Effect of tranexamic acid on intra- and postoperative haemorrhage in dogs with surgically treated hemoperitoneum

Sigrist, Nadja; Olgiati, L; Schefer, R S Jud

doi:10.17236/sat00160

Cited by 9 publications

(4 citation statements)

References 20 publications

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“…The SI is calculated by dividing the heart rate by the SBP. Previous studies have reported median SI at the time of presentation in dogs with haemoperitoneum to range from 1.1 to 1.2 17 . The median SI in this cohort was similar to that of previous studies, with the majority of dogs enrolled (78%) meeting the established criteria for shock.…”

Section: Discussionsupporting

confidence: 84%

“…Previous studies have reported median SI at the time of presentation in dogs with haemoperitoneum to range from 1.1 to 1.2. 17 The median SI in this cohort was similar to that of previous studies, with the majority of dogs enrolled (78%) meeting the established criteria for shock. SI could not be shown to be significantly associated with the likelihood of receiving a transfusion.…”

Section: Discussionsupporting

confidence: 83%

See 1 more Smart Citation

Prospective observational study of dogs with splenic mass rupture suggests potentially lower risk of malignancy and more favourable perioperative outcomes

Stewart¹,

Ehrhart²,

Davies³

et al. 2020

Vet Comparative Oncology

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Haemoperitoneum secondary to ruptured splenic tumours can be either benign or malignant in origin. The majority of previous studies of canine haemoperitoneum have been retrospective, which are associated with well-recognized biases, such as the potential to underappreciate the diversity of outcomes in a complex presentation such as haemoperitoneum. This study seeks to prospectively define perioperative morbidity and mortality of haemoperitoneum in dogs secondary to ruptured splenic masses. Forty dogs with haemoperitoneum secondary to a ruptured splenic mass met the inclusion criteria. As expected, the cohort predominately consisted of older large breed dogs. All dogs underwent preoperative staging and had a splenectomy performed. Histopathologic analysis was performed on the splenic mass, as well as any possible metastatic lesions that were noted intra-operatively. Perioperative care outside of splenectomy was delivered in specialty practices using current conventional approaches to care (eg, transfusions and anti-arrhythmic medications). Fifteen dogs (37.5%) had benign splenic tumours and were cured with surgery alone, whereas 62.5% had malignant disease (most often haemangiosarcoma [HSA]). Surgical outcomes were highly favourable in the vast majority of dogs. Indeed, 38 dogs (95%) survived and were discharged after a median hospitalization of 39.5 hours. Independent predictors of longer hospitalization times included receiving a transfusion and the development of an arrhythmia. Although small, this cohort defines distinctive and optimistic perspectives for dogs with haemoperitoneum from splenic tumour rupture. These favourable outcomes from this prospective study are sufficient to ask if larger prospective studies should be conducted to better inform owners during this challenging cancer emergency presentation.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 83%

Prospective observational study of dogs with splenic mass rupture suggests potentially lower risk of malignancy and more favourable perioperative outcomes

Stewart¹,

Ehrhart²,

Davies³

et al. 2020

Vet Comparative Oncology

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“… 40 In dogs, TXA improves clot strength in vitro, but the clinical effects of antifibrinolytic drugs are unclear. 41 , 42 , 43 The use of TXA has been described in a dog that received a dosage of 2303 mg/m 2 of cyclophosphamide over 21 days and developed severe pancytopenia. The patient was treated with antibiotics, 2 whole blood transfusions, G‐CSF, and TXA and made a full recovery.…”

Section: Discussionmentioning

confidence: 99%

Toxicity, outcome, and management of anthracycline overdoses in 16 dogs

Lawson

Musser

Regan³

et al. 2021

Veterinary Internal Medicne

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Background Despite multiple reports of chemotherapy overdoses (ODs) in human and veterinary medicine, anthracycline ODs have been described infrequently. Hypothesis/Objectives Describe toxicities, treatments, and overall outcome after anthracycline OD in dogs. Animals Twelve mitoxantrone (MTX) and 4 doxorubicin (DOX) ODs were evaluated. Methods Multicenter retrospective analysis. The American College of Veterinary Internal Medicine oncology and internal medicine listservs were solicited for cases in which a chemotherapy OD occurred. Results Sixteen anthracycline cases were collected. Anthracycline ODs occurred because of an error in chemotherapy preparation (n = 9), or dose miscalculation (n = 7). The overall median OD was 1.9× (range, 1.4‐10×) the prescribed amount. Most ODs were identified immediately after drug administration (n = 11), and the majority of patients were hospitalized on supportive care (n = 11) for an average of 8 days (range, 3‐34 days). Adverse events after the OD included neutropenia (94%), thrombocytopenia (88%), anemia (63%), diarrhea (63%), anorexia (56%), vomiting (38%), lethargy (31%), and nausea (25%). Two patients did not survive the OD. High grade neutropenia was common and did not appear to be mitigated by the administration of filgrastim. Conclusions and Clinical Importance All patients received supportive care after identifying the OD and death was uncommon. Further evaluation is needed to determine ideal therapeutic guidelines anthracycline OD.

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“…While it is now known that HF may occur in dogs with the initial diagnosis of SHP, 8 the duration of HF as well as the prevalence in these dogs is unknown. One retrospective study examined tranexamic acid use preoperatively in dogs with SHP to assess its utility and found no reduction in red blood cell transfusion requirements or postoperative bleeding tendency, though no dogs with ROTEM before surgery were characterized as hyperfibrinolytic 12 . There are no prospective trials evaluating AFT in dogs with SHP.…”

Section: Introductionmentioning

confidence: 99%

Rapid resolution of hyperfibrinolysis in dogs with spontaneous hemoperitoneum following surgical control of hemorrhage

DeStefano

Rozanski

Koethe

et al. 2023

J Vet Emergen Crit Care

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Objective To estimate the point prevalence and duration of hyperfibrinolysis (HF) in dogs undergoing surgical control of spontaneous hemoperitoneum (SHP). Design Prospective observational study. Setting Single veterinary teaching hospital. Animals Forty‐five client‐owned dogs with SHP were screened for HF. Eighteen HF dogs treated surgically were studied. Interventions None. Measurements and Main Results Dogs with SHP and evidence of shock admitted for surgical control of hemorrhage were screened for HF. Blood samples were collected for PCV, total plasma protein, platelet count, and thromboelastography with 50 U/mL of tissue plasminogen activator at presentation and every 8 hours postoperatively until 72 hours, discharge, or death. HF was defined as a tissue plasminogen activator‐activated thromboelastography lysis percentage measured 30 minutes after maximum amplitude (LY30) of ≥20%. LY30 values were compared to a cohort of samples obtained from healthy dogs (n = 22). The point prevalence of HF in all dogs screened was 40% (18/45 dogs), and the mean LY30 at baseline for HF dogs was 48.9% (±24.2%), which was significantly higher than that of control dogs (4.8% ± 7.1%, P < 0.001) and non‐HF dogs (1.9% ± 5.7%, P < 0.001). In HF dogs, there was a significant decrease in LY30 between baseline and 8 hours (P < 0.0001) and between 8 and 16 hours (P = 0.035) but no significant change thereafter. LY30 at 8 hours (4%, range: 0%–23.4%) was not statistically different from control dogs (6.5%, range: 1.2%–32.8%, P = 0.664) suggesting early resolution of HF in this population. Only 2 of 18 dogs were persistently hyperfibrinolytic at 24 hours. Malignancy was diagnosed in 12 of 18 dogs (66.6%), while a benign etiology occurred in 6 of 18 dogs (33.3%). All HF dogs survived to discharge. Conclusions HF occurs in some dogs with hypovolemic shock due to hemoperitoneum but resolves rapidly following surgical control of bleeding without antifibrinolytic medications. Routine postoperative use of antifibrinolytics in dogs with hemoperitoneum in dogs undergoing surgical control of bleeding may not be warranted.

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Effect of tranexamic acid on intra- and postoperative haemorrhage in dogs with surgically treated hemoperitoneum

Cited by 9 publications

References 20 publications

Prospective observational study of dogs with splenic mass rupture suggests potentially lower risk of malignancy and more favourable perioperative outcomes

Prospective observational study of dogs with splenic mass rupture suggests potentially lower risk of malignancy and more favourable perioperative outcomes

Toxicity, outcome, and management of anthracycline overdoses in 16 dogs

Rapid resolution of hyperfibrinolysis in dogs with spontaneous hemoperitoneum following surgical control of hemorrhage

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