Assessment of the CoaguChek-XS portable prothrombin time point-of-care analyzer for horses

Abstract

In horses, gastrointestinal (GI) disorders are the main cause of disseminated intravascular coagulation (DIC), a potentially life-threatening condition. Large colon volvulus, colitis, and strangulating small intestinal lesions are the most common GI conditions that cause DIC in horses, 4,12 but DIC is also reported in septicemia, snakebites, rhabdomyolysis, and diffuse clostridial myonecrosis. 11,13,16,19,21,22 Significantly prolonged PT was reported in 58% of horses with acute GI crisis-associated DIC, 12 and was significantly associated with strangulating GI lesions. 3,4 Early diagnosis of subclinical DIC is crucial, and depends on laboratory testing of hemostasis. 3 Prothrombin time (PT) is commonly measured in horses to assess the status of hemostasis, specifically the extrinsic and common pathways. 21 Monitoring changes in PT over time is of diagnostic and prognostic value, as well as a clinical tool to help guide treatment. 3,4 Equine medicine is often practiced at a distance from reference laboratories. Delays in receiving hemostasis test results may be detrimental in treating critically ill horses. A reliable, cost-effective, point-of-care (POC) test to assess hemostasis, such as PT measurement, would be useful under field conditions. The CoaguChek-XS (Roche Diagnostics, Mannheim, Germany) is a small, portable POC PT analyzer, commonly used in human medicine for home monitoring of warfarin therapy, that is suitable for both venous and capillary blood samples, providing results within minutes. 17,20 Studies have assessed the reliability, precision, and suitability of the CoaguChek-XS

Coagulation testing: Comparison of portable (CoaguChek® XS) and automated coagulation analyzer in healthy cats

“…Therefore, the sensitivity and specificity of CCX were not proven. Nevertheless, the previous studies reported sensitivity and specificity of this device as 92% and 56%, respectively, in dogs [ 12 ] and 50% and 74%, respectively, in horses [ 21 ]. Thus, we do not recommend using CCX for diagnosing coagulation abnormalities in cats.…”

“…Accuracy of PT measurement using the CCX was reported in human [ 17 - 19 ], horse [ 21 ], and dog [ 12 ]. The previous studies found that the CCX was reliable for screening dogs when the PT was normal [ 12 ], while it was potentially specific and quite sensitive for detecting abnormal hemostasis in horses [ 21 ]. However, the accuracy of the CCX for PT measurement in cats and normal ranges was not evaluated.…”

Prevalence of Anticoagulant Rodenticides in Ferruginous Hawk Nestlings and Evaluation of a Novel Method to Rapidly Assess Exposure

“…CoaguChek ® -XS, was shown to accurately and precisely measure PT in domestic dogs and horses (Newbould and Norman, 2013;Kelmer et al, 2014;Berlin et al, 2019).…”