Thromboelastographic evaluation of hemostatic function in dogs with disseminated intravascular coagulation

J Vet Intern Med. 2008 Mar-Apr;22(2):357-65. doi: 10.1111/j.1939-1676.2008.0058.x. Epub 2008 Mar 10.

Abstract

Background: There is considerable variation in the coagulation profile of dogs with disseminated intravascular coagulation (DIC), making it difficult to assess overall hemostatic function.

Objectives: To characterize the overall hemostatic state in dogs with DIC, by use of tissue factor-activated thromboelastography (TF-TEG), and to determine whether there is an association between hemostasis and outcome.

Animals: 50 dogs with DIC.

Methods: Dogs admitted to the intensive care units, with an underlying disease known to predispose to DIC, were prospectively assessed with TF-TEG. Citrated blood samples were collected daily during hospitalization and an extended coagulation panel and TF-TEG were performed. Diagnosis of DIC was based on expert opinion.

Results: Hemostatic dysfunction was observed on the TF-TEG profile in 33/50 of the dogs, of which 22/50 were hypercoagulable and 11/50 were hypocoagulable based on the TF-TEG G value alone. There were significant differences in k, alpha, and MA values (P < .0001) among hypo-, normo-, and hypercoagulable dogs. There was a significant difference in case fatality rate between hypo- (64%) and hypercoagulable (32%) dogs (relative risk = 2.38; P= .04). Dogs that died had significantly lower antithrombin activity (P= .03) and higher d-dimer concentration (P= .03) than survivors.

Conclusions: The most common overall hemostatic abnormality in dogs diagnosed with DIC was hypercoagulability, and there was significant difference in survival between hyper- and hypocoagulable dogs. The results suggest TF-TEG is valuable in the assessment of hemostatic function in dogs diagnosed with DIC.

MeSH terms

  • Animals
  • Disseminated Intravascular Coagulation / blood
  • Disseminated Intravascular Coagulation / veterinary*
  • Dog Diseases / blood*
  • Dogs
  • Female
  • Hemostasis / physiology*
  • Male
  • Thrombelastography / veterinary*
  • Whole Blood Coagulation Time / veterinary