Tranexamic acid stops hyperfibrinolysis in dogs with hemorrhagic shock: a randomized, controlled clinical trial.

Objective: To determine the effect of tranexamic acid (TXA) on clot hyperfibrinolysis (HF), defined as excessive clot lysis at 30 minutes (LY30%), with rapid thromboelastography (rTEG) or rTEG samples spiked with tissue plasminogen activator (tPA-stressed rTEG), in dogs with hemorrhagic shock.

Methods: Prospective blinded clinical trial at 2 teaching hospitals, March 16, 2018, to May 20, 2022. Twenty-five dogs with hemorrhagic shock and HF were treated with standard care plus either TXA (20 mg/kg; TXA group) or saline (SAL group) over 20 minutes followed by an infusion of the same dose over 8 hours.

Kaolin activation of recalcified citrated whole blood in a point-of-care viscoelastic coagulation test.

The viscoelastic coagulation monitor (VCM) is described as a point-of-care analyzer relying on activation of fresh whole blood (FWB) contact between 2 glass plates. Kaolin is used as an activator in thromboelastography to reduce variability and shorten clotting times. The goal of this study was to compare VCM results from kaolin-activated, recalcified citrated samples with that from FWB.

Viscoelastic Coagulation Testing in Exotic Animals.

Whole blood viscoelastic coagulation testing (VCT) allows global assessment of hemostasis and fibrinolysis. Although not widely used in exotic animal practice, VCT has been used in exotic animal research settings. Differences in patient demographics and analytical variables can result in dramatically different results with the same analyzer.

2022 Update of the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) Domain 1- Defining populations at risk.

Objectives: To expand the number of conditions and interventions explored for their associations with thrombosis in the veterinary literature and to provide the basis for prescribing recommendations.

Design: A population exposure comparison outcome format was used to represent patient, exposure, comparison, and outcome. Population Exposure Comparison Outcome questions were distributed to worksheet authors who performed comprehensive searches, summarized the evidence, and created guideline recommendations that were reviewed by domain chairs.

Evaluation of coagulation parameters in dogs with gallbladder mucoceles.

Background: Gallbladder mucocele (GBM) is a common biliary disorder in dogs. Limited information is available on the coagulation status of dogs with GBM.

Hypothesis/objectives: To determine patterns of coagulation alterations in dogs with GBM and correlate them with clinicopathologic abnormalities and ultrasonographic findings of disease severity.

Effect of time until sample analysis on lactate in dogs with shock.

Introduction: Lactate concentrations can increase with hypoperfusion in dogs and could be used as a prognostic indicator in sick dogs. In a busy emergency service, sample evaluation could be delayed. However, sample evaluation delays have been shown to cause lactate concentration increases in healthy dogs.

Clinical application of the American College of Veterinary Emergency and Critical Care (ACVECC) Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines to small animal cases.

Objective: To illustrate the application of the Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines to the management of dogs and cats at risk of developing thrombosis using a case-based approach.

Etiology: Dogs and cats become at risk of developing thrombosis from a wide range of conditions. These conditions often involve a specific insult followed by an inflammatory response and when combined with other contributing factors (eg, hypercoagulability, vascular endothelial injury, hemodynamic changes) create favorable conditions for thrombosis.

Effect of urinary bladder lavage on in-hospital recurrence of urethral obstruction and durations of urinary catheter retention and hospitalization for male cats.

OBJECTIVE To evaluate the effect of urinary bladder lavage on in-hospital recurrence of urethral obstruction (UO) and durations of urinary catheter retention and hospitalization for male cats. DESIGN Randomized controlled clinical trial. ANIMALS 137 male cats with UO.

Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 1-Defining populations at risk.

Objectives: Thrombosis is a well-recognized phenomenon in dogs and cats with a significant impact on morbidity and mortality. Despite growing awareness of thrombosis and increased use of antithrombotic therapy, there is little information in the veterinary literature to guide the use of anticoagulant and antiplatelet medications. The goal of Domain 1 was to explore the association between disease and thrombosis in a number of conditions identified as potential risk factors in the current veterinary literature, to provide the basis for prescribing recommendations.

American College of Veterinary Emergency and Critical Care (ACVECC) Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines: Small animal.

Objectives: To systematically review available evidence and establish guidelines related to the risk of developing thrombosis and the management of small animals with antithrombotics.

Design: Standardized, systematic evaluation of the literature (identified by searching Medline via PubMed and CAB abstracts) was carried out in 5 domains (Defining populations at risk; Defining rational therapeutic use; Defining evidence-based protocols; Refining and monitoring antithrombotic therapies; and Discontinuing antithrombotic therapies). Evidence evaluation was carried out using Population, Intervention, Comparison, Outcome generated within each domain questions to address specific aims.

Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 4-Refining and monitoring antithrombotic therapies.

Objectives: To systematically review the evidence for therapeutic monitoring of antithrombotic drugs in small animals, develop guidelines regarding antithrombotic monitoring, and identify knowledge gaps in the field.

Design: First, a standardized, systematic literature review was conducted to address predefined PICO (Population/Patient, Intervention, Control, Outcome) questions, with categorization of relevant articles according to level of evidence and quality. Preliminary guidelines were developed by PICO worksheet authors and the domain chair.

The Essential Ectoenzyme SmNPP5 from the Human Intravascular Parasite Schistosoma mansoni is an ADPase and a Potent Inhibitor of Platelet Aggregation.

Schistosomes are intravascular parasitic platyhelminthes infecting > 200 million people globally and causing a debilitating disease, schistosomiasis. Despite the relatively large size of the adult worms and their disruption of blood flow, surprisingly, they do not appear to provoke thrombus formation around them in vivo. We hypothesize that proteins expressed at the host-parasite interface are key to this ability.

Effect of transoral tracheal wash on respiratory mechanics in dogs with respiratory disease.

The purpose of this study was to determine the impact of a transoral tracheal wash (TOTW) on respiratory mechanics in dogs and to describe the use of a critical care ventilator (CCV) to determine respiratory mechanics. Fourteen client-owned dogs with respiratory diseases were enrolled. Respiratory mechanics, including static compliance (C) and static resistance (R), were determined before and after TOTW.

Severe brachycephalic obstructive airway syndrome is associated with hypercoagulability in dogs.

We evaluated whether dogs with severe brachycephalic obstructive airway syndrome (BOAS) developed a hypercoagulable state similar to people with obstructive sleep apnea. Five dogs with grade 3 BOAS were included as well as 5 healthy control Labrador Retrievers. Venous blood samples were collected from each dog for performance of thromboelastography and determination of hematocrit and platelet count.

Assessment of hemostatic changes in a model of acute hemorrhage in dogs.

Objective: To evaluate hemostatic changes following experimental acute hemorrhage in dogs using traditional coagulation tests (eg, platelet count, prothrombin time [PT], and activated partial thromboplastin time [aPTT]), kaolin-activated thromboelastography (TEG), and whole blood multiple electrode impedance platelet aggregometry.

Design: Prospective study.

Setting: Research laboratory.

Effects of in vitro hemodilution with crystalloids, colloids, and plasma on canine whole blood coagulation as determined by kaolin-activated thromboelastography.

Objective: To investigate the effects of in vitro hemodilution with lactated Ringers solution (LRS), hetastarch (HES), and fresh frozen plasma (FFP) on whole blood coagulation in dogs as assessed by kaolin-activated thromboelastography.

Design: In vitro experimental study.

Setting: University teaching hospital.

Clinical experience of anti-Xa monitoring in critically ill dogs receiving dalteparin.

Objectives: To describe a population of critically ill dogs receiving dalteparin monitored with an anti-Xa assay, to assess the potential utility of serial monitoring, and to investigate the association between pre-treatment thromboelastography (TEG) and the ability to achieve targeted anti-Xa activity.

Design: Descriptive retrospective study.

Setting: Veterinary teaching hospital.

Systematic evaluation of evidence on veterinary viscoelastic testing part 3: Assay activation and test protocol.

Objective: To systematically examine the evidence on activating agents and test protocols for the thrombelastography (TEG) and rotational thrombelastometry (ROTEM) viscoelastic point-of-care instruments and to identify knowledge gaps.

Design: Ten questions were considered, the primary question addressed the use of activating agents and secondary questions addressed assay temperature, length of analysis, pipetting, sample volume, reproducibility, and quality controls. Standardized, systematic evaluation of the literature was performed.

Iatrogenic water intoxication in two cats.

Objective: To describe 2 cats that developed acute iatrogenic water intoxication, one associated with a continuous infusion of water provided via an esophagostomy tube and one following SC administration of 5% dextrose in water (D5W).

Case Or Series Summary: A 10-year-old cat with squamous cell carcinoma was hospitalized for treatment of dehydration. Rehydration was provided with water via an esophagostomy tube at 5.

Kaolin-activated thromboelastography in echocardiographically normal cats.

Objective: To determine reference values for kaolin-activated thromboelastography in echocardiographically normal cats.

Animals: 30 healthy cats without evidence of cardiomyopathy on echocardiographic examination.

Procedures: All cats underwent echocardiographic examination, the findings of which were reviewed by a board-certified cardiologist.

Investigating hypercoagulability during treatment for immune-mediated thrombocytopenia: a pilot study.

Background: Thromboembolism has recently been described as a complication following treatment for idiopathic thrombocytopenic purpura (ITP). This pilot study was undertaken to determine whether dogs suffering from ITP experience hypercoagulability during treatment and recovery.

Study Design: Thromboelastograms (TEG) were performed on dogs with ITP within 24 hours of admission to the hospital, the first day the platelet count exceeded 40 × 10(9) /L (Day 1), and on Days 4, 7, and 14.

Identification of hypercoagulability in dogs with primary immune-mediated hemolytic anemia by means of thromboelastography.

Objective: To evaluate whole blood hemostasis by means of thromboelastography in dogs with primary immune-mediated hemolytic anemia (IMHA) to determine whether these dogs had evidence of hypercoagulability prior to the administration of immunosuppressant medications, blood transfusion products, or anticoagulant agents.

Design: Evaluation study.

Animals: 11 client-owned dogs admitted to a teaching hospital for management of primary IMHA and 20 clinically normal dogs.

Treatment and predictors of outcome in dogs with immune-mediated thrombocytopenia.

Objective: To characterize the clinical course of disease and identify prognostic indicators for immune-mediated thrombocytopenia in dogs.

Design: Retrospective cohort study.

Animals: 73 dogs treated for immune-mediated thrombocytopenia at the Foster Hospital for Small Animals at the Tufts Cummings School of Veterinary Medicine and the Tufts Veterinary Emergency Treatment and Specialties Hospital.