Thromboelastographic Evaluation of Hemostatic Function in Dogs with Disseminated Intravascular Coagulation

Wiinberg, Bo; Jensen, A. L.; Johansson, Pär I.; Rozanski, Elizabeth A.; Tranholm, Mikael; Kristensen, Annemarie T.

doi:10.1111/j.1939-1676.2008.0058.x

Cited by 166 publications

(267 citation statements)

References 39 publications

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“…Despite evidence of hyperfibrinolysis, there was no difference in D‐dimer concentration in dogs receiving tetrastarch compared to dogs given 0.9% NaCl in the present study. Likewise, a recent case series of dogs with disseminated intravascular coagulation revealed no association between D‐dimer concentration and fibrinolytic TEG variables 37. Other assays of fibrinolysis such as fibrin degradation products, fibrinogen, or plasminogen concentrations could be measured in future studies to further assess the effect of tetrastarch on fibrinolysis.…”

Section: Discussionmentioning

confidence: 99%

Effect of Synthetic Colloid Administration on Coagulation in Healthy Dogs and Dogs with Systemic Inflammation

Gauthier

Holowaychuk

Kerr

et al. 2015

Veterinary Internal Medicne

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BackgroundSynthetic colloids are often used during fluid resuscitation and affect coagulation.ObjectiveTo compare the effects of an isotonic crystalloid and synthetic colloid on coagulation in healthy dogs and dogs with systemic inflammation.AnimalsSixteen adult purpose‐bred Beagles.MethodsRandomized, placebo‐controlled, blinded study. Dogs were randomized into one of two groups receiving fluid resuscitation with either 40 mL/kg IV 0.9% NaCl or tetrastarch after administration of lipopolysaccharide or an equal volume of placebo. After a 14‐day washout period, the study was repeated such that dogs received the opposite treatment (LPS or placebo) but the same resuscitation fluid. Blood samples were collected at 0, 1, 2, 4, and 24 hours for measurement of coagulation variables.ResultsAdministration of either fluid to healthy dogs and dogs with systemic inflammation resulted in similar increases in prothrombin time and activated clotting time. In comparison to saline administration, tetrastarch administration resulted in significantly decreased R (P = .017) in healthy dogs, as well as significantly increased activated partial thromboplastin time (P ≤ .016), CL30% (P ≤ .016), and K (P < .001) and significantly decreased platelet count (P = .019), α (P ≤ .001), MA (P < .001), and von Willebrand factor antigen (P < .001) and collagen binding activity (P ≤ .003) in both healthy dogs and dogs with systemic inflammation.Conclusions and Clinical ImportanceTetrastarch bolus administration to dogs with systemic inflammation resulted in a transient hypocoagulability characterized by a prolonged activated partial thromboplastin time, decreased clot formation speed and clot strength, and acquired type 1 von Willebrand disease.

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Section: Discussionmentioning

confidence: 99%

Effect of Synthetic Colloid Administration on Coagulation in Healthy Dogs and Dogs with Systemic Inflammation

Gauthier

Holowaychuk

Kerr

et al. 2015

Veterinary Internal Medicne

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“…The inflammatory response to infection can activate the coagulation system via complex interactions and result in a consumptive coagulopathy (Esmon et al, 1999;Laforcade et al, 2003;Weiss and Rashid, 1998). Coagulation derangement, specifically hypercoagulability, is considered likely in a number of systemic diseases affecting small animals (Donahue and Otto, 2005;Kristensen et al, 2008;Otto et al, 2000;Wiinberg et al, 2008;Wiinberg et al, 2009). If uncontrolled, the hypercoagulable state may lead to DIC, which has been identified as a major risk factor for poor outcome in both human and canine medicine (Laforcade et al, 2003;Weiss and Rashid, 1998).…”

Section: Introductionmentioning

confidence: 99%

“…If uncontrolled, the hypercoagulable state may lead to DIC, which has been identified as a major risk factor for poor outcome in both human and canine medicine (Laforcade et al, 2003;Weiss and Rashid, 1998). The criteria for the definition of DIC in people, established by the International Society of Thrombosis and Hemostasis (ISTH), include procoagulant activation, inhibitor consumption, and increased fibrinolytic activity (Bick et al, 1999;Wiinberg et al, 2008). Clinical signs associated with DIC vary considerably and can range from no signs (non-overt DIC) to signs of organ failure, secondary to microvascular thrombosis, and overt hemorrhage (overt DIC) (Bick et al, 1999;Wiinberg et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Mortality in virulent canine babesiosis is associated with a consumptive coagulopathy

Goddard¹,

Wiinberg²,

Schoeman³

et al. 2013

The Veterinary Journal

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The inflammatory response to infection can activate the coagulation system via complex interactions. If uncontrolled, this may lead to a consumptive coagulopathy, which has been identified as a major risk factor for poor outcome in both human and canine medicine. This study was undertaken to prospectively determine whether the presence of a consumptive coagulopathy in dogs with Babesia rossi infection is related to mortality. A prospective, cross-sectional, observational study was performed. Seventy-two client-owned dogs diagnosed with canine babesiosis were included. Diagnosis was confirmed by polymerase chain reaction and reverse line blot and dogs infected with Babesia vogeli or Ehrlichia canis were excluded. Blood samples were collected at admission. Coagulation factor-, antithrombin (AT)-, and protein C (PC) activity, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and Ddimer concentrations were measured. The mortality rate was 18% (13/72) and results between non-survivors and survivors were compared. The median activities of all the coagulation factors were significantly lower in the non-survivors compared to the survivors. The median PT and aPTT were significantly longer in the non-survivors compared to the survivors. The median AT activity was not significantly different; however, the median PC activity was significantly 2 decreased in the non-survivors. The median D-dimer concentration was significantly higher in the non-survivors compared to the survivors. This study showed that dogs that died from B.canis infection suffered from a more severe consumptive coagulopathy compared to survivors, characterized by procoagulant activation, inhibitor consumption, and increased fibrinolytic activity.

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“…It has been hypothesised that during the initial stages of DIC the patients are thought to be hypercoagulable as a result of circulating inflammatory mediators that activate haemostasis. If not countered, coagulation factors are consumed, and increased fibrinolytic activity can lead to a hypocoagulable state with overt clinical symptoms such as bleeding (Esmon, 2005;Wiinberg et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Alterations in some blood coagulation parameters in naturally occurring cases of canine babesiosis

Rafaj

Matijatko

Kiš

et al. 2009

Acta Veterinaria Hungarica

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Changes in coagulation parameters were studied in dogs naturally infected with Babesia canis canis (n = 30), and haemostasis was evaluated and compared to values obtained from healthy dogs (n = 29). To date, there have not been any studies examining the dynamics of thrombin-antithrombin complex formation in cases of canine babesiosis. Coagulation parameters evaluated before (day 0) and on days 1, 2, and 3 after treatment with imidocarb (6 mg/kg inj. s.c.) included the determination of platelet counts, the formation of thrombin-antithrombin complexes (TAT), prothrombin time (PT), activated partial thromboplastin time (APTT) and antithrombin III (AT III) activity. TAT complexes were significantly elevated in animals with babesiosis on days 0 and 2 (mean 49.7 and 87.7 µg/L vs. control, 7.2 µg/L). AT III activity was significantly decreased at all time-points examined. There were no differences in PT. On days 2 and 3 the APTT was significantly shortened in the infected dogs when compared to control animals (means of 21.3 and 19.2 s vs. control, 30.0 s). Our analysis demonstrated that infected dogs had significant thrombocytopenia during the course of the study (mean day 0 -29 × 10 9 /L, day 1 -48 × 10 9 /L, day 2 -47 × 10 9 /L and day 3 -87 × 10 9 /L, vs. control -259 × 10 9 /L). These data suggest that babesiosis in dogs compromises primary and secondary haemostasis and that induction of disseminated intravascular coagulation (DIC) occurs in canine babesiosis.

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Thromboelastographic Evaluation of Hemostatic Function in Dogs with Disseminated Intravascular Coagulation

Cited by 166 publications

References 39 publications

Effect of Synthetic Colloid Administration on Coagulation in Healthy Dogs and Dogs with Systemic Inflammation

Effect of Synthetic Colloid Administration on Coagulation in Healthy Dogs and Dogs with Systemic Inflammation

Mortality in virulent canine babesiosis is associated with a consumptive coagulopathy

Alterations in some blood coagulation parameters in naturally occurring cases of canine babesiosis

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