This study was supported by a grant from the Companion Animal Health Fund at TCSVM.
Thromboelastographic Evaluation of Dogs with Congenital Portosystemic Shunts
Article first published online: 1 JUL 2013
Copyright © 2013 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 27, Issue 5, pages 1262–1267, September/October 2013
How to Cite
Kelley, D., Lester, C., DeLaforcade, A. and Webster, C.R.L. (2013), Thromboelastographic Evaluation of Dogs with Congenital Portosystemic Shunts. Journal of Veterinary Internal Medicine, 27: 1262–1267. doi: 10.1111/jvim.12130
- Issue published online: 13 SEP 2013
- Article first published online: 1 JUL 2013
- Manuscript Accepted: 21 MAY 2013
- Manuscript Revised: 3 MAY 2013
- Manuscript Received: 4 DEC 2012
- Companion Animal Health Fund at TCSVM
- Hepatic disease
On plasma-based assays, dogs with congenital portosystemic shunts (CPSS) have changes in serum concentrations of both pro- and anticoagulant proteins, but how these abnormalities affect whole blood coagulation assays (eg, thromboelastography) are unknown.
To conduct kaolin-activated thromboelastography (TEG) analysis in dogs with CPSS and to compare TEG coagulation status with clinical presentation, routine serum biochemistry, and plasma-based coagulation tests.
Twenty-one client-owned dogs with CPSS confirmed by ultrasound examination or nuclear scintigraphy.
In a prospective study, signalment, clinical presentation, TEG analysis, CBC, serum biochemistry, and hemostatic tests (platelet count, prothrombin time [PT], activated partial thromboplastin time [aPTT], quantitative fibrinogen, antithrombin [AT] activity, protein C [PC] activity, d-dimers, and factor VIII activity) were analyzed in dogs with CPSS.
Dogs with CPSS had significantly shorter K values and increased angle, maximum amplitude (MA), and G values compared with the reference population. On plasma-based coagulation testing, dogs with CPSS had significantly prolonged PT, lower platelet counts, lower AT and PC activities, and increased d-dimers and factor VIII activity. Evaluation of G value defined 9/21 dogs with CPSS as hypercoagulable. These dogs were more likely to have hepatic encephalopathy (HE) than CPSS dogs that had normal coagulation.
Conclusions and Clinical Importance
TEG analysis detected hemostatic abnormalities consistent with a hypercoagulable state in some dogs with CPSS. The presence of a hypercoagulable state was 40 times more likely in dogs with symptomatic HE.