Detection of Fibrin Deposits in Tissues from Horses with Severe Gastrointestinal Disorders

Abstract

Background: In humans and experimental animals, disseminated intravascular coagulation (DIC) causes fibrin deposition in several organs, which eventually leads to ischemia and multiorgan failure.Hypothesis: Horses who died or were euthanized for severe gastrointestinal disorders could have fibrin deposits in different tissues.Animals: Tissue-organ samples collected during postmortem examinations on 66 colic horses with poor prognoses (eg, severe intestinal ischemia, enteritis, peritonitis), from 11 colic horses with good prognoses (eg, large-colon obstruction or displacement), and from 16 slaughter horses.Methods: Tissue samples (kidney, lung, liver) were stained with hematoxylin and eosin, and phosphotungstic acid hematoxylin for a blinded histologic examination. A fibrin score (grades 0 to 4) was established for each tissue sample and for each horse.Results: Fibrin deposits were found in tissue specimens of 11 of 27 of horses (40.7%) in the ischemic group, 8 of 21 in the enteritis group (38.1%), and 7 of 18 in the peritonitis group (39.0%), whereas none of the horses in the obstructive group (n 5 11) and only 1 horse in the slaughter group (n 5 16) had fibrin deposits in their tissues. In addition, the mean fibrin score values for the ischemic, enteritis, and peritonitis groups (1.3 6 1.7, 1.1 6 1.6, and 0.9 6 1.3, respectively) were statistically higher than those for the obstructive and slaughter groups (0.0 6 0.0 and 0.1 6 0.5, respectively). The largest fibrin deposits were found in the lungs.Conclusions and Clinical Importance: Horses with severe gastrointestinal disorders have fibrin deposits that are consistent with capillary microthrombosis, multiorgan failure, and DIC.

Association of Admission Plasma D-Dimer Concentration with Diagnosis and Outcome in Horses with Colic

“…This finding is not surprising because the literature reports worse outcomes in horses with GI problems associated with a high number of coagulopathies and DIC 3,7,9,10 . Postmortem studies also found higher fibrin deposition scores in different organs of horses with colic diagnoses more commonly associated with DIC 8,38 . Nevertheless, previous results complementary with this study confirm that alterations of the coagulation profile in horses that survived tend to normalize during hospitalization regardless of the diagnosis a…”

“…A high percentage of horses with colitis (up to 36%) and ischemic lesions (up to 70%) have been reported to be in DIC, especially those disorders that have a poor prognosis, such as large colon volvulus 5–7 . Additionally, approximately 40% of horses with ischemic and inflammatory GI diseases of poor prognosis were found to have massive fibrin deposition in several organs at necropsy consistent with microthrombosis and DIC 8 . Thus, the severity of coagulopathies in horses with GI disorders appears to be related to the diagnosis.…”

Association Between Necropsy Evidence of Disseminated Intravascular Coagulation and Hemostatic Variables Before Death in Horses With Colic

“…For each renal section, 10 fields were examined, and the average value from all of them was calculated. A 0 to 4 scoring system also was used for lung and liver sections, following previous descriptions . For lung and liver sections, 20 fields were examined, and the number of fields positive for the presence of intravascular fibrin in alveolar capillaries and hepatic sinusoids was counted, respectively.…”

Pathophysiology, diagnosis and treatment of neonatal sepsis

“…In another study in mature horses, use of LMWH was linked by the authors with a better outcome (Cotovio et al . ). Heparin has not only antithrombotic but also anti‐inflammatory properties, which could be useful in the treatment of sepsis (de la Rebiere et al .…”