VS 6-35 Report of Suspicious TB Lessions or Thoracic Granulomas

See reverse for instructions.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of
OMB
information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0146. The time
APPROVED
required to complete this information collection is estimated to average .16 hours per response, including the time for reviewing instructions, searching
0579-0146
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
Exp.: 11/30/2016
UNITED STATES DEPARTMENT OF AGRICULTURE
1. TYPE OF INSPECTION
2. ESTABLISHMENT NUMBER
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
STATE
FEDERAL
VETERINARY SERVICES

REPORT OF TUBERCULOSIS LESIONS OR THORACIC
GRANULOMAS IN REGULAR KILL ANIMALS
4. DATE SLAUGHTERED

5. LOT NUMBER

BOVINE

CERVINE

PORCINE

BISON

OTHER (Specify)
6. NUMBER IN LOT

8. ESTABLISHMENT NAME AND ADDRESS (Include ZIP Code)

ESTABLISHMENT PHONE NUMBER

3. SPECIES

7. NUMBER WITH LESIONS

9. NAME AND ADDRESS OF OWNER (Include ZIP Code)

ESTABLISHMENT FAX NUMBER

10. NAME AND ADDRESS OF SHIPPER (Include ZIP Code)

11. NAME AND ADDRESS OF MARKET OR BUYER (Include ZIP Code)

12. ANIMAL IDENTIFICATION (Place all ID devices in box with tissues to National Veterinary Services Laboratories)
A. OFFICIAL PERMANENT ID/EAR TAG

D. CARCASS NUMBER

B. SALE/BACK TAG NUMBER

E. RETAIN TAG NUMBER

C. OTHER ID (Brand, Tattoo, Bangle Tag)

F. AGE

G. SEX

13. POST MORTEM REPORT
KEY: / = SLIGHT \ = WELL MARKED X = EXTENSIVE CS = CASEOUS CL = CALCIFIED
HEAD
(A)

CS

CL

CERVICAL
(B)

BRONCHIAL
(C)

MEDIASTINAL
(D)

CS

CS

CS

CL

CL

WEIGHT

OTHER
(H)
LUNG
(E)

CL

CS

PORTAL
(F)

CL

CS

CL

H. BREED/COLOR

SCALE

ESTIMATED

14. DRESSED

MESENTERI
C (G)

CS

15. LIVE

CL

16. COMMENTS

18. SEND TEST REPORT TO (Select One):
ESTABLISHMENT FAX NUMBER (BLOCK 8)

17. CHECK
IF CARCASS RETAINED
PENDING LAB RESULTS

ESTABLISHMENT POSTAL ADDRESS (BLOCK 8)

OTHER FAX OR EMAIL (Specify) _______________________________________________________________

19. NAME OF FOOD INSPECTOR (Type or Print)

20. NAME OF VETERINARIAN (Type or Print)

21. DATE COMPLETED

LABORATORY USE ONLY
22.ACCESSION NUMBER

23. ID ENCLOSED
YES

NO

27. TRACKING NUMBER

VS FORM 6-35

MAR 2014

24. PRESERVATIVE

28. LABORATORY COMMENTS

25.DISTRIBUTION

26. RECIEVED BY

INSTRUCTIONS FOR COMPLETING VS FORM 6-35
The information in this report is needed for effective monitoring and
management of the Tuberculosis and Brucellosis Federal-State Cooperative
Programs (9 CFR 51 and 77).
Use VS Form 6-35 to submit specimens from regular kill animals only, not
reactor or suspect cattle. Use VS Form 10-4 when tissues are submitted
from TB reactors or suspects. Both forms are available at
http://www.aphis.usda.gov/nvsl. Click on link to Lab-Related Forms.

INSTRUCTIONS FOR SUBMITTING TUBERCULOSIS LESIONS AND/OR
THORACIC GRANULOMAS
See
www.aphis.usda.gov/animal_health/animal_diseases/tuberculosis/downloads/tb_
guidebook.pdf for instructions on submitting tuberculosis lesions and/or thoracic
granulomas.

I. TISSUE SAMPLING AND PRESERVATION
A.

1. TYPE OF INSPECTION
Specify whether the slaughter plant is federally or State inspected.
2. ESTABLISHMENT NUMBER
Enter the FSIS establishment number for the slaughter plant.

B.
C.
D.
E.

3. SPECIES
Indicate the animal species from which the sample was obtained.
F.
4. DATE SLAUGHTERED
G.
5-7. LOT NUMBER, NUMBER IN LOT, NUMBER WITH LESIONS
8. ESTABLISHMENT NAME, ADDRESS, PHONE NUMBER, FAX NUMBER
Enter the contact information for the establishment where the sample was
collected. Do NOT enter a personal phone or fax for the submitting veterinarian
or the phone/fax number of another location. Use Block 18 if the test report
should be sent elsewhere.
9. NAME AND ADDRESS OF OWNER
Enter the name/address of the owner of the animal from which the samples were
taken.

II. IDENTIFYING DEVICES
Place all identifying devices, along with a dime-sized amount of attached tissue,
from each animal (except branded reactors) in a plastic bag and send to the
National Veterinary Services Laboratories in the box with the specimens.
III. SHIPPING CONTAINERS
A.

10. NAME AND ADDRESS OF SHIPPER
Enter the name/address of the shipper that brought the animal to slaughter.
B.
11. NAME AND ADDRESS OF MARKET OR BUYER
Enter the name/address of the market or buyer from which the animal was
obtained.
12. ANIMAL IDENTIFICATION
A-E. Provide all identification associated with the animal (e.g., official USDA ID,
backtag, ear tag, brands, tattoos, carcass number, retain tag number).
F-H. Enter the age of the animal, if known. Indicate the sex/gender (M or F).
Enter the animal breed if known; if unknown, enter the primary color(s) of the
animal.

Apply the enclosed sample ID stickers to this form and the formalin
and borate jars.
AVOID CONTAMINATION.
Remove excess fat.
Divide lesions in half. Place one portion in formalin for histopathology
and place the remaining portion in borate for culture.
BUFFERED FORMALIN PORTION: Cut specimen, including normal
tissue surrounding lesion, into slices approximately 1 cm (½ inch)
thick prior to placing in formalin.
BORATE PORTION: Place the intact portion of the sample into
borate. Do NOT cut the sample into slices.
Maximum tissue to preservative ration: Formalin – 1:10
Borate – 1:1

C.
D.
E.
F.
G.

H.

Use special 2-bottle TB mailer, available from the National Veterinary
Services Laboratories, for each carcass. Contact the shipping
department at 515-337-7530 or NCAH.Shipping@aphis.usda.gov.
No refrigeration required. DO NOT FREEZE; freezing damages the
specimens.
PREVENT LEAKAGE – Tighten and tape cap.
ABSORBENT PAD – Leave in place to absorb any leakage.
IDENTIFYING DEVICES – Leave in plastic bag on top of absorbent
pad.
LEAK-PROOF LINING – Insert polystyrene container in lined
corrugated box and seal.
BLOOD SAMPLE – If a blood sample is collected for concurrent
brucellosis testing, send to regular brucellosis laboratory but identify it
as a TB 6-35 animal, using VS Form 1-16 (orange TB ID card).
SUBMISSION FORMS – Place between sealed polystyrene container
and outside mailer.
RETURN ADDRESS – Provide complete return address and
establishment number on enclosed FED-EX mailing label.

13. POST MORTEM REPORT
An accurate description of the lesion, including the lymph node or tissue in which
it occurred, is important. Describe lesions using the key shown on the form.

I.

14-15. DRESSED and LIVE WEIGHT
Enter the dressed and live weight of the carcass, noting whether the weight was
measured (scale) or estimated.

Ship submissions to:

16. COMMENTS
Use this block for any additional information about the submission.
17. PENDING LAB RESULTS
Check only if carcass is held pending laboratory results. For quickest turnaround
when box 17 is checked, use the enclosed FED-EX billable stamp to ship tissue
overnight to the National Veterinary Services Laboratories.
18. SEND TEST REPORT TO: Test reports may be faxed OR sent by email.
Please specify ONE destination to which the test report should be sent. If the
report is to be sent by email, more than one email address may be specified.
19-21. NAMES AND DATE COMPLETED
Provide the name of the food inspector and veterinarian involved with the
submission and the date the submission was made (completed).

USDA APHIS
NATIONAL VETERINARY SERVICES LABORATORIES
1920 DAYTON AVE
AMES, IOWA 50010
TELEPHONE NUMBER: 515-337-7212