Form 1 for Yorkie Encephalitis


Form 1 is for pets that have died are will be euthanized because of encephalitis, including GME, NME, NLE or any other form of encephalitis.

Form 1 contains: a) instructions for your veterinarian on collecting and processing the tissue needed for our research, b) contact information for Dr. Barber and c) a request for whatever records are available on the pet, such as seizure history, MRI, blood tests, etc.

IMPORTANT: Please arrange aftercare (cremation, burial, etc.) for your pet with your veterinarian as soon as possible after your pet has passed. Your pet's brain will be evaluated by a neuropathologist and you will be contacted with the results as soon as they are available (Be aware this can take 1 month or longer). If you do not want to be contacted with the results, please let us know.

INSTRUCTIONS FOR VETERINARIAN:
1. If possible, obtain 2-3ml of blood in an EDTA tube prior to death or euthanasia. Blood can be stored in the refrigerator for up to 1 week prior to shipment.

2. At necropsy, remove the entire brain and place in 10% formalin. After the brain is thoroughly fixed (3-5 days), it can be placed in a ziplock bag with only a tiny amount of formalin to keep it moist. Then double or triple bag it to make sure there is no leakage during shipment.

3. At necropsy, excise two 2cm x 2cm sections of liver. Place one section into 10ml absolute isopropyl or rubbing alcohol in a tightly sealed container and store at room temperature. Place the other section into a ziplock bag or other appropriate container. This sample can be stored in the refrigerator for up to 1 week prior to shipment.

4. Please label all samples with the patient name, owner last name and date of necropsy. Samples should be shipped overnight at room temperature in standard packaging to insure against breakage. Please include material to absorb any leaks that occur during shipment.

Ship to:
Renee Barber
Department of Small Animal Medicine and Surgery
University of Georgia College of Veterinary Medicine
501 DW Brooks Drive
Athens, GA 30602
rbarber1@uga.edu

Please include complete medical records for the animal, including vaccination dates and manufacturers. Individual veterinarians will be responsible for obtaining permission to use the pet's tissues for genetics research. If needed, veterinarians can contact Dr. Renee Barber if they would like help developing a release form for owners to sign.

RECORDS NEEDED:
(These records are likely best supplied by the owner and the veterinarian. We understand that not all information is available on every animal.)

1. Form 3
2. Vaccination records
3. Pedigree
4. Seizure history
5. Treatment and condition progression
6. Neurological examination notes
7. Complete blood panel results, including:
a. CBC
b. Chemistry
c. Urinalysis
d. Bile acid test
e. Lactic acid test
f. Infectious disease titers
8. CSF results
9. MRI results (Generally, the facility that performed the MRI can provide a copy on CD.)



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