Thromboelastographic evaluation of hemostatic function in dogs treated for crotalid snake envenomation

Armentano, Robert A.; Bandt, Carsten; Schaer, Michael; Pritchett, J.F.; Shih, Andre

doi:10.1111/vec.12139

Cited by 15 publications

(27 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The current in vitro study could not entirely replicate the interactions in complicated living organisms; thus, hyperfibrinolysis was excluded [38]. In patients with natural snake envenomation as a result of a snake bite, the common coagulopathy reported using TEG was delayed fibrinolysis [39,40], and LY30 provided information on fibrinolysis before the decrease in fibrinogen concentrations [33]. As such, even though this study did not result in any valid conclusions in relation to LY30 as it focused on detecting early VICC, LY30 can provide useful information about hyperfibrinolysis in clinical practice.…”

Section: Discussionmentioning

confidence: 94%

Hemostatic Analysis of Simulated Gloydius ussuriensis Envenomation Using Canine Blood: A Comparison of Thromboelastography and Classical Coagulation Tests

Lee

Kim

2022

Animals

View full text Add to dashboard Cite

Snake envenomation may lead to venom-induced consumptive coagulopathy (VICC), usually diagnosed by classical coagulation tests (CCTs), such as prothrombin time (PT) and activated partial thromboplastin time (aPTT). However, the results of CCTs are frequently normal in the initial stages, which may delay anti-venom treatments. Thromboelastography (TEG) is a point-of-care and real-time diagnostic tool that enables a comprehensive assessment of the coagulation process. This in vitro study aimed to determine concentration-dependent changes in canine blood caused by Gloydius ussuriensis (G. ussuriensis) envenomation using TEG and CCTs. Lyophilized G. ussuriensis venom was reconstructed using mouse intravenous lethal dose 50 (LD50iv) and serially diluted to 25% LD50iv, 50% LD50iv, and 75% LD50iv to reproduce VICC at different concentrations. Normal saline was used for the control. We compared TEG values of the reaction time (R), kinetic time (K), rate of clot formation (α-angle), maximum amplitude (MA), fibrinolysis at 30 min (LY30), and global strength of the clot (G) with those of PT, aPTT, fibrinogen, and platelet counts (PLTs). Most TEG parameters, except R and LY30, demonstrated statistically significant changes compared with the control at all concentrations. CCTs, except PLTs, revealed significant changes at ≥50% LD50iv. Thus, TEG could be a useful diagnostic strategy for early VICC and preventing treatment delay.

show abstract

Section: Discussionmentioning

confidence: 94%

Hemostatic Analysis of Simulated Gloydius ussuriensis Envenomation Using Canine Blood: A Comparison of Thromboelastography and Classical Coagulation Tests

Lee

Kim

2022

Animals

View full text Add to dashboard Cite

show abstract

“…The mortality rate was lower in dogs with a hypercoagulable profile than in those with a hypocoagulable profile, and G values were significantly higher in survivors than in nonsurvivors. Other studies demonstrated that dogs with a hypocoagulable profile had a higher mortality rate than those with a hypercoagulable profile in DIC, in crotalid snake envenomation, and in immune‐mediated hemolytic anemia . This relationship brings into question the role of coagulation in inflammatory processes.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic, Hemostatic, and Thromboelastometric Disorders in 35 Dogs with a Clinical Diagnosis of Leptospirosis: A Prospective Study

Barthélémy

Magnin

Pouzot‐Nevoret

et al. 2016

Veterinary Internal Medicne

View full text Add to dashboard Cite

BackgroundLeptospirosis in dogs is occasionally associated with a hemorrhagic syndrome, the pathophysiology of which is not fully understood.Hypothesis/ObjectivesTo characterize hematologic, hemostatic, and thromboelastometric abnormalities in dogs with leptospirosis and to study their association with hemorrhagic diatheses and outcomes.AnimalsThirty‐five client‐owned dogs.MethodsA prospective observational single cohort study was conducted. Results from the CBC, coagulation tests (prothrombin, activated partial thromboplastin and thrombin times, fibrinogen, fibrin(ogen) degradation products, and D‐dimer concentrations), rotational thromboelastometry (TEM), signalment, hemorrhagic diatheses, occurrence of disseminated intravascular coagulation (DIC) at admission, and survival to discharge were recorded.ResultsThe most common hematologic and hemostatic abnormalities were anemia (30/35), thrombocytopenia (21/35), and hyperfibrinogenemia (15/35). Eight dogs were diagnosed with DIC. A normal TEM profile was found in 14 dogs, a hypercoagulable profile in 14 dogs, and a hypocoagulable profile in 7 dogs. The 8 dogs with hemorrhagic diatheses at admission had significantly decreased platelet counts (P = .037) and increased D‐dimer concentrations (P = .015) compared with other dogs. Dogs with a hypocoagulable profile exhibited more hemorrhagic diatheses compared with the dogs that had normal and hypercoagulable profiles (P = .049). The mortality rate was lower in dogs with a hypercoagulable profile than in those with a hypocoagulable profile (21% vs 57%; P = .043). Disseminated intravascular coagulation was not a significant prognostic factor.Conclusions and Clinical ImportanceThromboelastometric parameters were altered in dogs with both hypercoagulable and hypocoagulable profiles. A hypocoagulable profile was significantly correlated with hemorrhagic diathesis and higher mortality rate.

show abstract

“…TEG has been utilized previously to document and monitor coagulation changes in cases of envenomation before and after treatment 4,8,10,11,20–23 . Studies have shown that patients envenomated by pit vipers were most likely to be hypocoagulable on TEG analysis, meaning that they have lower coagulation potential than normal patients, which may or may not relate to in vivo coagulation 4,8,10,11,20–23 .…”

Section: Discussionmentioning

confidence: 99%

In vitro evaluation of canine whole blood with the addition of Crotalus atrox (Western Diamondback Rattlesnake) venom and antivenom using thromboelastography

Bailey

Lyon

Gilliam

2022

J Vet Emergen Crit Care

View full text Add to dashboard Cite

Objectives: To compare the efficacy of 2 equine-origin antivenom products on correction of coagulation abnormalities noted on thromboelastography (TEG) caused by Crotalus atrox venom in vitro. Design:Prospective in vitro controlled study.Setting: Veterinary teaching hospital. Animals: Six healthy dogs.Interventions: Blood from each dog was used for 4 separate kaolin-activated TEG analyses: A negative control (blood-saline) and positive control (blood-Crotalus atrox venom) were used to assess the dog's normal coagulation and the effect of venom on TEG parameters. Thromboelastographic analyses were then run with blood, venom, and either Argentinian or North American antivenom. All TEG analyses from each dog were compared for efficacy. Measurements and Main Results:The mean R values between the North American antivenom and negative controls were not significantly different (P = 0.681), but were significantly different (P = 0.024) between the Argentinian antivenom and negative controls. The mean fibrinolysis values measured 30 minutes after maximum amplitude achieved between the North American antivenom and negative controls were not significantly different (P = 0.198), but were significantly different (P < 0.001) between the Argentinian antivenom and negative controls. The mean K values between the Argentinian antivenom and negative controls were not significantly different (P = 0.274), but were significantly different (P = 0.043) between the North American antivenom and negative controls. Conclusions:The North American antivenom normalized time to clot formation and fibrinolysis, while the Argentinian antivenom normalized rate of clot formation. Further studies in naturally envenomated patients are necessary to determine if these in vitro results would translate into different clinical outcomes.Abbreviations: F(ab')2, antigen-binding fragments formed after pepsin digestion; Fc, fragment crystallizable region of antibody; K, kinetic time; LY30, fibrinolysis measured 30 minutes after MA achieved; LY60, fibrinolysis measured 60 minutes after MA achieved; MA, maximum amplitude; R, reaction time; TEG, thromboelastography; VICC, venom-induced consumptive coagulopathy.

show abstract

Thromboelastographic evaluation of hemostatic function in dogs treated for crotalid snake envenomation

Abstract: A hypocoagulable TEG tracing, particularly a decreased G value and MA, is associated with an increased mortality in crotaline snake envenomation. G and MA also demonstrate a significant increase over treatment time.

Cited by 15 publications

References 27 publications

Hemostatic Analysis of Simulated Gloydius ussuriensis Envenomation Using Canine Blood: A Comparison of Thromboelastography and Classical Coagulation Tests

Hemostatic Analysis of Simulated Gloydius ussuriensis Envenomation Using Canine Blood: A Comparison of Thromboelastography and Classical Coagulation Tests

Hemorrhagic, Hemostatic, and Thromboelastometric Disorders in 35 Dogs with a Clinical Diagnosis of Leptospirosis: A Prospective Study

In vitro evaluation of canine whole blood with the addition of Crotalus atrox (Western Diamondback Rattlesnake) venom and antivenom using thromboelastography

Contact Info

Product

Resources

About