1
|
Clarkin-Breslin RC, Chalifoux NV, Buriko Y. Standard tests of haemostasis do not predict elevated thromboelastographic maximum amplitude, an index of hypercoagulability, in sick dogs. J Small Anim Pract 2024. [PMID: 38804082 DOI: 10.1111/jsap.13741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 04/04/2024] [Accepted: 04/17/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES To compare standard tests of haemostasis in hypercoagulable and normocoagulable sick dogs as identified by thromboelastography. MATERIALS AND METHODS We compared prothrombin time, activated partial thromboplastin time, D-dimers, packed red blood cell volume and platelet counts in client-owned sick dogs with hypercoagulable (n = 36) and normocoagulable (n = 35) states as identified by thromboelastography maximum amplitude above or within the established reference interval, respectively. RESULTS Seventy-one dogs were included. Thirty-six dogs were hypercoagulable and 35 were normocoagulable on thromboelastography. Using multivariable linear models, prothrombin time, activated partial thromboplastin time and D-dimers were not associated with hypercoagulability. Platelet counts and packed red blood cell volume were significantly associated with hypercoagulability. CLINICAL SIGNIFICANCE Prothrombin time, activated partial thromboplastin time and D-dimers were not useful in the identification of hypercoagulability in dogs as defined by thromboelastography.
Collapse
Affiliation(s)
- R C Clarkin-Breslin
- Department of Clinical Sciences and Advanced Medicine, Veterinary Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - N V Chalifoux
- Department of Clinical Sciences and Advanced Medicine, Veterinary Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Y Buriko
- Department of Clinical Sciences and Advanced Medicine, Veterinary Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
2
|
Thomsen AS, Petersen MP, Willesen JL, Bach MBT, Kieler IN, Kristensen AT, Koch J, Nielsen LN. Clinical bleeding diathesis, laboratory haemostatic aberrations and survival in dogs infected with Angiostrongylus vasorum: 180 cases (2005-2019). J Small Anim Pract 2024; 65:234-242. [PMID: 38332620 DOI: 10.1111/jsap.13701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 10/25/2023] [Accepted: 12/06/2023] [Indexed: 02/10/2024]
Abstract
OBJECTIVES Bleeding diathesis is a complication in dogs infected with Angiostrongylus vasorum. This retrospective study investigated clinical and laboratory haemostatic differences in A. vasorum-positive dogs with and without signs of bleeding and impact of bleeding on survival. MATERIALS AND METHODS Demographics, type of clinical bleeding, haematocrit and a range of haemostatic tests, including thromboelastography and derived velocity curves were retrospectively registered from A. vasorum-positive dogs. All parameters were compared between dogs with and without signs of bleeding using univariable analyses. Binomial and multinomial regression models were applied to examine specific indicators in the bleeding dogs. P-values were false discovery rate adjusted, and adjusted P<0.05 was considered significant. RESULTS One hundred and eighty dogs entered the study, including 65 dogs (36.1%) presenting with bleeding diathesis. Different types of cutaneous and mucosal bleeding were the most common clinical findings. Twenty dogs presented with neurological signs associated with intracranial and intra-spinal bleeding. One hundred and thirty-seven dogs had haematological and/or haemostatic laboratory analyses performed. Haematocrit, platelet count, thromboelastographic angle, maximum amplitude, global clot strength, maximum rate of thrombin generation and total thrombin generation were decreased, while prothrombin time was prolonged in bleeding dogs. Survival rate of bleeding dogs was lower at hospital discharge (76.9%) and 1 month after diagnosis (66.0%) than in dogs without signs of bleeding (94.8% and 90.1% at discharge and at 1 month, respectively). CLINICAL SIGNIFICANCE Several haemostatic aberrations were detected in A. vasorum-positive dogs with bleeding diathesis. Bleeding was identified as an important negative prognostic indicator in A. vasorum-positive dogs.
Collapse
Affiliation(s)
- A S Thomsen
- Dyrlaegehuset Gentofte, Brogaardsvej 10, 2820, Gentofte, Denmark
| | - M P Petersen
- Vejen Dyrehospital, Oestergade 12, 6600, Vejen, Denmark
| | - J L Willesen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Dyrlaegevej 16, Copenhagen, Denmark
| | - M B T Bach
- Department of Veterinary Clinical Sciences, University of Copenhagen, Dyrlaegevej 16, Copenhagen, Denmark
| | - I N Kieler
- Department of Veterinary Clinical Sciences, University of Copenhagen, Dyrlaegevej 16, Copenhagen, Denmark
| | - A T Kristensen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Dyrlaegevej 16, Copenhagen, Denmark
| | - J Koch
- Department of Veterinary Clinical Sciences, University of Copenhagen, Dyrlaegevej 16, Copenhagen, Denmark
| | - L N Nielsen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Dyrlaegevej 16, Copenhagen, Denmark
| |
Collapse
|
3
|
Pazzi P, Fosgate GT, Rixon A, Hanekom J, Kristensen AT, Goddard A. A prospective evaluation of the prevalence of thromboemboli and associated hemostatic dysfunction in dogs with carcinoma or sarcoma. J Vet Intern Med 2023; 37:1848-1863. [PMID: 37548637 PMCID: PMC10473004 DOI: 10.1111/jvim.16828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/13/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Knowledge of the prevalence of thromboemboli and the associated hemostatic status in dogs with carcinoma or sarcoma is unknown and might allow earlier intervention. OBJECTIVES Estimate prevalence of thromboemboli and their association with hemostatic changes in dogs with carcinomas or sarcomas; estimate predictive values of hemostatic variables for thromboembolic disease in tumor-bearing dogs. ANIMALS Thirty-two dogs with sarcoma, 30 with carcinoma, 20 healthy age-controlled dogs. METHODS Prospective cross-sectional study. A hemostasis panel (platelet concentration, thromboelastography, fibrinogen and D-dimer concentration, factor X, VII and antithrombin activity) was performed in all dogs. Tumor-bearing dogs underwent complete post mortem and histopathological evaluation. Comparisons between healthy dogs and tumor-bearing dogs with and without intracavitary hemorrhage; and tumor-bearing dogs with and without microthrombi were analyzed. RESULTS Thromboembolic disease was identified in 32/62 (52%, 95% CI: 39%-65%) tumor-bearing dogs. Microthrombi were identified in 31/62 (50%, 95% CI: 37%-63%) dogs, 21/31 (68%, 95% CI: 49%-83%) had exclusively intra-tumoral microthrombi, 10/31 (32%, 95% CI: 17%-51%) had distant microthrombi. Macrothrombi were identified in 3 tumor-bearing dogs. Hemostatic changes potentially consistent with overt and non-overt disseminated intravascular coagulation were identified in some tumor-bearing dogs. D-dimer concentrations were significantly higher (P = .02) and platelet concentration significantly lower (P = .03) in tumor-bearing dogs with microthrombi compared to tumor-bearing dogs without microthrombi. D-dimer concentration above 500 ng/mL was 80% sensitive and 41% specific for the prediction of microthrombi presence. CONCLUSION The high microthrombi prevalence and concomitant hemostatic dysfunction in dogs with carcinomas or sarcomas has not previously been reported, though the clinical importance is unknown. Increased D-dimer concentration might increase suspicion of microthrombi.
Collapse
Affiliation(s)
- Paolo Pazzi
- Department of Companion Animal Clinical Studies, Faculty of Veterinary ScienceUniversity of PretoriaPretoriaSouth Africa
| | - Geoffrey T. Fosgate
- Department of Production Animal Studies, Faculty of Veterinary ScienceUniversity of PretoriaPretoriaSouth Africa
| | - Anouska Rixon
- Department of Companion Animal Clinical Studies, Faculty of Veterinary ScienceUniversity of PretoriaPretoriaSouth Africa
| | - Josef Hanekom
- Department of Companion Animal Clinical Studies, Faculty of Veterinary ScienceUniversity of PretoriaPretoriaSouth Africa
| | - Annemarie T. Kristensen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Amelia Goddard
- Department of Companion Animal Clinical Studies, Faculty of Veterinary ScienceUniversity of PretoriaPretoriaSouth Africa
| |
Collapse
|
4
|
Pazzi P, Celliers A, du Plessis EC, Kristensen AT, Goddard A. The prevalence of intra-tumoral and distant thrombi, as well as tumour-cell emboli in canine neoplasia. Vet Comp Oncol 2021; 20:154-163. [PMID: 34314552 DOI: 10.1111/vco.12757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/24/2021] [Indexed: 11/29/2022]
Abstract
Macroscopic thromboembolic disease has been associated with canine neoplasia, whereas prevalence studies of concurrent microthrombi and tumour-cell emboli are lacking. This retrospective study investigated microthrombi and tumour cell emboli by reviewing pathology records of dogs diagnosed with lymphoma, sarcoma, carcinoma and mast cell tumours with a concurrent description of thrombi or emboli. Pathology reports and medical records of cases with either tumour biopsies and/or post mortems with a diagnosis of neoplasia were reviewed for the presence of microthrombi, macrothrombi and/or tumour-cell emboli and the association with tumour type. Of the 28 895 canine cases in the database, 21 252 (73.5%) were antemortem biopsy specimens and 7643 were post mortems (26.5%); 2274 solid tumours were identified, 2107 (92.7%) were antemortem biopsy diagnoses and 167 (7.3%) were post mortem diagnoses. The prevalence of solid tumour types in the database (28 895 cases) was 872 (3.0%) lymphoma, 722 (2.5%) sarcoma, 455 (1.6%) carcinoma and 225 (0.8%) mast cell tumour. The prevalence of microthrombi associated with these tumours was 58/2274 (2.6%). Intra-tumoral microthrombi were reported in 53/2274 (2.3%) cases, the majority in sarcomas (37/53, 69.8%). No macrothrombi were reported. Tumour-cell emboli were identified in 39/2274 (1.7%) cases, 31/39 (79.5%) were extra-tumoral or distant emboli, and carcinoma the most commonly associated tumour (29/39; 74.4%). Microthrombi were reported in 2.6% of cases, the majority in sarcomas and tumour-cell emboli were identified in 1.7% of cases, the majority carcinomas. Prospective investigations are necessary to explore the potential clinical and prognostic implications of microthrombi and tumour-cell emboli in canine neoplasia.
Collapse
Affiliation(s)
- Paolo Pazzi
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Anri Celliers
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | | | - Annemarie T Kristensen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Amelia Goddard
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
5
|
Nagahara T, Ohno K, Nagao I, Nakagawa T, Yokoyama N, Ohmi A, Goto-Koshino Y, Chambers JK, Uchida K, Tomiyasu H, Tsujimoto H. Changes in the coagulation parameters in dogs with protein-losing enteropathy between before and after treatment. J Vet Med Sci 2021; 83:1295-1302. [PMID: 34176824 PMCID: PMC8437731 DOI: 10.1292/jvms.21-0137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Protein-losing enteropathy (PLE) is known to induce hypercoagulability and resultant
thromboembolism in dogs. We hypothesized that hypercoagulability would improve if
remission was obtained in dogs with PLE after treatment. This study aimed to evaluate the
changes in the coagulation parameters after treatment in dogs diagnosed with PLE. As
coagulation parameters, prothrombin time (PT), activated partial thromboplastin time
(aPTT), fibrinogen, thrombin-antithrombin complex (TAT), D-dimer, and antithrombin (AT)
were measured. In addition to these parameters, rotational thromboelastometry (ROTEM),
which evaluates the comprehensive coagulation and fibrinolysis reactions of whole blood,
was conducted and the data of clotting time (CT), clot formation time (CFT), α angle (α),
maximum clot firmness (MCF) and lysis index at 60 min (LI60) were obtained. Eleven of the
14 dogs diagnosed with PLE were classified as responders to the treatment based on the
changes in their plasma albumin (ALB) concentration after treatment. Significant increase
in CFT and decrease of α and MCF indicating the resolution of hypercoagulability were
found after treatment in responder dogs; however, there was no significant change in the
coagulation and fibrinolysis parameters other than those measured by ROTEM. This study
demonstrated that the hypercoagulability detected by ROTEM was significantly improved
after treatment in dogs with PLE.
Collapse
Affiliation(s)
- Takuro Nagahara
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Koichi Ohno
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Itsuma Nagao
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Taisuke Nakagawa
- Veterinary Medical Center, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Nozomu Yokoyama
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Kita-ku, Sapporo, Hokkaido 060-0818, Japan
| | - Aki Ohmi
- Veterinary Medical Center, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Yuko Goto-Koshino
- Veterinary Medical Center, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - James K Chambers
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Kazuyuki Uchida
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Hirotaka Tomiyasu
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Hajime Tsujimoto
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| |
Collapse
|
6
|
Burton AG, Jandrey KE. Use of Thromboelastography in Clinical Practice. Vet Clin North Am Small Anim Pract 2021; 50:1397-1409. [PMID: 32981595 DOI: 10.1016/j.cvsm.2020.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Viscoelastic testing, such as thromboelastography or thromboelastometry, is performed on whole-blood samples, which include both soluble plasma factors as well as blood cells and platelets bearing tissue factor and phospholipid. This methodology allows identification of fibrinolysis and can provide analysis of platelet function. Viscoelastic testing has become increasingly accessible and popular in emergency and critical care settings in recent years and can provide important information for the diagnosis and management of patients with hemostatic disorders. This article discusses the principles and interpretation of viscoelastic testing, application to small animal emergency and critical care medicine, and potential advantages and disadvantages.
Collapse
Affiliation(s)
- Andrew G Burton
- IDEXX Laboratories, Inc., 3 Centennial Drive, North Grafton, MA 01536, USA
| | - Karl E Jandrey
- Clinical Small Animal Emergency and Critical Care, Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, One Shields Avenue, 1104C Tupper Hall, Davis, CA 95616, USA.
| |
Collapse
|
7
|
Dixon A, Hall EJ, Adamantos S, Kathrani A, McGrath C, Black V. Hypercoagulability in dogs with chronic enteropathy and association with serum albumin concentration. J Vet Intern Med 2021; 35:860-866. [PMID: 33527508 PMCID: PMC7995358 DOI: 10.1111/jvim.16044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/23/2020] [Accepted: 01/14/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Dogs with protein-losing enteropathy (PLE) are at risk of developing a hypercoagulable state, but the prevalence of hypercoagulability in dogs with chronic enteropathies (CE) and normal serum albumin concentration is unknown. HYPOTHESIS Dogs with CE are predisposed to a hypercoagulable state as assessed by thromboelastography (TEG) independent of serum albumin concentration. METHODS Dogs with chronic gastrointestinal signs from suspected inflammatory CE between 2017 and 2019 were included. Thirty-eight were evaluated; every dog had a CBC, serum biochemistry panel, and abdominal imaging performed. The Canine Inflammatory Bowel Disease Activity Index (CIBDAI) was calculated. Thromboelastography was performed at presentation, and reaction time (R), kinetic time (K), α-angle, maximal amplitude (MA), and global clot strength (G) were recorded. Dogs were considered hypercoagulable if the G value was ≥25% above the reference interval. RESULTS Seventeen of 38 (44.7%; 95% confidence interval [CI], 28.6-61.7%) dogs with CE were hypercoagulable. The G value did not differ between the 19 dogs with normal (≥28 g/L) serum albumin concentrations (9.05 kdyn/cm2 ; 95% CI, 7.26-10.84; SD 3.71) and 19 dogs with hypoalbuminemia (11.3 kdyn/cm2 ; 95% CI, 9.04-13.6, SD; 4.7; P = .11). The G value was negatively correlated with hematocrit, serum albumin concentration, and duration of signs and positively correlated with age. CONCLUSIONS AND CLINICAL IMPORTANCE Dogs with CE and normal serum albumin concentration can be hypercoagulable as measured by TEG.
Collapse
Affiliation(s)
- Amy Dixon
- Bristol Veterinary School, University of Bristol, Langford House, Langford, BS40 5DU, United Kingdom
| | - Edward J Hall
- Small Animal Referral Hospital, Langford Vets, Langford House, Langford, BS40 5DU, United Kingdom
| | - Sophie Adamantos
- Paragon Veterinary Referrals, Paragon Business Village, Red Hall Crescent, Wakefield, West Yorkshire, WF1 2DF, United Kingdom
| | - Aarti Kathrani
- Department of Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - Ciara McGrath
- Bristol Veterinary School, University of Bristol, Langford House, Langford, BS40 5DU, United Kingdom
| | - Vicki Black
- Small Animal Referral Hospital, Langford Vets, Langford House, Langford, BS40 5DU, United Kingdom
| |
Collapse
|
8
|
Pfaff A, de Laforcade AM, Rozanski EA. The Use of Antithrombotics in Critical Illness. Vet Clin North Am Small Anim Pract 2020; 50:1351-1370. [PMID: 32893002 DOI: 10.1016/j.cvsm.2020.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Hypercoagulable tendencies may develop in critically ill dogs and to a less known extent, cats. Although the use of antithrombotics is well-established in critically ill people, the indications and approach are far less well-known in dogs and cats. The goal of this article was to review the relevant CURATIVE guidelines, as well as other sources, and to provide recommendations for critically ill patients with directions for future investigation.
Collapse
Affiliation(s)
- Alexandra Pfaff
- Tufts University, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA 01536, USA
| | - Armelle M de Laforcade
- Tufts University, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA 01536, USA
| | - Elizabeth A Rozanski
- Tufts University, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA 01536, USA.
| |
Collapse
|
9
|
Ruehl M, Lynch AM, O'Toole TE, Morris B, Rush J, Couto CG, Hmelo S, Sonnenshein S, Butler A, Guillaumin J. Outcome and treatments of dogs with aortic thrombosis: 100 cases (1997-2014). J Vet Intern Med 2020; 34:1759-1767. [PMID: 33463770 PMCID: PMC7517508 DOI: 10.1111/jvim.15874] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 07/21/2020] [Accepted: 07/30/2020] [Indexed: 01/30/2023] Open
Abstract
Background Aortic thrombosis (ATh) is an uncommon condition in dogs, with limited understanding of risks factors, outcomes, and treatments. Objectives/Hypothesis To describe potential risk factors, outcome, and treatments in dogs with ATh. Animals Client‐owned dogs with a diagnosis of ATh based on ultrasonographic or gross necropsy examination. Method Multicentric retrospective study from 2 academic institutions. Results One hundred dogs were identified. Anti‐thrombin diagnosis, 35/100 dogs were nonambulatory. The dogs were classified as acute (n = 27), chronic (n = 72), or unknown (n = 1). Fifty‐four dogs had at least one comorbidity thought to predispose to ATh, and 23 others had multiple comorbidities. The remaining 23 dogs with no obvious comorbidities were classified as cryptogenic. Concurrent illnesses potentially related to the development of ATh included protein‐losing nephropathy (PLN) (n = 32), neoplasia (n = 22), exogenous corticosteroid administration (n = 16), endocrine disease (n = 13), and infection (n = 9). Dogs with PLN had lower antithrombin activity than those without PLN (64% and 82%, respectively) (P = .04). Sixty‐five dogs were hospitalized with 41 subsequently discharged. Sixteen were treated as outpatient and 19 euthanized at admission. In‐hospital treatments varied, but included thrombolytics (n = 12), alone or in combination with thrombectomy (n = 9). Fifty‐seven dogs survived to discharge. Sixteen were alive at 180 days. Using regression analysis, ambulation status at the time of presentation was significantly correlated with survival‐to‐discharge (P < .001). Conclusions/Clinical Importance Dogs with ATh have a poor prognosis, with nonambulatory dogs at the time of presentation having worse outcome. Although the presence of comorbid conditions associated with hypercoagulability is common, an underlying cause for ATh was not always identified.
Collapse
Affiliation(s)
| | - Alex M Lynch
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Therese E O'Toole
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
| | - Bari Morris
- VCA Shoreline Veterinary Referral and Emergency Center, Shelton, Connecticut, USA
| | - John Rush
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
| | | | | | | | - Amy Butler
- Critical Consults, LLC, Pittsburgh, Pennsylvania, USA
| | - Julien Guillaumin
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| |
Collapse
|
10
|
Brooks AC, Cooper ES, Couto CG, Guillaumin J. Effect of packed red blood cell transfusion on thromboelastographic tracings in dogs with naturally occurring anemia. Am J Vet Res 2020; 81:499-505. [PMID: 32436791 DOI: 10.2460/ajvr.81.6.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the effect of packed RBC (pRBC) transfusion on thromboelastographic (TEG) tracings in dogs with naturally occurring anemia. ANIMALS 22 clinically anemic dogs that received a pRBC transfusion. PROCEDURES For each dog, a blood sample was collected before and within 3 hours after completion of the pRBC transfusion for a CBC, nonactivated TEG analysis, and measurement of blood viscosity. Wilcoxon signed rank tests were used to compare CBC, viscosity, and TEG variables between pretransfusion and posttransfusion blood samples. Multivariable linear regression was used to assess the effects of pretransfusion-posttransfusion changes in Hct, WBC count, and platelet count on changes in TEG variables. RESULTS Median posttransfusion Hct (21%; range, 13% to 34%) was significantly greater than the median pretransfusion Hct (12.5%; range, 7% to 29%). Packed RBC transfusion was associated with a median increase in Hct of 6.2% (range, 1.2% to 13%). Maximum amplitude significantly decreased from 74.9 to 73.8 mm and clot strength significantly decreased from 14,906 to 14,119 dynes/s after pRBC transfusion. Blood viscosity significantly increased, whereas platelet and WBC counts significantly decreased after transfusion. Multivariable linear regression revealed that pretransfusion-posttransfusion changes in Hct, WBC count, and platelet count were not associated with changes in TEG variables. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that pRBC transfusion had only small effects on the TEG tracings of hemodynamically stable dogs. Therefore, large changes in TEG tracings following pRBC transfusion are unlikely to be the result of the transfusion and should be investigated further.
Collapse
|
11
|
Phipps WE, de Laforcade AM, Barton BA, Berg J. Postoperative thrombocytosis and thromboelastographic evidence of hypercoagulability in dogs undergoing splenectomy for splenic masses. J Am Vet Med Assoc 2020; 256:85-92. [PMID: 31841092 DOI: 10.2460/javma.256.1.85] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the frequency and severity of thrombocytosis and thromboelastographic evidence of hypercoagulability during the first 2 weeks after splenectomy in dogs with splenic masses and to investigate relationships between platelet counts and thromboelastography values. ANIMALS 34 dogs undergoing splenectomy for splenic masses. PROCEDURES Blood samples for platelet counts and thromboelastography were obtained at induction of anesthesia (day 0) prior to splenectomy and on days 2, 7, and 14. RESULTS Mean platelet counts were 167.9 × 103/μL, 260.4 × 103 μ/L, 715.9 × 103/μL, and 582.2 × 103/μL on days 0, 2, 7, and 14, respectively, and were significantly higher at all postoperative assessment points than on day 0. Thrombocytosis was observed in 3% (1/34), 6% (2/33), 81% (21/26), and 69% (18/26) of dogs on days 0, 2, 7, and 14. Platelet counts > 1,000 × 103/μL were observed in 1 dog on day 2 and in 5 dogs on day 7. One or more thromboelastography values suggestive of hypercoagulability were observed in 45% (15/33), 84% (26/31), 89% (24/27), and 84% (21/25) of dogs on days 0, 2, 7, and 14. At each assessment point, higher platelet counts were correlated with thromboelastography values suggestive of hypercoagulability. CONCLUSIONS AND CLINICAL RELEVANCE Marked thrombocytosis and thromboelastography values suggestive of hypercoagulability were common during the first 2 weeks after splenectomy for the dogs of this study. If present, hypercoagulability could increase the risk for development of postsplenectomy thrombotic conditions such as portal system thrombosis and pulmonary thromboembolism.
Collapse
|
12
|
Pereira JM, Rohn K, Mischke R. Reference intervals for rotational thromboelastometry measurements using the ROTEM® delta device in dogs. Res Vet Sci 2020; 130:26-32. [PMID: 32114247 DOI: 10.1016/j.rvsc.2020.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/15/2020] [Accepted: 01/22/2020] [Indexed: 01/11/2023]
Abstract
Aims of the present study were to define reference intervals for viscoelastic analyses of canine haemostasis using the ROTEM® delta analyser, and as a secondary aspect to determine the precision (repeatability) of this method. Blood samples from 125 clinically healthy dogs were included. Measurements were performed with commercially available activating reagents (ex-tem, in-tem and kaolin solution) as well as without activation. Additional fourfold measurements were done in 3 of the normal blood samples and in 3 samples with haemostatic alterations to evaluate the precision of the method. Coefficients of variation (CVs) for most of the ROTEM variables were < 10%. Clot formation time and maximum clot elasticity showed a wide inter-individual variation in comparison with alpha angle and maximum clot firmness. A multivariate analysis on various ROTEM parameters revealed particularly a significant influence of neuter status and a significant interrelationship between the factors sex and neuter status for measurements with different activating reagents. These results reflected the fact that significant differences occurred only between intact and neutered females, but not in males. No or only occasionally significant differences were found between groups of sex, age, and size. In conclusion, CVs demonstrated that the method delivers repeatable results in canine citrated whole blood. Established reference intervals should deliver valuable orientation for the evaluation of viscoelastic properties of clotting whole blood in dogs using the ROTEM delta analyser. Neuter status in females appeared to be the most relevant influencing factor and should be considered for the interpretation of ROTEM delta test results.
Collapse
Affiliation(s)
- Jose Mauricio Pereira
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D-30559, Hannover, Germany
| | - Karl Rohn
- Institute of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Foundation, Bünteweg 2, D-30559 Hannover, Germany.
| | - Reinhard Mischke
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D-30559, Hannover, Germany.
| |
Collapse
|
13
|
Bely DD, Rublenko MV, Smoyuluk VV, Yevtushenko ID, Maslikov SN. Breast tumour size as a predictor of hemostatic system status and endothelial function in dogs. REGULATORY MECHANISMS IN BIOSYSTEMS 2019. [DOI: 10.15421/021946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The high level of morbidity of dogs from mammary gland tumours and deficiencies in the pathogenesis give relevance to study of the disorders of the hemostatic system for predicting the neoplasia process. Our research concerned the determination of markers of the hemostatic system and endothelial function at different sizes (≤ 2, 5–7 and >10 cm) of benign (n = 28) and malignant (n = 27) breast tumours in dogs, taking into account their histological structure. The progression of the tumour process was accompanied by a 1.24–1.81 times increase in the fibrinogen content in the benign forms and 1.39–2.38 times in malignant against the background of progressive excess accumulation of soluble fibrin. The results of coagulation tests indicate that the increase in blood coagulation, which correlates with the magnitude of tumours, occurred mainly externally. In malignant neoplasms reliable, compared to clinically healthy dogs, reduction of total fibrinolytic activity occurred due to deficient inhibition of tissue plasminogen activator by 1.62–2.03 times. Increase in the size of benign neoplasms was accompanied by increased activity of the α1-inhibitor of proteinases, and in malignant – only in tumours of the size of 5–7 cm, against the background of its decrease in dogs with small and giant neoplasia. The progression of the disease was characterized by an increase in the content of α2-macroglobulin in benign lesions from 1.19–1.24 times, malignant – from 1.25–2.03 times. At the same time, there was a deepening of oxidative stress, as evidenced by the excess accumulation in the blood of malondialdehyde by 1.29–1.70 times in benign tumours, and 1.58–2.73 times in malignant. Regardless of the pathomorphologic form, the magnitude of the neoplasia foci is directly correlated with excess accumulation of nitric oxide and the level of hypoproteinemia, and vice versa – the content of ceruloplasmin. Further research should be undertaken to study the hemostatic status in certain nosological forms of breast tumours in dogs, which will improve the diagnosis and development of effective treatment protocols.
Collapse
|