Evaluation of Human Recombinant Tissue Factor‐Activated Thromboelastography in 49 Dogs with Neoplasia

Abstract

Background: Abnormal routine coagulation assay results have been reported to be common in veterinary patients with neoplasia, but the overall hemostatic functional state, including hypercoagulability, has not been described. Hypothesis: The overall hemostatic functional state, including hypercoagulability, can be assessed in dogs with neoplasia by tissue factor (TF)‐activated thromboelastography (TEG). Animals: Thirty‐six dogs with malignant neoplasia and 13 dogs with benign neoplasia presented to the Small Animal Veterinary Teaching Hospital, The University of Copenhagen, Frederiksberg, Denmark. Methods: Prospective study evaluating the overall hemostatic functional state in dogs with neoplasia by a newly validated TF‐activated TEG assay and routine coagulation parameters activated partial thromboplastin time (aPTT), prothrombin time (PT), platelet count, and D‐dimer concentration. Results: Hemostatic dysfunction was observed in 28/49 (57%) dogs with neoplasia. Twenty‐four were dogs with malignant neoplasia, the majority of which 18/36 (50%) were hypercoagulable, whereas 6/36 (17%) were hypocoagulable. All hypocoagulable dogs had metastatic disease. The proportion of dogs with altered hemostasis was significantly different between dogs with malignant and benign neoplasia. Conclusions and Clinical Importance: TF‐activated TEG detected hypercoagulable and hypocoagulable states in this population of dogs with neoplasia. The most common hemostatic abnormality in dogs with malignant neoplasia was hypercoagulability. These findings suggest that this novel hemostatic function test may be of value as a cage side method for the assessment of overall hemostatic function in dogs with cancer, including the detection of both hyper‐ and hypocoagulable states as well as mixed disorders.

Evaluation of Hemostatic Abnormalities in Canine Spirocercosis and Its Association with Systemic Inflammation

“…Indicators of inflammation, the APPs, total leukocyte and mature neutrophils were correlated with the thromboelastogram‐derived MA. These findings are in agreement with previous studies of other inflammatory and neoplastic conditions in which hypercoagulability was reported based on the presence of thromboemboli or changes in TEG variables 11, 12, 25…”

“…Systemic inflammation has been reported to result in activation of hemostasis,10 and subsequent alterations in the inflammatory and hemostatic variables in spirocercosis are expected. Definitions of hypercoagulability based on TEG variables have not yet been established for animals and numerous variables are used in different studies to define hypercoagulability, including maximal amplitude (MA) or global clot strength (G) alone or in combination with shortened reaction time (R), increased angle (α), or both 11, 12. Increased MA has been reported to be indicative of hypercoagulability in studies on animals,11, 13 and a single variable may be easier to interpret and may have greater clinical application.…”

Protective effects of S-adenosylmethionine (SAMe) and silybin on hepatorenal and hemostatic functions in dogs with endotoxemia

“…Studies also showed that fibrinogen concentration and platelet counts were correlated with G/MA and K time in dogs (11,12). Previous studies regarding the use of TEG showed hypercoagulability (evidenced by an increased MA) in dogs with parvoviral enteritis (13), neoplasia (14), or immunemediated hemolytic anemia (15), and hypocoagulapathy (evidenced by increased R and K, and decreased α-angle and MA) in dogs with DIC (12). Reference ranges for TEG parameters in healthy dogs were reported as follows: R, 1.8-8.6 min; K, 1.3-5.7 min; α-angle, 36-74 degrees; MA, 42-67 mm; and G value, 3.2-9.6 kdyn/cm 2 (10).…”

Thromboelastographic evaluation of hemostatic functionin dogs with dilated cardiomyopathy

“…Previous studies reported hypercoagulable results based on TEG measurements in dogs with parvoviral enteritis (24), endotoxemia (11), neoplasia (25), and immune-mediated hemolytic anemia (26). A hypercoagulable state in dogs with DCM may be due to increased catecholamine and cytokine responses, upregulation of the renin-angiotensin-aldosterone system, or increased P-selection expression during heart failure (27)(28)(29).…”