Being prepared for a specimen collection is an important way patients can contribute to the quality of the test results and the efficiency of the process.

Tests Requiring an Appointment

Most visits to our Patient Services Centres do not require appointments. Tests that usually, in most locations, require you to make an appointment include:

  • Oral Glucose Tolerance Tests (GTTs)
  • Lactose and Xylose Tolerance Tests
  • Holter Monitoring Locations offering Holter monitor testing [PDF]
  • Urea Breath Tests for Helicobacter Pylori
  • Breath Alcohol Testing
  • US Department of Transportation (DOT) urine procedures
  • Ultrasound Imaging (Roxboro, Quebec)
  • Spermogram (Quebec)

Tests Requiring Fasting

So that your clinician can accurately interpret your results on certain tests, you might be asked to fast prior to specimen collection. This is because the levels of many analytes become elevated in the bloodstream immediately after eating and fluctuate depending on when you have eaten and the quantity of food consumed. When you fast, these variations are eliminated. This also allows your clinician to compare your current results with your past results. In addition to fasting, you might also be requested to avoid stimulants (such as caffeine or nicotine), physical activity or specific foods that can alter clinical results.

It is recommended that you fast (no food, including chewing gum, or drink other than water) for a minimum of 12 hours prior to specimen collection for the following tests:

  • Cholesterol
  • Glucose
  • HDL Cholesterol
  • Homocysteine
  • Lactose Tolerance
  • LDL Cholesterol
  • Lipoprotein Phenotyping
  • Oral Glucose Tolerance (GTT)
  • Triglycerides
  • Xylose Tolerance

Urine Collection

24-hour Urine

This procedure must be followed without deviation since the results provided to the clinician depend on the accuracy of timing and the collection of the entire 24-hour specimen.

The containers required to collect suitable samples are provided at Gamma-Dynacare Patient Services Centres. Do not remove any tablets or other preservatives that are in the bottles. CONTAINERS MAY CONTAIN STRONG ACIDS; THEREFORE, BE AWARE OF ANY WARNINGS OR INSTRUCTIONS PRINTED ON THE CONTAINER. 

ANY DEVIATION FROM THE FOLLOWING STEPS WILL INVALIDATE THE RESULTS:

  • Clearly label container with your full name.
  • In the morning, completely empty the bladder into the toilet as usual. This specimen is NOT collected for testing. Print “collection started” and time and date in appropriate space on container label.
  • Add all urine passed over the next 24 hours to container. Always place urine into container immediately.
  • Prior to any bowel movement, completely empty bladder and add urine to container to prevent any loss.
  • The following morning, exactly 24 hours later (to the hour) empty bladder completely and ADD final specimen to container. Print “collection completed” and time and date in appropriate space on the container label. This final addition completes the 24-hour collection period started the day before. If a second specimen is required, collection can begin from this time and continue over the next 24-hour period.
  • Keep collection bottle in cool place or refrigerate.
  • Return 24-hour collection as soon as possible to a Gamma-Dynacare Patient Services Centre or to your clinician’s office, along with the requisition.

Urine for Culture and Susceptibility

Urine samples should reach our laboratory within two hours of collection. Otherwise, the urine MUST be refrigerated immediately after collection and received by Gamma-Dynacare within 24 hours.

The containers required to collect suitable samples are provided at Gamma-Dynacare Patient Services Centres. The first morning urine should be collected. If not, the urine should be held in the bladder as long as possible before collection. Complete the label on the container with your full name and date of collection.

Follow these directions carefully to provide a suitable sample:

FEMALES:

  • Clearly label container with your full name.
  • Wash and dry hands thoroughly.
  • WASH: It is necessary to wash only the area from which you pass urine. Soak sponge or washcloth with soap. Using one sponge or washcloth at a time, wipe only from the front to the back between the folds of your skin.
  • RINSE: After washing with soap, rinse with warm water using a clean sponge or washcloth.
  • Remove lid from container and set lid upside down. DO NOT TOUCH INNER SURFACE.
  • Squat over toilet, separating skin of the vulva. Continue to hold skin apart and pass a small amount of urine into the toilet, then collect in container.
  • Secure lid tightly.
  • Return container to a Gamma-Dynacare Patient Services Centre or to your clinician’s office, along with the requisition.
  • Refrigerate sample if not returned to a Gamma-Dynacare Patient Services Centre or to your clinician’s office immediately.

MALES:

  • Clearly label container with your full name.
  • Wash and dry hands thoroughly.
  • WASH: Expose penis, retract foreskin (if not circumcised) and, if necessary, wash with sponge or washcloth soaked with soap.
  • RINSE: Rinse with a clean sponge or washcloth soaked with warm water.
  • Remove lid from container and set lid upside down. DO NOT TOUCH INNER SURFACE.
  • Pass a small amount of urine into the toilet, then collect into container. DO NOT TOUCH CONTAINER OPENING.
  • Secure lid tightly.
  • Return container to a Gamma-Dynacare Patient Services Centre or to your clinician’s office, along with the requisition.
  • Refrigerate sample if not returned to a Gamma-Dynacare Patient Services Centre or to your clinician’s office immediately.

Urine Collection for Schistosoma Haematobium 

Urine collection for the detection of Schistosoma haematobium eggs should be conducted between noon and mid afternoon. Early morning specimens will not yield acceptable results. Up to three consecutive daily urine specimens might be required. When collecting the urine, the last portion of the urine flow must be collected rather than the routine midstream urine flow.

Clearly label container with your full name, date and time of collection.

Return container to a Gamma-Dynacare Patient Services Centre or to your clinician’s office, along with the requisition.

Urine for Cytology

It is recommended that three specimens be collected on three consecutive days. The containers required to collect suitable samples are provided at Gamma-Dynacare Patient Services Centres. Patients in Manitoba and Saskatchewan are advised to call your local Patient Services Centre, as urine for cytology collection containers and instructions are different from those described below.

Follow these directions carefully to provide a suitable sample:

  • Discard your first morning urine. This specimen is NOT suitable for testing.
  • Drink five to six eight-ounce glasses of water over a period of three hours. Urinate and discard.
  • When the urge to urinate arises again, urinate into an empty sterile specimen container and then carefully pour an amount of urine into the container equal to the volume of the preservative. PROMPT FIXATION IS IMPORTANT.
  • Make sure the lid is tightly secured and mix by tipping container upside down.
  • Clearly label the container with your full name. Return the specimen to a Gamma-Dynacare Patient Services Centre or to your clinician’s office within a few hours, along with the completed cytology requisition. The specimen should be refrigerated if it is not delivered soon after collection.
  • NOTE: If more than one sample is required, they must be collected on consecutive days. DO NOT collect more than one sample in a single day. Specimens collected in ethanol fixative CANNOT be used for other investigations. Epithelial cells shed in urine degenerate very quickly. PROMPT FIXATION IS ESSENTIAL.

Stool Collection

Stool Collection for Culture

Stool specimens for culture must be collected in an enteric pathogen transport media container. The containers required to collect suitable samples are provided at Gamma-Dynacare Patient Services Centres. One stool collection per day is recommended. Refrigeration is suggested.

Follow these directions carefully to provide a suitable sample:

  • Clearly label containers with your full name and date of collection.
  • Collect feces in a dry, clean container such as a chamber pot, plastic bag, plastic jar, wide-mouth jar, or on waxed paper. Avoid stool contact with urine or toilet water.
  • Add a teaspoonful of feces to transport container immediately after bowel movement. Select bloody or mucous-covered areas if seen.
  • Screw cap tightly onto container.
  • Mix feces with transport medium in container.
  • Return container to Gamma-Dynacare Patient Services Centre or to your clinician’s office as soon as possible, along with the requisition.

Stool for Clostridium Difficile Toxin

Fresh stool must be placed in a Gamma-Dynacare sterile specimen container. The containers required to collect suitable samples are provided at Gamma-Dynacare Patient Services Centres.

Clearly label the container with your full name and date of collection. Return container to a Gamma-Dynacare Patient Services Centre or your clinician’s office, along with the requisition. If you cannot return the specimen immediately, please refrigerate it.

Stool for Ova and Parasites

The containers required to collect suitable samples are provided at Gamma-Dynacare Patient Services Centres.

The fluid inside the bottle contains small amounts of formaldehyde and acetic acid. Avoid prolonged contact with skin. DO NOT drink the fluid.

A teaspoonful of freshly passed stool should be completely emulsified in SAF preservative/fixative. No more than two specimens, properly collected and preserved, is recommended.

Follow these directions carefully to provide a suitable sample:

  • Clearly label the containers with your full name and date of collection.
  • Do not take any laxatives, enemas or antibiotics for one week before stool collection unless otherwise directed by your clinician.
  • Pass stool onto clean, dry surface, such as a chamber pot, plastic bag, plastic wrap or waxed paper. Avoid stool contact with urine or toilet water.
  • Use scoop attached to container lid or use sticks provided. Add about one teaspoonful of fresh stool to transport fluid immediately after bowel movement. Be sure to take small samples from all parts of stool (e.g., hard and soft areas), and especially from any parts with blood or mucous.
  • Break up stool pieces in the transport fluid as much as possible.
  • Screw lid on tightly and shake container to emulsify stool.
  • Return bottle to plastic bag and reseal.
  • Wash hands immediately.

Return container to a Gamma-Dynacare Patient Services Centre or to your clinician’s office, along with the requisition.

Stool for Occult Blood

The kit required to collect suitable samples is provided at Gamma-Dynacare Patient Services Centres.

DO NOT collect specimen:

  • During or until three days after menstrual period;
  • While you have blood in your urine;
  • If you have bleeding haemorrhoids;
  • If dental work has taken place within three days.

Protect test slides from heat, light or volatile liquids (iodine, bleach).

You should follow a high-fibre diet free of red meat starting two days before testing and continuing through test period.

Recommended diet:

  • Generous portions of cooked and raw vegetables, especially lettuce, corn and spinach,;
  • Plenty of fruits such as prunes, plums, grapes and apples;
  • Moderate portions of high-fibre foods such as bran cereal, popcorn, whole-wheat bread and peanuts;
  • Tuna fish, well-cooked poultry or pork.

NOTE: If any of the above recommended foods are known to cause discomfort, do not consume them. Please consult your clinician.

Foods, vitamins and drugs to avoid:

  • Red or lightly cooked meats (e.g., beef or lamb);
  • Turnips, broccoli, horseradish, cantaloupes, parsnips and radishes;
  • Vitamin C in excess of 250 mg per day;
  • Iron supplements;
  • Aspirin and medications that can cause gastrointestinal irritation.

Follow these directions carefully to provide a suitable sample:

  • Clearly print your full name on each card with a ballpoint pen.
  • Before a bowel movement, flush toilet to clear water (DO NOT use bowl with automatic cleansers or bluing agents). Place plastic wrap or several layers of toilet paper over rim of bowl to ease collecting stools.
  • Lift front flap of test pack from one test slide. Defecate and use applicator stick to apply very thin smear of stool to “Oval I.” Use same stick to apply a thin smear from a different area of feces to “Oval II.” Discard stick in trash. DO NOT flush down toilet.
  • Close flap by sliding tab into crescent-slit. Enter date on front of slide. Place completed test slide into specially provided envelope.
  • Repeat procedure for three consecutive bowel movements.
  • Seal envelope by removing tape strip and folding as shown. Return to a Gamma-Dynacare Patient Services Centre or to your clinician’s office, along with the requisition.
    NOTE: It is against postal regulations to mail specimens in a standard paper envelope.

Other Collections

Oral Glucose Tolerance Test

For Glucose Tolerance Tests (GTTs), patients must fast for 8 to 12 hours (10 to 12 hours in Saskatchewan) before coming to the laboratory. Fasting means you may consume only water; no coffee, tea or other caffeinated drinks; milk; cream or even chewing gum. Avoid smoking if possible; any medication taken should be reported on the requisition. This test requires you to make an appointment at any of our Patient Services Centres.

Pinworm Examination

Pinworm ova are deposited on the skin near the anus. Deposits usually occur overnight while the patient is asleep. The kits required to collect suitable samples are provided at Gamma-Dynacare Patient Services Centres. These kits contain a clear polystyrene paddle, one side of which is coated with a non-toxic, mildly adhesive material.

Follow these directions carefully to provide a suitable sample:

  • Clearly label the containers with your full name and date of collection.
  • Collect specimen upon waking, before using the toilet or bathing.
  • DO NOT wipe or wash area before sampling.
  • Remove container cap and select “sticky” side of paddle. DO NOT TOUCH STICKY SURFACE WITH FINGERS. Hold paddle by rounded end and press sticky surface of square end firmly against skin around and across anal opening. DO NOT insert paddle into rectum. DO NOT contaminate paddle with stool.
  • Place paddle into tube, inserting square end to bottom of the tube.
  • Place container in plastic bag and reseal.
  • Thoroughly wash and dry hands immediately. Pinworm eggs are easily transferred by contaminated hands during collection and can infect others.
  • Return sample to a Gamma-Dynacare Patient Services Centre or to your clinician’s office.

Sputum for Culture and Susceptibility

The containers required to collect suitable samples are provided at Gamma-Dynacare Patient Services Centres. Thick sputum gathers in the lungs overnight. A morning sample is recommended and the collection should result from a deep cough. The patient should NOT spit into the collection container. Saliva is not a suitable specimen and could be rejected, which will delay results. Collection of one sputum sample is recommended.

Follow these directions carefully to provide a suitable sample:

  • Clearly label the container with your full name, date and time of collection.
  • Before breakfast, cough deeply to loosen thick sputum.
  • Release sputum specimen with no saliva directly into sterile collection container provided.
  • Refrigerate specimen immediately. Deliver specimen within 24 hours of collection to a Gamma-Dynacare Patient Services Centre or to your clinician’s office, along with the requisition.

NOTE: Specimens submitted for TB culture should be clearly marked on the outside of the container. Specimens obtained after nebulizer treatments should be marked as such.

Sputum for Cytology

Sputum is material collected from the lower respiratory tract. Saliva, by contrast, accumulates in the mouth and is unsuitable for cytological examination. Sputum specimens should be collected on three consecutive mornings before eating. The containers required to collect suitable samples are provided at Gamma-Dynacare Patient Services Centres.

To obtain the best specimen, inhale and exhale deeply several times and cough deeply from the chest. This will create secretions from the bronchial tree rather than saliva.

Follow these directions carefully to provide a suitable sample:

  • Clearly label the containers with your full name and date of collection.
  • Before eating breakfast or brushing teeth, assume an elbow-knee position on the bed for five minutes so lungs are higher than windpipe.
  • Inhale and exhale several times. Cough deeply from the chest/diaphragm to obtain secretions from bronchial tree.
  • Collect specimen directly into a Gamma-Dynacare sterile container.
  • Deliver sputum sample to a Gamma-Dynacare Patient Services Centre or to your clinician’s office immediately, along with the requisition. If there is a delay, keep the specimen refrigerated or fix in 50% alcohol. Fresh specimens are preferred.

Sperm Analysis

The containers required to collect suitable samples are provided at Gamma-Dynacare Patient Services Centres, with the exception of locations in Saskatchewan, where the containers are provided and the tests performed by regional health authority laboratories.

Follow these directions carefully to provide a suitable sample:

  • Patients must abstain from intercourse for 2-7 days prior to testing.
  • Ejaculate specimen by means of self-stimulation. DO NOT use a condom.
  • Collect ALL seminal fluid into sterile container provided, as greatest concentration of sperm is found in first portion of ejaculate.
  • Clearly label the container with your full name, date and time of collection.

NOTE: For fertility testing, analysis must be performed within one hour of collection. Contact Customer Service for the Gamma-Dynacare location where the test can be performed.

For post-vasectomy or culture and susceptibility testing, the specimen can be dropped off at any Patient Services Centre location within 24 hours. In Manitoba, specimens must be dropped off to our main laboratory in Winnipeg within one hour of collection.