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    Necropsy Sample Submission Form SW

    Uploaded by

    Alberto Uribely
    (1) This document is a necropsy and sample submission form for swine submitted to the Minnesota Veterinary Diagnostic Laboratory (MVDL). (2) It requests information about the attending veterinarian, owner, farm, clinical history, tests requested, and narrative history or necropsy findings. (3) The form provides fields to fill in details like the animal's identification, breed, age, symptoms, herd information, and more.

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    Necropsy Sample Submission Form SW

    Uploaded by

    Alberto Uribely
    42 views2 pages
    (1) This document is a necropsy and sample submission form for swine submitted to the Minnesota Veterinary Diagnostic Laboratory (MVDL). (2) It requests information about the attending veterinarian, owner, farm, clinical history, tests requested, and narrative history or necropsy findings. (3) The form provides fields to fill in details like the animal's identification, breed, age, symptoms, herd information, and more.

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    Necropsy Sample Submission Form Sw

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    (1) This document is a necropsy and sample submission form for swine submitted to the Minnesota Veterinary Diagnostic Laboratory (MVDL). (2) It requests information about the attending veterinarian, owner, farm, clinical history, tests requested, and narrative history or necropsy findings. (3) The form provides fields to fill in details like the animal's identification, breed, age, symptoms, herd information, and more.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    42 views2 pages

    Necropsy Sample Submission Form SW

    Uploaded by

    Alberto Uribely
    (1) This document is a necropsy and sample submission form for swine submitted to the Minnesota Veterinary Diagnostic Laboratory (MVDL). (2) It requests information about the attending veterinarian, owner, farm, clinical history, tests requested, and narrative history or necropsy findings. (3) The form provides fields to fill in details like the animal's identification, breed, age, symptoms, herd information, and more.

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    © All Rights Reserved
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    You are on page 1of 2

    (612) 625-8787 E-mail: vdl@umn.

    edu
    Phone:
    MDH use
    Fax: (612) 624-8707 Web site access/results:
    Toll Free: 1-800-605-8787 www.vdl.umn.edu
    ONLY
    Necropsy and Sample Submission Form - Swine
    Attending Veterinarian Billing Information
    (Results* will be sent here unless otherwise noted)
    Pay at drop off
    Veterinarian Bill veterinarian
    Bill owner
    Clinic Contract/PO number
    Specimen History
    Address
    Specimen(s)
    City State Zip
    Animal name/ID
    For office
    Phone Email:
    Species Breed
    use only
    Send *results via: Email:
    OR Ident/color
    Fax:
    Affiliate (list codes)
    Age (Please circle: day wk mo yr )
    Owner/Producer
    Weight (Please circle: lb kg )
    Owner Name
    Sex: M F N/M S/F
    Address Yes No
    Date of Death Time of Death Purchased:
    City State Zip
    Euthanized: Yes No How Date
    Phone Fax
    Herd size No. in affected group No. sick No. dead
    Email
    Duration of problem in submitted animal(s) Duration in herd
    Prem./Ref. ID County
    Type of housing/environment Ration
    Site/Farm Source/Flow

    Lot Delivered By Vaccination Therapy

    Laboratory Procedures Requested


    Necropsy/General Exam of Tissue (includes bacteriology, EM, histopathology, molecular diagnostics, parasitology, serology, and virology, as determined by the pathologist to be
    part of the investigation; nutrition, toxicology and other out-sourced tests will be charged at cost; fees may apply to additional tests;).
    General Exam of Feces
    0 -10 Days: Aerobic culture (Salmonella); Anaerobic culture; Clostridium difficile culture or ELISA; PEDv/PCoDv/TGE PCR; Rotavirus PCR; Senecavirus A PCR
    10 days - 7 weeks: Aerobic culture (Salmonella); fecal float; PEDv/PCoDv/TGE PCR; Rotavirus PCR
    8 weeks +: Aerobic culture (Salmonella); PEDv/PCoDv/TGE PCR; Brachyspira culture; Lawsonnia intracellularis PCR
    Other: _______________________________________________________________________________________________________________________________________

    History/Clinical Signs/Clinical Diagnosis/Necropsy Findings/Additional Information or Requests

    Note: The MVDL reserves the right to subcontract any work required to complete testing of any and all submissions. Any subcontracted
    work will be identified on the laboratory report. If applicable
    FAD Number:
    SYS.FORM.095, Rev. 4, 09/22/2017 Page 1
    Narrative history/necropsy findings (continued)

    Section below is for Laboratory use only.


    Specimen
    Fixed Unfixed
    Specimen condition: Live Good Fair Poor Unsuitable
    Necropsy/Gross findings:

    SYS.FORM.095, Rev 4, 09/22/2017 Page 2

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