Evaluation of a Viscoelastic Coagulation Monitoring System (VCM Vet(®)) and Its Correlation with Thromboelastometry (ROTEM(®)) in Diseased and Healthy Dogs

SIMPLE SUMMARY: Viscoelastic coagulation testing provides an assessment of global coagulation in whole blood, from the beginning of clot formation to clot lysis. A novel bed-side viscoelastic coagulation monitor (VCM) has been developed for use in small animals. The aims of this study were to determine inter-device agreement of two VCM devices, to evaluate the correlation between VCM and rotational thromboelastometry (ROTEM), and to determine the accuracy of VCM to diagnose hypo-, normo-, and hypercoagulability. ROTEM analysis was performed using anticoagulated blood and VCM analysis using native blood. Twenty healthy and forty diseased dogs with and without coagulopathies were enrolled. The VCM inter-device agreement was moderate to strong for most of the parameters. Correlation between VCM and ROTEM was moderate to strong for parameters of clotting time and clot strength. The VCM most likely detects true hypocoagulability and thus can reliably rule out hypocoagulability. The VCM has a high sensitivity for diagnosing normocoagulability, but incorrectly classified dogs with abnormal coagulation as normocoagulable. The VCM was not able to detect hypercoagulability. ROTEM and VCM cannot be used interchangeably. ABSTRACT: Thromboelastometry provides a real-time assessment of global coagulation in whole blood. A novel bed-side viscoelastic coagulation monitor (VCM) has been developed for use in small animals. The aims of the study were to determine inter-device agreement of two VCM devices, to evaluate the correlation between VCM and rotational thromboelastometry as a reference method (ROTEM), and to determine the sensitivity and specificity of VCM to diagnose hypo-, normo-, and hypercoagulability. ROTEM (extrinsic and intrinsic activation) analysis was performed using citrated blood and VCM analysis using native blood. Twenty healthy and forty diseased dogs with and without coagulopathies were enrolled. The VCM inter-device agreement was moderate to strong for most of the parameters, depending on the grading scale. Correlation between VCM and ROTEM was moderate to strong for parameters of clotting time and clot strength. The VCM most likely detects true hypocoagulability and reliably rules out hypocoagulability. The VCM has a high sensitivity in diagnosing normocoagulability, but incorrectly classified dogs with abnormal coagulation as normocoagulable. The VCM was not able to detect hypercoagulability. ROTEM and VCM cannot be used interchangeably.