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/cm 2 ; 95% CI, 7.26-10.84; SD 3.71) and 19 dogs with hypoalbuminemia (11.3 kdyn/cm 2 ; 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.
A young male whippet presented in hypovolaemic shock with a penetrating thoracic wound. Point-of-care ultrasound documented a moderate volume of pleural effusion and a hyperechoic mass adjacent to the right ventricle suspected to be a haematoma. Thoracic CT confirmed these findings. Following stabilisation, the patient proceeded to theatre and a median sternotomy was performed. A large haematoma was attached to the ventral surface of the right ventricle. The haematoma was removed, and a partial thickness laceration was visualised on the ventral surface of the right ventricular free wall. The defect was repaired with pledgeted mattress sutures. A chest drain was placed and the thorax closed routinely. The patient recovered without complication. This case report describes the importance of considering internal trauma, including cardiac trauma, in patients presenting with a penetrating thoracic injury. It also highlights the importance of emergency stabilisation and utility of point-of-care ultrasonography in these patients.
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