Retrospective evaluation of the effectiveness of epsilon aminocaproic acid for the prevention of postamputation bleeding in retired racingGreyhounds with appendicular bone tumors: 46 cases (2003–2008)

Abstract

This retrospective study suggests that preemptive postoperative administration of EACA appears to be efficacious in decreasing the frequency of bleeding in RRGs undergoing limb amputation; however, a prospective study is warranted to corroborate its effectiveness.

Evaluation of tranexamic acid and ϵ-aminocaproic acid concentrations required to inhibit fibrinolysis in plasma of dogs and humans

“…7,26 However, recently the ability of EACA to reduce clinical postoperative bleeding in Greyhounds has been determined in a retrospective analysis of limb amputations and a prospective, randomized clinical trial of dogs undergoing elective ovariohysterectomy or orchiectomy. 11,12 Given the lack of pharmacokinetic and pharmacodynamic data in dogs, doses were extrapolated from human data. 27 The data presented here suggest that this may result in suboptimal plasma concentrations.…”

“…7 Antifibrinolytic drugs have been used clinically in veterinary medicine to reduce postoperative hemorrhage in Greyhounds, a breed with a high prevalence of postoperative bleeding complications. 11,12 Despite their clinical use, effective plasma concentrations of antifibrinolytic agents in dogs are unknown, and administration regimens have been extrapolated from pharmacodynamic data in humans.…”

Postoperative Hemostasis Monitoring and Management

“…A syndrome of delayed postoperative bleeding has been reported in greyhounds and is hypothesized to be secondary to a robust fibrinolytic response. 57 Few tests reliably detect fibrinolysis in veterinary patients. D-dimers are breakdown products of cross-linked fibrin and indicate not only the formation of thrombi but also the body's effort to dissolve the clots.…”

Hematologic Disorders

“…96 An increase in fibrinolysis can be detected by an increased number of circulating fibrin fragments, either fibrin(ogen) degradation products (FDPs) or d-dimers. D-dimers can only be formed after fibrin cross-linking has occurred in a mature clot and so are indicative of fibrinolysis secondary to thrombosis.…”

“…Delayed (2-3 days) postoperative bleeding in retired racing greyhounds has been reported and has been posited to be caused by hyperfibrinolysis. 97,98 It is not possible to predict which dogs will experience delayed bleeding, but it is wise to closely monitor sighthounds in the postoperative period. Drugs such as epsilon-aminocaproic acid or tranexamic acid may be useful to mitigate hyperfibrinolysis in some cases.…”