Aipedia: Veterinary surgeons and practices

AI cytology and in-house lab analysers

Aipedia, by the Apex broking team · Last reviewed 2026-10-30

Vets can use in-house analysers that apply AI to blood smears, cytology and faecal samples, but results should be verified before they drive treatment. A misread sample can lead to the wrong treatment or a missed cancer, and the vet who acts on it usually carries the claim.

Part of: AI in veterinary practice

In short

Some practice labs may run analysers that image slides and use AI to count cells, flag abnormal morphology, classify cytology and identify parasite eggs. The RCVS Spring 2026 advice says decisions must not be wholly delegated to AI, output must be critically appraised and users need enough subject knowledge to judge it. Code 1.2 limits vets to their competence and requires responsible referral. A flagged or unflagged result accepted without review can lead to a misdiagnosis claim. Recording who reviewed the result, what they saw and whether it went to an external lab is the best evidence that care was reasonable.

How practices use AI in the lab

In-house analysers save the wait for an external lab. AI-assisted haematology systems image a blood film and report differential counts and morphology flags. Cytology tools classify fine needle aspirates or ear and skin samples. Faecal analysers image a prepared sample and identify eggs and oocysts. Results appear in the practice management system, often alongside reference intervals and a summary.

The output looks like a lab report, which is part of the risk. Unlike an external laboratory result signed by a clinical pathologist, an in-house AI result may not have been seen by any human with cytology expertise before it reaches the consulting room.

The duties that apply

These duties apply whether or not AI is involved:

Critical appraisal: the RCVS AI advice asks users to understand a tool's source, data, assumptions and limitations, and to have "sufficient understanding of the subject matter".
Competence and referral: Code 1.2 means sending samples to an external pathologist when interpretation is beyond the practice's skills.
Appropriate care: Code 1.3 requires care that is appropriate and adequate, including follow-up when results do not fit the clinical picture.
Records: Code 2.5 and Chapter 13 call for clear, accurate records, which should include who reviewed the result.
Delegation: if nurses or lay staff run the analyser, the RCVS expects AI tasks to go only to people with appropriate knowledge and training.
Systems: under 17.8, practice leaders who set up the lab workflow are at least as accountable as those following it.

What can go wrong

Illustrative scenario: a lump on a dog is aspirated and run through an in-house cytology analyser, which classifies it as benign fatty tissue. Nobody looks at the slide, and the owner is reassured. The lump grows and is later confirmed as a malignant tumour. The owner's complaint asks why the sample was not sent to a pathologist, and the record shows no human review.

Other failures include parasite eggs missed in a poorly prepared faecal sample, platelet clumps read as low platelets leading to unnecessary investigation, and abnormal cells unflagged because the species or sample type was outside what the tool was validated for.

How PI usually responds

A misdiagnosis claim is usually a negligence claim against the practice or vet, and veterinary PI required under Code 3.4 is intended to respond to it, subject to the policy terms. The defence will turn on whether reliance on the in-house result was reasonable in the circumstances. A record showing a human review, a note of any limitations and a decision on external referral is much easier to defend than a bare analyser printout. If the analyser itself was faulty, recovery from the manufacturer depends on the supply contract; see AI contract clauses and indemnities.

Practical controls

Put these controls in place:

Know which species and sample types each analyser is validated for.
Have a trained person look at slides that the tool flags, and a sample of those it does not.
Set clear rules for when a sample goes to an external pathologist, such as any mass or unexpected result.
Run the quality control the manufacturer recommends and keep the logs.
Record who reviewed the result and what decision followed.
Explain to owners that in-house results may need confirmation.

How Apex helps

Apex arranges PI for vets and veterinary practices. A broker reviews your cover and how the policy treats claims where an in-house AI analyser contributed to a diagnosis.

Sources

Frequently asked

Do I need to check every AI analyser result?

Not necessarily every routine count, but the RCVS expects critical appraisal by someone with enough subject knowledge. Abnormal flags, results that do not fit the clinical picture and any cytology from a mass deserve human review or external referral.

Should masses always go to an external lab?

That is a clinical judgement. Code 1.2 requires vets to keep within their competence and refer responsibly. Some practices may set a rule that cytology from a mass is reviewed by a pathologist, because the cost of a missed malignancy is high.

Can a nurse run the analyser and report the result?

Nurses can run analysers, and the RCVS allows AI tasks to be delegated to staff with appropriate knowledge and training. The vet acting on the result remains responsible for the diagnosis and treatment decision.

What should the record show?

The analyser result, who reviewed it, whether a slide was examined, any limitations noted, and whether the sample was sent externally. That gives a clear picture of the reasoning if a complaint or claim follows.

Check your PI covers how you use AI

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Apex Insurance Brokers Limited is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales, company number 07014570. This page is general information about how AI is used in the profession and how insurance may respond. It is not legal, regulatory or insurance advice on your circumstances, and it does not guarantee that cover will be available or on what terms.