PetChek IP Frequently Asked Questions. About PetChek IP. What is PetChek IP?

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1 PetChek IP Frequently Asked Questions About PetChek IP What is PetChek IP? PetChek IP is a diagnostic tool for detecting intestinal parasitic infections in pets. The home collection kit conveniently puts the entire faecal sampling and submission process in the hands of the pet owner, while results are returned directly to the veterinary practice. For your clinic, the product is workflow-free : you only need to dispense the kit no samples are taken to the practice, no stool handling, no 3-day composite of samples, no requisition forms. Every kit sold by your staff is electronically linked to your practice using a special barcode system, with codes being assigned when the kit is dispatched from IDEXX. As a result, you can simply hand the PetChek IP kit to the pet owner and the rest happens on your behalf. PetChek IP is designed to be used as part of the routine/wellness visit when screening patients for intestinal parasites. PetChek IP uses novel technology developed by IDEXX for the detection of antigens in three nematodes (hookworm, roundworm and whipworm) in faeces, and couples them with the Giardia antigen test for the most accurate results. The test does not rely on egg detection, as the group-specific nematode antigens are excreted/secreted from the adult worm, whether it lays eggs or not. Why screen healthy cats and dogs for intestinal parasites? Testing provides prevalence data Testing pets as part of the routine visit lets you learn what parasites are infecting patients and putting families at risk. It also provides an important point of individual risk assessment and builds a base for control strategies. Knowledge of what parasitic agents are prevalent in your clinic s area allows you to formulate an appropriate control programme and increase awareness and vigilance in the practice s staff. Prevalence data can be used to educate and motivate pet owners Real data from your own practice can be a powerful tool for educating pet owners on the actual risk of infection in their pet. Sharing this information and making the risk real helps to drive awareness and also makes pet owners more likely to comply in administering deworming medication. Identifying positive animals reduces shedding and avoids disease Many animals remain infected despite frequent deworming. These animals contaminate the environment, continue to be at risk of breaking out with disease and potentially put their families at risk of infection. Regular testing identifies such pets, so that they can be treated to reduce the threat. Testing instead of unnecessary treatment Overall less than 10 % of all canine and feline samples sent to IDEXX in the past years have been positive for roundworms, hookworms or whipworms. It is good to know which are the positive ones, so that they can be treated, and that there is no need for treatment for the rest.

2 Why screen for intestinal parasites with faecal antigen tests? Adult parasites often shed proteins in the host s gut before they lay eggs. The faecal antigen tests can detect those proteins before a faecal flotation test can detect the eggs. Finding intestinal parasites earlier in the infection cycle enables earlier disease diagnosis and treatment intervention, as well as reducing the chance of environmental contamination with potentially infectious eggs. The faecal antigen test is not subject to the problems of intermittent egg shedding that may cause a false negative with the flotation test. PetChek IP only requires one small faecal sample (0.2 g) versus the pet owner taking multiple stool samples over several days. What is included in the IDEXX PetChek IP kit? Pet owner sampling kit with instructions Spatula to scoop the sample and vials for securing the sample safely for transport back to an IDEXX laboratory Requisition form for owner to fill in (in local language), including a pre-registered barcode linked to your clinic Pre-paid postage Cost of the lab test About antigen technology How does the new IDEXX faecal antigen test for hookworms, roundworms and whipworms work? IDEXX s innovative faecal antigen tests for the detection of roundworm, hookworm and whipworm parasites use enzyme-linked immunosorbent assay (ELISA) technology. This technology is offered to vets and pet owners through the PetChek IP kit, which also tests for Giardia infections. Unlike traditional flotation testing methods, these new antigen tests offer improved sensitivity, detect parasites earlier in their lifecycle and do not require subjective assessment. How does the faecal ELISA test detect antigens before faecal flotation? Flotation by centrifugation has long been recommended as the most accurate method of ova and parasite detection. However, in contrast to egg detection, faecal antigen testing detects specific antigens from the adult whipworm, hookworm and roundworm, which may be present in faeces before the parasite begins laying eggs. Another factor is that eggs may only be shed intermittently in the faeces, which is why they may not always be detected by faecal flotation. Some intestinal parasite eggs, such as whipworm eggs, are heavier when compared to eggs from other parasites. As a result, they may not always be detected because they do not float to the surface of the faecal flotation solution. Adding antigen detection to the faecal testing increases the overall sensitivity of the faecal parasite screening. Do the faecal antigen tests replace the faecal flotation by centrifugation test? No. For sick patients, a full flotation or faecal profile is recommended to screen for a wider range of intestinal parasites. The PetChek IP kit is designed for healthy patient screening, looking for the more common and concerning pathogens of healthy animals.

3 How are the faecal antigen tests for whipworm, hookworm, and roundworm different from the faecal antigen test for Giardia? Is the Giardia test in PetChek IP different from the Giardia SNAP test I use in clinic? Both of these tests use ELISA technology to detect a specific antigen. The ELISA for Giardia detects antigens released by Giardia cysts, whereas the ELISAs for whipworms, hookworms and roundworms detect antigens shed by the infecting worms. PetChek IP s Giardia test uses the same reagents as SNAP and the current lab test. However, the usage of Giardia SNAP and PetChek IP should be different. Whenever a pet presents sick to the clinic and shows clinical signs such as diarrhoea, it is essential that the diagnosis be made rapidly at the practice, so the treatment can be implemented with no delay. In this case, performing a Giardia SNAP is recommended as best practice. If the animal comes for a wellness check, selling PetChek IP would be the standard way to test for the most common parasites; the analysis will be performed at the lab and your clinic will receive the results directly from IDEXX. Why does IDEXX offer this Ag test along with the PetChek IP box? Is this test offered at the lab? Will extremes in outdoor temperatures affect the results of a faecal O&P or faecal antigen test? PetChek IP combines an easy sampling kit for pet owners with an innovative Ag test performed at the lab. It comes with the box to allow the pet owner to collect stools hassle-free and mess-free. No. A pilot of the antigen tests was conducted in the U.S. during the 12 months prior to launch. A study of the results from the pilot programme demonstrated no difference in parasite prevalence rates across the US within areas of extreme temperature variations compared to specimens sent in via regular routes. This suggests that variation in temperature will not impact faecal results. We are in the process of performing further studies. Does the age of the sample effect the test results? No. The antigen PetChek detects are very stable even in older samples, but it is easier for our lab to process fresher samples, which have not dried out.

4 About intestinal-parasite testing What are these parasites and what disease do they cause? Different parasites have varying modes of infection. Pets become infected with some intestinal parasites when they ingest infective larva from a contaminated source or by ingesting small animals like mice. Some parasites, like hookworms, can penetrate a pet s skin to cause an infection. Infected pets pass the parasite s eggs into the environment in their faeces, which can in turn infect other pets. Humans are also at risk for several of these infections (zoonosis). Roundworms can cause serious disease in young animals including weight loss, failure to thrive and distention of the abdomen. In adult pets, infected animals are often without clinical signs, but they still continue to excrete eggs, putting other animals at risk. Hookworms attach themselves to the intestinal wall and suck blood with their hook-like mouthparts, causing anaemia (blood loss) especially in younger pets. Other complications can include diarrhoea, malnutrition and respiratory disease. Whipworm adults use their slender head to penetrate and anchor themselves to the intestinal wall. Infections can be without signs of disease, but severe infections can cause colitis with signs of diarrhoea and blood. Giardia attaches and causes injury to the small intestinal wall, which reduces the intestines ability to absorb fluid and nutrients. The infection can have no clinical signs or cause diarrhoea. Which animals can be infected with intestinal parasites? Hookworms and roundworms are found in both dogs and cats. Giardia, hookworms and roundworms can be zoonotic infections, which means they can be passed from pets to people. Whipworm infections are most common in dogs and are rarely seen in cats. Why is Giardia included into PetChek IP? The prevalence of Giardia infections in dogs and cats will vary by region, but on average it is 20.3 % and 11.7 % respectively (European data for 2016 from samples sent to IDEXX labs). However, studies have shown that dogs and cats can present subclinical infections with no signs of disease. Wellness testing is a good way to diagnose those pets.

5 How to use PetChek IP at your clinic Can I include PetChek IP in a wellness protocol? Screening adult patients is what PetChek IP was designed for. As sub-clinically infected dogs and cats do not present symptoms, routine testing is the only way to determine which animals are infected. Testing is also indicated in cases where the pet owner does not want to give their pet deworming pills as a preventative measure, when a pet owner compliance problem is suspected, or when the pet lives in a high-incidence parasitic risk area. Can I use PetChek IP on sick pets? PetChek IP was designed to test adult asymptomatic cats and dogs for the most common intestinal parasites, such as roundworms, hookworms and whipworms. PetChek IP can also be used on sick animals, but it does not represent a complete assessment of all possible intestinal parasites or other infectious causes of diarrhoea. For sick dogs and cats, we offer a Nematode-ELISA test at the lab, which uses the same technology as PetChek IP and can be ordered as an add-on test to a faecal flotation or a diarrhoea profile. Why would I use PetChek IP instead of deworming 4 times a year (ESCCAP guidelines)? ESCCAP and other professional organizations advocate for the control of intestinal parasites through both testing and preventative pharmaceutical interventions. Testing and prevention are therefore complementary approaches to intestinal pet health. For roundworms, the ESCCAP guidelines indicate a minimum frequency of deworming of 4 times a year for adult pets. In the USA, the CAPC advocates administering monthly year-round broad-spectrum parasite control against heartworm, intestinal parasites, fleas and ticks. However, we know that pet owner compliance is not 100 %. Despite recommendations from vets, the average frequency of treatment/deworming is around 2 to 3 times a year. It is often unclear what the parasitic pressure is in a specific pet s environment. Despite widespread protocols and frequent dispensing of dewormers, there are still between 5 10 % of animal across Europe harbouring infections of hookworm, round-worm and whipworm. Giardia prevalence is even higher, but this parasite is not covered by some of the current deworming protocols. Regular testing will give your practice better insight into the prevalence of the infections you are trying to control. It also tells you which individual pets are infected and require a course of medication to address that infection (this may be more than just one pill). Screening through routine testing will also inform the owner of the infected pet, giving them a more active role when the right treatment and prevention protocols are implemented. How frequently should I screen healthy pets with PetChek IP? IDEXX proposes an annual check. However, at the vet s discretion, the test may also be recommended more often if an animal is deemed to be in a high-risk environment or if it is suspected that pet owner compliance is an issue. On which healthy pets should I propose PetChek IP? All healthy adult dogs and cats should be screened for intestinal parasites. PetChek IP can be sold to the pet owner during a routine wellness exam and included in wellness programmes.

6 Does IDEXX recommend using PetChek IP after the treatment period (diet or pills)? Every situation is unique. A healthy animal that is infected should have the proper treatment prescribed to address the infection. A recheck at 3 to 6 months allows time enough to assess whether the animal has been re-infected via a contaminated environment or whether the course of treatment was effective depending on owner compliance. Why should I buy a good but expensive test that does not replace normal flotation? Due to many pre- and post-analytical issues, the flotation method can generate false-positive and false-negative results. This is especially true if centrifugation is not used for flotation. - A flotation test only looks for the presence of eggs, which is an indirect measure of whether there is a mature worm in the intestinal gastrointestinal tract. This method can miss a prepatent infection, in which a pet is infected but is not shedding eggs in its faeces (false negative). The prepatent period ranges from days in hookworms, to days in roundworms, to as long as days in whipworms. - A single-round flotation test can lead to a misdiagnosis, as eggs may be shed intermittently or there can be a single-sex infection. In addition, the flotation method can also lead to false positives, as pollen or other debris can be misidentified as eggs. Coprophagy or ingestion of faeces by dogs may also contribute to false positive flotation results due to the presence of spurious eggs. PetChek IP s antigen tests detect 4 antigens that are specific to the adult worms and Giardia. This Ag-based test is a direct measure of the presence of the adult worm (male or female) in the intestinal tract, whether there are eggs or not. This allows for earlier detection of infections. Thanks to the use of unique biomarkers, the tests are specific for the species of worm. PetChek IP is also more accurate, as it detects more parasites and identifies them sooner (for whipworms and hookworms). Another benefit is that the antigen test requires a much smaller quantity of faeces: 0.2 g versus at least 1g. In addition, PetChek IP is much more convenient and saves a lot of time, as your clinic staff does not have to handle faecal samples anymore. Can I use PetChek IP instead of endoparasiticides? PetChek IP is a perfect complement to the use of endoparasiticides. Intestinal parasite control starts with determining which animals are infected and PetChek IP is helpful in diagnosing asymptomatic animals. Positive animals will then need appropriate treatment and an individual risk assessment to determine the best anthelminthic plan post-treatment. Will using PetChek IP reduce my prescription of endoparasiticides? It might, as fewer endoparasiticides will be prescribed unnecessarily. On the other hand, for the positive patients, compliance on treatment will greatly increase with educated owners of infected pets. And as those patients are in infected environments, prescription of medication for other patients will also increase.

7 Why is PetChek IP not in the ESCCAP guidelines? PetChek IP is a new test. IDEXX is working with ESCCAP to develop new protocols, and our antigen targets have already been included in the USA s CAPC group guidelines. The United States Department of Agriculture has also recognized them as part of the new gold-standard benchmark. If I screen pets with PetChek IP and they are negative, should I give the pet deworming medication? No, this is not necessary as no parasite was detected. How does the PetChek IP process work? How do I order a PetChek IP kit? You can order PetChek IP in the same way you order your SNAP kits or slides. Contact IDEXX customer support or IDEXX On-line Ordering. What package sizes does PetChek IP come in? What is the cost of a kit? What if I do not have an IDEXX reference lab account? Why don t I have to open the box or fill out a lab requisition form? Each PetChek IP carton contains 10 kits. Please contact the IDEXX customer support for details. If you don t have a lab account, our team will be happy to create one for you. They will also register the correct results transmission details for your clinic ( , fax, etc.). Each PetChek IP kit has a barcode that we scan and assign to your practice when we ship the kits from our warehouse. The barcode information is automatically uploaded into the Lab LIMs system. When the box arrives at the lab for processing, the barcode tells us that it came from your clinic, so we will already know where to send the results. The pet owner fills out the requisition form with the patient information. Can I record the barcode into my clinic s PIMS myself? The barcodes are on the requisition forms and the barcode numbers are scanned and linked to your practice when the kits are shipped from IDEXX. If you want to, you can open the box, manually enter the barcode into your system and assign the barcode in your Practice Information Management System (PIMS) to the individual patient. However, it does not matter if you put the barcode on a requisition form or if we did it; you will still receive the results to your practice with the patient details as entered by the pet owner on the form. Can I request other tests on the same requisition form used in the kit? Can other tests be added for the same sample? No. This kit has already been assigned to only run the antigen tests for ascarids (roundworms), hookworms, whipworms and Giardia. No, faecal samples are not stored by IDEXX; they are immediately discharged.

8 Why is there a use by expiration-like date on the kit? IDEXX wants to ensure having the most current kits available for customers like you, which is why the lifespan of the kits is limited. However, there are no perishable items in the kit. How does the pet owner get the kit back to IDEXX? For most countries, the pet owner will simply drop the kit in the postbox, but some may choose to return it to the practice. An exception is Italy, where the kit will not have a postal option and will always be returned to the practice. If pet owners return the kit to your practice, always be sure to ship the kit in the standard lab shipping materials (country-specific: red/white/yellow plastic bag or DHL box). Otherwise the driver might refuse to take the shipment or it could get stuck at the airport. What reference lab does the PetChek IP kit go to? What is the turnaround (TAT) once the pet owner sends the kit to IDEXX? All PetChek IP samples will be processed in our lab in Leipzig, Germany. The turnaround starts when the sample arrives in the lab. Lab TAT is 2 3 working days. IDEXX cannot track timing for how long the pet owner takes to obtain the sample and send to the lab. It is therefore important for you to encourage pet owners to take and submit the sample right away. You should also factor in the time it takes for the post to travel in your region. What are the sample requirements? Can the pet owner put more than one pet sample in the box? Can the pet owner request a copy of results? An on-time sample collection of 0.2 g of fresh faeces. No. Each kit includes the supplies needed to collect one faecal sample only. Please provide only one kit per pet. There is no change to our standard process regarding pet owners. They should contact their pet s clinic regarding all information about their results. All /TM marks are owned by IDEXX Laboratories, Inc. or its affiliates in the United States and/or other countries. The IDEXX Privacy Policy is available at idexx.eu 2017 IDEXX Laboratories. Inc. All rights reserved EU