Thromboelastographic Evaluation of Hemostatic Function in Dogs with Disseminated Intravascular Coagulation
Article first published online: 10 MAR 2008
Copyright © 2008 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 22, Issue 2, pages 357–365, March–April 2008
How to Cite
Wiinberg, B., Jensen, A.L., Johansson, P.I., Rozanski, E., Tranholm, M. and Kristensen, A.T. (2008), Thromboelastographic Evaluation of Hemostatic Function in Dogs with Disseminated Intravascular Coagulation. Journal of Veterinary Internal Medicine, 22: 357–365. doi: 10.1111/j.1939-1676.2008.0058.x
- Issue published online: 10 MAR 2008
- Article first published online: 10 MAR 2008
- Submitted April 18, 2007; Revised June 16, 2007; Accepted November 19, 2007.
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, α, 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.