Retrospective characterization of canine coagulopathies using the turbidimetric ACL-TOP 300 analyzer (2014–2015)

Forty-seven dogs

Rae Richardson, Jeffrey M Todd, Leslie C. Sharkey, Robert J Washabau, VMD, PhD, Kevin D. Williams, Kim J. Little, Aaron Rendahl

Research output: Contribution to journalArticle

Abstract

Objective: To characterize disseminated intravascular coagulation (DIC), liver failure (LF), post-hepatic cholestasis (PHC), and anticoagulant rodenticide intoxication (ROD) in dogs using an immunoturbidimetric coagulation analyzer and to characterize the relationship between clinical bleeding and bleeding parameters. Design: Retrospective study (August 2014–July 2015). Setting: University teaching hospital. Animals: Forty-seven client-owned dogs diagnosed with DIC (n = 24), LF (n = 9), PHC (n = 5), or ROD (n = 9) based on history, clinical pathology, cytology, histopathology. or exploratory surgery. Interventions: None. Measurements and Main Results: Median prothrombin time (PT), activated partial thromboplastin time (aPTT), and quantitative fribrinogen assay (QFA) were above the reference interval for DIC, LF, PHC and ROD with the exception of a normal QFA for LF. Clot curve analysis for DIC was characterized by elevated PT Delta, PT first derivative, and aPTT Delta, and normal for aPTT second derivative; all LF parameters were within the RI; all PHC parameters were above the RI; and ROD had elevated aPTT delta, but low aPTT second derivative. Coagulopathic bleeding recognized within the DIC group was characterized by median PT delta in mABS (milliabsorbance), first derivative and aPTT delta values in mABS within the RI at 35.0, 55.5 and 38, respectively. The nonbleeding DIC group median values of these same parameters were 189.5, 586.5 and 288, respectively. Conclusions: The classically utilized indicators of secondary hemostasis, PT and aPTT, were prolonged within all 4 groups; DIC, LF, PHC and ROD as expected. Fibrinogen concentration was increased in both PHC and ROD, decreased in LF and increased but with a bimodal distribution in DIC that correlated with clinical bleeding. The degree of PT and aPTT prolongation did not correlate with clinical bleeding in the DIC group, however clot curve analysis, did reveal an association.

Original languageEnglish (US)
Pages (from-to)551-558
Number of pages8
JournalJournal of Veterinary Emergency and Critical Care
Volume28
Issue number6
DOIs
StatePublished - Nov 1 2018

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disseminated intravascular coagulation
Disseminated Intravascular Coagulation
thromboplastin
Partial Thromboplastin Time
liver failure
Rodenticides
Canidae
rodenticides
Liver Failure
cholestasis
prothrombin
Cholestasis
Prothrombin Time
Dogs
poisoning
dogs
hemorrhage
liver
Hemorrhage
Liver

Keywords

  • bleeding disorders
  • coagulometer
  • coagulopathy
  • disseminated intravascular coagulation

PubMed: MeSH publication types

  • Journal Article

Cite this

Retrospective characterization of canine coagulopathies using the turbidimetric ACL-TOP 300 analyzer (2014–2015) : Forty-seven dogs. / Richardson, Rae; Todd, Jeffrey M; Sharkey, Leslie C.; Washabau, VMD, PhD, Robert J; Williams, Kevin D.; Little, Kim J.; Rendahl, Aaron.

In: Journal of Veterinary Emergency and Critical Care, Vol. 28, No. 6, 01.11.2018, p. 551-558.

Research output: Contribution to journalArticle

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title = "Retrospective characterization of canine coagulopathies using the turbidimetric ACL-TOP 300 analyzer (2014–2015): Forty-seven dogs",
abstract = "Objective: To characterize disseminated intravascular coagulation (DIC), liver failure (LF), post-hepatic cholestasis (PHC), and anticoagulant rodenticide intoxication (ROD) in dogs using an immunoturbidimetric coagulation analyzer and to characterize the relationship between clinical bleeding and bleeding parameters. Design: Retrospective study (August 2014–July 2015). Setting: University teaching hospital. Animals: Forty-seven client-owned dogs diagnosed with DIC (n = 24), LF (n = 9), PHC (n = 5), or ROD (n = 9) based on history, clinical pathology, cytology, histopathology. or exploratory surgery. Interventions: None. Measurements and Main Results: Median prothrombin time (PT), activated partial thromboplastin time (aPTT), and quantitative fribrinogen assay (QFA) were above the reference interval for DIC, LF, PHC and ROD with the exception of a normal QFA for LF. Clot curve analysis for DIC was characterized by elevated PT Delta, PT first derivative, and aPTT Delta, and normal for aPTT second derivative; all LF parameters were within the RI; all PHC parameters were above the RI; and ROD had elevated aPTT delta, but low aPTT second derivative. Coagulopathic bleeding recognized within the DIC group was characterized by median PT delta in mABS (milliabsorbance), first derivative and aPTT delta values in mABS within the RI at 35.0, 55.5 and 38, respectively. The nonbleeding DIC group median values of these same parameters were 189.5, 586.5 and 288, respectively. Conclusions: The classically utilized indicators of secondary hemostasis, PT and aPTT, were prolonged within all 4 groups; DIC, LF, PHC and ROD as expected. Fibrinogen concentration was increased in both PHC and ROD, decreased in LF and increased but with a bimodal distribution in DIC that correlated with clinical bleeding. The degree of PT and aPTT prolongation did not correlate with clinical bleeding in the DIC group, however clot curve analysis, did reveal an association.",
keywords = "bleeding disorders, coagulometer, coagulopathy, disseminated intravascular coagulation",
author = "Rae Richardson and Todd, {Jeffrey M} and Sharkey, {Leslie C.} and {Washabau, VMD, PhD}, {Robert J} and Williams, {Kevin D.} and Little, {Kim J.} and Aaron Rendahl",
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AU - Richardson, Rae

AU - Todd, Jeffrey M

AU - Sharkey, Leslie C.

AU - Washabau, VMD, PhD, Robert J

AU - Williams, Kevin D.

AU - Little, Kim J.

AU - Rendahl, Aaron

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N2 - Objective: To characterize disseminated intravascular coagulation (DIC), liver failure (LF), post-hepatic cholestasis (PHC), and anticoagulant rodenticide intoxication (ROD) in dogs using an immunoturbidimetric coagulation analyzer and to characterize the relationship between clinical bleeding and bleeding parameters. Design: Retrospective study (August 2014–July 2015). Setting: University teaching hospital. Animals: Forty-seven client-owned dogs diagnosed with DIC (n = 24), LF (n = 9), PHC (n = 5), or ROD (n = 9) based on history, clinical pathology, cytology, histopathology. or exploratory surgery. Interventions: None. Measurements and Main Results: Median prothrombin time (PT), activated partial thromboplastin time (aPTT), and quantitative fribrinogen assay (QFA) were above the reference interval for DIC, LF, PHC and ROD with the exception of a normal QFA for LF. Clot curve analysis for DIC was characterized by elevated PT Delta, PT first derivative, and aPTT Delta, and normal for aPTT second derivative; all LF parameters were within the RI; all PHC parameters were above the RI; and ROD had elevated aPTT delta, but low aPTT second derivative. Coagulopathic bleeding recognized within the DIC group was characterized by median PT delta in mABS (milliabsorbance), first derivative and aPTT delta values in mABS within the RI at 35.0, 55.5 and 38, respectively. The nonbleeding DIC group median values of these same parameters were 189.5, 586.5 and 288, respectively. Conclusions: The classically utilized indicators of secondary hemostasis, PT and aPTT, were prolonged within all 4 groups; DIC, LF, PHC and ROD as expected. Fibrinogen concentration was increased in both PHC and ROD, decreased in LF and increased but with a bimodal distribution in DIC that correlated with clinical bleeding. The degree of PT and aPTT prolongation did not correlate with clinical bleeding in the DIC group, however clot curve analysis, did reveal an association.

AB - Objective: To characterize disseminated intravascular coagulation (DIC), liver failure (LF), post-hepatic cholestasis (PHC), and anticoagulant rodenticide intoxication (ROD) in dogs using an immunoturbidimetric coagulation analyzer and to characterize the relationship between clinical bleeding and bleeding parameters. Design: Retrospective study (August 2014–July 2015). Setting: University teaching hospital. Animals: Forty-seven client-owned dogs diagnosed with DIC (n = 24), LF (n = 9), PHC (n = 5), or ROD (n = 9) based on history, clinical pathology, cytology, histopathology. or exploratory surgery. Interventions: None. Measurements and Main Results: Median prothrombin time (PT), activated partial thromboplastin time (aPTT), and quantitative fribrinogen assay (QFA) were above the reference interval for DIC, LF, PHC and ROD with the exception of a normal QFA for LF. Clot curve analysis for DIC was characterized by elevated PT Delta, PT first derivative, and aPTT Delta, and normal for aPTT second derivative; all LF parameters were within the RI; all PHC parameters were above the RI; and ROD had elevated aPTT delta, but low aPTT second derivative. Coagulopathic bleeding recognized within the DIC group was characterized by median PT delta in mABS (milliabsorbance), first derivative and aPTT delta values in mABS within the RI at 35.0, 55.5 and 38, respectively. The nonbleeding DIC group median values of these same parameters were 189.5, 586.5 and 288, respectively. Conclusions: The classically utilized indicators of secondary hemostasis, PT and aPTT, were prolonged within all 4 groups; DIC, LF, PHC and ROD as expected. Fibrinogen concentration was increased in both PHC and ROD, decreased in LF and increased but with a bimodal distribution in DIC that correlated with clinical bleeding. The degree of PT and aPTT prolongation did not correlate with clinical bleeding in the DIC group, however clot curve analysis, did reveal an association.

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