Background: Underlying conditions in dogs admitted to an intensive care unit (ICU) can cause hemostatic dysfunction. Thrombelastography (TEG) may be useful in detecting hemostatic alterations as compared with standard coagulation tests. Objectives: The purpose of this study was to compare TEG results and those of standard coagulation tests in identifying hemostatic dysfunction in dogs admitted to an ICU and to investigate associations among the variables measured. Methods: Tissue factor-activated TEG analysis, D-dimer and fibrinogen concentrations, antithrombin (AT) activity, prothrombin time (PT), activated partial thromboplastin time (aPTT), and platelet count were measured using standard techniques on 27 dogs admitted to ICU with a disease known to be associated with hemostatic dysfunction and in 31 clinically healthy control dogs. Results were compared between groups using nonparametric tests and k analysis; principal component analysis (PCA) and Spearman rank correlation were used to measure associations among variables. Results: Fourteen of 27 ICU dogs had abnormal TEG tracings, which were used to classify the dogs as hypercoagulable (n = 11), hypocoagulable (n = 3), or normocoagulable (n = 13). Hypercoagulable dogs had significantly increased D-dimer (P =.03) and fibrinogen (P =.01) concentrations compared with normocoagulable dogs. In ICU dogs, positive associations were identified between maximum amplitude (MA), a-angle, fibrinogen concentration, and platelet count, and between PT, aPTT, and reaction time (R). Significant correlations were found between MA and fibrinogen (r s = .76, P o.001) and between reaction time (R) and PT (r s = .51, P =.003). Conclusions: TEG was useful in detecting hemostatic dysfunction in dogs in an ICU. Positive associations among variables may provide insight as to how overall coagulation status reflects alterations in clot strength and coagulation time. Dogs with TEG tracings indicative of hypercoagulability are likely in procoagulant states. Future studies of the incidence of thrombotic complications in dogs with hypercoagulable TEG tracings are warranted.
Administration of prednisone to healthy Beagles resulted in hypercoagulability as indicated by TEG tracings, whereas the effect on TG was more variable. Further studies are needed to determine the underlying mechanisms of hypercoagulability and its clinical impact.
Background: Thrombelastography (TEG) is used to evaluate the viscoelastic properties of blood during clotting and provides a global assessment of hemostasis and clot lysis. TEG analysis initiated with recombinant human tissue factor (TF) has not been evaluated in clinically healthy horses. Objectives: The purpose of this study was to determine whether TEG results are affected by the time elapsed between sampling and analysis (storage time) of equine blood samples and to establish a preliminary equine reference interval for a modified TEG assay, using recombinant human TF to initiate coagulation. Methods: Citrated blood samples were obtained from 20 clinically healthy adult horses. Thirteen samples were stored for 30, 60, and 120 minutes at room temperature before TEG analysis. Coagulation was initiated by adding 20 mL of CaCl 2 to 330 mL of blood and 10 mL of diluted recombinant TF for a final dilution of 1:3600. Reaction (R) and clotting (K) times, angle (a), and maximum amplitude (MA) were compared between time points. A preliminary reference interval (minimum-maximum values) was determined using data from all 20 horses after 30 minutes of sample storage. Results: There was a significant effect of storage time on R, K, and a but not MA. Reference intervals were: R, 3.65-6.4 minutes; K, 1.8-5.45 minutes; a, 33.4-66.21; MA, 41.2-64.1 mm; lysis at 30 minutes post-MA (LY30), o 2.75%; and lysis at 60 minutes post-MA (LY60), 1.55-9.5%. Conclusions: TEG can be performed on equine citrated blood samples using recombinant human TF to activate clot formation. TEG parameters were significantly affected by storage time, suggesting an incomplete inhibition of coagulation in citrated blood.While conventional coagulation tests evaluate the soluble or plasmatic components of coagulation, in vivo coagulation is the sum of complex interactions among coagulation factors, platelets, endothelial cells, erythrocytes, and even leukocytes.1,2 Thrombelastography (TEG) assesses the mechanical properties of the blood clot during its formation and subsequent lysis. [3][4][5] In human medicine, TEG is used to detect clinically significant coagulation disorders in patients perioperatively and in intensive care.6 TEG is commonly performed on native fresh whole blood within 5 minutes of collection.7 This constraint limits its use in clinical pathology laboratories and in many veterinary hospital facilities. More recently, the use of citrated whole blood has extended the time that may lapse between blood collection and initiation of coagulation. 7,8 TEG has been validated and used to predict the risk of bleeding and assess hypercoagulability in dogs [9][10][11][12] and has been used to monitor heparin therapy in cats.13 TEG also was used to evaluate a horse with a platelet dysfunction.14 Horses, like other species, can have congenital and acquired coagulation disorders 15 and TEG could be useful in the rapid diagnosis of coagulopathies associated with gastrointestinal disorders or neonatal sepsis. 16,17 The objectives of this study were to as...
Abstract.A 12-year-old Persian cat was examined for a firm swelling of the right tarsal region and enlargement of the corresponding right popliteal lymph node. Cytologic evaluation demonstrated a population of malignant cells consistent with large cell lymphoma. Necropsy revealed a multilobulated subcutaneous mass involving the tarsus with some extension into adjacent deep muscular tissue. Histologically, the mass was composed of round cells with eosinophilic cytoplasm and pleomorphic anisokaryotic nuclei. Evidence of articular and nodal infiltration by these cells was observed. Differential diagnoses included synovial sarcoma and histiocytic sarcoma. Neoplastic cells were negative for cytokeratin, CD79a, and CD3 and positive for CD18, vimentin, lysozyme, and alpha-1-antitrypsin, most consistent with a diagnosis of histiocytic sarcoma. This is the first report of a histiocytic sarcoma involving a joint of a cat. The final diagnosis was based on the light microscopic appearance in combination with the immunohistochemical stains.
Our study demonstrates that thrombin generation can be measured in canine plasma and may be useful in assessing the degree of anticoagulation provided by UFH.
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