Global hemostasis in healthy bitches during pregnancy and at different estrous cycle stages: Evaluation of routine hemostatic tests and thromboelastometry

Klainbart, Sigal; Slon, Alexandra; Kelmer, Efrat; Bdolah‐Abram, Tali; Raz, Tal; Segev, Gil; Aroch, Itamar; Tal, Smadar

doi:10.1016/j.theriogenology.2017.04.023

Cited by 15 publications

(18 citation statements)

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“…45 However, this was later rebutted in a different study, where thrombocytosis was only documented at late pregnancy, but not during diestrus. 4 Iron deficiency, a known etiology of thrombocytosis, 46 is an improbable cause of thrombocytosis during pregnancy, given the findings of the present study. Similarly, while inflammation is a common cause of thrombocytosis in dogs, 46 pregnancy-related inflammation is an unlikely explanation for the observed rise in platelet count during pregnancy, because of the opposite temporal trends in inflammation and thrombocytosis during pregnancy in the bitch.…”

Section: Discussionmentioning

confidence: 52%

“…[1][2][3] A few smallcohort studies in dogs have addressed similar changes in red blood cell (RBC) indices in pregnant bitches, with conflicting results. Most commonly, PRA has been reported to develop during later pregnancy stages, [4][5][6][7] whereas 2 studies either failed to document preparturition anemia or had reported statistically significant, albeit clinically insignificant, hematocrit decrease during pregnancy. 8,9 Several mechanisms jointly contribute to the development of PRA in women.…”

Section: Introductionmentioning

confidence: 99%

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Time course of serum cobalamin, folate, and total iron binding capacity concentrations in pregnant bitches and association with hematological variables and survival

Nivy

Mazaki‐Tovi

Aroch

et al. 2019

Veterinary Internal Medicne

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Background Hypocobalaminemia, hypofolatemia and iron deficiency are associated with pregnancy‐related anemia (PRA) and neonatal survival (NS) in women. Similar associations have not been investigated in pregnant bitches. Objectives To investigate time course and associations of serum cobalamin, folate and iron status indicators with hematological variables and NS in pregnant bitches. Animals Forty‐eight pregnant bitches. Methods A prospective cohort study. Pregnancy was confirmed by abdominal ultrasonography twice during mid‐ and late pregnancy, concurrently with blood sampling. Associations among pregnancy stage, NS and laboratory variables were assessed by generalized estimating equations. Results Compared with midpregnancy, serum cobalamin (adjusted mean [95% confidence interval, CI]) decreased at late pregnancy (430 pg/mL [394‐466] versus 330 pg/mL [303‐357], respectively; P < .001), whereas serum folate did not. Every increment of 1 in parity number or litter size corresponded to 28.6 pg/mL (95% CI, 5.6‐51.6; P = .02) and 20.3 pg/mL (95% CI, 10.9‐29.7; P < .001) decrease in serum cobalamin concentration. Compared with midpregnancy, serum iron ( P < .001) and transferrin saturation ( P = .01) increased at late pregnancy. The decrease in red blood cell count ( P < .001) at late pregnancy was significantly, albeit weakly, correlated with decreasing serum folate concentration ( r = 0.33; P = .02). None of the measures was associated with NS. Conclusions and Clinical Significance Pregnancy‐related anemia was common at late pregnancy. Unlike in women, in pregnant bitches, serum iron and transferrin saturation were increased at late pregnancy. Future studies are warranted to investigate the clinical ramifications of hypocobalaminemia in pregnant bitches and the utility of prophylactic folate administration in mitigating PRA.

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Section: Discussionmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Time course of serum cobalamin, folate, and total iron binding capacity concentrations in pregnant bitches and association with hematological variables and survival

Nivy

Mazaki‐Tovi

Aroch

et al. 2019

Veterinary Internal Medicne

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“…Rather, the hemostatic changes appear to be associated with the inflammation that an embryo incites in the uterus. 12,14,15 A previous investigation of 66 pregnant queens did not detect an association between either the presence of an embryo or higher progesterone concentrations and platelet count, prothrombin time, activated partial thromboplastin time (aPTT), fibrinogen concentration and D-dimer. 16 However, testing of individual components of the hemostatic system may not provide a reliable assessment of the overall coagulation status of a patient.…”

Section: Introductionmentioning

confidence: 90%

“…This possibility is supported by a canine study that identified associations between both pregnancy and estrous cycle stages and viscoelastic parameters, but not prothrombin time or D-dimer concentrations. 15 Viscoelastic testing has traditionally relied on costprohibitive and complex instruments, 17 but a small point-of-care device has recently become available (VCM Vet; Entegrion). This device requires loading nonanticoagulated whole blood into a prewarmed singleuse cartridge, which avoids the 30-min rest time recommended for analysis of citrated blood by thromboelastography (TEG) or rotational thromboelastometry (ROTEM).…”

Section: Introductionmentioning

confidence: 99%

Blood loss and coagulation profile in pregnant and non-pregnant queens undergoing elective ovariohysterectomy

Fudge¹,

Page²,

Mackrell³

et al. 2020

Journal of Feline Medicine and Surgery

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Objectives The aims of this study were to determine if there is increased risk of intraoperative bleeding in pregnant cats undergoing elective ovariohysterectomy (OHE), and to compare coagulation in queens in various stages of estrus and pregnancy subjected to elective OHE using a whole-blood viscoelastic assay. Methods Intraoperative blood loss was compared between non-pregnant and pregnant cats undergoing elective OHE. Viscoelastic evaluations of whole blood drawn pre- and postoperatively were performed using a point-of-care device measuring clot time (CT), clot formation time (CFT), alpha angle, maximum clot formation (MCF), amplitude at 10 and 20 mins (A10 and A20, respectively), and lysis index at 30 and 45 mins after MCF (LI30 and LI45, respectively). Results One hundred and ninety-three cats underwent OHE by a ventral midline approach. Median blood loss was greater for pregnant cats (2.0 ml, range <0.5–13 ml) than non-pregnant cats (<0.5 ml, range <0.5–15 ml; P <0.0001). Preoperatively, pregnant cats had a shorter median CFT (165 s vs 190.5 s), increased median A10 (31 from 25.5 VCM units) and A20 (38 from 35 VCM units), and a lower median LI45 (99% from 100%) than non-pregnant cats. Postoperatively, A10 and A20 increased, and LI30 and LI45 decreased in both non-pregnant and pregnant queens. In pregnant queens, mean CT also increased postoperatively. Conclusions and relevance Pregnant cats were relatively hypercoagulable and had an increased rate of clot lysis than non-pregnant cats. Intraoperative blood loss was increased in pregnant vs non-pregnant cats, but no clinically relevant bleeding conditions occurred.

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“…Furthermore, during pregnancy bitches have a higher fibrinogen concentration, platelet count and plateletcrit. Fibrin and global clot formations can occur faster than in non‐pregnant bitches, which might lead to thrombus formation and the risk of thromboembolism 18 . These changes can lead to an increased risk during anaesthesia.…”

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confidence: 99%

Survival and fertility of bitches undergoing caesarean section

Conze¹,

Jurczak

Fux³

et al. 2020

Veterinary Record

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BackgroundWith the increasing popularity of planned caesarean section, the need for knowledge regarding this surgery has become increasingly important. The reported death and survival rates for caesarean sections vary widely. Another important aspect is the fertility rate in subsequent oestrous after caesarean section. The aim of this study was to investigate the mortality and survival rate of bitches during caesarean section. Additionally, the fertility of bitches after caesarean sections was determined.MethodsCaesarean sections which were performed in the years 1997–2009 at two university clinics were evaluated retrospectively. A distinction was made between bitches in which a conservative caesarean section was performed and bitches with a caesarean section followed by an ovariohysterectomy.ResultsA total of 482 caesarean sections were included in the study. The overall mortality rate was 3.11 per cent, with 2.59 per cent during or after a conservative caesarean section and 4.19 per cent during or after caesarean section with ovariohysterectomy. The reason for ovariohysterectomy was the owner’s preference in 63 bitches (47.01 per cent); in 71 (52.98 per cent) bitches, ovariohysterectomy was performed due to a medical indication. The fertility rate after caesarean section was 100 per cent.ConclusionThe results show a high mortality rate during and after caesarean section. On the other hand, caesarean section does not seem to have a big impact on further fertility. Further studies are needed to investigate possible reduction of litter sizes and the suitability of caesarean section in subsequent pregnancies.

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Global hemostasis in healthy bitches during pregnancy and at different estrous cycle stages: Evaluation of routine hemostatic tests and thromboelastometry

Cited by 15 publications

References 57 publications

Time course of serum cobalamin, folate, and total iron binding capacity concentrations in pregnant bitches and association with hematological variables and survival

Time course of serum cobalamin, folate, and total iron binding capacity concentrations in pregnant bitches and association with hematological variables and survival

Blood loss and coagulation profile in pregnant and non-pregnant queens undergoing elective ovariohysterectomy

Survival and fertility of bitches undergoing caesarean section

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