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Thromboelastography in Dogs with Chronic Hepatopathies

BACKGROUND: The coagulation status of dogs with liver disease is difficult to predict using conventional coagulation testing. HYPOTHESIS/OBJECTIVES: To evaluate thromboelastography (TEG) results and associations with conventional coagulation results and indicators of disease severity and prognosis i...

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Autores principales: Fry, W., Lester, C., Etedali, N.M., Shaw, S., DeLaforcade, A., Webster, C.R.L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354028/
https://www.ncbi.nlm.nih.gov/pubmed/28097681
http://dx.doi.org/10.1111/jvim.14639
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author Fry, W.
Lester, C.
Etedali, N.M.
Shaw, S.
DeLaforcade, A.
Webster, C.R.L.
author_facet Fry, W.
Lester, C.
Etedali, N.M.
Shaw, S.
DeLaforcade, A.
Webster, C.R.L.
author_sort Fry, W.
collection PubMed
description BACKGROUND: The coagulation status of dogs with liver disease is difficult to predict using conventional coagulation testing. HYPOTHESIS/OBJECTIVES: To evaluate thromboelastography (TEG) results and associations with conventional coagulation results and indicators of disease severity and prognosis in dogs with chronic hepatopathies (CH). ANIMALS: Twenty‐one client‐owned dogs. METHODS: Dogs with CH were prospectively (10 dogs) and retrospectively (11 dogs) enrolled from 2008 to 2014. Kaolin‐activated TEG was performed and compared with reference intervals by t‐tests or Mann‐Whitney tests. Correlation coefficients for TEG results and conventional coagulation and clinicopathologic results were determined. Significance was set at P < .05. RESULTS: Dogs with CH had significant increases in R (5.30 min vs 4.33 min), K (3.77 min vs 2.11 min), and LY30 (4.77% vs 0.68%) and decreased angles (55.3° vs 62.4°). G value defined 9 of 21, 7 of 21, and 5 of 21 dogs as normocoagulable, hypercoagulable, and hypocoagulable, respectively. G and MA were correlated with fibrinogen (r = 0.68, 0.83), prothrombin time (PT; r = −0.51, −0.53), and activated partial thromboplastin time (aPTT; r = −0.50, −0.50). K was correlated with PT (r = 0.75) and protein C activity (r = −0.92). Angle was correlated with aPTT (r = −0.63). Clinical score was correlated with PT (r = 0.60), MA (r = −0.53), and R (r = −0.47). Dogs with hyperfibrinolysis (LY30 > 3.04%; 5 of 21) had significantly higher serum transaminase activities. Dogs with portal hypertension had significantly lower G, MA, and angle and prolonged, K, R, and PT. CONCLUSIONS AND CLINICAL RELEVANCE: Dogs with CH have variable TEG results. Negative prognostic indicators in CH correlate with hypocoagulable parameters on TEG. Hyperfibrinolysis in dogs with CH is associated with high disease activity.
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spelling pubmed-53540282017-03-22 Thromboelastography in Dogs with Chronic Hepatopathies Fry, W. Lester, C. Etedali, N.M. Shaw, S. DeLaforcade, A. Webster, C.R.L. J Vet Intern Med SMALL ANIMAL BACKGROUND: The coagulation status of dogs with liver disease is difficult to predict using conventional coagulation testing. HYPOTHESIS/OBJECTIVES: To evaluate thromboelastography (TEG) results and associations with conventional coagulation results and indicators of disease severity and prognosis in dogs with chronic hepatopathies (CH). ANIMALS: Twenty‐one client‐owned dogs. METHODS: Dogs with CH were prospectively (10 dogs) and retrospectively (11 dogs) enrolled from 2008 to 2014. Kaolin‐activated TEG was performed and compared with reference intervals by t‐tests or Mann‐Whitney tests. Correlation coefficients for TEG results and conventional coagulation and clinicopathologic results were determined. Significance was set at P < .05. RESULTS: Dogs with CH had significant increases in R (5.30 min vs 4.33 min), K (3.77 min vs 2.11 min), and LY30 (4.77% vs 0.68%) and decreased angles (55.3° vs 62.4°). G value defined 9 of 21, 7 of 21, and 5 of 21 dogs as normocoagulable, hypercoagulable, and hypocoagulable, respectively. G and MA were correlated with fibrinogen (r = 0.68, 0.83), prothrombin time (PT; r = −0.51, −0.53), and activated partial thromboplastin time (aPTT; r = −0.50, −0.50). K was correlated with PT (r = 0.75) and protein C activity (r = −0.92). Angle was correlated with aPTT (r = −0.63). Clinical score was correlated with PT (r = 0.60), MA (r = −0.53), and R (r = −0.47). Dogs with hyperfibrinolysis (LY30 > 3.04%; 5 of 21) had significantly higher serum transaminase activities. Dogs with portal hypertension had significantly lower G, MA, and angle and prolonged, K, R, and PT. CONCLUSIONS AND CLINICAL RELEVANCE: Dogs with CH have variable TEG results. Negative prognostic indicators in CH correlate with hypocoagulable parameters on TEG. Hyperfibrinolysis in dogs with CH is associated with high disease activity. John Wiley and Sons Inc. 2017-01-18 2017 /pmc/articles/PMC5354028/ /pubmed/28097681 http://dx.doi.org/10.1111/jvim.14639 Text en Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle SMALL ANIMAL
Fry, W.
Lester, C.
Etedali, N.M.
Shaw, S.
DeLaforcade, A.
Webster, C.R.L.
Thromboelastography in Dogs with Chronic Hepatopathies
title Thromboelastography in Dogs with Chronic Hepatopathies
title_full Thromboelastography in Dogs with Chronic Hepatopathies
title_fullStr Thromboelastography in Dogs with Chronic Hepatopathies
title_full_unstemmed Thromboelastography in Dogs with Chronic Hepatopathies
title_short Thromboelastography in Dogs with Chronic Hepatopathies
title_sort thromboelastography in dogs with chronic hepatopathies
topic SMALL ANIMAL
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354028/
https://www.ncbi.nlm.nih.gov/pubmed/28097681
http://dx.doi.org/10.1111/jvim.14639
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