Coagulation profiles in 27 horses with large colon volvulus

Abstract

Objective: The objective of this study was to evaluate coagulation profiles in horses with surgical treatment of large colon volvulus (LCV), and determine if an association exists between hemostatic dysfunction and outcome. Design: Prospective clinical investigation from February to December 2000. Setting: Large animal intensive care unit in a veterinary teaching hospital. Interventions: Blood was collected from horses intra-operatively, 24, and 48 hours following surgical treatment for LCV. Measurements: Coagulation profiles, thrombin-antithrombin (TAT) levels, and D-dimer concentrations were determined for each time point. The number of tests abnormal in the standard coagulation profile, defined as the degree of hemostatic dysfunction, was determined for each horse for the duration of the study period. The association between each test and outcome, as well as the degree of hemostatic dysfunction for each horse and outcome, was determined using univariate analysis and logistic regression. TAT levels and D-dimer concentrations were compared to the results of the standard coagulation profile and to patient outcome using univariate analysis and logistic regression. Main results: Seventy percent of horses evaluated with surgical treatment of LCV had evidence of hemostatic dysfunction (3/6 tests abnormal). Only 18% of those patients had clinical signs recognized by the attending clinician as a coagulopathy. There was an association between the development of a coagulopathy and outcome, with horses with 4/6 tests abnormal being more likely to be euthanized, and those with 3/6 tests abnormal having a prolonged hospital stay. Platelet count, prothrombin time, and TAT levels may be helpful in predicting outcome in horses with LCV. Conclusions: Hemostatic function should be evaluated in horses with surgical treatment of LCV to detect subclinical coagulopathies and direct subsequent intervention. (J Vet Emerg Crit Care 2003; 13(4): 215-225)

Evaluation of platelet function in horses undergoing colic surgery using the PFA-100 platelet function analyser

“…Mean PLT and MPV gradually decreased due to surgery for intestinal displacement. Various authors have indicated that after surgical intervention thrombocytopenia is more likely to occur than after conservative treatment (Chang 1996;Dallap et al 2003;Yaguchi et al 2004). Postoperative reduction of platelet counts may be due to platelet activation and subsequent consumption in the process of clot formation, sequestration in the spleen or adhesion to endothelial surfaces, as well as destruction and exhaustion of thrombopoiesis (Levi et al 1997;Salat et al 1999;Nunez et al 2001;Kimberley et al 2004;Levi and Opal 2006;Alsaad and Nori 2009;Levi et al 2011).…”

“…Acute colic causes such as large colon volvulus can induce changes in the coagulation system (Dallap et al 2003). These changes are secondary to the haemodynamic and functional disorders of the gastrointestinal tract and are also a consequence of an inflammatory process (Levi et al 1997;Dallap et al 2003;Levi and Opal 2006;Dallap Schaer and Epstein 2009;Levi et al 2011).…”

“…Acute colic causes such as large colon volvulus can induce changes in the coagulation system (Dallap et al 2003). These changes are secondary to the haemodynamic and functional disorders of the gastrointestinal tract and are also a consequence of an inflammatory process (Levi et al 1997;Dallap et al 2003;Levi and Opal 2006;Dallap Schaer and Epstein 2009;Levi et al 2011). Therefore, haemorrhage and prolonged bleeding after surgery or thromboembolic complications are realistic risks (Dallap et al 2003;Segura et al 2005;Segura et al 2006;Alsaad and Nori 2009).…”

“…These changes are secondary to the haemodynamic and functional disorders of the gastrointestinal tract and are also a consequence of an inflammatory process (Levi et al 1997;Dallap et al 2003;Levi and Opal 2006;Dallap Schaer and Epstein 2009;Levi et al 2011). Therefore, haemorrhage and prolonged bleeding after surgery or thromboembolic complications are realistic risks (Dallap et al 2003;Segura et al 2005;Segura et al 2006;Alsaad and Nori 2009). Most previous studies on haemostatic changes in the course of colic were mainly focused on secondary haemostasis (Dallap et al 2003;Dallap Schaer and Epstein 2009).…”

“…Therefore, haemorrhage and prolonged bleeding after surgery or thromboembolic complications are realistic risks (Dallap et al 2003;Segura et al 2005;Segura et al 2006;Alsaad and Nori 2009). Most previous studies on haemostatic changes in the course of colic were mainly focused on secondary haemostasis (Dallap et al 2003;Dallap Schaer and Epstein 2009). Only a few studies assessed platelet function in horses with gastrointestinal disease using aggregometry or thromboelastography (Epstein et al 2011;Brooks et al 2007;Mendez-Angulo et al 2010;Epstein et al 2013); however, to our knowledge, there have been no reports evaluating platelet function in horses with colic using the PFA-100.…”