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Perry KM, Enders BD, Negrão Watanabe TT. Refractory shock, hypercoagulability, and multiorgan thrombosis associated with hypertrophic osteodystrophy in a dog. J Vet Emerg Crit Care (San Antonio) 2023; 33:257-262. [PMID: 36799891 DOI: 10.1111/vec.13280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/07/2022] [Accepted: 02/26/2022] [Indexed: 02/18/2023]
Abstract
OBJECTIVE To describe the clinical findings and case progression in a dog presenting with severe systemic inflammatory response, refractory shock, progressive metabolic acidosis, and respiratory failure that was ultimately diagnosed with hypertrophic osteodystrophy (HOD). CASE SUMMARY A 4-month-old male intact Mastiff presented with a 24-hour history of lethargy and generalized ostealgia. On examination, the dog was recumbent, febrile, and tachycardic with pain on palpation of the abdomen, right femur, and mandible. Appendicular joint radiographs showed changes consistent with osteochondrosis and ulnar-retained cartilaginous cores, with no overt evidence of HOD. Initial treatment included IV fluid therapy, multimodal analgesia, and broad-spectrum antimicrobials. Vasopressor therapy was initiated following hemodynamic decompensation. Synovial fluid cytological analysis and culture revealed nonseptic suppurative inflammation and no bacterial growth, respectively. Blood and urine cultures also yielded no growth. Viscoelastic testing was consistent with hypercoagulability. The dog initially had a metabolic acidosis with appropriate respiratory compensation that progressed to a mixed metabolic and respiratory acidosis despite aggressive therapies that included antimicrobials, vasopressors, positive inotropes, and corticosteroids. Humane euthanasia was elected approximately 32 hours after admission. Necropsy yielded a diagnosis of HOD. NEW OR UNIQUE INFORMATION PROVIDED This is the first report detailing the occurrence of refractory shock and hypercoagulability associated with HOD in a dog without evidence of another identified comorbidity. HOD should be considered in any young, large-breed dog with generalized ostealgia and signs of systemic illness, even in the absence of classic radiographic abnormalities. Further investigation of coagulation status in dogs with HOD and a secondary systemic inflammatory response is warranted.
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Affiliation(s)
- Kayla M Perry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Brittany D Enders
- Small Animal Emergency and Triage Services, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
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Lemon AV, Goddard A, Hooijberg EH. Effects of storage time and temperature on thromboelastographic analysis in dogs and horses. Vet Clin Pathol 2021; 50:9-19. [PMID: 33622027 DOI: 10.1111/vcp.12980] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 04/01/2020] [Accepted: 05/05/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND The accessibility of thromboelastography (TEG) to general practitioners is limited by short sample storage times (30 minutes) and storage temperatures (20-23°C). OBJECTIVES We aimed to evaluate the stability of canine and equine citrated blood samples when stored for extended periods of time, both at room temperature (RT) (20-23°C) and refrigerator temperature (FT) (2-7.5°C). METHODS Citrated whole blood samples from healthy dogs and horses (n = 10 for each) were stored for 30 minutes (baseline) at RT before TEG analysis. Baseline values for TEG variables R, K, α, MA, LY30, and LY60 were compared with those from samples stored for 2, 8, and 22.5 h, at RT and FT. Results were compared using an ANOVA (P < .05). Total allowable analytical error (TEa ) based on biological variation data was used to evaluate stability. RESULTS In dogs, statistically significant differences included shorter R, longer K, decreased MA, and increased LY60 at various time points and storage temperatures from 2 h onward. Only samples stored for 2 h at FT showed acceptable stability compared with TEa . In horses, statistically significant differences included shorter R and K, and decreased α, LY30, and LY60 at various time points and storage temperatures from 2 h onward. Samples were not stable at any time compared with TEa , regardless of the temperature. CONCLUSIONS In this study, canine samples could be stored for up to 2 h at FT without affecting TEG results; equine samples should be stored for 30 minutes at RT.
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Affiliation(s)
- Ashleigh V Lemon
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Amelia Goddard
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Emma H Hooijberg
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
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3
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Mansi ET, Waldrop JE, Davidow EB. Retrospective evaluation of the indications, safety and effects of fresh frozen plasma transfusions in 36 cats (2014-2018). J Feline Med Surg 2020; 22:696-704. [PMID: 31576775 PMCID: PMC10814499 DOI: 10.1177/1098612x19876728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The goals of this study were to classify the indications, risks, effects on coagulation times and outcomes of cats receiving fresh frozen plasma (FFP) transfusions in clinical practice. METHODS This was a retrospective study of FFP transfusions administered in two referral hospitals from 2014 to 2018. Transfusion administration forms and medical records were reviewed. Information was collected on indication, underlying condition, coagulation times and signs of transfusion reactions. Seven-day outcomes after FFP administration were also evaluated when available. RESULTS Thirty-six cats received 54 FFP transfusions. Ninety-four percent of cats were administered FFP for treatment of a coagulopathy. Twenty cats had paired coagulation testing before and after FFP administration. Eighteen of these cats had improved coagulation times after receiving 1-3 units of FFP. Eight of the 36 cats had probable transfusion reactions (14.8% of 54 FFP transfusions). These reactions included respiratory signs (n = 4), fever (n = 2) and gastrointestinal signs (n = 2). Five of the eight cats with probable reactions had received packed red blood cells contemporaneously. Overall mortality rate during hospitalization was 29.7%, with 52.8% (n = 19/36) of cats confirmed to be alive 7 days after discharge. CONCLUSIONS AND RELEVANCE This retrospective study shows that FFP transfusions improve coagulation times in cats. Transfusion reactions are a risk, and risk-benefit ratios must be measured prior to administration and possible reactions monitored. In the study cats, the FFP transfusions appeared to be a tolerable risk given the benefit to prolonged coagulation times.
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Affiliation(s)
- Elizabeth T Mansi
- Emergency and Critical Care Service, BluePearl Veterinary Partners, Seattle, WA, USA
| | - Jennifer E Waldrop
- Emergency and Critical Care Service, BluePearl Veterinary Partners, Seattle, WA, USA
| | - Elizabeth B Davidow
- Emergency and Critical Care Service, BluePearl Veterinary Partners, Seattle, WA, USA
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Corda A, Pinna Parpaglia ML, Sotgiu G, Zobba R, Gomez Ochoa P, Prieto Ramos J, French A. Use of 2-dimensional speckle-tracking echocardiography to assess left ventricular systolic function in dogs with systemic inflammatory response syndrome. J Vet Intern Med 2019; 33:423-431. [PMID: 30773683 PMCID: PMC6430955 DOI: 10.1111/jvim.15438] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 01/18/2019] [Indexed: 02/06/2023] Open
Abstract
Background Early identification of systolic dysfunction in dogs with systemic inflammatory response syndrome (SIRS) potentially could improve the outcome and decrease mortality. Objective To compare 2‐dimensional speckle tracking (2D‐STE) with 2‐dimensional (2D) and M‐mode echocardiography in the evaluation of systolic function in SIRS dogs. Animals Seventeen SIRS and 17 healthy dogs. Methods Prospective observational case‐control study. Each dog underwent physical examination, conventional echocardiography, 2D‐STE, and C‐reactive protein measurement. Results Dogs with SIRS had lower 2D‐STE ejection fraction (X4D‐EF; 44 ± 8 versus 53 ± 8; P = .003), endocardial global longitudinal strain (ENDO‐G‐Long‐St; −14.6 ± 3.2 versus −18.5 ± 4.1; P = .003), and normalized left ventricular diameter in diastole (1.38 ± 0.25 versus 1.54 ± 0.17; P = .04) and systole (0.85 ± 0.18 versus 0.97 ± 0.11; P = .03) as compared to healthy dogs. Simpson method of disks (SMOD) right parasternal EF (55 ± 9 versus 60 ± 6; P = .07) and end systolic volume index (ESVI; 23 ± 10 versus 21 ± 6; P = .61), SMOD left apical EF (59 ± 9 versus 59 ± 6; P = .87) and ESVI (20 ± 8 versus 22 ± 6; P = .25), fractional shortening (FS; 34 ± 5 versus 33 ± 4; P = .39), M‐mode EF (64 ± 7 versus 62 ± 5; P = .35), and ESVI (23 ± 11 versus 30 ± 9; P = .06) were not significantly different between SIRS and control group, respectively. Conclusion and Clinical Importance Speckle tracking X4D‐EF and ENDO‐G‐Long‐St are more sensitive than 2D and M‐Mode FS, EF, and ESVI in detecting systolic impairment in dogs with SIRS.
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Affiliation(s)
- Andrea Corda
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Sassari, Sassari, Italy
| | | | - Giovanni Sotgiu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Rosanna Zobba
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Sassari, Sassari, Italy
| | - Pablo Gomez Ochoa
- Faculty of Veterinary Medicine, University of Zaragoza, Zaragoza, Spain
| | - Jorge Prieto Ramos
- School of Veterinary Medicine, Small Animal Hospital, University of Glasgow, Glasgow, United Kingdom
| | - Anne French
- School of Veterinary Medicine, Small Animal Hospital, University of Glasgow, Glasgow, United Kingdom
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Llewellyn EA, Todd JM, Sharkey LC, Rendahl A. A pilot study evaluating the prognostic utility of platelet indices in dogs with septic peritonitis. J Vet Emerg Crit Care (San Antonio) 2017; 27:569-578. [PMID: 28749085 DOI: 10.1111/vec.12628] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/22/2015] [Accepted: 11/08/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To characterize platelet indices at time of diagnosis of septic peritonitis in dogs and to assess the relationship between platelet parameter data and survival to discharge in dogs treated surgically. DESIGN Retrospective, observational, descriptive pilot study from 2009 to 2014. SETTING University teaching hospital. ANIMALS Forty-eight dogs diagnosed with septic peritonitis were included in this study. Thirty-six dogs had surgical source control. Blood samples from 46 healthy control dogs were used for reference interval (RI) generation. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Dogs with septic peritonitis had significantly increased mean values for mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) with increased proportions of dogs having values above the RI compared to healthy dogs. A significantly increased proportion of dogs with septic peritonitis had platelet counts above (12.5%) and below (8.3%) the RI, with no significant difference in mean platelet count compared to healthy dogs. No significant differences in the mean platelet count, MPV, PCT, or PDW were found between survivors and nonsurvivors in dogs with surgical source control; however, dogs with MPV values above the RI had significantly increased mortality compared to dogs within the RI (P = 0.025). Values outside the RI for other platelet parameters were not associated with significant differences in mortality. CONCLUSIONS Dogs with septic peritonitis have increased frequency of thrombocytosis and thrombocytopenia with increased MPV, PCT, and PDW. An increased MPV may be a useful indicator of increased risk of mortality in dogs treated surgically.
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Affiliation(s)
- Efa A Llewellyn
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN, 55108
| | - Jeffrey M Todd
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN, 55108
| | - Leslie C Sharkey
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN, 55108
| | - Aaron Rendahl
- School of Statistics, University of Minnesota, St Paul, MN, 55108
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Perez-Ecija A, Mendoza FJ. Characterisation of clotting factors, anticoagulant protein activities and viscoelastic analysis in healthy donkeys. Equine Vet J 2017; 49:734-738. [DOI: 10.1111/evj.12685] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 03/14/2017] [Indexed: 11/30/2022]
Affiliation(s)
- A. Perez-Ecija
- Department of Animal Medicine and Surgery; University of Cordoba; Cordoba Spain
| | - F. J. Mendoza
- Department of Animal Medicine and Surgery; University of Cordoba; Cordoba Spain
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Rodríguez-Pozo ML, Armengou L, Monreal L, Viu J, Cesarini C, Jose-Cunilleras E. Evaluation of an oral direct factor Xa inhibitor anticoagulant in healthy adult horses. J Vet Emerg Crit Care (San Antonio) 2016; 27:82-88. [PMID: 27712038 DOI: 10.1111/vec.12540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 03/12/2015] [Accepted: 05/04/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess whether an oral direct factor Xa inhibitor (DiXaI) anticoagulant drug used at the low end of the recommended dose in people achieves presumed prophylactic plasma concentrations and does not induce bleeding in horses. DESIGN Experimental study. SETTING Field study. ANIMALS Ten healthy adult horses. INTERVENTIONS A DiXaI was administered at a dose of 0.125 mg/kg every 24 h orally for 4 days. Following a wash-out period of 2 weeks, 8 of 10 horses received daily subcutaneous doses of a low molecular weight heparin (dalteparin) for 4 consecutive days at 50 IU/kg. In both trials, antifactor Xa activity was measured at baseline time and 3 hours after each dose administration. Activated partial thromboplastin time, prothrombin time, hematocrit, erythrocyte agglutination, and platelet aggregation were monitored throughout the study. In addition, an in vitro spiking experiment was performed to demonstrate anticoagulant activity of this DiXaI in horse plasma. MAIN RESULTS When treated with the DiXaI, this group of horses did not achieve the suggested thromboprophylactic plasma range of antifactor Xa activity (0.1-0.2 IU/mL), except for 1 horse after the first administration of the drug. In contrast, median values of plasma antifactor Xa activity 3 hours after receiving dalteparin were within the prophylactic range (0.16 IU/mL). No hemorrhagic events or erythrocyte agglutination were observed. In vitro addition of this DiXaI caused a concentration-dependent effect in antifactor Xa activity. CONCLUSIONS At the low end of the recommended dose in people this oral formulation of DiXaI did not reach prophylactic plasma antifactor Xa activity in this group of healthy adult horses. Further studies are warranted in order to establish the prophylactic dose for horses.
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Affiliation(s)
- Maria L Rodríguez-Pozo
- Servei de Medicina Interna Equina i Unitat Equina, Fundació Hospital Clínic Veterinari, Departament de Medicina i Cirurgia Animals, Universitat Autònoma de Barcelona, Barcelona, 08310, Spain
| | - Lara Armengou
- Servei de Medicina Interna Equina i Unitat Equina, Fundació Hospital Clínic Veterinari, Departament de Medicina i Cirurgia Animals, Universitat Autònoma de Barcelona, Barcelona, 08310, Spain
| | - Luis Monreal
- Servei de Medicina Interna Equina i Unitat Equina, Fundació Hospital Clínic Veterinari, Departament de Medicina i Cirurgia Animals, Universitat Autònoma de Barcelona, Barcelona, 08310, Spain
| | - Judit Viu
- Servei de Medicina Interna Equina i Unitat Equina, Fundació Hospital Clínic Veterinari, Departament de Medicina i Cirurgia Animals, Universitat Autònoma de Barcelona, Barcelona, 08310, Spain
| | - Carla Cesarini
- Servei de Medicina Interna Equina i Unitat Equina, Fundació Hospital Clínic Veterinari, Departament de Medicina i Cirurgia Animals, Universitat Autònoma de Barcelona, Barcelona, 08310, Spain
| | - Eduard Jose-Cunilleras
- Servei de Medicina Interna Equina i Unitat Equina, Fundació Hospital Clínic Veterinari, Departament de Medicina i Cirurgia Animals, Universitat Autònoma de Barcelona, Barcelona, 08310, Spain
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Verschoof J, Moritz A, Kramer M, Bauer N. Hemostatic variables, plasma lactate concentration, and inflammatory biomarkers in dogs with gastric dilatation-volvulus. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2015; 43:389-98. [PMID: 26568318 DOI: 10.15654/tpk-150284] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 06/06/2015] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Prospective characterization of hemostastatic variables, plasma lactate concentration, and inflammatory biomarkers in dogs with gastric dilatation-volvulus (GDV). MATERIAL AND METHODS Coagulation variables (platelets, prothrombin time [PT], activated partial thromboplastin time [aPTT], fibrinogen, antithrombin [AT], protein C [PC], protein S [PS], D-dimers), plasma lactate concentration and inflammatory biomarkers (C-reactive protein, white blood cell [WBC] count, lymphocyte and neutrophil numbers) were assessed in 20 dogs with GDV presented between 2011 and 2012. Blood was taken preoperatively and at days 1 and 3 postoperatively. The prognostic value of these variables before and after surgery was evaluated as well as the behavior of variables during the study. RESULTS Overall, 7/20 (35%) dogs did not survive; two dogs (29%) were euthanized during surgery due to severe gastric necrosis and 5 (71%) dogs after surgery due to sepsis and disseminated intravascular coagulopathy. Prior to surgery, median plasma lactate concentration was significantly (p = 0.01) lower in survivors (6.2 mmol/l, range 1.9-9.7 mmol/l) when compared to non-survivors (11.8 mmol/l, range 7.5-16.2 mmol/l). In dogs dying after surgery, significantly higher plasma lactate concentration, coagulation times and D-dimer concentration were present as well as lower fibrinogen concentration and activity of PC and AT compared to survivors. At discharge, activity of AT, PC and PS were markedly below the reference interval in 6/13 (46%), 11/13 (85%), and 8/13 (62%) dogs, respectively. CLINICAL RELEVANCE Only lactate plasma concentration was of preoperative prognostic value. After surgery, severe abnormalities of coagulation variables, especially the endogenous anticoagulants were present in most of the dogs. The severity of the abnormalities was associated with survival.
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Affiliation(s)
- J Verschoof
- Joyce Verschoof, Small Animal Clinic, Surgery, Justus-Liebig-University Giessen, Frankfurter Strasse 108, 35392 Giessen, Germany,
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Kelley D, Lester C, Shaw S, de Laforcade A, Webster CRL. Thromboelastographic Evaluation of Dogs with Acute Liver Disease. J Vet Intern Med 2015; 29:1053-62. [PMID: 26179169 PMCID: PMC4895357 DOI: 10.1111/jvim.13441] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 05/01/2015] [Accepted: 05/07/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Given the liver's pivotal role in hemostasis and fibrinolysis, the coagulopathy accompanying hepatic disease is complex. HYPOTHESIS/OBJECTIVES To prospectively evaluate kaolin-activated thromboelastography (TEG) in dogs with acute liver disease (ALD) and compare with plasma-based coagulation tests. ANIMALS Twenty-one dogs with a diagnosis of ALD based on recent onset of clinical signs accompanied by increases in serum bilirubin concentration and alanine aminotransferase activity. METHODS Clinical presentation, CBC, serum biochemistry, platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), and TEG analysis were evaluated in 21 dogs with a subset also having fibrinogen, antithrombin (AT) activity, protein C (PC) activity, d-dimers, and von Willebrand's factor (vWF) activity analyzed. A PT >1.5 times the upper limit of normal defined acute liver failure (ALF). RESULTS Dogs with ALD had mean increases in R, K, LY30, PT, aPTT, and vWF activity, and decreases in angle, maximal amplitude (MA), G, AT activity, and PC activity. The TEG results defined dogs as hypocoagulable (11/21), normocoagulable (8/21), or hypercoagulable (2/21). Increases in LY30 defined 8/21 dogs as hyperfibrinolytic. Hypocoagulable and hyperfibrinolytic dogs had lower fibrinogen and PC activity than dogs without these abnormalities. Overall, ALF dogs had greater increases in K and LY30, and decreases in MA, G, and PC activity than dogs with less severe hepatic impairment. Results for MA and LY30 were positively correlated with serum bilirubin concentration and white blood cell count, and negatively correlated with serum cholesterol concentration. CONCLUSIONS AND CLINICAL IMPORTANCE ALD dogs have a range of coagulation abnormalities that trend toward hypocoagulability and hyperfibrinolysis as functional impairment occurs.
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Affiliation(s)
- D Kelley
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - C Lester
- Ocean State Veterinary Specialists, East Greenwich, RI
| | - S Shaw
- VCA Animal Hospitals, Los Angeles, CA
| | - A de Laforcade
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - C R L Webster
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
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Beer KS, Silverstein DC. Controversies in the use of fresh frozen plasma in critically ill small animal patients. J Vet Emerg Crit Care (San Antonio) 2015; 25:101-6. [PMID: 25603692 DOI: 10.1111/vec.12280] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Accepted: 09/15/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To review the literature supporting or discouraging the use of fresh frozen plasma (FFP) transfusion in critically ill patients. DATA SOURCES Human and animal publications were searched using PubMed without time limits and the following keywords were used: "fresh frozen plasma," "coagulopathy," "hypocoagulable state," "hypercoagulable states," and "critical illness." HUMAN DATA SYNTHESIS The commonly used tests of coagulation (eg, prothrombin time, activated partial thromboplastin time, international normalized ratio) are poorly predictive of clinical bleeding. FFP use in critically ill patients is unlikely to result in improved outcomes and may be associated with increased risks. VETERINARY DATA SYNTHESIS There is insufficient evidence to make definitive conclusions regarding the use of FFP in critically ill animals, but clinical studies are underway that may provide further data that clarify the optimal use of FFP in animals. CONCLUSIONS The use of FFP in critically ill patients remains controversial. In the absence of clinical bleeding or a risk for clinical bleeding associated with a planned procedure, treatment use of FFP is not recommended in human patients. There are insufficient data in critically ill animals to enable formulation of recommendations. Further research is warranted in dogs and cats to establish evidence-based guidelines.
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Affiliation(s)
- Kari Santoro Beer
- Department of Clinical Studies, University of Pennsylvania, Philadelphia, PA
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Kelley D, Lester C, DeLaforcade A, Webster C. Thromboelastographic Evaluation of Dogs with Congenital Portosystemic Shunts. J Vet Intern Med 2013; 27:1262-7. [DOI: 10.1111/jvim.12130] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 05/03/2013] [Accepted: 05/21/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- D. Kelley
- Department of Clinical Sciences; Tufts Cummings School of Veterinary Medicine; Grafton MA
| | - C. Lester
- Department of Clinical Sciences; Tufts Cummings School of Veterinary Medicine; Grafton MA
| | - A. DeLaforcade
- Department of Clinical Sciences; Tufts Cummings School of Veterinary Medicine; Grafton MA
| | - C.R.L. Webster
- Department of Clinical Sciences; Tufts Cummings School of Veterinary Medicine; Grafton MA
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