Histograms enable you to quickly scan results for abnormalities, and also allow the versed practi-

tioner to derive more information about the sample than is displayed by the values alone. The fol-

lowing pages describe each of the three histograms (WBC, RBC, and PLT), and show a typical

example of each with an explanation.

White Blood Cell Histogram (WBC)

The WBC histogram shows white blood cell popula-

tions sorted by size. Cells larger than discriminator 1

are counted as WBCs. Blood includes three WBC

populations:

■ Lymphocytes (LYM), shown by the first

peak in the histogram.

■ Monocytes (MON), indicated by the area

between the second and third discriminators

(although the MON region does demon-

strate a distinctive peak of its own, this peak

is not always clear in histogram form).

■ Granulocytes (GRA), indicated by the peak to the right of the third discriminator.

Note: Always check whether the results include any warning flags — see

“Warning Indicators” on page 9-2.

LYM

discriminator 1discriminator 2discriminator 3

GRAMON

(fl)


The histogram on the previous page shows the lymphoctye cell population (LYM in the CBC

parameters) to be in the range 33–95 fl. The two other discriminators define a MON population of

95–102 fl, and a GRA population of > 102 fl (above discriminator 3).

Neutrophils normally make up the vast majority of the granulocytes, although considerable

increases in eosinophils/basophils from an allergic or parasitic condition may be identified by the

presence of an additional peak between the monocyte and primary granulocyte populations.

Red Blood Cell Histogram (RBC)

The distribution of red blood cells normally appears

as a single, steep bell curve. The presence of distinc-

tive cell populations of various sizes, such as occurs

in anemia, can be identified by the presence of more

than one peak in the RBC histogram.

This RBC histogram follows a normal distribution,

with the RDW value within the normal range, and with the histogram normalized (100% fit) to the

RBC peak.

Platelet Histogram (PLT)

The PLT histogram is a magnified portion of the

beginning of the RBC histogram.

The example PLT histogram at right follows a log-

normal distribution, with a good separation from

RBCs.

The most commonly identified anomaly in platelet histograms results from aggregated (clumped)

platelets. This appears as a flattened, lumpy histogram.

See “Veterinary Case Studies” on page D-1 for a variety of sample test results and interpretations.

Note: Measurements detected to the left of or near the first discriminator

can include nucleated RBCs, and giant or clumped platelets.

Note: Feline samples may demonstrate platelet aggregation (clumps).

Careful sample collection and vortex mixing for up to 30 seconds

can avoid or disaggregate clumps with no adverse effect on the

sample.

(fl)


4.7 Printing and Exporting Results

The analyzer can print a wide range of results, statistics, and settings, and prints analysis results

automatically if the Autoprint function is selected (see Table 3-2 on page 3-4). If Autoprint is not

selected, you can print by pressing the Print key .

■ To print any displayed screen, press the Print key .

For instructions on connecting and setting up an external printer, see “Printer Settings” on

page 3-2.

4.7.1 Printing Saved Results

The HM2 automatically stores the most recent 1,000 test results (record 1,001 overwrites record 1,

record 1,002 overwrites record 2, and so on). For more information about saved results, see “Data-

base Table” on page 6-2.

■ To print a single saved result, press the Database key . Use the and keys to

highlight the record, then press the Print key .

■ To print multiple saved results, press the Database key , then press the OK key to

select the records to print (as indicated by filled boxes in the SmpID column). When the

records to print are selected, press the Print key .

4.7.2 Exporting Results

You can export results through the HM2’s serial port or USB Type B port, using a special software

interface developed specially to communicate with the VetScan HM2. For availability, check with

Abaxis Technical Support (see page 1-2) or your data management system (DMS) provider.

■ To export a saved result, press the Database key , select the result, then select the

“Send Selected Records” function in the Database menu.

Note: Printouts from the integrated (thermal) printer last approximately

one year. To ensure the results remain legible for longer, photocopy

the printout. Do not expose the thermal paper printout to heat

extremes. Heat causes the printout to deteriorate more rapidly.

Note: Abaxis does not create interface programs for data management

software, but can initiate the process with your current software

provider. For further information, please contact Abaxis Technical

Support — see “Customer and Technical Support” on page 1-2.


4.8 Combining Chemistry and Hematology Results

The HM2 can print results from a connected VetScan Classic or VetScan VS2 analyzer. The HM2

can print the VetScan results only, or the combined VetScan and HM2 results for a given patient ID.

(For connection instructions, see “Connecting a VetScan Chemistry Analyzer (Optional)” on

page 2-22.)

Printing VetScan results requires that the HM2 be configured to receive data from the VetScan (see

“General Settings” on page 3-9). This is normally done on installation. If you have questions, con-

tact Abaxis Technical Support — see “Customer and Technical Support” on page 1-2.

4.8.1 Combining Previously Saved Results

To export combined VetScan and HM2 data, first display the CBC results to be combined on the

HM2, then do the following on the VetScan:

1. Press the RECALL key. The following

appears:

2. Press ENTER. The following appears:

3. Press ENTER to select patient results. The fol-

lowing appears:

4. Press ENTER to select a single result. The fol-

lowing appears:

5. Press 2 and ENTER to transmit.

If the Patient IDs match, both results will be transmitted.

Press ENTER toRecall Results

MENU for next optionEXIT to leave.

Recall:1 Results 1-Patient results2-Patient flags ENTER to accept.

Recall:1 Single 1-Single result card2-All patients ENTER to accept.

Select:1 Print 1-Print result card2-Transmit patient ENTER to accept.


4.8.2 Combining Results During Testing

1. Use a USB cable to connect the printer to the HM2.

2. Turn on the printer, then turn on the HM2 and the VetScan.

3. Make sure the HM2 uses the same date format as the VS2 — see “Date and Time Set-


4. Configure the HM2’s printer settings as follows (see “Printer Settings” on page 3-2 for

instructions):

■ Set Printer to HP 5650, Canon i455, or SeikoLPTH245 Built in.

■ HP 5650 only: set Printer cable to USB (this setting is made automatically for the

Canon i455 and built-in printers).

■ Set Autoprint to No.

5. Configure the HM2’s general settings as follows (see “General Settings” on page 3-9):

■ Set PC Link to Offline.

■ Set VSx Link to USB.

■ Set VetScan-HM2 combining within as needed.

6. To print a VetScan result only:

As long as no matching VetScan record exists, the VS2 results will be printed.

Note: Be sure to set VetScan-HM2 combining within the time frame so

that no matching record will exist in the HM2. For example, if a

VetScan analysis was run for a given patient 5 days ago, you would

set VetScan-HM2 combining within to 4 days or less to exclude

any earlier records.

Note: If you run VetScan and VS2 analyses for the same patient on the

same day and want to print only the VetScan result, you can change

the patient ID on the HM2 so that there will be no matching record.


7. To print combined HM2 and VS2 results:

■ Start the CBC first, and then run the chemistry rotor.

When the rotor finishes, the VS2 automatically transmits the results to the HM2,

and the HM2 prints out the combined results.

4.8.3 Printout Examples

Thermal Paper Printout — VetScan Chemistry Results

Note: The Patient ID of the HM2 record must match the Sample ID field

of the VS2 record.

Patient information Patient species

VetScan information

Test result units

Test quality

Test parameters

Reference ranges

Test results

indicators (rotor QC,interfering substances)


Thermal Paper Printout — HM2 + VetScan Chemistry Results

Patient informationPatient species

Report header

Report date

Test date & time(dates and timesassignedautomatically)

HM2 serial number

Sample ID (assignedautomatically)

Test parameters

Test result unitsTest results

Reference ranges

WBC histogram

RBC histogram

location of test

upperlimit

results withinreference range limits

lowerlimit

PLT histogram

VetScan results


8 x 11.5 Letter Printout — HM2 + VetScan Chemistry Results

Patient

Report date

Sample ID(assigned automatically)

Test

Reference ranges

lowerlimit shows location

upperlimit

of test resultswithin referencerange limits

Patientinformation

Reportheader

information

(assignedPatient

speciesautomatically)

and HM2serial number

parameters

Test results

WBC histogram

RBC histogram

PLT histogramand unit

VetScanresults


4.9 Using Prediluted Mode

The HM2 software provides a special predilution function for use in the following situations:

■ if an insufficient amount of blood is available for a routine CBC

■ if the CBC results are abnormally high (non-linear), resulting in an m, M, or N flag (see

“Warning Indicators” on page 9-2)

Perform an external predilution of the sample using HM2 reagent diluent, or an isotonic saline

solution. Dilute the sample by a 1:6 ratio (1 part sample to 5 parts diluent) — for example, 50 μl

sample to 250 μl diluent or saline. Mix well.

Perform the analysis as follows.

1. Press the Measurement/Analysis key ,

then press the soft key.

2. Select Prediluted mode. (The accompanying

checkbox is filled in.)

Note: Before using prediluted mode, always call Abaxis Technical Sup-

port — see “Customer and Technical Support” on page 1-2.

Note: Prediluted mode must be calibrated before use. The HM2 is cali-

brated at installation, and can be recalibrated as described in

“Calibration” on page 5-2 (select Prediluted blood (1:5) as the

calibrator).

After the dilution, perform a QC run for the 1:5 diluted quality

control blood. See “Performing Quality Control” on page 5-6 for

instructions.

MENU


3. Press the soft key. Notice that “1:5”

now appears in the upper left corner of the

screen.

4. If you are processing a new sample: press the

soft key, enter the patient information,

then press .

If you are processing a sample that has

already been tested as non-prediluted: select

Repeat Last Sample to avoid re-entering the

patient information.

5. Press the Start button to begin the analy-

sis. The HM2 will automatically calculate the

results with the 1:5 predilution factor.

Note: The HM2 automatically returns to normal mode after the predi-

luted analysis completes.

ACCEPT

PT.ID

ACCEPT


4.10 Interpreting CBC Parameters

Complete Blood Count (CBC) parameters are useful in assessing the overall wellness of a patient,

as well as for identifying and monitoring certain disease states.

The following tables outline the various CBC parameters and associated clinical indications.

Table 4-1: White Blood Cells and Associated Indications

White Blood Cell (Leukocyte) Role Increase in Disease State Decrease in Disease State

Non-Granulocytic

Lymphocytes B-cells: humoral immunity (antibody synthesis)T-cells: cellular immunity

• Chronic inflammation• Acute infection/recovery• Lymphocytic anemia• Hypoadrenocorticism

• Acute/severe disease• Viral disease• Endotoxemia• Hyperadrenocorticism• Stress-related corticos-

teroid response

Monocytes Immature macrophages — phagocytosis of debris/for-eign material, killer-cell acti-vation

Necrotic, malignant, hemor-rhagic, or immune-mediated disease

Rare, no known significance

Granulocytes

Neutrophils

Left shift: Increased numbers of immature neutrophils/band cells.• regenerative: < 10%

bands, neutrophilia, absence of myelo-cytes/metamyelo-cytes

• degenerative: >10% bands, depressed total neutropenia, presence of myelo-cytes/metamyelo-cytes (poor prognostic indicator)

Right shift: Increased number of hyperma-ture (hyper-seg-mented) neutrophils, usually seen with non-infectious inflammatory process (e.g. malig-nancy)

Phagocytize/kill microorgan-isms, initiate and modify inflammatory process, cyto-toxic

• Inflammation• Neoplasm• Stress• Exercise/excitement

• Bacterial infection• Viral infection • Drug-induced (bone mar-

row depression)

Eosinophils • Parasiticidal• Cytotoxic• Phagocytic

• Parasitic infection• Allergic responses• Hypoadrenocorticism

• Stress• Hyperadrenocorticism• ACTH therapy

Basophils • Initiate inflammation• Prevent coagulation• Activate lipoprotein lipase

• Allergic reactions• Parasitic infection• Neoplasia

No known significance


Table 4-2: Red Blood Cell Parameters and Associated Indications

Table 4-3: Platelet Parameters and Associated Indications

Parameter Definition Diagnostic Consideration

Hematocrit (HCT) Percentage of total cellular constituents (primarily red blood cells) in a unit of whole blood

Anemia exists when the HCT falls below the reference range for the species.Increase in red cell count or polycythemia is most commonly the result of dehydration.Hematocrit will normally have a value of approximately three times (3X) the hemoglo-bin value.

Hemoglobin (HGB) The oxygen-carrying component of red blood cells; allows for the calculation of MCH and MCHC

Hemoglobin normally falls in the range of one third (1/3) of the hematocrit value.

RBC IndicesAnemia Characteriza-tion

MCVMean Corpuscular Hemoglobin

Measure of the volume of an average RBC:• MCV = (HCT x 10) / RBC

• Increase: most commonly associated with reticulocytes/regenerative anemia

• Decrease: iron-deficiency anemia

MCHMean Corpuscular Hemoglobin

Calculated HGB concentration of an aver-age RBC• MCH = (HGB x 10) / RBC (in pico-

grams)

• Increase: most commonly the result of hemolysis

• Decrease: hypochromasia common in iron-deficiency anemia and reticulocytosis

MCHCMean Corpuscular HemoglobinConcentration

Calculated HGB concentration in an aver-age RBC• MCHC = MCH / MCV (in grams of

HGB per 100 ml RBCs)

• Increase: most commonly the result of hemolysis

• Decrease: hypochromasia common in iron-deficiency anemia and reticulocytosis

RDWRed Cell Distribution Width

Measure of red blood cell anisocytosis (cell size variation)

• Increase: indicates increased production of large immature cells. RDW increases even before the MCV exceeds the normal range: early indicator of regenerative anemia. RDW also increases with the production of small RBCs in iron-deficiency anemia.

Parameter Increase in Disease State Decrease in Disease State

Total Platelet Count Thrombocytosis is present with excess bleeding, iron deficiency anemia and myeloproliferative syndromes.

• Disseminated intravascular coagulation• Bone marrow depression• Autoimmune hemolytic anemia• Severe hemorrhage

MPVMean Platelet Volume

Indirect evidence of increased (bone mar-row) megakaryocyte response.

Not an accurate predictor of decreased mega-karyocyte response.

PCTPlatelet Hematocrit

Volume of platelets expressed as a per-centage of whole blood (used as a research tool).

Volume of platelets expressed as a percent-age of whole blood (used as a research tool).

PDWPlatelet Distribution Width

Increased measure of platelet anisocyto-sis (platelet size variation) indicative of active platelet release.

No known clinical significance.


Section 5
Calibration and Quality ControlThis section describes the calibration and quality control procedures for
the VetScan HM2.

Section Contents

5.1 Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2

5.1.1 When to Calibrate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2

5.1.2 Required Calibration Materials and Handling . . . . . . . . 5-2

5.1.3 Calibration Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3

5.1.4 Viewing Calibration History . . . . . . . . . . . . . . . . . . . . . . . 5-6

5.2 Performing Quality Control. . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6

5.2.1 Required Quality Control Materials. . . . . . . . . . . . . . . . . 5-6

5.2.2 Quality Control Procedure . . . . . . . . . . . . . . . . . . . . . . . . 5-7

5.2.3 Monitoring Quality Control Values Over Time . . . . . . . . 5-8

5.2.4 Viewing the Accepted QC Database . . . . . . . . . . . . . . . . . 5-8

Calibration and Quality Control 5-1

5.1 Calibration

5.1.1 When to Calibrate

The HM2 is factory-calibrated for optimal performance. In the following situations, a fine-tuning

calibration can be done (using three measures of calibrator material):

■ on initial installation

■ when quality control measurements show a systematic error (bias — the curve is shifted

upward or downward) or are repeatedly outside predefined limits

■ after service that replaces any component related to the process of dilution or measure-

ment

■ after relocating the instrument

■ after software upgrades (as directed by Abaxis)

■ before using prediluted mode

5.1.2 Required Calibration Materials and Handling

The calibration procedure requires the Hematology Calibrator, Abaxis Part No. 700-9005.

WARNING: THE CALIBRATION PROCEDURE REQUIRES A SPECIAL CALI-

BRATOR THAT IS DERIVED FROM HUMAN SOURCES.

OBSERVE UNIVERSAL SAFETY PRECAUTIONS WHEN HAN-

DLING THE CALIBRATOR SAMPLE.

5-2 Calibration and Quality Control

5.1.3 Calibration Procedure

1. Press the Utilities key , then select Calibration.

2. Select Run Calibrator.

3. Select the calibrator: Whole blood or Predi-

luted blood (1:5).

Select Prediluted blood (1:5) only if you are

using prediluted mode.

4. Enter the assay values for each parameter from

the calibrator package insert.

Use the and soft keys to move

between pages.

5. When all parameters are set, press the

soft key.

WARNING: IT IS STRONGLY RECOMMENDED THAT LATEX GLOVES BE

WORN DURING THIS PROCEDURE.

Note: Make sure to bring the calibrator up to room temperature

before beginning this procedure.

PGUP PGDN

ACCEPT


6. Mix the calibrator by gently inverting the tube between thumb and forefinger 10 to 15

times. Remove the tube cap.

7. Place the calibrator into the control tube adapter.

8. Press the Start button .

9. When analysis is complete and the display

shows the results, press .

The display then shows 2/3 Calib at the top.

10. Remove the tube from the adapter, and mix by gently inverting the tube between thumb

and forefinger 10 to 15 times.

11. Replace the tube in the adapter, and press the Start button.

Note: Needle height must be at

–2 mm. To adjust,

press , select

3: Needle Height,

press repeatedly

until needle height

= –2 mm, then

press .

The display shows 1/3 Calib

at top center, and Calib at

top right.

MENU

OK

ACCEPT

ACCEPT


12. When the second analysis is complete and the

results are displayed, press .

The display then shows 3/3 Calib at top.

13. Remove the tube from the adapter, and mix by gently inverting the tube between thumb

and forefinger 10 to 15 times.

14. Replace the tube in the adapter, and press Start.

15. When the third analysis is complete, press

.

The new calibration factors are then displayed.

Use the and soft keys to move

between pages.

ACCEPT

ACCEPT

NEXT PREV


16. Press to accept the new calibration factors. The instrument is now calibrated.

17. Press .

5.1.4 Viewing Calibration History

All calibration times and the settings used are logged and

saved, and can be viewed as follows:

1. Press the Utilities key , then select Cali-

bration.

2. Select View Calibration History.

5.2 Performing Quality Control

The HM2 is pre-programmed to monitor three different quality control (QC) types: Dog, Cat, and

Human. You should perform QC determinations regularly to verify continued optimal perfor-

mance.

We recommend testing control material (dog control or cat control) each time the reagent pack is

changed, or otherwise approximately once per month. Also, perform a quality control measure

after each service. The analyzer stores all accepted QC results in an internal database.

5.2.1 Required Quality Control Materials

The quality control procedure requires the following materials:

■ Dog Control, Abaxis Part No. 700-9003

■ Cat Control, Abaxis Part No. 700-9004

■ Human Calibrator, Abaxis Part No. 700-9005

Note: To complete the calibration, you need to press the

soft key after each calibration measurement. When all three

measurements are accepted, the instrument then calculates

and displays the new calibration factors. Do not change

any of these displayed calibration factors.

If the message “1 or more of your factors are out of range”

appears, call Abaxis Technical Support — see “Customer

and Technical Support” on page 1-2.

ACCEPT

EXIT

ACCEPT


5.2.2 Quality Control Procedure

Perform a quality control (QC) check as follows.

1. Press the Utilities key , then select Quality control.

2. Select Select QC type, then select the QC

material you want to use: Dog, Cat, or Human.

3. Select Set QC reference ranges.

4. From the package insert, enter the lot no., exp.

date, and assay and gap values for each test

parameter.

■ To disable QC of a parameter, set that

parameter to 0.0.

■ Use the and soft keys to

view and enter additional parameters.

5. Press to accept the data, then press again to confirm.

6. Mix the control vial by gently inverting the tube between thumb and forefinger 10 to 15

times, and remove its cap.

7. Put the control vial onto the control vial adapter on the sample rotor.

Note: Before performing this procedure, be sure to bring the qual-

ity control materials up to room temperature.

PGDN PGUP

ACCEPT ACCEPT


8. Select Run QC to start the analysis.

Press the Start button .

The results screen displays Quality Control

as ID.

9. Press to accept the results and save them

in the QC database.

10. Abaxis strongly recommends performing three successful QC runs after calibrat-

ing the instrument.

5.2.3 Monitoring Quality Control Values Over Time

Many laboratories monitor the recovery values of quality control material over time to identify

trends and potential performance drift. The HM2 allows you to do this easily using a database table

and in graphic form.

5.2.4 Viewing the Accepted QC Database

You can view all of the accepted QC results from the instrument’s database in table or graphic

(Levy-Jennings) form. The QC measurement results are assigned sequential ID numbers.

1. Press the Utilities key , then select Quality control.

2. Select View table of QC measures.

■ Use the and keys to select entries,

and the and keys to move among

parameters.

■ To print a selected QC result, press

, then press the Print key .

Note: Any values that are out of range are highlighted.

If you don't accept the QC results, they will not be saved in

the instrument’s database.

ACCEPT

GRAPH


Section 6
Managing the DatabaseThis section describes how to use the analyzer’s database.
Section Contents

6.1 Database Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2

6.2 Database Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2

6.3 Navigating the Database System . . . . . . . . . . . . . . . . . . . . . . . . 6-3

Managing the Database 6-1

6.1 Database Overview

The analyzer can store up to 1,000 complete test results in its internal database. Results are stored

chronologically by date and time. (When more than 1,000 measurements are stored, the most

recent file replaces the oldest file.) You can retrieve these results anytime.

6.2 Database Table

To access the Database table, press the Database key on the front panel.

The first screen shows a table of the most recently saved

tests, as shown at right.

You can view the results in this screen as follows:

■ Use the and keys to view results that extend past the edge of the screen. Each test

result includes the following:

■ Use the and keys to move through individual results.

■ Select the highlighted patient results by pressing the OK key on the keypad. (The check

box next to the patient name is then filled.)

❑ To display the WBC, RBC, and PLT histograms, press the histogram soft key.

❑ To view the second panel, containing PLT results, press the soft key.

❑ To view sample information, press .

❑ To view the results in table format, press to return to the previous screen.

❑ To go to the Local Menu, press .

■ Print selected patient results by pressing the Print key. The screen then displays:

❑ Print as table — select this to print the selected results in table format.

❑ Print result by result — select this to print each result with its sample information,

CBC values, and histograms.

To print an individual result, highlight the result, press , then press Print .

❑ Sample ID ❑ Warnings (if any) ❑ Mode

❑ Date ❑ Name ❑ Doctor

❑ Patient ID ❑ Age ❑ Lyse

❑ 18 CBC parameters ❑ Sex ❑ Clogging report

GRAPH

NEXT

PT.ID

TABLE

MENU

GRAPH

6-2 Managing the Database

6.3 Navigating the Database System

Use the Database local menu to access and manage the records stored in the analyzer’s database.

From the Database table screen, enter the Database local

menu by pressing the key.

The menu contains the following items:

■ Go to specified record: Jumps to a particular

sample record. Enter the date and time, sample

ID, and patient ID of the sample you want to

view, and press the key. The first sample

meeting your parameters is then displayed. If

Patient ID is blank (0), records are searched by

date/time only.

■ Selection: Selects all records in memory, or all

those with a specific date, time, and ID. Select

by date, time and ID selects a range of records

by date, time, and/or ID number. Select all

selects all records, and Deselect all deselects all

records. Entering 0 as an ID searches by date

only. Corresponding results are marked with a

filled box.

■ Change sort order: Changes the order in

which results are displayed: Unsorted, Sort by

time, Sort by sample ID, or Sort by patient

ID.

MENU

ACCEPT

Managing the Database 6-3

■ Manage selected records: Enables you to

Send selected records to a PC, Delete selected

records, or Backup selected records to a USB

flash drive. (Before selecting Backup selected

records, insert a USB flash drive into the USB

port on the analyzer’s front-panel.)

■ View external: Views previously saved data from a USB flash drive inserted into the

USB port on the analyzer’s front-panel.

■ Backup one day: Backs up all records from a

specified day to a USB flash drive.

1. Select the date to back up, and confirm by

pressing the soft key.

2. Insert a flash drive in the USB port on the

front of the analyzer, then press .

The records are then copied to the flash

drive.

ACCEPT

ACCEPT

6-4 Managing the Database

Section 7
Maintenance & ServiceThis section details maintenance and service procedures for the analyzer.
Section Contents

7.1 Periodic Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2

7.1.1 Daily Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2

7.1.2 Weekly Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2

7.1.3 Monthly Preventive Maintenance . . . . . . . . . . . . . . . . . . . 7-4

7.2 Cleaning the Aperture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-5

7.3 Bleach-Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-5

7.4 Shut-Down Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-7

7.5 Changing the Reagent Pack . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-8

7.6 Running the Self Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-10

7.7 Replacing the Peristaltic Pump Tube Assembly. . . . . . . . . . . . 7-11

Maintenance & Service 7-1

7.1 Periodic Maintenance

Performing the simple and easy maintenance procedures in this section will help keep your ana-

lyzer in optimal operating condition, thus ensuring peak performance, high-quality results, and a

good return on your investment.

7.1.1 Daily Maintenance

The analyzer’s automatic standby mode is designed to keep the system’s internal workings in opti-

mal condition, and so reduces the amount of maintenance needed.

■ Always keep the analyzer and its immediate surroundings as clean as possible to prevent

debris from getting into the system.

■ Check all reagent lines for kinks, pinches, abnormalities, and leaks or spills.

■ Clean up any standing fluid near the analyzer.

■ Wipe up any spills on the sample rotor.

7.1.2 Weekly Maintenance

Perform the following tasks once a week.

Clean the Wash Head

The wash head cleans the outer surface of the sample needle with a saline diluent. Salt can build up

around the wash head if it is not cleaned regularly. As a reminder, once a week the analyzer dis-

plays this message on the bottom of its screensaver:

“It is time to clean the needle wash head. Go to , Maintenance, Cleaning for

instructions.”

When this message appears, follow the instructions below to clean the wash head and prevent salt

accumulation. The process takes only a few seconds to complete.

Note: Pay particular attention to the weekly maintenance.

CAUTION: Do not touch any components inside the instrument except as spe-

cifically directed.

7-2 Maintenance & Service

1. Press the Utilities key , then select Maintenance.

2. Select Clean the wash head.

3. Open the door on the right side of the instrument.

The wash head’s location is shown at right.

4. Use a soft, lint-free cloth and warm tap water to gently rub

the lower surface of the wash head to remove any salt build-

up.

5. When finished, close the side door, then press the soft key.

Once this procedure is complete, the screensaver reminder will disappear, and will reappear

in one week.

ACCEPT


7.1.3 Monthly Preventive Maintenance

Once a month, clean the analyzer as follows.

1. Turn off and (if possible) unplug the analyzer.

2. Use a slightly damp cloth to clean the analyzer’s cover, front panel, and sampling rotor.

3. Open the side and rear doors, and clean the internal metal chassis underlay if necessary.

4. Clean the entire pneumatic system (tubes, valves, chamber, and aperture) with a “Prime

all” cycle:


b. Select Priming.

c. Select Prime all.

The analyzer then performs its priming process, including cleaning.

CAUTION: Do not use chemical cleaners such as bleach, and do not use an

excessively wet cloth. Water can cause the instrument’s electronics

to malfunction. Avoid touching internal components.

Note: Step 4 can be skipped if the reagent pack is changed monthly

and the instrument is shut down weekly.


7.2 Cleaning the Aperture

The analyzer automatically performs a three-step cleaning process after each analysis. In addition,

the analyzer provides a software-driven process that you can use to clear the measuring aperture of

any debris when needed (such as when directed to perform as a part of troubleshooting).

1. Press the Utilities key , select Mainte-

nance, then select Cleaning.

2. Select Automatic self-cleaning.

The analyzer then performs its cleaning process,

and returns to the Maintenance menu when fin-

ished.

7.3 Bleach-Cleaning

Use this procedure to bleach-clean the analyzer’s internal tubing each time you change the reagent

pack. You will need the following materials:

■ cleaning tube kit (shown on page 2-10)

■ household-strength chlorine bleach — at least 5 ml

■ distilled water — at least 195 ml

Run the bleach-cleaning process as follows:

1. Prepare a 5% bleach solution using 5 ml of bleach and 95 ml of distilled water.

In addition to the bleach solution, you will need at least 100 ml of distilled water for

rinsing.


2. Press the Utilities key , then select

Maintenance.

3. Select Bleaching.

4. When asked to confirm, press .

5. When prompted, disconnect the reagent tubing from the reagent inlets (diluent, lyse,

cleaner, and rinse) on the back of the analyzer, but leave the waste tubing connected.

6. Press to continue.

7. When prompted, connect the cleaning tube kit to the

reagent inputs as shown.

Note: If you do not have the cleaning tubing, leave the reagent

lines connected to the analyzer, and instead disconnect the

rinse, lyse, diluent, and cleaner bottle caps, and submerge

all four lines into the bleach solution — see step 8.

ACCEPT

ACCEPT


8. Submerge the free end of the cleaning tube in the

bleach solution.


10. When prompted, disconnect the cleaning tube (leaving the waste tubing connected), then

press .

11. When prompted, connect the cleaning tube kit to the reagent inputs as shown in step 7,

and submerge the free end of the cleaning tube in a container of at least 100 ml of dis-

tilled water, as shown in step 8.


13. When prompted, disconnect the cleaning tube (leaving the waste tubing connected), then

press .

14. When prompted, select from the following options as needed:

■ To install a new reagent pack, press .

■ To reconnect the old reagents, press .

■ To turn off the analyzer, press .

7.4 Shut-Down Procedures

If you will not use the instrument for more than 72 hours, shut it down as described in “Turning the

Analyzer Off” on page 2-28.

Note: Proper use of the analyzer’s shut-down procedure is critical

for maintaining the instrument in good working condition.

ACCEPT

ACCEPT

ACCEPT

ACCEPT

NEW

OLD

STOP


7.5 Changing the Reagent Pack

Follow this procedure to change the reagent pack.

1. Disconnect the reagent tubing from the reagent inlets (diluent, lyse, cleaner, and rinse)

on the back of the analyzer, but leave the waste tubing connected.

2. Perform a bleach cleaning — see “Bleach-Cleaning” on page 7-5.

3. Reconnect the reagent tubing to the inlets on the back of the analyzer.

4. Remove the caps (with tubing still attached) from the old reagent pack (including the

waste container).

5. Connect a new reagent pack, using the same tubing and reagent cap connectors.

6. Re-cap the used reagents with their original caps, and dispose of them in an environmen-

tally appropriate manner.

7. Prime all reagent lines:


b. Select Priming, then select Prime All.

8. Reset the reagent status:


b. Select Reagent Status.


c. Press the soft key, then press

to confirm.

The analyzer updates the installation

date, reagent lifetime, and the amount of

reagent in each container.

d. Press when finished.

9. If you place the new reagent pack in a different location relative to the instrument (com-

pared to the old pack), recalibrate the fluid sensors to obtain the maximum number of

tests per pack. (Calibration is not necessary if the new pack is placed in the same loca-

tion as the old one.)

If needed, calibrate the fluid sensors — see “Fluid Sensor Settings” on page 3-16.

10. Run a quality control procedure using a dog or cat sample — see “Performing Quality

Control” on page 5-6.

Note: If you selected NEW at the last step of the bleach-cleaning,

the reagent status will be automatically reset for a new pack

(100% for each reagent).

CHANGE

ACCEPT

EXIT


7.6 Running the Self Test

The analyzer includes an automated Self test that verifies proper operation of essential components

of the instrument. Run the Self test at these times:

■ at installation

■ after replacing any component

■ after any extended time out of use

■ if you suspect the analyzer is not working properly

1. Press the Utilities key , and select Diagnostics.

2. Select Self test. The analyzer then lists and checks off subsystems as it tests each.

3. When the test is finished, the analyzer displays

a summary of the results.

Press and to move through the

pages and view details.

Note: If the Overall result displayed is Errors, call Abaxis Techni-

cal Support — see “Customer and Technical Support” on

page 1-2.

PGDN PGUP


7.7 Replacing the Peristaltic Pump Tube Assembly

The analyzer’s peristaltic pump is designed to be maintenance-free. However, after extended, long-

term use (normally longer than a year), the pump tubing may eventually need to be replaced. The

analyzer includes a spare peristaltic pump tube set, with two plastic connectors and two metal

spring clips.

Though replacement is a simple process, Abaxis strongly recommends that you call Abaxis Tech-

nical Support before beginning, so that they can verify the need for pump tube replacement and

guide you through the process if necessary. See “Customer and Technical Support” on page 1-2.

Replace the peristaltic pump tube assembly as follows.

1. Open the analyzer’s rear door, and locate the peristal-

tic pump at the lower left of the rear compartment.

Disconnect the color-coded tubes attached to the base

of the pump housing, as shown.

2. Locate the locking mechanism on the underside of the

pump housing. Use the middle finger and thumb of

your right hand (as shown) to twist the fixing lock at

the base of the pump counterclockwise to loosen the

tube case.

WARNING: MAKE SURE THE INSTRUMENT IS POWERED OFF BEFORE YOU

BEGIN THIS PROCEDURE.

Note: Wear gloves while performing this procedure.

Keep paper towels on hand in case any liquid spills from the

tubes.

turn counterclockwise


3. Lift the pump tube case upward and remove it.

4. Remove the tubing from inside the case and replace

it with the new tubing provided.

Make sure the two plastic connectors at the ends

of the tubing are properly placed into the slots of

the tube case, and that the metal clips face

inward. Otherwise, the tube case cannot be

installed properly.

5. Fit the tube case back onto the pump housing from

the top, and firmly press both sides of the case.

6. Twist the fixing lock at the base of the pump clock-

wise until it clicks. The pump tube is then properly

installed.

Make sure the tubing case fits properly and tightly

in the correct position.

7. Reconnect the color-coded tubes to their proper

connectors: white to white, green to green.

8. Wipe up any spilled fluids from the base of the instrument. Close the rear door.


Section 8
Special FunctionsThis section describes special functions you can use in operating the
instrument.

Section Contents

8.1 Viewing the Software Version . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2

8.2 Viewing Status Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2

8.3 Updating the Software. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-3

8.4 Customizing the User-Defined Species Profile . . . . . . . . . . . . . 8-3

8.5 Customizing and Printing the Normal Range . . . . . . . . . . . . . . 8-4

Special Functions 8-1

8.1 Viewing the Software Version

■ To view the software version number, press the

Utilities key , select Diagnostics, then

select Device information.

8.2 Viewing Status Information

■ To view device statistics — number of analyses

performed, clogs, and errors, and other infor-

mation that may be useful for technical service

— press the Utilities key , select Diagnos-

tics, then select Statistics.

■ To view the status of the reagent pack, press the

Utilities key , select Maintenance, then

select Reagent status.

Note: Do not press the soft key unless you are changing

the reagent pack. Otherwise, the analyzer will not display

the true reagent status.

CHANGE

8-2 Special Functions

8.3 Updating the Software

From time to time, Abaxis will send you an updated version of the analyzer software on a CD. Use

the following procedure to install the update from the CD.

1. Press the Utilities key , and select Maintenance.

2. Select Software upgrade.

3. Open the analyzer’s CD-ROM drive by pressing the button on the drive door.

4. Insert the update CD in the drive, then close the drive.

5. Press . The system then restarts.

6. When the Upgrade/Install menu appears, select Upgrade existing version.

7. When the CD-ROM drive opens, remove the CD from the drive and store it in a safe

place.

8. Restart the analyzer by turning it off and then on again using the power switch on the

back of the instrument

The analyzer then automatically functions with the upgraded software version.

8.4 Customizing the User-Defined Species Profile

The analyzer includes a User-Defined Species Profile that enables you to define your own species

for testing. This profile can only be activated by Abaxis Technical Support personnel.

If you need to create custom species, please contact Abaxis Technical Support — see “Customer

and Technical Support” on page 1-2. They will guide you through activating the profile, and help

you to customize it to suit your requirements.

ACCEPT

Special Functions 8-3

8.5 Customizing and Printing the Normal Range

If you need to print out the normal range for particular species, do so as follows.


2. Select the species you want, then press the key. The species you selected are

shown at the upper right corner of the next screen.

3. Press . The normal ranges of the

selected species are then displayed.

4. Change any limits as needed, then press

.

5. Press the Print key .

The normal range of the selected species then

prints.

PT.ID

ACCEPT

LIMITS

ACCEPT

8-4 Special Functions

Section 9
TroubleshootingUse the information in this section to help diagnose and solve problems
with the analyzer.

Section Contents

9.1 Warning Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

9.1.1 Blank Flags . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

9.1.2 Measurement conditions. . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

9.1.3 Out-of-Range Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

9.1.4 Results Flags . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

9.2 Error Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-4

9.3 Evaluating Unexpected Results . . . . . . . . . . . . . . . . . . . . . . . . . 9-5

9.3.1 Examples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6

9.4 Preparing the Analyzer for Shipment . . . . . . . . . . . . . . . . . . . 9-10

Troubleshooting 9-1

9.1 Warning Indicators

This section lists warning indicators (flags) that can appear in test results, along with possible solu-

tions for each.

9.1.1 Blank Flags

If analysis errors occur or the blank measurement is too high,

an E error flag appears along with the affected parameter,

and “---” is displayed instead of results. In this situation, per-

form a cleaning — see “Cleaning the Aperture” on page 7-5.

If the problem persists, contact Abaxis Technical Support —

see “Customer and Technical Support” on page 1-2.

9.1.2 Measurement conditions

Warning flags are grouped according to measurement conditions and problems with the sample.

■ c, C, q, and Q flags are related to aperture clogging. Perform three to five cleanings as

needed (see “Cleaning the Aperture” on page 7-5), and repeat the blank measurement

(see “Run a Blank Measurement” on page 4-5).

■ b, p, E, H, and B are generally due to reagent contamination or lack of sample. Check

the sample (needle height, etc.). If contamination is suspected, change the reagent pack

(see “Changing the Reagent Pack” on page 7-8).

■ m, M, and N are caused by too high a cell concentration. Perform an external 1:5 dilu-

tion and repeat the measurement (see “Using Prediluted Mode” on page 4-21). Run a

quality control procedure if needed (see “Performing Quality Control” on page 5-6).

An asterisk (*) near a parameter indicates uncertainty. A variety of causes are possible. If a result

warning flag is present, refer to Table 9-1 on page 9-3 for possible causes and solutions.

9.1.3 Out-of-Range Results

If a parameter is outside the normal reference range, it is flagged with “–” if below the normal

range, or “+” if above the normal range. Reference ranges can be edited and customized in the

Limits menu. A setting of 0 for a range limit results in no reference range flagging.

9.1.4 Results Flags

If a warning occurs, a “*” flag appears before the result. Specific warning flags are displayed on

the results screen, and are grouped according to measurement conditions and the problems relating

to the blood sample:

■ Uppercase warning flags (E, H, B, C, Q) are related to WBC or HGB measures.

■ Lowercase flags (p, b, c, q) are related to RBC or PLT measures.

9-2 Troubleshooting

The following table summarizes these flags.

Table 9-1: Result Warning Flags

Flag Meaning Description / Recommended action

E Empty sample. • Needle may not reach sample. Check needle height and adjust to –2 mm if needed.

No WBC 3-part differential(unable to report a WBC dif-ferential)

• May occur in pathological lymphocytosis. Review slide if WBC count is outside normal limits.

• Possible lyse problem. Prime lyse and repeat the blank.

H HGB blank is high, or no HGB blank

• Possible interference. Make sure the side door is closed, and repeat the blank measurement.

• Possible bubbles in the WBC chamber. Check the connec-tions of the reagent inputs and perform a cleaning. Repeat the blank.

B WBC blank is high, or no WBC blank

• Check to see if wash head needs cleaning. If cleaning is needed, perform 3 to 5 cleaning cycles and repeat the blank measurement.

• If the blank is too high, perform 3 to 5 cleaning cycles and repeat the blank measurement.

• Possible lyse problem. Prime lyse and repeat the blank.• Possible lyse contamination. Check lyse container and line

for contamination. Repeat the blank.• Possible electrical noise interference. Be sure to use an unin-

terruptable power supply (UPS). Repeat the blank.

M, N Linearity error, or WBC coin-cidence is too high

• The results are out of the linearity range. Make a dilution with an external method to achieve 1:5 dilution rate, and run again. (1:5 calibration should be current.)

• Prime lyse and repeat the blank.

C, Q WBC clogging • Aperture clogging. Perform 3 to 5 cleaning cycles and repeat the measurement. If the problem persists, contact Abaxis Technical Support — see page 1-2.

• Low-temperature reagents (mainly diluent) can cause this. Be sure to allow reagents to reach room temperature.

p PLT blank is high, or no PLT blank


• Possible reagent contamination or system cleanliness prob-lem. If the problem persists, change the reagent pack, per-form a cleaning, and repeat. If the problem still remains, contact Abaxis Technical Support — see page 1-2.

b RBC blank is high, or no RBC blank


• Possible reagent contamination or system cleanliness prob-lem. If the problem persists, change the reagent pack, per-form a cleaning, and repeat. If the problem still remains, contact Abaxis Technical Support — see page 1-2.

m Linearity error, or RBC/PLT coincidence is too high

• Results are out of linearity range. contact Abaxis Technical Support — see page 1-2. Run a control cycle.

c RBC/PLT clogging • Low-temperature reagents (mainly diluent) can cause this. Be sure to allow reagents to reach room temperature.

• Aperture clogging. Run cleaning and repeat the measure-ment. If the problem persists, contact Abaxis Technical Sup-port — see page 1-2.

Troubleshooting 9-3

9.2 Error Messages

Below are a few very common error messages and solutions to the errors.

■ Error message: “Out of diluent, lyse, cleaner, or rinse”

Solutions:

❑ Visually check the reagent containers for reagent. If needed, change the reagent pack

— see “Changing the Reagent Pack” on page 7-8.

❑ Check for bubbles in the reagent tubing. If bubbles are present, check the connec-

tions at the back of the instrument, at the top of the corresponding reagent container,

and under the container cap to make sure they are tight.

❑ Make sure the reagent sensor is on — if it is not, there will be an “S” in the top left

corner of the display. In this case, calibrate the fluid sensor — see “Fluid Sensor Set-


■ Error message: “Pressure or vacuum error”

Solutions:

❑ Check for loose, detached, or kinked tubing inside and outside the instrument. Make

sure there are no leaks.

❑ Check the tubing inside the instrument for clots.

❑ Check for bubbles in the reagent tubing. If bubbles are present, check the connec-

tions at the back of the instrument, at the top of the corresponding reagent container,

and under the container cap to make sure they are tight.

❑ Visually check the reagent containers for reagent. If needed, change the reagent

pack— see “Changing the Reagent Pack” on page 7-8.

9-4 Troubleshooting

9.3 Evaluating Unexpected Results

This section presents several histograms demonstrating unexpected results. These examples will

assist you in identifying various cell populations, their position, and their ratio as indicated by their

respective histograms.

The figure at right shows a “full-spectrum” histogram.

The first two discriminators in this example show a clean val-

ley between 29 and 34, which is ideal. The first discriminator

indicates the end of the platelet population (and is not nor-

mally displayed in the PLT histogram), and the second indi-

cates the start of the WBC category. High peaks or lack of a

“valley” here indicate one or more of the following:

■ existence of nucleated RBCs or reticulocytes

■ existence of resistive RBCs (bigger pieces of hemolysed RBCs in WBC solution)

■ contaminated reagents, or other interference such as electrical noise, etc.

Note that this illustration shows a “full-spectrum” histogram (2–400 fl) following the RBC lysing

process, whereby the entire RBC population is ideally lysed for accurate counting of white blood

cells and platelets.

In the above histogram, the third and fourth discriminators establish the WBC differential:

■ The area (cells) between the second and third discriminators is classified as lympho-

cytes.

■ The area between the third and fourth discriminators is classified as monocytes.

■ The area to the right of the fourth discriminator is classified as granulocytes.

Discriminators

1 2 3 4

Troubleshooting 9-5

9.3.1 Examples

1 — High Blank, Flag p

The blank measurement shown below indicates a high PLT background, most likely due to a con-

taminated system. Blank is optimal if PLT < 26.

Evaluation

The above histograms indicate the following (see the arrows):

■ WBC — normal: shows no traces of particles

■ RBC — shows some background “noise”

■ PLT — shows a p flag, indicating background “noise” (such as chamber contamination)

Solution

1. Perform three to five cleanings as needed — see “Cleaning the Aperture” on page 7-5.

2. Repeat the blank measurement — see “Run a Blank Measurement” on page 4-5.

3. If the problem persists, contact Abaxis Technical Support — see “Customer and Techni-

cal Support” on page 1-2.

any cells in this area may reflectthe presence of aggregated/giantplatelets, nRBCs, retics, etc.

9-6 Troubleshooting

2 — No results due to having accepted a high blank — flags p, b, and B

A report similar to that shown below results from measuring a sample without first generating an

acceptable blank. The p (high PLT), b (high RBC), and B (high WBC) flags show that the previous

blank measurement had high background values. Although histograms are shown, the values are

not reported (see the arrows in the values listing).

Evaluation

The above histograms indicate the following (see the arrows):

■ WBC — B flag, high WBC background

■ RBC — b flag, high RBC background

■ PLT — p flag, high WBC background

Solution


2. Repeat the blank measurement — see “Run a Blank Measurement” on page 4-5.

3. Repeat the sample run after obtaining an acceptable blank.



Troubleshooting 9-7

3 — WBC clogging, flag C

In cases of aperture clogging, the histogram represents apparent large cells, since clogging results

in a smaller effective aperture, which makes the particles passing through appear relatively larger.

The histograms are drawn, but WBC results are not available.

Evaluation

The above histograms indicate the following (see the arrows and highlight):

■ WBC — flag C shows WBC aperture clogging

■ HGB — the result is unbelievably high (resulting in erroneous MCH/MCHC results)

■ RBC — normal

■ PLT — normal

Solution


2. Repeat the measurement.



Note: In cases of RBC clogging, MCV (and consequently HCT)

are artificially larger.

9-8 Troubleshooting

4 — WBC non-linear, flag M

This particular sample shows a typical lymphocytosis (WBC count beyond linearity limits).

Evaluation

The above histograms indicate the following (see the arrow and highlight):

■ WBC — WBC is very high, indicating leukocytosis. Flag M means that the WBC

results are out of the linearity range. The absolute and percentage values are marked

with asterisks (*), due to overlapping cell populations (cell discriminators may not be

accurate).

■ RBC — normal

■ PLT — normal

Solution

Contact Abaxis Technical Support — see “Customer and Technical Support” on page 1-2.

Troubleshooting 9-9

9.4 Preparing the Analyzer for Shipment

If Abaxis Technical Support determines that your instrument needs to be sent in for service, Abaxis

will send you a loaner unit for use in the meanwhile. After you receive the loaner unit, prepare your

analyzer for shipping as follows.

1. Switch off the instrument as described on page 2-29.

2. Remove the waste connector from the instrument.

3. Put the cap on each reagent intake valve on the instrument to prevent reagent solutions

from leaking out.

4. Remove the thermal printer paper roll from the built-in printer.

5. Remove the sample adapter from the sample rotor.

6. Unplug the external power supply, printer cable, and mini-keyboard from the instrument.

7. Open the instrument side door. Wipe up any liquid left inside the instrument.

8. Insert the foam piece in the position

shown to prevent sample needles from

sliding.

9. If you received a loaner instrument,

transfer the tape from the loaner instru-

ment's counting chamber onto the top of

your instrument’s counting chamber to

protect it from dust.

If you did not receive a loaner instru-

ment, proceed to the next step.

10. Close the side door. Wipe up any liquid left outside of the instrument.

11. Place the analyzer into its original plastic bag and place it inside its shipping box. Make

sure that the forms and instrument fit perfectly inside of the box.

12. Place the power supply and power cord properly into the shipping box.

13. Close the box and seal the box using a strong tape.

The instrument is now ready for shipping.

CAUTION: DO NOT use any other type of tape, as the tape’s adhesive may

damage the counting chamber.

9-10 Troubleshooting

Section 10
SpecificationsThis appendix contains technical specifications for the HM2 system, and
lists its linearity ranges.

Section Contents

10.1 VetScan HM2 Specifications . . . . . . . . . . . . . . . . . . . . . . . . . 10-2

10.2 Linearity Ranges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3

Specifications 10-1

10.1 VetScan HM2 Specifications

Sample volume 25 µl whole blood (50 µl in prediluted mode)

Aperture diameter 80 µm

Throughput Approximately 25 tests/hour

CharacteristicsAccuracy

(max. deviance from expected)

Reproducibility (CV)

Carry-over betweensamples Test range

WBC 3% < 3% < 1% 4.0–20.0

RBC 3% < 3% < 1% 4.00–15.00

HCT 3% < 3% < 1% 25.0–50.0

MCV 2% < 1% N/A 50–90

HGB 2% < 2% < 1% 9–16

PLT 4% < 4% < 3% 200–900

HCT 3% < 3% < 1% 25.0–50.0

Sampling method Open tube system with automatic sample rotor

Clog prevention High-voltage pulse and chemical cleaning of the aperture in each analysis cycle

Cleaning procedure High-voltage burst of the aperture, high-pressure back-flush, chemical cleaning of the aperture

Quality control 3 QC options. QC parameters include: mean, ± range, SD and CV for all measured and calculated parameters, 16- and 64-day Levy-Jennings charts, separate QC database

Calibration Automatic based on 3 measurements (default method). Predilution method must be calibrated independently.

Multi user feature Three-level Multi user operation with selective privilege levels, user identi-fication with ID and password

User interface Easy-to-use, menu-driven user interface with 6 hard-function buttons, graphic icons, and on-screen help

Languages available English. For other languages, contact Abaxis Technical Support — see page 1-2.

Data capacity 1000 results, including histograms on-board. Data can be saved to USB flash drive or downloaded to computer.

Host computer interface Serial (RS-232) computer link and USB

Data back-up method USB flash drive

Software upgrade method USB flash drive or CD-ROM

External printer interface USB

Built-in printer “Easy Paper Operation” built-in thermal printer

Display 240x128-dot, high-contrast, CCFL, backlit, graphics liquid crystal diode

Keypad 24 foil keys + START button

External keyboard Standard PS/2 or USB-compatible keyboard

Power supply External 12 VDC, 8 A power module

Power supply (input) 100/240 V, 50–60 Hz, 10 W stand by, 80 W operating

Operating temperature 59–86 °F (15–30 °C). Optimal temperature is 77 °F (25 °C).

Dimensions (W x D x H) 12.6 x 10.2 x 14.4 in (320 x 260 x 365 mm)

Net weight 26.4 lbs (12 kg)

10-2 Specifications

10.2 Linearity Ranges

The HM2 is guaranteed to provide specified accuracies within its linearity range. Beyond this

range, results may still be displayed, but accuracy is no longer guaranteed.

If the value is over the maximum range of guaranteed linearity, the instrument cannot measure it,

and the result will be marked with an E, m, M, or N flag.

To measure a sample whose parameters exceed the maximum linear value indicated in the table

below, predilution is recommended — see “Using Prediluted Mode” on page 4-21.

The following tables list the linearity ranges for primary parameters in normal measuring mode

and prediluted mode.

Table 10-1: Linearity Ranges in Normal Measuring Mode

Table 10-2: Linearity Ranges for Prediluted Mode

Parameter Linearity Ranges Maximum Unit

WBC 0–100 150 109 cells/liter

RBC 0–15 20 1012 cells/liter

PLT 0–700 1000 109 cells/liter

HGB 0–250 400 g/l

HCT 0–100 — %

MCV 30...150 — Fl

MPV 3...30 — Fl

Parameter Linearity Ranges Maximum Unit

WBC 2–200 300 109 cells/liter

RBC 1–30 40 1012 cells/liter

PLT 100–2000 3000 109 cells/liter

Specifications 10-3

10-4 Specifications

Appendix A
Introduction to Veterinary HematologyThis section introduces several fundamental concepts of veterinary hema-
tology. Having a basic knowledge of these concepts will help you better

understand the results from the analyzer.

Appendix Contents

A.1 Function of Blood. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2

A.2 Composition of Blood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3

A.3 Blood Cell Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-4

A.3.1 Red Blood Cells, Hemoglobin . . . . . . . . . . . . . . . . . . . . . A-4

A.3.2 White Blood Cells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-5

A.3.3 Automated WBC Classification. . . . . . . . . . . . . . . . . . . . A-5

A.3.4 Platelets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-6

A.4 Normal Hematology Ranges (Dog, Cat, Horse, and Others) . A-7

A.5 Veterinary Hematology References . . . . . . . . . . . . . . . . . . . . . A-8

Introduction to Veterinary Hematology A-1

A.1 Function of Blood

Blood circulates in the body and acts as a transport medium that carries oxygen, essential nutrients,

and other materials to the cells of the body. It also serves to transport waste products for disposal.

Neurons, muscle cells, connective tissue cells, and epithelial cells draw their nourishment from

interstitial spaces, and respond to the glucose and oxygen content of that environment. Fresh sup-

plies of oxygen and glucose are exchanged with the blood circulating in the capillaries. Blood

receives its oxygen from lungs and glucose from the intestines and liver.

Normal cell function depends on the rapid removal of toxic metabolic products (CO2 and NH3)

from the interstitial fluid environment. These waste products are taken up by the plasma and red

blood cells, and eliminated as the blood passes through the kidneys and lungs. Blood also delivers

hormones, lipids, amino acids, salts, and vitamins, and removes urea and conjugated acids.

Blood distributes the heat generated by metabolizing body cells, so that body temperature is main-

tained at a constant level. In the event of vascular injury, blood platelets and plasma coagulation

mechanisms prevent blood loss by aggregating with other platelets to form large hemostatic plugs

(clots).

White blood cells protect against infections by identifying and killing invasive bacteria.

The number, size and distribution of blood cells provide important information for clinical diagno-

sis and therapy. The aim of hematology is to collect this information.

A-2 Introduction to Veterinary Hematology

A.2 Composition of Blood

Whole blood contains three cellular components:

■ Red blood cells (erythrocytes, RBC)

■ White blood cells (leukocytes, WBC)

■ Platelets (thrombocytes, PLT)

Table A-1: Cell Composition of Whole Blood*

Red Blood Cells White Blood Cells Platelets

Normal density 5–12 x 1012 cells/l 6–15 x 109 cells/l 100–700 x109 cells/l

Nucleated? No ** Yes No

Sub-populations and their per-centages

RBC: 99.9%

NRBC **(Nucleated RBC) 0.1%

GRAnulocytes: 65%NEUtrophil: 60%EOSinophil: 4%BASophil: 1%

LYMphocytes: 32%MONocytes: 3%

Shape, sizeBiconcave (donut) shapediameter: 5–7 µmthickness: 1.8–2 µm

GRAnulocytes: 13–16 µmLYMphocytes: 8–15 µmMONocytes: 15–25 µm

Fragments with a diameter of 2-4 µm

Volume of cell 30–80 fl 50–1500 fl 5–15 fl

Volumetric% in whole blood

40–45% 0.1% 0.3%

* Data generated using whole human blood.**Mature mammalian RBCs are non-nucleated.


A.3 Blood Cell Parameters

A.3.1 Red Blood Cells, Hemoglobin

Red blood cells — RBC — are formed in the bone marrow. A mature human red blood cell is non-

nucleated, and has a mean corpuscular volume (MCV) of approx. 70 fl. RBCs are the most numer-

ous cell type in blood. There are approximately 5–10 x 1012 cells/l in the blood of a healthy dog.

RBC and MCV are directly measured primary parameters.

Hematocrit — HCT — is the proportion of RBCs to plasma (liquid portion) in blood. HCT is the

most accurate and simplest way to measure the degree of anemia, and is calculated from the RBC

and MCV values:

HCTpercent = RBC x MCV / 10

HCTabsolute = HCTpercent / 10

Typically, HCT = 0.45 = 45%

Red Blood Cell Distribution Width — RDW — is a

measure of RBC anisocytosis, the degree of cell size

variation. In a healthy sample, RBCs demonstrate a

normal (Gaussian) distribution (bell curve), as shown

at right. RDW can be characterized by a standard

deviation (RDW-SD) or a coefficient of variation

(RDW-CV) represented as a percentage.

Hemoglobin — HGB — is the main component of RBCs. It is a conjugated protein (with Fe), and

its main function is to transport oxygen from the lungs to tissues and carbon dioxide from the tis-

sues back to the lungs. Normal HGB concentration of samples is approximately 14 g/dl or 140 g/l

or 87 mmol/l.

Mean Corpuscular Hemoglobin — MCH — is the average hemoglobin content of RBCs, and is

calculated from RBC and HGB values:

MCH = HGB / RBC x 10, reported in picograms or fmol

Mean Corpuscular Hemoglobin Concentration — MCHC — is the concentration of HGB in an

average RBC, calculated from the HGB and HCT values:

MCHC = HGB / HCTabsolute , reported in g/dl, g/l or mmol/l

(fl)


A.3.2 White Blood Cells

White Blood Cells — WBC — are formed in the bone marrow. During their maturation sequence

they differentiate from the parent cell into five sub-populations. WBCs are nucleated and classified

as granulocytes (neutrophils, eosinophils, and basophils), lymphocytes, and monocytes. WBCs are

equipped with all cell organelles necessary to perform vital protective functions in the body.

The normal WBC is in the range of 7 x 109 cells/l, a fraction of the RBC population. In pathologi-

cal conditions, the WBC count can increase dramatically (up to 300 x 109 cells/l in extreme leuke-

mia). In these cases, predilution of the sample is recommended for the most accurate results (see

“Diluting Whole Blood” on page B-3).

Three-part differential histograms (volume distribution curves) of WBCs can be used as a simple,

visual evaluation of the number and relative percentage of lymphocytes (LYM, LYM%), mono-

cytes (MON, MON%), and granulocytes (GRA, GRA%).

WBC-related parameters are defined as follows:

WBC = LYM + MON + GRA

LYM% = LYM / WBC

MON% = MON / WBC

GRA% = GRA / WBC

A.3.3 Automated WBC Classification

The analyzer evaluates each sample as a unique population, using dynamic cellular discriminators

to assess the cellular distribution most accurately. To determine WBC sub-populations, the ana-

lyzer first sets “discriminator 1” at the limit of hemolysed RBCs + PLTs (on the left) and LYM

population, then fits normal distribution curves to the remaining WBC histogram (shown below in

different shades of grey).

RBC/PLT region

LYM population

GRA population

Discriminators:1. 2.3.

MID population


Eosinophilia is often depicted as a peak between the MON and GRA classifications.

As with any automated system, good laboratory practice requires that all abnormal results be veri-

fied by slide (blood smear) review.

A.3.4 Platelets

Platelets — PLT — are non-nucleated fragments of the megakaryocyte. Note that platelets are

formed by cellular fragmentation and not by a so-called maturation sequence. Therefore, the plate-

let histogram normally has a logarithmic shape on the left side, and a normal shape on the right

side (“log-normal” distribution).

Normal PLT concentrations range from 200–800 x 109 cells/l (for dogs), depending on the mean

platelet volume (MPV), but can vary from 0–1000x109 cells/l under certain circumstances.

PLTs are relatively small compared to RBCs. The mean platelet volume — MPV — is approxi-

mately 10 fl, so PLTs can effectively be separated from RBCs by their size.

Platelet aggregation is common, particularly in feline

species, and is depicted by a flattened, lumpy histogram,

as shown at right. This effect can be minimized with

proper sample collection and vortex mixing of the sam-

ple (up to 30 seconds) before analysis.

The analyzer calculates the volumetric ratio of PLTs in whole blood as follows:

PCTpercent = PLT x MPV/10%,

PCTabsolute = PCTpercent / 10

Typically, PCT = 0.003 = 0.3%

Platelet Distribution Width — PDW — is a measure of platelet anisocytosis, the degree of size

variation. In a healthy sample, platelets demonstrate a normal (Gaussian) distribution (bell curve).

PDW can be characterized by a standard deviation (PDW-SD) or a coefficient of variation

(PDW-CV) represented as a percentage.


A.4 Normal Hematology Ranges (Dog, Cat, Horse, and Others)

The following table summarizes normal ranges of blood cell parameters. Keep in mind that normal

values vary from population to population.

Parameter Unit Dog Cat Horse Bovine Pig Mouse

WBC 109 cells/l 6–17 5.5–19.5 5.4–14.3 4–12 11–22 6–15

LYM% % 12–30 20–55 17–68 45–75 39–62 57–93

MID% % 2–4 1–3 0–14 2–7 2–10 0–7

GRA% % 62–87 35–80 22–80 15–65 28.5–64 8–48

RBC 1012 cells/l 5.5–8.5 5–10 6.8–12.9 5–10 5–8 7–12

HCT % 37–55 24–45 32–53 24–46 32–50 35–45

MCV fl 60–77 39–55 37–59 40–60 50–68 45–55

RDWcv %

HGB g/dl 120–180 80–150 110–190 80–150 100–160 122–162

MCH pg 19.5–24.5 12.5–17.5 12.3–19.7 11–17 17–21 11.1–12.7

MCHC g/dl 310–340 300–360 310–390 300–360 300–340 223–320

PLT 109 cells/l 200–500 300–800 100–400 100–800 325–715 200–450

MPV fl 3.9–11.1 12–17

Parameter Unit Dog Cat Horse Bovine Pig Mouse

WBC 109 cells/l 2.1–19.5 3–11.5 2–10 5.7–21 6–17 6–17

LYM% % 55–97 55–98 27–80 43–77 12–30 12–30

MID% % 0–5 0–6 0–10 0.4–6

GRA% % 2–31 0–40 16–70 19–52 62–87 62–87

RBC 1012 cells/l 5.3–10 5–9 7.8–13 4.8–6.3 5.5–8.5 5.5–8.5

HCT % 35–52 36–50 36–56 30–44 37–55 37–55

MCV fl 50–62 57–70 40–48 50–90 60–77 60–77

RDWcv %

HGB g/dl 140–180 127–163 124–187 80–150 120–180 120–180

MCH pg 16–23 17.5–23.5 13.5–16.5 12–13 19.5–24.5 19.5–24.5

MCHC g/dl 310–400 300–380 321–355 300–360 310–340 310–340

PLT 109 cells/l 500–1370 218–641 96–776 200–600 200–500 200–500

MPV fl


A.5 Veterinary Hematology References

■ “Schalm’s Veterinary Hematology,” 5th ed.,

Feldman, Bernard, et al, Lippincott Williams & Wilkins, 2000.

■ “Veterinary Hematology, Atlas of Common Domestic Species,”

Reagan, William, et al, Iowa State Press, 1998.

■ “Veterinary Laboratory Medicine, Interpretation & Diagnosis,” 3rd ed.,

Meyer, Denny & Harvey, John, Elsevier Press, 2004.

■ “A Guide to Hematology in Dogs & Cats,”

Rebar, Alan, et al, Teton New Media, 2002.

■ “Automated Blood Counts & Differentials, A Practical Guide,”

Bessman, J David, Johns Hopkins University Press, 1986.

■ “Hematology Techniques & Concepts for Veterinary Technicians,”

Voigt, Gregg, Blackwell Publishing, 2000.


Appendix B
Operating PrinciplesThis appendix explains the basic operating principles of the analyzer.
Appendix Contents

B.1 Complete Blood Count (CBC) . . . . . . . . . . . . . . . . . . . . . . . . . B-2

B.2 Measurement Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-2

B.2.1 Volumetric Impedance Method . . . . . . . . . . . . . . . . . . . . B-2

B.2.2 Diluting Whole Blood . . . . . . . . . . . . . . . . . . . . . . . . . . . B-3

B.2.3 Three-Part WBC Differential Method . . . . . . . . . . . . . . B-4

B.3 Hemoglobin Determination . . . . . . . . . . . . . . . . . . . . . . . . . . . B-5

B.3.1 Hemoglobin Determination by Photometry . . . . . . . . . . B-5

B.4 Measured and Calculated Values. . . . . . . . . . . . . . . . . . . . . . . B-6

Operating Principles B-1

B.1 Complete Blood Count (CBC)

The analyzer utilizes impedance technology whereby electrically neutral blood cells pass through

an electrically charged aperture thereby generating a “pulse.” Cell counts are determined by the

number of pulses measured in a given volume of blood over a set period of time. The decrease in

electrical conductance (degree of intensity) as measured is directly proportional to the cell volume.

This size discrimination, along with susceptibility to various lysing agents distinguish the basic

cell types (red, whites, platelets).

B.2 Measurement Methods

This section provides an overview of the hematology measurement methods used by the analyzer.

B.2.1 Volumetric Impedance Method

The analyzer uses a volumetric impedance method of counting blood cells. The following figure

illustrates this method.

The principle of this method is that blood diluted with an isotonic solution (diluent) conducts elec-

tric current by ionic conduction. A counting chamber made of an insulating material (plastic) holds

this diluted blood, while a small circular hole (aperture) in this chamber allows the flow of diluted

blood. (The analyzer aperture diameter and length is 80 µm — the optimal size for veterinary

hematology.)

Placing two electrodes on the two sides of this aperture and applying constant electric current

causes the isotonic solution to conduct electricity, and allows a voltage to be measured on the aper-

ture.

B-2 Operating Principles

Applying pressure to the diluted sample causes it to flow through the aperture. When a cell is pass-

ing the aperture, a small change in electric impedance occurs, so that the voltage rises somewhat

and a small electric pulse occurs. The amplitude of this pulse is proportional to the ratio of the cell

volume (size) and the aperture volume: the bigger the cell, the higher the pulse.

Proper counting (or differentiation) of cells requires passing of only one cell through the aperture

at a time. To help ensure this, the blood samples must be diluted, since cell concentrations are oth-

erwise too high.

In cases of cell counts beyond the linear range, an external predilution of the sample is recom-

mended — see “Using Prediluted Mode” on page 4-21.

B.2.2 Diluting Whole Blood

The analyzer uses the following procedure to dilute the blood sample for processing:

Although diluted blood is used, in cases of extremely high concentrations (such as leu-kemia) WBC density can be 100x higher than normal, causing two or more cells to pass through the aperture at a time, generat-ing one pulse instead of two (or more). This is called coincidence, and results in non-lin-ear counting of cells. Flags m, M, and N appear in this case.

The WBC linearity range is 100 x 109 cells/l.


In this procedure, 25 µl of whole blood is diluted with 4 ml of diluent to form a 1:160 first dilution.

25 µl of this dilution is then mixed with 0.5 ml of lyse to form an overall 1:180 dilution, suitable

for measuring WBC and HGB. After WBC-HGB measurement, 25 µl of the first dilution is mixed

with 5 ml of diluent to form an overall 1:32000 dilution, suitable for measuring RBC and PLT.

B.2.3 Three-Part WBC Differential Method

Since RBCs are typically 1000 times more concentrated in normal blood than are WBCs, they

would interfere with WBC counting if left intact.

In addition, the analyzer directly measures HGB, which is inside the RBCs and so must be

extracted.

Therefore, a hemolysing reagent (lyse) is used to dissolve cellular membranes, thus destroying

RBCs, and creating a complex solution suitable for photometry of HGB and counting WBCs.

The following figure shows the changes in blood cell characteristics that occur during three-part

differential hemolysis.

The membranes of the WBCs become selectively permeable, so that they begin to shrink down to

their nuclei in the slightly hypertonic lyse solution. Effectively hemolysed samples contain WBC

particles in the 30–300 fl region (for veterinary species).


The figure below shows a typical three-part differential WBC histogram of selective hemolysis

(dog).

B.3 Hemoglobin Determination

Hemoglobin is measured directly by means of the traditionally used cyanomethoglobin reaction,

but using cyanide-free substances to reach the same endpoint:

Fe 2+ converted to Fe 3+ methemoglobin + KCN cyanmethemoglobin

Hemoglobin concentration is measured photometrically.

B.3.1 Hemoglobin Determination by Photometry

HGB determination is one of the most important hematology parameters, as it relates to the oxygen

carrying capacity of blood.

The analyzer uses a cyanide-free lysing reagent to minimize environmental impact. The effect of

cyanide-free lyse is very similar to that of lyse containing cyanide, but the chemical reaction is

slightly different. The figure below illustrates the HGB measurement method.

HGB is measured by passing light (540 nm) through the WBC dilution, and measuring the transmitted light with a photo detector.

The light intensity (I) of the sample liquid is logarithmically proportional to the concen-tration of HGB:

HGB ≈ log (Ireference / Isample)

LYM GRAMON


B.4 Measured and Calculated Values

Each sample is analyzed to produce a complete, 18-parameter blood count (CBC), including the

following measured or calculated parameters:

■ WBC — total white blood cell count

■ LYM — lymphocytes count

■ MON — monocyte count*

■ GRA — granulocytes count

■ LYM% — lymphocyte percentage

■ MO% — monocyte* percentage

■ GRA% — granulocytes percentage

■ RBC — red blood cell count

■ HGB — hemoglobin

■ HCT — hematocrit

■ MCV — mean corpuscular volume

■ MCH — mean corpuscular hemoglobin

■ MCHC — mean corpuscular hemoglobin concentration

■ RDWc — red cell distribution width

■ PLT — platelet count

■ PCT — platelet percentage

■ MPV — mean platelet volume

■ PDWc — platelet distribution width

* The monocyte category consists primarily of monocytes. Impedance counters categorize white blood cell types (differential) according to size, and therefore a certain percentage of eosinophils may have a mass that falls in the normal range for monocytes (the exact percentage depends on the individual animal and is generally inconsequential due to the very low numbers of eosino-phils in a healthy animal). Eosinophilias, however, can typically be visualized as a distinct peak between the monocyte range and the granulocyte peak on a histogram.


B.5 Measured and Calculated Values

The HM2 measures and calculates the following values from tested blood samples.

Table B-1: Measured and Calculated Values

Values Definitions

White Blood Cells — WBC(reportable as: cells/l, cells/µl)

Total number of leukocytes (white blood cells).• WBC = WBCcal x (cells/l, cells/µl)

Red Blood Cells — RBC(reportable as: cells/l, cells/µl)

Total number of erythrocytes (red blood cells).• RBC = RBCcal x (cells/l, cells/µl)

Hemoglobin concentration — HGB(reportable as: g/dl, g/l, mmol/l)

Measured photometrically at 540 nm (see page B-2 for details).• HGB = HGBcal x (HGBmeasured – HGBblank)

Mean Corpuscular Volume — MCV (fl) Average volume of individual erythrocytes derived from the RBC histogram.

Hematocrit — HCT(reportable as: percentage, absolute)

Also known as Packed Cell Volume (PCV).Calculated from the RBC and MCV values:• HCTpercentage = RBC x MCV / 10• HCTabsolute = RBC x MCV

Mean Corpuscular Hemoglobin —MCH (reportable as: picogram, fmol)

Average hemoglobin content of erythrocytes, calculated from RBC and HGB values:• MCH = HGB / RBC

Mean Corpuscular Hemoglobin Concen-tration — MCHC (reportable as: g/dl, g/l, mmol/l)

Calculated from the HGB and HCT values:• MCHC = HGB / HCTabsolute

Red Cell Distribution Width —(reportable as: RDW-SD [fl], RDW-CV [absolute])

Measure of the degree of RBC anisocytosis. Calculated using the distribution width of the erythrocyte or platelet population derived from the histogram at 20% of peak:

Platelet — PLT(reportable as: cells/l, cells/µl)

Number of thrombocytes (platelets).• PLT = PLTcal x (cells/l, cells/µl)

Mean Platelet Volume — MPV (fl) Average volume of individual platelets derived from the PLT histogram.

Platelet Distribution Width —(reportable as: PDW-SD [fl], PDW-CV [absolute])

Measure of the degree of platelet anisocytosis.

Platelet Hematocrit (Thrombocrit) — PCT (reportable as: percentage, absolute)

Calculated from the PLT and MPV values:• PCTpercentage = PLT x MPV x 100• PCTabsolute = PLT x MPV


White Blood Cell Differential:LYM, LYM%: lymphocytesMON, MON%: monocytesGRA, GRA%: neutrophil, eosinophil and basophil granulocytes

Absolute values counted in the channels determined by the three WBC discriminators:

Percentages calculated from the absolute WBC value.

Values Definitions

LYMMON

GRA


Appendix C
Potential Sample InterferencesTable C-1 lists situations in which substances in the samples themselves
can interfere with accurate analysis, and provides possible solutions.

Potential Sample Interferences C-1

Tabl

e C

-1:

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ubst

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Appendix D
Veterinary Case StudiesThe following pages present a variety of veterinary case studies.
Appendix Contents

D.1 Human Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-2

D.2 Dogs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-3

D.2.1 Dog: Normal Sample. . . . . . . . . . . . . . . . . . . . . . . . . . . . D-3

D.2.2 Dog: High LYM%, Low GRA% . . . . . . . . . . . . . . . . . . . D-4

D.2.3 Dog: High PLT, High GRA. . . . . . . . . . . . . . . . . . . . . . . D-5

D.2.4 Dog: Low PLT, High WBC and GRA. . . . . . . . . . . . . . . D-6

D.2.5 Dog: High RBC and HGB . . . . . . . . . . . . . . . . . . . . . . . D-7

D.2.6 Dog: Low RBC and PLT, high WBC . . . . . . . . . . . . . . . D-8

D.2.7 Dog: Eosinophilia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-9

D.3 Cats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-10

D.3.1 Cat: Optimal Sample . . . . . . . . . . . . . . . . . . . . . . . . . . . D-10

D.3.2 Cat: Low PLT and RBC . . . . . . . . . . . . . . . . . . . . . . . . D-11

D.3.3 Cat: Clumped/Aggregated Platelets . . . . . . . . . . . . . . . D-12

D.3.4 Cat: High WBC and GRA, Low RBC, HCT, and HGB D-12

D.3.5 Cat: Possible nRBCs and Clumped Platelets . . . . . . . . D-13

D.4 Horses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-15

D.4.1 Horse: Normal Sample . . . . . . . . . . . . . . . . . . . . . . . . . D-15

D.4.2 Horse: Low LYM%, High GRA%. . . . . . . . . . . . . . . . . D-16

D.4.3 Horse: Low PLT and MPV . . . . . . . . . . . . . . . . . . . . . . D-17

D.4.4 Horse: Low RBC and HGB . . . . . . . . . . . . . . . . . . . . . D-18

Veterinary Case Studies D-1

D.1 Human Control

The following report shows typical histograms of normal human control blood (that is, human con-

trol run in QC mode).

Note the differences in cell populations: human sample and control blood contains larger cells than

does animal blood.

D-2 Veterinary Case Studies

D.2 Dogs

Dog samples show RBC peaks around 60-70 fl with a good separation of the PLTs from the RBCs.

Canine lymphocyte populations (lymphocytes, monocytes, and granulocytes) can overlap as a

result of similar cell sizes.

D.2.1 Dog: Normal Sample

The following shows a normal dog histogram.

These histograms indicate the following:

■ WBC — All cells larger than 39 fl are counted as WBCs (indicated by discriminator 1).

Discriminators 2 and 3 show the MON population.

■ RBC — All cells larger than 25 fl are counted as RBCs. The RBC histogram follows a

normal distribution. The expected MCV is near 60 fl, and the expected RBC is near

7 x 1012 cells/l.

■ PLT — PLT cell population is between 2 and 25 fl. The PLT histogram follows a log-

normal distribution.


D.2.2 Dog: High LYM%, Low GRA%

The following shows a sample that has high LYM%. (LYM% is normally near 25–30% for dogs.)

This case shows a lymphocytosis.


■ WBC — High LYM%, low GRA%.

■ RBC — Normal.

■ PLT — Normal.


D.2.3 Dog: High PLT, High GRA

In this sample, the absolute value of GRA and PLT is high, and the LYM population is much

smaller than the GRA population. This case demonstrates a neutrophilia and thrombocytosis.


■ WBC — Three-part differential curve with good separation between populations.

■ RBC — Normal.

■ PLT — High PLT. (Note that the RBC histogram shows that the peak of the PLT curve,

to the left of the RBC discriminator, is higher than normal.)


D.2.4 Dog: Low PLT, High WBC and GRA

This sample shows a very low PLT, while the WBC is high due to an extremely high GRA. This

case demonstrates a neutropenia and thrombocytosis.


■ WBC — Discriminator 1 is at 53 fl, accurately separating the RBC/PLT region. Discrim-

inators 2 and 3 are placed correctly according to the WBC population.

■ RBC — Normal. Note that the PLT curve is very flat.

■ PLT — Very low PLT.


D.2.5 Dog: High RBC and HGB

This sample shows a slightly high RBC and HGB, while the WBC and PLT are normal.




■ RBC — Slightly high RBC, normal distribution.

■ PLT — Normal, with a perfect discriminator at 25 fl.


D.2.6 Dog: Low RBC and PLT, high WBC

This sample shows low RBC, PLT, HGB, and HCT values. The WBC is high due to a high GRA

population. This case demonstrates anemia and neutrophilia.




■ RBC — Very low RBC, with a normal distribution, indicating anemia.

■ PLT — Low PLT.


D.2.7 Dog: Eosinophilia

This sample demonstrates an eosinophilic canine patient.


■ WBC — The histogram indicates a normal WBC accompanied by an absolute lym-

phopenia and relative granulocytosis. The presence of the secondary eosinophil peak

(indicated by the arrow) indicates a eosinophil count higher than normal, and a need for

a manual blood smear.


D.3 Cats

An important characteristic of cat blood is that the RBCs are much smaller than those of dogs (20–

50 fl, MCV = 35–40 fl), potentially causing the RBC and PLT histograms to overlap slightly.

Cats also commonly demonstrate both platelet aggregation and giant platelets. The analyzer mini-

mizes these effects with a proprietary technology and dynamic discriminator approach to maxi-

mize accuracy.

A good practice when taking blood from cats is to discard the first few drops of the sample. This

can prevent hair and skin pieces from getting into the sample. Some clinics have minimized stress-

induced platelet aggregation by collection from the saphenous vein using a vacutainer. Pre-analyti-

cal vortex mixing (up to 30 seconds) also helps disaggregate platelets, with no deleterious effects.

D.3.1 Cat: Optimal Sample

The following shows an optimal normal cat sample.


■ WBC — Normal.

■ RBC — Normal.

■ PLT — Optimal: the PLT is well separated from the RBC.


D.3.2 Cat: Low PLT and RBC

This sample demonstrates a very low PLT, and a typical feline WBC histogram.


■ WBC — Normal. (Note that the WBC histogram at discriminator 1 is high, indicating

the presence of lyse-resistive RBCs.)

■ RBC — Slightly low RBC, with a correct distribution.

■ PLT — Very low PLT.


D.3.3 Cat: Clumped/Aggregated Platelets

The following samples show normal and clumped platelets, respectively:

D.3.4 Cat: High WBC and GRA, Low RBC, HCT, and HGB

The results for this cat indicate anemia and leukocytosis.


■ WBC — Discriminators are set correctly, showing a high GRA population.

■ RBC — Normal distribution, low RBC.

■ PLT — Discriminators are set correctly, showing a slightly low PLT.

Normal Clumped


D.3.5 Cat: Possible nRBCs and Clumped Platelets

This sample demonstrates a patient that may have nucleated RBCs and clumped platelets.


■ WBC — Rising left side of the histogram may indicate nucleated RBCs, or highly lyse-

resistant RBCs, which can be present in feline samples.

■ RBC — Normal distribution.

■ PLT — Flattened, lumpy histogram indicates aggregated (clumped) platelets.


D.3.6 Cat: Eosinophilia

This sample demonstrates an eosinophilic feline patient.

Cat eosinophils can appear as a “shoulder” (indicated by the arrow) on the main granulocyte peak.


■ WBC — Leukocytosis with an absolute granulocytosis and a relative monocytosis. All

cases of granulocytosis with an atypical histogram should be evaluated with a manual

blood smear.

■ RBC — Normal, with normal distribution.


D.4 Horses

Horse samples typically show a good separation of PLT/RBC, and well-separated WBC popula-

tions. The MCV is relatively low, while the RBC is high — around 10x1012 cells/l — giving a cor-

rect HCT near 40%.

D.4.1 Horse: Normal Sample

The following shows a typical normal sample for a horse:


■ WBC — WBC value is normal, and the discriminators are set accurately.

■ RBC — Normal. (Compare dog and horse histograms to see the smaller cells in the

horse.)

■ PLT — PLT is correct. (Note the good separation at the PLT/RBC discriminator.)


D.4.2 Horse: Low LYM%, High GRA%

The following is a typical horse sample with a low LYM content.


■ WBC — Slightly low LYM% and a high GRA%. Discriminators are set accurately.

■ RBC — Normal.

■ PLT — Normal. (Note the good separation from RBCs.)


D.4.3 Horse: Low PLT and MPV

In some cases, the PLT will be low. You can compare the height of the PLT peak to the RBC peak

on the RBC histogram. Low MPV is typical for horse samples, because their PLTs are small.


■ WBC — Normal WBC, with accurately placed discriminators.

■ RBC — Normal.

■ PLT — Low PLT (and MPV). (Note that the valley between the PLT and RBC popula-

tions is well defined, indicating that the PLT value is correct.)


D.4.4 Horse: Low RBC and HGB

This case shows a normal sample, with a slightly low RBC and HGB. It also shows good separa-

tion of the WBC populations from the RBC and from each other.


■ WBC — WBC is well separated histogram from the RBC. Clear populations, good

WBC differentials.

■ RBC — Slightly low RBC (HCT) and HGB, indicating possible anemia.

■ PLT — Normal. (Note the good separation from RBCs.)


Appendix E
Glossary■ Anemia
Anemia with reticulocytosis or polychromasia is described as regenera-tive or responsive. This type of anemia occurs when the bone marrow is actively producing red blood cells (RBCs). Findings that indicate regenerative anemia include polychromasia, reticulocytosis, and hyper-cellular bone marrow with a low myeloid:erythroid ratio. The presence of regeneration suggests blood loss or RBC destruction. Regenerative anemia also denotes that sufficient time has elapsed for regeneration to occur (two to three days), that there are adequate blood-forming ele-ments (iron, appropriate vitamins, protein) for regeneration, that there are enough erythrocytic colonies in the bone marrow, and that there is adequate kidney function to form erythropoietin.

■ Anemia, Macrocytic Hypochromic

Macrocytic, hypochromic anemia is characterized by abnormally large red blood cells (RBCs) containing subnormal amounts of hemoglobin. It is seen after acute blood loss or hemolysis. This type of anemia indi-cates marked RBC regeneration, but several days must elapse before this response is noted. Production of reticulocytes in response to ane-mia contributes to the pallor, increased mean corpuscular volume (MCV), and decreased mean corpuscular hemoglobin concentration (MCHC).

■ Anemia, Microcytic Hypochromic

Microcytic, hypochromic anemia is characterized by abnormally small red blood cells (RBCs) containing subnormal amounts of hemoglobin. It is caused by iron deficiency, impaired iron metabolism, or iron deple-tion from chronic blood loss. In rare cases, portosystemic shunts and chronic inflammation cause this type of anemia.

■ Anemia, Non-regenerative

Anemia without reticulocytosis or polychromasia is described as non-regenerative. During the first two or three days after hemorrhage or hemolysis, anemia may be non-regenerative. The slight anemias of dis-ease can also be non-regenerative. When no response is seen for several days, a primary or a secondary bone marrow disorder is indicated.

■ Anisocytosis

Anisocytosis is a variation in red blood cell (RBC) size without a change in cell shape. Slight anisocytosis occurs normally in cats and dogs, and by itself is not diagnostic. In moderate to marked anisocyto-sis, RBCs can be macrocytic or microcytic. Microcytic RBCs occur in immune-mediated hemolytic anemia, microvascular constriction, early Heinz-body anemia, and iron-deficiency anemia. Macrocytic RBCs occur with regenerative anemia and rarely with erythrocytic leukemia. Since macrocytes raise the mean corpuscular volume (MCV), if micro-cytic anemia is also a regenerative anemia (such as occurs with Heinz-body anemia), the MCV is normal but the smear shows marked aniso-cytosis.

Glossary E-1

■ Band Cells (stab cells)

The band cell (also called a stab cell) is an immature neutrophil occasionally found circulating in peripheral blood. An increase in the absolute number of bands indicates increased demand due to inflammation. Increased numbers are termed a “left shift.” Slight increases in bands (300–1,000/ml) can occur in non-suppurative diseases, such as hemorrhagic or granulomatous disease. Bands in excess of 1,000/ml indicate an intense purulent exudative process. Human labs often misdiagnose canine neutrophils as band cells because the canine neutrophil is less lobulated than the human neu-trophil.

■ Basophils

Basophils and tissue mast cells contain granules of histamine and heparin. These substances initiate inflammation, prevent coagulation, and activate lipoprotein lipase. Basophils can be seen with a vari-ety of diseases, while the presence of many mast cells on a blood smear signifies mast-cell neoplasia. Mast cells and basophils are similar in appearance because both contain purple metachromatic gran-ules. Mast-cell granules usually stain intensely and are often numerous enough to obscure the nucleus. Canine and feline basophils contain fewer dark granules. The granules in feline basophils stain light blue and are often missing from the cytoplasm, making them difficult to identify on blood films. Basophils have a tri-lobed nucleus, similar to that of neutrophils. Mast cells have a single, round nucleus.

■ Blood Indices

Anemia occurs when the number of circulating RBCs is below the normal level for the age, sex, and breed of the species. The laboratory identifies anemia by low values for the PCV, hemoglobin, and RBC count. Anemias are classified by response, cause, and cell characteristics such as cell size, shape. and hemoglobin concentration. The red blood cell indices consist of the mean corpuscular vol-ume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC), which are used to determine the type of anemia. Red cell indices are estimations of the size and cellular hemoglobin concentration of a population of RBCs. Determining the type of anemia can help select appropriate therapy and monitor therapy progress. Automated blood analyzers often have a built-in function that determines one or more of the indices; the remaining indices are then calcu-lated from determined values. The values can be calculated by knowing the PCV, hemoglobin level, and RBC count. The MCHC and MCH are high at birth, but decrease to adult values in two months.

■ Differential White Blood Cell Count

In a differential WBC count, the number of each leukocytic cell type is reported as a percentage of the total WBC count. To determine absolute numbers of each cell type, individual (100–200) WBCs are identified and reported as a percentage of the total WBC count. This percentage is then multiplied by the total WBC count to obtain absolute numbers of each cell type. The five-part traditional system classifies the cells into neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Immature forms are classified separately.

The analyzer gives a three-part differential count. It groups the granulocytes (neutrophils, eosinophils, and basophils), but differentiates the lymphocytes and monocytes. A Percent Differential reports each cell type and a percent of the total count. An absolute differential count multiplies the percent count by the number of total WBCs. A good hand count evaluates 100–200 cells, but a machine count eval-uates several thousand. An absolute count is determined by multiplying the percent of each cell by the total white blood cell count, and provides a more accurate representation of the circulating cells.

■ Eosinophils

Eosinophils are WBCs with numerous functions. They are parasiticidal, help regulate allergic and inflammatory responses by inhibiting mast cell release of histamine and serotonin, detoxify histamine at the site of antigen-antibody reactions, regulate the intensity of IgE reactions, and have some phago-cytic activity against invading bacteria. Their granules contain potent cytotoxic proteins and lipids that are active in almost all types of inflammation and tissue injury. Eosinophils are easily recognized on stained blood smears by their large yellow-orange granules. They normally occur in small numbers in peripheral blood.

E-2 Glossary

■ Fibrin

Fibrin is a filamentous protein that is formed when the blood clots. It is deposited in filaments that entangle with blood cells and platelets to form a clot.

■ Granulocytes

Granulocytes are WBCs that contain cytoplasmic granules. These include neutrophils, eosinophils, and basophils. These cells are produced in the bone marrow. Increased granulocyte counts normally indicate a neutrophilia, and decreased counts indicate a neutropenia.

■ Hematocrit

The terms hematocrit (HCT) and packed cell volume (PCV) are used interchangeably to indicate the percent of red blood cells in a unit of whole blood. The analyzer calculates the HCT, which is equiva-lent to the manual centrifuge packing of red cells done for the PVC. When a blood sample is centri-fuged (spun hematocrit), it separates into three layers: an upper layer of plasma, a middle layer of WBCs and thrombocytes (buffy coat), and a bottom layer of packed RBCs. Technically, the hemat-ocrit is a measure of all cellular elements of blood (WBCs, thrombocytes, and RBCs), but by common usage it has become synonymous with PCV. See also “Packed Cell Volume (PCV)” on page E-6.

■ Hemoglobin

Hemoglobin (Hb) is the oxygen-carrying pigment formed by developing RBCs in the bone marrow. The hemoglobin value of a blood sample is approximately one-third of the PCV. Variations from this indicate a laboratory error, hemolysis, or abnormalities such as Heinz bodies or lipemia. Altered hemoglobin can form Heinz bodies or crystals. Determination of hemoglobin provides no clinical advantage over measurement of the PCV, other than allowing the determination of mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC).

■ Immature Red Blood Cell (RBC)

Immature RBCs include reticulocytes and nucleated red blood cells. Reticulocytes are indicated on the analyzer by a high mean corpuscular volume (MCV) and high red cell distribution width (RDW). Occasionally, immature cells retain their nuclei and are counted by the analyzer as WBCs.

■ Left Shift

The term left shift indicates increased numbers of circulating immature neutrophils (band cells, meta-myelocytes, myelocytes). These cells cannot be differentiated by automatic cell counters. A regenera-tive left shift is characterized by band cells and increased numbers of mature neutrophils. The number of immature neutrophils does not exceed 10% of the mature neutrophils, and no young cells (such as metamyelocytes) are present. A degenerative left shift is characterized by circulating band cells that exceed 10% of the segmented neutrophils, in conjunction with decreased numbers of neutrophils or the presence of very young cells, such as metamyelocytes or myelocytes. In a degenerative left shift, the total WBC count can vary from below normal to slightly above normal. A degenerative left shift is an unfavorable prognostic sign. Left shift must be determined by visual inspection of a blood smear (slide).

■ Leukemia

Leukemia implies neoplastic cells in the peripheral blood. It can occur in myeloproliferative and lym-phoproliferative diseases. In myeloproliferative diseases, immature precursers of red blood cells — granulocytes — are seen on stained blood smears. In lymphoproliferative diseases, large numbers of immature lymphocytes are present in peripheral blood smears.

■ Leukocytes

Leukocytes — “white blood cells” — are classified as neutrophils, eosinophils, monocytes, lympho-cytes, or basophils. These include the granulocytes and the mononuclear cells of the lymphoid sys-tem. A total WBC count is the sum of all leukocytes.

Glossary E-3

■ Leukocytosis

Leukocytosis is an increased number of WBCs. It is usually caused by an increase in the number of circulating neutrophils (neutrophilia), though lymphocytosis (especially with leukemia) occasionally produces leukocytosis. Absolute values of individual WBC types provide much more diagnostic spec-ificity than a simple WBC count. Exercise, fear, and digestion cause physiologic leukocytosis. Infec-tion, rapidly growing neoplasms, acute hemolysis, hemorrhage, intoxication, leukemia and trauma cause pathologic leukocytosis.

■ Leukopenia

Leukopenia indicates a decreased total WBC count. It is usually characterized by decreased numbers of circulating neutrophils. The most common causes of leukopenia are excessive consumption in an inflammatory process and primary bone marrow disease. Persistent leukopenia is a poor prognostic sign.

■ Lymphocytes

Lymphocytes in the blood are a mixed population of B-cells and T-cells. They are the major cellular component of immunity in the body. B-lymphocytes synthesize antibodies that are responsible for humoral immunity. T-lymphocytes are the principal component of cellular immunity. Lymphocytes also participate in immune regulation and surveillance, and some are cytotoxic.

■ Lymphocytosis

Lymphocytosis indicates increased numbers of circulating lymphocytes. Pathologic lymphocytosis occurs in chronic inflammation, recovery from acute infection, lymphocytic leukemia, and hypoa-drenocorticism. Lymphocytosis usually indicates a strong immune stimulus of some chronic duration from a bacterial infection, viremia, or immune-mediated disease. Lymphocytic leukemia may or may not be accompanied by lymphocytosis.

Lymphocytosis not associated with disease occurs with physiologic leukocytosis, from excitement in healthy cats, from immature age-related responses in young puppies and kittens, and sometimes fol-lowing vaccination.

■ Lymphopenia

Lymphopenia indicates decreased numbers of circulating lymphocytes. It can occur with acute severe disease, some viral diseases (canine distemper, hepatitis, parvovirus and coronavirus infections, feline panleukopenia, and FeLV infection), stress-related corticosteroid response, and loss of lymph into the gut (chylothorax, lymphangiectasia).

■ Mean Corpuscular Volume (MCV)

The MCV is the average volume of a single RBC. It is determined by direct measurement with an electronic cell counter such as the analyzer. Increases are usually due to reticulocytes and indicate a responsive anemia.

■ Mean Corpuscular Hemoglobin (MCH)

The MCH is the average amount of hemoglobin in each RBC. This calculated index is increased with hemolysis. Decreases are termed hypochromasia, and are seen with reticulocytosis and iron defi-ciency.

■ Mean Corpuscular Hemoglobin Concentration (MCHC)

MCHC measures the average concentration of hemoglobin in RBCs. Increases are usually caused by hemolysis. Decreases are termed hypochromasia and are seen in reticulocytosis and iron deficiency anemia.

E-4 Glossary

■ Mean Platelet Volume (MPV)

The MPV is a machine calculation of platelet size. In thrombocytopenic dogs, increased mean platelet volume gives indirect evidence of increased megakaryocyte response. High mean volume (>12 fl) indicates increased response, but decreased volume (<12 fl) is not accurate in predicting lack of bone marrow megakaryocyte production.

■ Monocytes

Monocytes are the immature blood stage of tissue macrophages. Increased numbers occur in response to inflammation. Their main function is phagocytosis of foreign material, cellular debris, and patho-gens that are not effectively controlled by neutrophils. They engulf intracellular organisms and those causing a granulomatous inflammatory response. They are effective scavengers, removing tissue debris, cellular remnants, and foreign material. Monocytes are also active in regulating the immune response, processing antigen, and activating killer cells and macrophages. Monocytes are the most commonly misidentified leukocyte in blood smears, often being placed into the lymphocyte category.

■ Monocytosis

Increased numbers of circulating monocytes (monocytosis) occur in chronic suppurative, pyogranulo-matous, necrotic, malignant, hemolytic, hemorrhagic, or immune-mediated diseases. Monocytosis also occurs in dogs as a corticosteroid-induced response from stress, adrenal hyperfunction, or exoge-nous corticosteroids. Some animals with chronic disease have persistent monocytosis. Decreased numbers of circulating monocytes (monocytopenia) is rare and has no diagnostic significance.

■ Neutrophils

Neutrophils phagocytize and kill microorganisms. They also initiate and modify the acute inflamma-tory process, cause tissue damage, and are cytotoxic. Production and storage in the bone marrow, margination of cells in the capillary beds, and the demands of peripheral tissues affect the numbers of circulating neutrophils.

■ Neutropenia

Neutropenia indicates decreased numbers of circulating neutrophils. It can be due to insufficient pro-duction or increased destruction of neutrophils. Conditions that cause neutropenia include endotox-emia, viral infections, overwhelming bacterial infections, and administration of drugs that cause bone marrow suppression.

■ Neutrophilia

Neutrophilia indicates increased numbers of circulating neutrophils. It can be physiologically induced by exercise and corticosteroids, or pathologically induced by infections and tissue destruction. The primary differential diagnoses for neutrophilia are inflammation (septic or non-septic), stress, exer-cise, or excitement.

■ Nucleated Red Blood Cells (nRBC)

Nucleated RBCs (nRBCs) are larger and less mature than reticulocytes and mature RBCs. These immature, nucleated stages of the erythrocyte generally occur within the bone marrow, and are rarely observed in the peripheral blood of normal dogs and cats. They appear as metarubricytes in small numbers in response to acute blood loss or anemia. Nucleated RBCs without concurrent anemia or reticulocytosis are a sign of disease. They are found in splenic disease, extramedullary hemopoiesis, lead poisoning, hyperadrenocorticism, leukemia, and bone marrow disease. Circulating nucleated RBCs can be metarubricytes or younger cells, such as rubricytes. RBCs of birds and reptiles are all nucleated and cannot be accurately measured by automated systems (nucleated RBCs are counted as WBCs).

Glossary E-5

■ Packed Cell Volume (PCV)

The packed cell volume (PCV) and hematocrit (HCT) are measures of RBC numbers, expressed as a percentage of the total volume of blood. By common usage, the PCV has become synonymous with the HCT. Traditionally, the PCV is obtained by centrifuging an anti-coagulated blood sample (spun crit); automated counters (including the HM2) calculate this value from the measured mean corpuscu-lar volume (MCV) and RBC count. This is why laboratory values can differ slightly from in-clinic values. The column of packed RBCs (PCV) is measured in millimeters and expressed as a percentage of the total blood volume. Anemia exists when the PCV falls below the reference range for the spe-cies. Hemoconcentration can exist when the PCV exceeds the reference range. There is normally a 3:1 ratio of PCV to hemoglobin value.

■ Platelet Clumping

Platelet clumping is an aggregation of thrombocytes that produces inaccurate counts with electronic counters. This is caused by activation of the platelets by poor collection technique, but can occur spontaneously in cats. Careful collection, pre-analytical vortex mixing (up to 30 seconds), and prompt testing minimizes problems associated with platelet aggregation.

The histogram may show an abnormal distribution of large cells, indicating platelet clumping. Because of clumping in samples, reference labs usually give only an estimation of platelet numbers as seen on blood smears. An adequate count of 8–10 platelets per 100x objective field would suggest platelet numbers greater than 150,000. Thrombocytopenic slides show < 7 per 100x objective, indi-cating counts less than 100,000. Platelet aggregation/clumping often results in a flattened, lumpy PLT histogram.

■ Platelet Count

Counts below 100,000/ml are significant. Platelets can be counted directly, or estimated from the blood smear (>5 per oil-immersion field). Decreased platelet numbers (thrombocytopenia) occur with disseminated intravascular coagulation, bone marrow depression, autoimmune hemolytic anemia, systemic lupus erythematosus, and severe hemorrhage. Thrombocytosis (increased platelet numbers) is caused by excess bleeding (from trauma, blood sucking parasites, or neoplasia), iron deficiency anemia, and myeloproliferative syndromes.

■ Platelet Distribution Width (PDW)

Platelet distribution width (PDW) is a measure of platelet anisocytosis (variation in size). A mixture of large and small platelets can give a normal mean platelet volume (MPV) but a high PDW. This would indicate active platelet release.

■ Platelets (Thrombocytes)

Platelets (thrombocytes) are small, flat disks produced by megakaryocytes. They adhere to exposed subendothelial collagen within seconds of injury to form a hemostatic plug. Low platelet counts pre-dispose an animal to hemorrhage.

■ Poikilocytes

Poikilocytes are abnormally shaped RBCs. Poikilocyte is a general term that encompasses all catego-ries of abnormal RBC shapes, including more specific terms such as echinocyte, acanthocyte, schizo-cyte, and crenation. RBC distortion can occur with improperly prepared blood films and should not be confused with poikilocytosis. Poikilocytosis is a non-specific change seen in chronic blood loss, iron-deficiency anemia, diseases characterized by RBC fragmentation, and chronic lead poisoning. A stained blood smear will show the abnormally shaped RBCs.

E-6 Glossary

■ Polycythemia

Polycythemia is an increase in the red cell mass of the blood. This is seen as an increase in PCV, hemoglobin concentration, and RBC count. Absolute polycythemia results from increased bone mar-row production of RBCs, and can be primary, as with polycythemia vera or myeloproliferative dis-ease, or secondary to hypoxia and renal disease. Absolute polycythemia must be distinguished from relative polycythemia that occurs with dehydration (high plasma protein), hypovolemia (low plasma protein), shock, or splenic contraction (normal plasma protein).

■ Red Blood Cell Count (RBC)

Red blood cells (RBCs) transport oxygen from the lungs to body tissues. Their production is stimu-lated by erythropoietin, secretion of which is controlled by blood oxygen tension. Erythropoietin stimulates maturation of RBC precursors in bone marrow into mature RBCs. Blood loss, parasitism, renal failure, RBC damage, chronic inflammatory disease, hematopoietic malignancies, and insuffi-cient dietary iron, copper, or vitamin B12 cause a deficiency of RBCs (anemia). Shock, fluid loss, or increased RBC production can cause increased RBC numbers (polycythemia). Dehydration or protein fluid extravasation causes a relative decrease in the fluid portion of the blood and a relative increase in the cellular portion. Carbon monoxide, lung disease, heart disease, and high altitude cause excessive RBC production by stimulating erythropoietin secretion. Erythrocytic malignancies and polycythemia vera cause excessive RBC production without normal stimulation.

■ Red Cell Distribution Width (RDW)

The red cell distribution width is an electronic measure of anisocytosis (variation of cell size). RDW increases where the degree of anisocytosis is increased. In regenerative anemia, RDW increases when large cells are produced even before the MCV exceeds the reference range. It also increases when small cells are produced as with iron deficiency anemia.

■ Reticulocytes

Reticulocytes are immature RBCs without a nucleus. They retain a fine network of endoplasmic retic-ulum that stains with reticulocyte stains. These immature cells are slightly larger than mature RBCs, and normally circulate in small numbers. Elevated numbers of circulating reticulocytes (reticulocyto-sis) occur in chronic hemorrhagic or hemolytic anemia with increased erythropoiesis. A lack of circu-lating reticulocytes in chronic anemia indicates bone marrow depression. Reticulocytosis without evidence of anemia can indicate reduced blood oxygenation, which leads to increased erythropoietin levels, which in turn stimulate erythropoiesis and release of reticulocytes from the bone marrow. Reticulocytes are not counted by the analyzer, but are suggested by a high MCV and possibly an ele-vated RDW. When present, this indicates that the animal is responding to blood loss by increased red cell regeneration.

■ Right Shift

The term right shift indicates increased numbers of circulating hypermature neutrophils in neutro-philic blood samples. These are cells showing hypersegmentation. This is usually seen in non-infec-tious inflammatory processes, such as inflammation secondary to a malignancy. Right shift must be determined by visual inspection of a blood smear (slide).

■ 3x Rule: Hemoglobin x 3 = Hematocrit (± 2%)

In normal blood samples, the hemoglobin is approximately one-third the hematocrit. This relationship can be used to cross-check the accuracy of the blood counts. If abnormal, the sample should be checked for hemolysis or Heinz bodies.

Glossary E-7

■ White Blood Cell Count (WBC)

The total WBC count combines circulating numbers of neutrophils, lymphocytes, monocytes, eosino-phils and basophils. Because neutrophils are the predominant leukocytic cell type, a high total WBC count (leukocytosis) is generally due to an increase in this cell line. However, absolute values of indi-vidual leukocytic cell lines (found by performing a differential count and multiplying each cell line percentage by the total WBC count) often provides more diagnostic specificity. Leukopenia (decreased WBCs) is generally evident only with a decrease in neutrophils. Leukocytosis and leuko-penia occur with a variety of diseases. Normal ranges for total WBC counts are printed by the ana-lyzer and should be similar to textbook ranges.

Note: The analyzer groups neutrophils, eosinophils, and basophils into the single category of Granu-locytes.

E-8 Glossary

Index

AAbaxis

Technical Support 1-2website 1-2

Analysis procedure 4-7Anisocytosis B-7Aperture, cleaning 7-5

BBasophils 4-14, 4-23, B-8Blank measurements

flags 9-2running 4-5

Bleach-cleaning 7-5Built-in printer 2-3, 2-4

configuring 3-3installing paper 2-20

CCalibration 5-2, 5-3

Hematology Calibrator 5-2history, viewing 5-6materials 5-2when needed 5-2

CD-ROM drive 2-3opening 8-3

Cell discriminators 9-5, A-5granulocytes 9-5in histograms 4-13lymphocytes 9-5monocytes 9-5nucleated red blood cells (nRBC) 9-5resistive red blood cells 9-5reticulocytes 9-5

Cleaningaperture 7-5automatic 2-2, 7-5bleach-cleaning 7-5daily 4-4on reagent pack change 7-8wash head 7-2wash head (weekly) 7-2

Cleaning tube kit 2-10, 2-17, 7-5

Ind

Combined results (HM2 and VetScan) 4-16Combined results (HM2/VetScan) 3-11Complete Blood Count (CBC) B-2

interpreting 4-23measured or calculated values 4-13, B-6, B-7platelet parameters 4-24red blood cell parameters 4-24white blood cell parameters 4-23

Components, analyzer 2-3Computer

connecting to analyzer 2-23USB driver for 2-24

Control panel 2-3cursor control keys 2-6hard-function keys 2-6keypad 2-6OK key 2-6soft-function keys 2-7Start button 2-5status indicator (LED) 2-5

Controls. See Quality Control (QC)Cursor control keys 2-6

DDaily maintenance 7-2Database

backing up results 6-4deleting results 6-4saving results to PC or USB flash drive 6-4viewing results 6-2, 6-3

Date and time, setting 3-15Diagnostic Self test 7-10

EElectrical requirements 2-19Environmental requirements 2-19Eosinophils 4-14, 4-23, B-6, B-8Erythrocytes

See also Red blood cellsExporting results 4-15External printer 2-20

configuring 3-4

ex I-1

FFlags. See Warning indicators (flags)Fluidic system 2-11

GGranulocytes 4-14

and cell discriminators 9-5GRA/GRA% 4-13, B-8

HHard-function keys 2-6Hematocrit (HCT) 4-24, A-4, B-7Hematology

Calibrator 5-2measurement methods B-2

Hemoglobin A-4average content of erythrocytes B-7concentration (HGB) B-7mean corpuscular hemoglobin (MCH) 4-24,

A-4, B-7mean corpuscular hemoglobin concentration

(MCHC) 4-24, A-4, B-7measured and calculated values B-7measurement method B-5

Hemoglobin Concentration (HGB) 4-24Histograms 4-13

cell discriminators 4-13cell-type populations 4-13full-spectrum 9-5interpreting 4-12, 4-13, 4-14PLT (platelet) 4-14RBC (red blood cell) 4-14scanning for abnormalities 4-13viewing 6-2WBC (white blood cell) 4-13

History, calibration 5-6

IInitialization 2-31Installation 2-20

electrical requirements 2-19environmental requirements 2-19external keyboard 2-20external printer 2-21power supply 2-20selecting a location 2-18space requirements 2-18

I-2 Ind

KKeyboard

external, connecting external 2-20mini 2-17port 2-4

Keypad 2-6

LLaboratory information 3-12Language used by analyzer 3-10Leukocytes

See White blood cellsLevy-Jennings graphs 5-8Linearity ranges 10-3Lymphocytes 4-23

and cell discriminators 9-5LYM/LYM% 4-13, B-8

MMaintenance 7-1

cleaning wash head (weekly) 7-2daily 7-2Self test 7-10weekly 7-2

Measurement units, setting 3-11Menus and commands 2-12Microbubbles 2-25, 2-26, 2-31, 4-3Monocytes 4-23, B-6

and cell discriminators 9-5MON/MON% 4-13, B-8

Multi user mode 3-13, 3-14

NNeutrophils 4-14, 4-23, B-8

OOK key 2-6Operating principles B-1Out-of-range results 9-2

PPatient identification data 4-8Peristaltic pump

replacing tube assembly 7-11spare tube assembly 2-17

ex

Platelets A-6aggregation (clumping) 4-14, A-6anisocytosis, measure of B-7average volume B-7clumped/giant 4-14count (PLT) 4-24distribution width B-7histogram (PLT) 4-14in CBC parameters 4-24in WBC histograms 4-13mean platelet volume (MPV) 4-24, B-7measured and calculated values B-7platelet count (PLT) B-7platelet distribution width (PDW) 4-24, A-6,

B-7platelet hematocrit (PCT) 4-24, B-7PLT histogram 4-14thrombocrit B-7

PortsPS/2 keyboard 2-4serial (RS-232) 2-4USB 2-3, 2-4

Powerturning on and off 2-28

Power supply 2-19connecting 2-20cord 2-17input 2-4surge protection 2-9, 2-19uninterruptable (UPS) 2-9, 2-19

Power switch 2-4Prediluted mode

analysis 4-21, 4-22calibrating before use 4-21preparing samples 4-21

Printerbuilt-in 2-3, 2-4, 2-20external 2-21, 3-2settings 3-3

PrintingAutoprint 3-5combined HM2 and VetScan results 4-16combined HM2/VetScan results 3-11examples 4-18results 4-9, 4-15settings 3-4

PS/2 keyboard port 2-4

Ind

QQuality Control (QC) 5-6, 5-7

database 5-8Levy-Jennings graphs 5-8materials 5-6monitoring over time 5-8stored results 5-6types 5-6viewing results 5-8when to perform 5-6

RReagent pack 2-18

changing 7-8color-coded connections 2-4, 2-27connecting 2-25status 8-2

Reagent tubing kit 2-17Red blood cells A-4

anisocytosis B-7distribution width B-7histogram (RBC) 4-14in CBC parameters 4-24in WBC histograms 4-13mean corpuscular volume (MCV) 4-24, B-7measured and calculated values B-7nucleated (nRBC) 4-14, 9-5red blood cell (RBC) histogram 4-14red blood cell count (RBC) 4-14, B-7red cell distribution width (RDW) 4-24, A-4,

B-7resistive 9-5

References, veterinary hematology A-8Results

backing up 6-4contents stored 6-2deleting 6-4exporting 4-15interpreting 4-12linearity ranges 10-3measured and calculated values B-7out-of-range 9-2printing 4-9, 4-15report contents 4-12saved automatically 6-2saved to database 4-15saving to PC or USB flash drive 6-4viewing 6-3

ex I-3

viewing from USB flash drive 6-4warning indicators 4-9

Reticulocytes 9-5RS-232 port 2-4

SSample tube adapter 2-3Sample tube adapters 2-10, 2-17Samples

collecting and preparing 4-2feline, special techniques 4-3, 4-14in prediluted mode 4-21multiple tube draws 4-2potential interferences C-1proper handling 4-2quality assurance 4-2storing 4-3tube adapters 4-7useful life 4-3verifying species 4-8

Sampling rotor 2-3, 4-7Screensaver

messages 4-5, 7-2wait time 3-10

Self test 7-10Serial (RS-232) port 2-4Service, preparing for 7-1Shipping the analyzer 9-10

shut-down before 2-29Shutting down

for 10 days or more 2-29for 72 hours or more 2-29for shipping 2-29

Single user mode 3-13Soft-function keys 2-7Software

updating 8-3version number 8-2

Space requirements 2-18Species

available 1-2defining custom 8-3printing ranges 8-4verifying before analysis 4-8

Specifications 10-2Standby mode 2-5

leaving 2-32Start button 2-5Status indicator (LED) 2-5

I-4 Ind

Status information 8-2Storing the analyzer 7-7Subsystems, analyzer 2-11Surge protector 2-9, 2-19System components 2-17

TTechnical Support 1-2Thermal paper 2-17Thrombocytes. See PlateletsTroubleshooting 9-1

UUninterruptable power supply (UPS) 2-9, 2-19Units, setting 3-11USB driver for computer 2-24USB ports 2-3, 2-4

VVeterinary hematology references A-8VetScan VS2/Classic analyzers

connecting 2-22, 2-23printing combined results 3-11, 4-16

WWarning indicators (flags) 4-21, 9-2

blank flags 9-2examples 9-6interpreting 9-6measurement conditions 9-2result flags 9-2result warnings 9-3

Wash headcleaning 7-2cleaning reminder 7-2cleaning weekly 7-2

Weekly maintenance 7-2White blood cells A-5

classification A-5differential count 9-5GRA/GRA% differentials 4-13, B-8in CBC parameters 4-23LYM/LYM% differentials 4-13, B-8measured and calculated values B-7MON/MON% differentials 4-13, B-8three-part differential method B-4WBC histogramswhite blood cell count (WBC) 4-13, B-7

ex

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