We are very excited to attend the 2022 Leman Swine Conference ! We are attending this meeting as vendors for the first time this year and we hope to see many new faces there! Come visit us at booth # 318  to meet  Sandy Clark , VMRD’s Molecular Product Manager, and  Chris Helm , Longhorn Vaccines and Diagnostics’ Executive VP of Global Business Development. We'll have sample tubes of PrimeStore® Molecular Transport Medium for your evaluation along with some fun squeezie pigs and other useful goodies to give away. Learn more:  https://lemanconference.umn.edu/ We'd love to have a conversation with you and find ways to meet your needs! Are you worried about dangerous pathogens i.e. ASFv, Influenza, JEV? Are you sampling in remote areas requiring long transport times? Are you seeking longer/better reads for WGS, NGS, or Proteomics? More info about the topics we're looking forward to sharing with you:  PrimeStore® MTM Nucleic Acid Extraction Kits

Join us in Minneapolis for the 2022 AAVLD/USAHA Annual Meeting! Come visit us at booth # 201/300  to meet with our team, including  Sandy Clark , VMRD’s molecular Product Manager,  JJ McCallie , VMRD's new VP of Products, and  Chris Helm , Longhorn Vaccines and Diagnostics’ Executive VP of Global Business Development. LOOK OUT FOR OUR WELCOME BAG INSERT TO TAKE A DNA QUIZ & COME BY OUR BOOTH TO RECEIVE YOUR REWARD! LEARN MORE We'd also love to have a conversation with you and find ways to meet your needs! Would you like to explore alternative methods for molecular extraction that can save time and costs? We can assist with evaluation and manage the process with you. Are you seeking longer/better reads for WGS, NGS, or Proteomics? Protective transport medium used in tandem with our high quality extraction tools can improve your sequencing data. More info about the topics we're looking forward to sharing with you:  PrimeStore® MTM Nucleic Acid Extraction Kits Johne's Antibody Test Kit (ELISA) CWD RT-QuIC Reagents We'll have our  ELISAPro Serology Processor  on display so you can see it in action!

Most colic cases are straightforward, however those that are not pose a constellation of challenges when making decisions for management.

One of the key advantages for using VMRD’s SAA test for equine, canine, and feline is the accuracy and consistency provided by the calibration system. SAA is an "intrinsically disordered" protein. SAA exists in varying configurations and changes structure frequently, including binding with cholesterol in the bloodstream, making absolute quantification a challenge. Different assays have different components that may bind differently to the variable structures of SAA; therefore, it is not unexpected that absolute numbers may vary between assays [1]. This is very similar to how reference ranges for hematology and biochemistry values often vary between labs and different machines when running standard bloodwork. Even if specific values may vary, the overall trend observed should be the same with SAA increasing after an acute systemic inflammatory insult (such as infection) and decreasing as the issue resolves. Eiken LZ-SAA was the original reference standard for SAA. There is no existing test that can provide exact quantitation of SAA, therefore it is necessary to understand the reference standard and its importance. During development of VMRD SAA, we chose to calibrate against the Eiken LZ-SAA assay as it has historically been considered the “gold standard” [2] used in most veterinary publications [3-31] and specifically validated for equine [32] and feline [33] samples. In the independent validation study performed by Dr. Nicola Pusterla at UC Davis, the equine VMRD SAA assay correlated very well with Eiken LZ-SAA. [34] Data for graph adapted from Karam et al. (34) VMRD SAA is now calibrated against Eiken VET-SAA. In 2022, Eiken stopped producing LZ-SAA and switched to a different assay for the veterinary market (VET-SAA) that could also be used for canine samples. This naturally led to a change in the assay used by reference labs such as Cornell and the University of Miami to Eiken VET-SAA. In our experience, and that of others, VET-SAA results are often half the values seen with LZ-SAA, and reference labs will only report values up to 3000 μg/mL. To align with these changes and ensure results from the VMRD SAA test match well with reference lab testing, we elected to recalibrate our test to Eiken VET-SAA in late 2022. This was made possible by our lot-specific calibration card system which allows us to be adaptable and keep our VMRD POC products updated to current standards. Every batch of VMRD SAA is calibrated for greatest consistency To calibrate VMRD SAA, we use clinical equine samples as standards, with the same samples tested in each lot to ensure consistency. These samples were tested with Eiken VET-SAA at both Cornell and the University of Miami, then stored at -80°C in single-use aliquots for long-term use. During manufacturing, these standards are used as reference points to ensure that each lot/batch of tests is performing as expected and generating consistent results from one lot to the next. How does the calibration card work? When each lot of tests is completed, we use the results from the calibration samples to create a standard curve, which plots the known SAA concentration for each sample against the raw data obtained when the reader reads the intensity of the red lines on the test cartridge. This lot-specific and test-specific standard curve is programmed onto the calibration card, which communicates the information to the VMRD reader via RFID technology when the card is attached to the reader. When a patient sample is run, the 2 test lines get darker and the 1 control line ("C") gets lighter as SAA concentration increases. The reader measures the intensity of the 3 lines and uses the standard curve from the calibration card to translate those raw numbers into an SAA value. In this manner, the reader is able to adjust interpretation of the test cartridge based on specifications for that individual lot and test type. All diagnostic assays have some degree of unavoidable variability between lots that occurs during manufacturing. However, this process of lot-specific calibration using a standard curve mitigates any existing variability to maximize consistency and reliability over time and between readers. References 1 Jacobsen S, Andersen PH. The acute phase protein serum amyloid A (SAA) as a marker of inflammation in horses. Equine Vet Educ 2007;19(1):38-46. 2 Canisso IF, Loux SC, and Lima FS. Biomarkers for placental disease in mares. Theriogenology 2020;150:302-307. 3 Jacobsen S, Niewold TA, Halling-Thomsen M, et al. Serum amyloid A isoforms in serum and synovial fluid in horses with lipopolysaccharide-induced arthritis. Vet Immunol Immunopathol 2006;110(3-4):325-330. 4 Belgrave RL, Dickey MM, Arheart KL. Assessment of serum amyloid A testing of horses and its clinical application in a specialized equine practice. J Am Vet Med Assoc 2013;243(1):113-119. 5 Borba LDA, Nogueira CEW, Bruhm FRP, et al. Peripheral blood markers of sepsis in foals born from mares with experimentally induced ascending placentitis. Vet Rec 2020;187(1):29-37. 6 Christoffersen M, Baagoe CD, Jacobsen S, et al. Evaluation of the systemic acute phase response and endometrial gene expression of serum amyloid A and pro- and anti-inflammatory cytokines in mares with experimentally induced endometritis. Vet Immunol Immunopathol 2010;138:95-105. 7 Canisso IF, Vall BA, Cray C, et al. Use of a qualitative hose-side test to measure serum amyloid A in mares with experimentally induced ascending placentitis. J Equine Vet Sci 2015;35:54-59. 8 Daniel AJ, Leise BS, Burgess BA, et al. Concentrations of serum amyloid A and plasma fibrinogen in horses undergoing emergency abdominal surgery. J Vet Emerg Crit Care 2016;26(3):344-351. 9 Duran MC, Dumrath CAC, Bartmann CP, et al. Serum amyloid A (SAA) concentration after vaccination in horses and mules. J Equine Vet Sci 2020;92:103165. 10 Escribano D, Bustillo AO, Marin LP, et al. Analytical validation of two point-of-care assays for serum amyloid A measurements in cats. Animals 2021;11:2518. 11 Falomo ME, Del Re C, Rossi M, et al. Relationship between postpartum uterine involution and biomarkers of inflammation and oxidative stress in clinically healthy mares (Equus caballus). Heliyon 2020;6:e03691. 12 Gluck K, Mohrs S, Hazuchova K, et al. Impact of radioiodine treatment on acute phase proteins in hyperthyroid cats. J Feline Med Surg 2022;24(4):359-365. 13 Haltmayer E, Schendenwein I, Licka TF. Course of serum amyloid A (SAA) plasma concentrations in horses undergoing surgery for injuries penetrating synovial structures, an observational clinical study. BMC Vet Res 2017;13:137-147. 14 Hooijberg EH, van der Hoven R, Tichy A, et al. Diagnostic and predictive capability of routine laboratory tests for the diagnosis and staging of equine inflammatory disease. J Vet Intern Med 2014;38:1587-1593. 15 Howard J and Graubner C. Comparison of paired serum and lithium heparin plasma samples for the measurement of serum amyloid A in horses using an automated turbidometric immunoassay. Vet J 2014;199:457-460. 16 Lilliehook I, Brojer J, Nostell K, et al. Hematologic, Prostaglandin F2α-metabolite, serum amyloid A, and serum iron changes in horses with experimentally induced endotoxemia. Vet Clin Pathol 2020;49:319-325. 17 Pihl TH, Andersen PH, Kjelgaard-Hansen M, et al. Serum amyloid A and haptoglobin concentrations in serum and peritoneal fluid of healthy horses and horses with acute abdominal pain. Vet Clin Pathol 2013;42(2):177-183. 18 Pihl TH, Scheepers E, Sanz M, et al. Influence of disease process and duration on acute phase proteins in serum and peritoneal fluid of horses with colic. J Vet Intern Med 2015;29:651-658. 19 Pihl TH, Scheepers E, Sanz M, et al. Acute-phase proteins as diagnostic markers in horses with colic. J Vet Emerg Crit Care 2016;26(5):664-674. 20 Robinson CS, Singer ER, Piviani M, et al. Are serum amyloid A or D-lactate useful to diagnose synovial contamination or sepsis in horses? Vet Rec 2017;181(16):425-429. 21 Rossi H, Raekallio M, Maatta M, et al. Effects of general anesthesia in dorsal recumbency with and without vatinoxan on bronchoalveolar lavage cytology of healthy horses. Vet J 2019;251:105352. 22 Rossi G, Meazzi S, Giordano A, et al. Serum paraoxonase 1 activity in cats: analytical validation, reference intervals, and correlation with serum amyloid A and alpha-1-acid glycoprotein. J Vet Diagn Invest 2020;32(6):844-855. 23 Sinovich M, Villarino NF, Singer E, et al. Can blood serum amyloid A concentrations in horses differentiate synovial sepsis from extrasynovial inflammation and determine response to treatment? Vet Rec 2020; 187(6):235-240. 24 Vandenplas ML, Moore JN, Barton MH, et al. Concentrations of serum amyloid A and lipopolysaccharide binding protein in horses with colic. Am J Vet Res 2005;66(9):1509-1516. 25 Vilhena H, Figueiredo M, Ceron, JJ, et al. Acute phase proteins and antioxidant responses in queens with pyometra. Theriogenology 2018;115:30-37. 26 Vilhena H, Tvarijonaviciute A, Ceron JJ, et al. Acute phase responses in cats naturally infected by hemotropic mycoplasmas. Comp Immunol Microbiol Infect Dis 2018;56:1-5. 27 Vilhena H, Tvarijonaviciute A, Ceron JJ, et al. Acute phase proteins and biomarkers of oxidative status in feline spontaneous malignant mammary tumors. Vet Comp Oncol 2019;17(3):394-406. 28 Westerman TL, Tornquist SJ, Foster CM, et al. Evaluation of serum amyloid A and haptoglobin concentrations as prognostic indicators for horses with inflammatory disease examined at a tertiary care hospital. Am J Vet Res 2015;76(10):882-888. 29 Westerman TL, Foster CM, Tornquist SJ, et al. Evaluation of serum amyloid A and haptoglobin concentrations as prognostic indicators for horses with colic. J Am Vet Med Assoc 2016;248(8):935-940. 30 Tamamoto T, Ohno K, Ohmi A, et al. Time-course monitoring of serum amyloid A in a cat with pancreatitis. Vet Clin Pathol 2009;38(1):83-86. 31 Tamamoto T, Ohno K, Takahashi M, et al. Serum amyloid A as a prognostic marker in cats with various diseases. J Vet Diagn Invest 2013;25(3):428-432. 32 Jacobsen S, Kjelgaard-Hansen M, Petersen HH, et al. Evaluation of a commercially available human serum amyloid A (SAA) turbidometric immunoassay for determination of equine SAA concentrations. Vet J 2006;172(2):315-319. 33 Tamamoto T, Ohno K, Ohmi A, et al. Verification of measurement of the feline serum amyloid A (SAA) concentration by human SAA turbidimetric immunoassay and its clinical application. J Vet Med Sci 2008;70(11):1247-1252. 34 Karam B, Hines S, Skipper L, et al. Whole-blood validation of a new point-of-care equine serum amyloid A assay. J Equine Vet Sci 2020;94:103222.

ICYMI:  Are you feeling the strain of high-maintenance clients, compassion fatigue, and relentless stress? Join us for a webinar tailored to address the unique communication challenges veterinarians face every day.  Purpose: This engaging and practical session will help simplify the complexities of interpersonal dynamics and provide tools to handle tough conversations. From challenging client situations to stressful everyday interactions, enhance your ability to utilize empathy effectively while maintaining necessary boundaries for your well-being.  Key Takeaways: The Science of Empathy: Learn how connecting with clients streamlines your interactions for greater clinical success.Effective Communication Techniques: Discover tools and strategies to skillfully navigate difficult conversations with confidence. Building better relationships: Understand the many factors contributing to a great relationship that provides a solid foundation for effective and efficient communication.  Did you miss the broadcast? No worries! You can still access the recorded webinar here . Dr. Hines has taught Veterinary Communications for 10 years at the WSU College of Vet Med and completed extensive continuing education on the art and science of communication. She attained her DVM from WSU in 2007 followed by ACVIM board certification and a PhD. Dr. Hines serves as the VMRD Veterinary Affairs Manager. VMRD has provided trusted diagnostics to veterinary reference labs for over 40 years, including most US Coggins tests, and more recently has applied that expertise to patient-side tests such as SAA and Foal IgG for veterinarians.

Watch and learn how to run VMRD's point-of-care lateral flow test for equine serum amyloid A (SAA) for horse-side results!

Antigenic variation is a result of changes in the protein sequence of agents which are caused by changes in the nucleic acid sequence that determine which amino acids are used to make the protein. Changes in nucleic acid sequence are caused by different mechanisms in different agents. In lentiviruses—including equine infectious anemia virus (EIAV), caprine arthritis and encephalitis virus (CAEV), ovine progressive pneumonia virus (OPPV), feline immunodeficiency virus (FIV), human immunodeficiency virus (HIV) and others—amino acid changes occur in all the proteins the virus makes. These changes occur when a DNA copy is made from viral RNA after a cell is infected because about one in 5000 nucleotides used to make the DNA is wrong. This is not corrected because the reverse transcriptase (RNA-dependent DNA polymerase) which catalyses the reaction does not have the proof-reading capacity attributed to other DNA polymerases. Therefore, one or two random mutations occur each time a DNA copy of the approximately 8000 nucleotide viral RNA is made. During virus production, the mutated DNA copy is integrated into the infected cell’s genome and then RNA and subsequently protein are made. Some of this new RNA is packaged into progeny virus which carries the mutations to newly infected cells to repeat the cycle. Since the mutations are random, amino acid changes occur in every protein that the virus makes. Why then does the envelope protein gp90 of EIAV have more mutations when the sequence is actually determined than do other proteins like p26? The answer is selection. In this case, the selective pressures that determine which mutant viruses survive are the immune response of the host and the survivability of the mutants. Examples that affect virus survivability are that some mutations are lethal, some may infect cells better or worse, and some may replicate faster or slower. Rapid changes in gp90 are best explained by the host immune response, in particular, neutralizing antibody. Neutralizing antibody is made to gp90 of the infecting virus and prevents infection of new cells by any virus with the same gp90. Therefore, for the continued infection which occurs with EIAV, viruses which have mutations in gp90 occur which cannot be recognized by existing neutralizing antibody in the horse. Only those gp90 mutants can infect new cells. Since neutralizing antibody does not bind to p26 which is an internal capsid protein of the virus, what is the explanation for amino acid changes in p26 which can be as high as 12%? One explanation is selection by cytotoxic T lymphocytes (CTL) which recognize and kill infected cells which present p26 epitopes bound to MHC class I molecules on their surface. Once these CTL are present, there is a selective advantage for mutant viruses which have amino acid changes in the recognized epitopes. Another explanation is selection based on mutations that affect survivability that were listed in the previous paragraph. If antigenic variation occurs in p26, how can protein derived from a single recombinant bacterium used in the VMRD AGID and cELISA tests detect antibody in the serum of horses infected with viruses with amino acid changes in p26? First, the maximum p26 amino acid difference described is 12%, so shared epitopes remain and/or mutated epitopes cross-react. Second, other common epitopes are present and stable in p26 because mutations in these regions do not result in viable virus or competitive virus. Such common epitopes are likely located in regions of the protein required for function. In addition, there are common epitopes in functional regions of gp90. These explanations may account for the initial observation that p26 derived from a single virus strain could be used to detect serum antibody from horses infected with laboratory and field strains.

Watch how to run an ELISA test by VMRD

Through the Whitman County Humane Society foster program, a couple are charged with the care of a VERY rotund and pregnant polydactyl mama. While home alone, a squeamish man witnesses the immediate aftermath of 8 babies being born, saving one of them from outside of the crate. After sharing the birth story and pictures of the mama and her babies, several coworkers are inspired to start the adoption process to bring these polydactyl toe beans into their homes. In the midst of lockdown, the Whitman County Humane Society asked us to care for a very pregnant young cat we called "Mumford". She was so sweet and cute (even with her extra toe beans), how could we say no? So we took this hairy cantaloupe with legs and put her in the foster room, knowing full well that it was only a matter of days before we saw some newborn kitties. Several comments were made about how funny it would be if this birth happened while I was the only person in the house, and fate definitely has a sense of humor. As I sat at home, likely not doing anything productive, some suspicious squeaky noises started happening. In a house with 3 dogs and 2 cats suspicious noises are not uncommon, however these squeaks were a little more sus than usual. So, dreading what I knew I was about to see, I went down to the foster room. I am a squeamish man. Mumford, looking tired but relieved, lay there in her crate with 8 newborn babies. One of these poor babies somehow ended up on the outside of the crate. So, I take a deep breath, ignore all the things that would normally make me faint, and place this poor baby back in with the group, hoping that I don't pass out while holding it and that it doesn't get rejected. All turns out well though. Mumford was the best mama cat and took great care of all her babies: Jethro, Pearl, Ezra, Floyd, Pepper, Bizkit, Mac, and Queen (bonus points to anyone who can guess the theme and references of their names). We normally like to share our foster stories with our coworkers but this one got special attention for 2 reasons: First, because everyone enjoys my discomfort. Second, because several of these adorable little kittens inherited their mama's polydactyl trait. Extra toe beans are extra adorable. After hearing the story and seeing some pictures, some of our coworkers were inspired to adopt. Their individual stories are below. DAISY (The Cat Formerly Known as "Mumford") | Submitted & Written by Laurel Pacios-Rivera, Sr. HR Business Partner My co-workers were fostering Daisy and her kittens.  Several of us followed the progress of the growing kittens and the young mama cat.  I had it on good authority that the small mama cat would make a good pet, just what we had been looking for. I met and adopted Daisy at the Whitman County Humane Society on September 30th.  She was the last adoption of the day, and the 100th adoption of the month. She had recently been fixed and was not in the most amenable of moods when I reached out to her in her cage.  That quickly changed when she came home to rest and recover with us. Daisy not only has the classic white paws against her fluffy gray tabby body, she is polydactyl with 6 toes.   This makes her paws look like super-sized Uggs!  Daisy has grown to be quite rotund and relaxed.  Her favorite position is lying on the bed, on her belly, with her back legs splayed out to either side.  She has become quite the communicator – letting us know when the dog needs to be let in, or if there is a bird or a rabbit outside the window.  She has clearly found a home and we have found a wonderful pet. EZRA | Submitted & Written by Shelly Howenstine, Quality Director Meet Ezra! He was a kitten fostered by my coworkers, Amanda and Phil. He is the sweetest ball of fluff there could ever be. I adopted him 2 ½ years ago to be a companion for my old man Moose. His quirky personality, disheveled fur, polydactyl toes, and kitten energy make for a constant source of entertainment and occasional trouble. He loves carrying things around in his mouth- toy mice, wool dryer balls, fridge magnets, and I even saw him with a spool of kitchen twine once! He greets me with purrs and meows when I come home from work and loves to make biscuits with his big, fluffy feet. He has so many adorable features, but my favorite is his little white vampire teeth that make an appearance every now and again. I love my baby! ASTROBOT & SPYRO (Formerly Queen & Floyd) | Submitted & Written by Siddra Hines, Veterinary Affairs Manager As part of the VMRD polydactylcat family, these fabulous many-toed fluffycat brothers are the focus of much adoration in our household! Their favorite hobbies include flopping for belly rubs, long cuddles on the weekends, fitting into boxes, and showing off their toebeans. Even though Astrobot and Spyro are named after video game characters, they still haven’t figured out how to work those game controllers with their cat-thumbs, but they enjoy watching!

A dog's late-night visit to WSU Vet Teaching Hospital with an unusual and life-threatening heart condition turns into 5 more years of learning opportunities for the hospital and many more of boops and snugs for a relieved and grateful dog-mom. Nigel was found abandoned and wandering around a popular hiking trail in Missoula. My mom brought him home and he immediately took to me, so I decided to adopt him. It was one of the best decisions I ever made in my life. For more than a decade, Nigel was my favorite companion. He charmed everyone with his sweet, goofy, and loving demeanor. He was scared of his own shadow and was the definition of a lap dog, despite his 85 lb size.  He was the type of dog that had people saying “if you die, I want Nigel” after knowing him for about 30 minutes. When Nigel was about 8, he unexpectedly suffered from a severe heart event. He was behaving oddly and I took him into Washington State University Teaching Hospital at 10 p.m. because I just knew something was really wrong. It turned out I was right – his heart rate was extremely elevated and unstable. In the subsequent days his body would not respond to medication and other attempts to intervene, and his organs were starting to decline. In a last-ditch effort, he was placed under anesthesia to try to electro convert his heart using a defibrillator, and it worked! After spending a couple more days in ICU recovering, Nigel was diagnosed with supraventricular tachycardia (SVT) and had a heart monitor surgically implanted. This monitor was connected to his heart and allowed vets to scan the device to see heart activity. Nigel remained on medication for the remainder of his life, but he lived another 5 happy and relatively healthy years. He would visit the vets at WSU every 6 months for checkups. They would scan his monitor and look for heart irregularities while feeding him at least 3 lbs of treats. He loved to visit everyone and was beloved by the cardiologists at the hospital. He became famous for the unknown cause of his issue and his body’s refusal to cooperate with almost every known form of intervention, as well as his borderline miraculous recovery. Incoming vet students would always greet us with “I’ve heard so much about Nigel!” He was a star patient and exceedingly tolerant, which allowed many students to use him for various heart scans and education opportunities whenever he was on site. In September of 2018, Nigel passed away. He was estimated to be 13 years old, which is a great age for any large dog and an exceptional age for a dog that tried to kick the bucket 5 years prior. We were inundated with flowers and cards from multiple vets, friends, family, etc. He was everyone’s favorite dog and touched so many people’s lives, and he helped educate numerous vet students. He was a one of a kind guy and I feel so lucky that I was able to call him mine.

You asked, we answered. Fun facts about VMRD SAA!

Horse Vets work in all parts of the world, with all types of Equids: from million-dollar racehorses to the working donkeys and horses in Third World countries. The veterinary work focusing on working equines might not get a lot of coverage in magazines and journals, but that says nothing about the importance of the work. An NGO that has been working for more than 85 years on free veterinary care for working animals, is Brooke Hospital for Animals. After visiting Egypt in 1930, Mrs. Dorothy Brooke (founder of the organization) was heartbroken and outraged by the state former WW1 war horses were in. Instead of shipping the animals back to the UK the army had sold the animals to local Egyptian owners, who had no notion of proper animal care. The first former war horse Dorothy saw in Egypt – the animals were recognizable by a double arrow firing mark - was so emaciated that its “hips looked like hat racks” (quote from Dorothy’s diary). She sent a letter to a British newspaper, with a plight to help these animals. With the money the letter generated Dorothy was able to buy 5000 remaining war horses. Most of the animals were too weak to live and were put down. In 1934 the Old War Horse Memorial Hospital was established in Cairo. After the completion of the mission to help the old war horses, the hospital opened its doors to all working donkeys and horses in Egypt who needed veterinary help. This work has continued and expanded to different locations in Egypt, as well as India and Pakistan. Today Brooke Egypt has five hospital centers, 25 mobile clinics and 28 veterinarians. On average, they reach 160.000 animals each year with free veterinary care and hundreds of thousands of owners and children (future owners) with education. To keep the quality of veterinary care as high as possible (with the available means), the Brooke Egypt vets get yearly Continuing Professional Development (CPD). Normally, the vets travel to the Netherlands for this education, but during the Covid-pandemic this was not possible. Last summer, a new CPD has taken place, but for the very first time it was held in Egypt and Dutch Equine Vets traveled to Cairo. For those of you who have never been to Cairo, imagine an extremely busy city with smog, millions of people, blistering heat and some the greatest buildings of ancient history. In the middle of ‘Crazy Cairo’, as some Egyptians call their capital, there is a veterinary clinic that can house about 50 horses, donkeys, and mules. Especially the sand paddock at the clinic seems to be an oasis of peace and rest. Animals that have been overworked and deal with lameness and debility issues are here to get back to their strength. While on the other side of the wall claxons are honking and people are screaming, the animals in the sand paddock are sunbathing, relaxing, and eating. Surrounded by their four-legged friends and pampered by the grooms of Brooke-Cairo. The Brooke vets work with animals that suffer mostly from musculoskeletal problems, wounds, and debility. They depend strongly on their clinical examination to be able to come to a working diagnosis and treatment plan. To be able to increase their diagnostic abilities, the last CPD focused on the use of digital radiography in lameness and diagnostics for colic problems. Part of the diagnostics used at the CPD was the SAA-test, to measure the amount of Serum Amyloid A in the blood. The VMRD SAA-tests were sponsored by Grovet and proved to function well in temperatures of >35 degree Celsius, something that was not tested yet. One of the interesting experiences we had during the CPD days, was that all horses that were measured had SAA-values that were far above the reference values. This seems to support the observation that a lot of the working animals have comorbidities and that it is very important to look beyond the problem the owner is initially consulting the vet for. With the use of more diagnostic tools, we hope to come to more precise diagnosis and a better treatment plan, which will benefit not only the working animals but also the families that depend on them. And that is what makes the Brooke Egypt vets #proudhorsevets.