Viscoelastic coagulation monitoring parameters in cats with acute arterial thromboembolism.

Background: Hypercoagulability has been documented in cats with cardiac disease. However, hemostatic parameters, including viscoelastic coagulation monitoring (VCM) have not been reported in cats with arterial thromboembolism (ATE).

Hypothesis/objectives: Compare VCM parameters in cats with acute cardiogenic ATE and in control cats.

Rapid resolution of hyperfibrinolysis in dogs with spontaneous hemoperitoneum following surgical control of hemorrhage.

Objective: To estimate the point prevalence and duration of hyperfibrinolysis (HF) in dogs undergoing surgical control of spontaneous hemoperitoneum (SHP).

Design: Prospective observational study.

Setting: Single veterinary teaching hospital.

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.

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.

The Use of Antithrombotics in Critical Illness.

Hypercoagulable tendencies may develop in critically ill dogs and to a less known extent, cats. Although the use of antithrombotics is well-established in critically ill people, the indications and approach are far less well-known in dogs and cats. The goal of this article was to review the relevant CURATIVE guidelines, as well as other sources, and to provide recommendations for critically ill patients with directions for future investigation.

Postoperative thrombocytosis and thromboelastographic evidence of hypercoagulability in dogs undergoing splenectomy for splenic masses.

Objective: To determine the frequency and severity of thrombocytosis and thromboelastographic evidence of hypercoagulability during the first 2 weeks after splenectomy in dogs with splenic masses and to investigate relationships between platelet counts and thromboelastography values.

Animals: 34 dogs undergoing splenectomy for splenic masses.

Procedures: Blood samples for platelet counts and thromboelastography were obtained at induction of anesthesia (day 0) prior to splenectomy and on days 2, 7, and 14.

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.

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.

Evaluation of thromboelastography in bitches with pyometra.

We investigated the effect of pyometra on kaolin-activated thromboelastography (TEG). Eighteen client-owned dogs with pyometra and 8 healthy spayed dogs were recruited. TEG parameters and packed cell volume were determined.

Adult-onset, chronic, cyclic thrombocytopenia in a Rhesus macaque (Macaca mulatta) after dengue virus vaccination and viral challenge.

An 8-year-old, male Rhesus macaque (Macaca mulatta), previously used for dengue virus (DENV) vaccine research with viral challenge, was presented with adult-onset, chronic, cyclic thrombocytopenia. Platelet number, morphology, and function were evaluated by automated hematology, peripheral blood smears, electron microscopy, flow cytometry, and impedance aggregometry. Bone marrow was evaluated by cytology.

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.

The impact of schistosomes and schistosomiasis on murine blood coagulation and fibrinolysis as determined by thromboelastography (TEG).

Schistosomes are parasitic platyhelminths that currently infect over 200 million people and cause the chronic debilitating disease schistosomiasis. While these large intravascular parasites can disturb blood flow, surprisingly they do not appear to provoke thrombus formation around them in vivo. In order to determine if the worms can alter their local environment to impede coagulation, we incubated adult worms (50 pairs) in murine blood (500 µl) for 1 h at 37 °C and, using thromboelastography (TEG), we compared the coagulation profile of the blood with control blood that never contained worms.

Assessment of the relationships among coagulopathy, hyperfibrinolysis, plasma lactate, and protein C in dogs with spontaneous hemoperitoneum.

Objective: To relate coagulation and fibrinolysis derangements to shock severity as reflected by plasma lactate concentrations in dogs with spontaneous hemoperitoneum (SHP) and determine the impact on transfusions.

Design: Prospective, observational, case-control study.

Setting: Three veterinary teaching hospitals.

Platelet activation in a population of critically ill dogs as measured with whole blood flow cytometry and thromboelastography.

Objective: To determine whether critically ill dogs had increased platelet activation and whether the proportion of activated platelets correlated with severity of illness.

Animals: 82 dogs in the intensive care unit of a veterinary teaching hospital and 24 healthy control dogs.

Procedures: Flow cytometry with monoclonal mouse anti-human CD61 and CD62 antibodies in resting and ADP-treated samples and kaolin-activated thromboelastography were used to compare platelet activation in blood samples of critically ill and control dogs.

Clinical outcome after diagnosis of hemophilia A in dogs.

Objective: To evaluate the clinical course of dogs with hemophilia A (factor VIII deficiency) and to determine whether factor VIII coagulant activity (FVIII:C) was associated with severity of clinical signs and outcome.

Design: Survey study.

Sample: Respondent information for 39 client-owned dogs with FVIII deficiency.

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.

An ex vivo evaluation of efficacy of refrigerated canine plasma.

Objectives: To determine thawing times of fresh frozen plasma (FFP), and to evaluate the activity of hemostatic proteins (coagulation factors V, VII, VIII, IX, X, and fibrinogen), clotting times (prothrombin time and activated partial thromboplastin time), and sterility of canine plasma stored refrigerated.

Design: Prospective laboratory-based study.

Setting: Veterinary teaching hospital blood bank.

Partnership on Rotational ViscoElastic Test Standardization (PROVETS): evidence-based guidelines on rotational viscoelastic assays in veterinary medicine.

Objective: To systematically examine the evidence relating to the performance of rotational viscoelastic testing in companion animals, to develop assay guidelines, and to identify knowledge gaps.

Design: Multiple questions were considered within 5 parent domains, specifically system comparability, sample handling, assay activation and test protocol, definitions and data reporting, and nonstandard assays. Standardized, systematic evaluation of the literature was performed.

Hypoperfusion and acute traumatic coagulopathy in severely traumatized canine patients.

Objective: To determine the incidence of acute traumatic coagulopathy in dogs suffering severe trauma and to investigate the association of markers of hypoperfusion with coagulation abnormalities.

Design: A prospective observational study performed June, 2009 to February, 2011.

Setting: A university teaching hospital.

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.