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Hypoperfusion and acute traumatic coagulopathy in severely traumatized canine patients

Authors

  • Amanda L. Abelson DVM, DACVECC,

    Corresponding authorCurrent affiliation:
    1. Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
    • Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536
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  • Therese E. O'Toole DVM, DACVIM, DACVECC,

    1. Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536
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  • Andrea Johnston DVM,

    1. Department of Clinical Sciences, School of Veterinary Medicine, Cornell University, Ithaca, NY 14850
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  • Meghan Respess DVM,

    1. Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536
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  • Armelle M. de Laforcade DVM, DACVECC

    1. Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536
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  • This work was conducted at the Cummings School of Veterinary Medicine at Tufts University.

  • This study was funded by a private grant.

  • The authors declare no conflict of interest.

Address correspondence and reprint requests to Dr. Amanda L. Abelson, Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, USA. Email: amanda.abelson@tufts.edu

Abstract

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.

Animals

Thirty client-owned dogs weighing >5 kilograms that were presented to the Tuft's Cummings School of Veterinary Medicine following severe trauma as defined by an animal trauma triage score (ATT) ≥5 and having received no resuscitation with IV fluids or blood products prior to blood sampling.

Interventions

None.

Measurements and Main Results

Prior to resuscitation, data obtained at the time of admission to the emergency service included HCT, platelet count, lactate concentration, pH, base excess, thromboelastrogram (TEG), prothrombin time, activated partial thromboplastin time, fibrinogen level, and protein C activity. Rectal temperature and ATT were recorded for all dogs. Neither HCT nor platelet count was significantly decreased in any of the dogs. Based on G values as measured by TEG, 10/30 dogs (33%) showed evidence of hypercoagulability. Hypocoagulability as determined by prothrombin time, activated partial thromboplastin time, or TEG was not shown in any of the 30 dogs.

Conclusion

Dogs with severe trauma may experience hypercoagulability that is unrelated to fluid resuscitation or transfusion therapy. Future studies are warranted to better characterize coagulation changes in dogs with severe trauma, particularly in relationship to fluid therapies and/or hemorrhage.

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