BHBCheck
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SETTING THE METER AND RESETING THE MEMORY The BHBCheck™ blood ketone test system consists of two main components: the meter and test strips. These components have been designed, tested and proven to work together as a system to produce accurate blood ketone test results. Only use the BHBCheck™ test strips with the BHBCheck™ meter. The system is intended to be used for the quantitative measurement of beta-hydroxybutyrate (BHB) in fresh whole bovine blood samples. The system provides plasma equivalent results that are displayed in either millimoles per liter of blood (mmol/L) or in milligrams per deciliter of blood (mg/dL). Blood Ketone Test System Use BHBCheckTM meter with BHBCheck TM test strips only With the month flashing, press “M” until the correct month appears. Press “S”. It is important to make sure that the LCD displayed code is the same as the code on the test strip vial before testing. Failure to do so will result in inaccurate results. With the year flashing, press “M” until the correct year appears. Press “S”. BHBCHECKTM KETONE TEST STRIPS With the hour flashing, press “M” until the correct hour appears. Press “S”. More recent studies suggest using a slightly lower cut-point of 1.2 mmol/L (11.7 mg/dL) of blood BHB for defining ketosis. References: Duffield, T. 2001. Importance of Subclinical Ketosis in Lactating Dairy Cattle. Proc. Michigan Vet. Conf. Geishauser T, Leslie K, Kelton D, Duffield T. 1998 Evaluation of Five Cowside Tests for Use with Milk to Detect Subclinical Ketosis in Dairy Cows. J. Dairy Sci 81:438-443 Geishauser T, Leslie K, Tenhag J, Bashiri A. 2000. Evaluation of Eight Cowside Ketone Tests in Milk for Detection of Subclinical Ketosis in Dairy Cows. J. Dairy Sci 83:296-299 Oetzel, G.R. 2007, Herd Level Ketosis - Diagnosis And Risk Factors, American Association of Bovine Practitioners 40th Annual Conference, Vancouver, BC, Canada The test strip consists of the following parts: STEP 3. Setting the unit of measurement Press M to switch between mg/dL and mmol/L. Press “S”. 4. Data Port 5. Set Button (S) 6. Battery Compartment 1. Test slot 2. Display Screen 3. M Button (M) STEP 4. Deleting the memory With “dEL” and a flashing “M” on the display, press “S” to keep the results in memory to skip and turn off the meter. NOTE The meter will turn off automatically after 180 seconds without any action, or you can press and hold the M for 3 seconds to turn off the meter. • Hematocrit: The hematocrit level is limited to between 20% and 40%. • This test strip is used for testing fresh capillary and venous blood. • Altitude effects: Altitudes up to 10,742 feet (3,275m) do not affect test results. • Use only heparin for anticoagulation of whole blood. To delete all results, press “M”, then press “S” to turn off the meter. 1. Code 2. Blood Drop Symbol 3. Test Result 4. Date 5. Day Average 6. Time 7. Low Battery Symbol 8. Temperature Display Symbol 9. Control Solution Mode 10. Test Strip Indicator 11. Measurement Unit 12. Ketone Indicator 13. Memory Symbol ABSORBENT HOLE Apply a drop of blood here. The blood will be automatically absorbed. CONFIRMATION WINDOW This is where you confirm if enough blood has been applied to the absorbent hole in the strip. TEST STRIP HANDLE Hold this part to insert the test strip into the meter. CONTACT BARS Insert this end of the test strip into the meter. Push it firmly until it will go no further. b) Gently apply the drop of blood to the absorbent hole of the test strip at a tilted angle. Confirmation window should be completely filled if enough blood sample has been applied. c) If the confirmation window is not filled completely before the meter begins to count down, do not add more blood to the test strip. Discard the test strip and start again. If you have trouble filling the test strip, please contact your veterinarian or your local customer service representative for assistance. STEP 3. Wait 5 seconds (Note: Meter will countdown the wait time). NOTE If you don’t apply a blood sample to the test strip within 3 minutes, the meter will automatically turn off. You must remove and reinsert the test strip to start a new test. STEP 4. Get results. The result of your BHB test will be stored in the memory automatically. BEFORE TESTING CALIBRATION You must calibrate the meter every time you begin to use a new lot of test strips by setting the meter with the correct code. Test results may be inaccurate if the code number displayed on the monitor does not match the number printed on the strip vial. HOW TO CODE YOUR METER 1. Insert the code test strip when the monitor is off. Wait until the code number appears on the display. Subclinical ketosis can be detected by measuring the level of ketone bodies in blood, milk or urine. Beta-hydroxybutyrate (BHB), a major ketone body formed during ketosis, is more stable than acetone or acetoacetate (Geishauser, 1998; Oetzel, 2007). Blood BHB testing is considered the “gold standard” for ketosis detection (Oetzel, 2007). The BHBCheck™ blood ketone test is a simple, on-farm test to screen for BHB levels in blood. Early lactation cows with blood BHB concentrations ≥ 1.4 mmol/L (14.4 mg/dL) are 3 times more likely to develop clinical ketosis or displaced abomasum (Oetzel, 2007). With the minute flashing, press “M” until the correct minute appears. Press “S”. a) Obtain a drop of blood that is at least 0.7 µL of volume. Your system measures the amount of BHB in whole blood. Blood is applied to the absorbent hole on the test strip and is automatically drawn into the cell where the reaction takes place. STEP 1. Insert the test strip to turn on meter. Wait for the meter to display ambient temperature value, code no. and then a flashing “ ”. STEP 2. Obtain a blood sample. STEP 2. Setting the time BACKGROUND Ketosis in dairy cows occurs as a result of negative energy balance, a condition most common during the early postpartum period. During this time, milk production is increasing dramatically, while energy intake may not be adequate to sustain this production level. When this happens, cows metabolize body fat to meet their energy needs, resulting in increased production of ketones, a condition known as subclinical ketosis. This condition is much more common than clinical ketosis, and has been associated with significant economic losses due to decreased milk production, impaired fertility, displaced abomasums and metritis. Researchers have determined that the herd prevalence of subclinical ketosis is approximately 41% for the first 9 weeks of lactation. (Duffield, 2001). TESTING WITH BLOOD SAMPLE With the day flashing, press “M” until the correct day appears. Press “S”. APPEARANCE AND KEY FUNCTIONS OF THE METER Start with the meter off (no test strip inserted). Press “S”. 2. Remove the code strip, the display will show “OK”. This tells you that the meter has finished coding and is ready for testing. STORAGE & HANDLING OF TEST STRIPS • Write the first opening date on the vial label. Test strips expire 6 months after that date. Do NOT use expired test strips. • Store the test strips in a cool, dry place between 2°C and 30°C (35.6°F and 86°F) and below 85% relative humidity. • Keep the test strips away from direct sunlight. Do not store the test strips in high humidity. • Store the test strips in their original vial containers. • Do not touch the test strips with wet hands. • Use each test strip immediately after taking it out of the vial. Close the vial immediately after taking out a strip. • Keep the vial closed at all times. • Do not bend, cut, or alter the test strip. WARNINGS 1. For single use only. 2. Please do not change your treatment of animals based on the results without first consulting your veterinarian. 3. Turn the meter off by removing the test strip. Discard the used test strip carefully according to your local regulations. 4. Keep test strips away from small children. If swallowed, contact a doctor immediately for advice.