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Tonthong S, Rungpupradit J. Coagulation testing: Comparison of portable (CoaguChek ® XS) and automated coagulation analyzer in healthy cats. Vet World 2020; 13:2541-2545. [PMID: 33363352 PMCID: PMC7750227 DOI: 10.14202/vetworld.2020.2541-2545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/19/2020] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: The CoaguChek® XS (CCX) is a portable coagulation analyzer that is widely used to monitor prothrombin time (PT) in human patients taking oral anticoagulants. It can also be reliably used for screening dogs when PT is in the normal range. Efficacy of the portable CCX coagulation analyzer was evaluated for testing PT in healthy cats and the normal range was established. Materials and Methods: Blood samples of 82 cats were collected from the jugular vein and PT was measured using both the CCX and an automated coagulation analyzer (ACA). Spearman’s correlation was used to measure the strength and direction of association between the two analyzers, while limits of agreement were assessed utilizing Bland-Altman analysis. Results: Range of PT using the CCX was 10.1-14.1 s. Correlation between the two analyzers was moderate but significant (r=0.3465, p=0.0014). Mean difference between CCX-PT and ACA-PT was 1.624 s and standard deviation was 0.890 with 95.1% of the samples falling within the limits of agreement. Conclusion: The CCX is a portable, easy to use coagulation analyzer that requires a small volume of blood and gives results within 1 min. Results showed moderate correlation and good agreement with a standard automated laboratory analyzer. The CCX can be used for screening coagulation testing when PT is in the normal range for cats. However, testing accuracy of the CCX in abnormal PT cats should be further investigated before diagnostic coagulopathy applications.
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Affiliation(s)
- Sireeporn Tonthong
- Department of Small Domestic Animal and Radiology, Faculty of Veterinary Medicine, Mahanakorn University of Technology, Bangkok, Thailand
| | - Jetsada Rungpupradit
- Department of Small Domestic Animal and Radiology, Faculty of Veterinary Medicine, Mahanakorn University of Technology, Bangkok, Thailand
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Dickson AJ, Belthoff JR, Mitchell KA, Smith BW, Wallace ZP, Stuber MJ, Lockhart MJ, Rattner BA, Katzner TE. Evaluating a Rapid Field Assessment System for Anticoagulant Rodenticide Exposure of Raptors. ARCHIVES OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2020; 79:454-460. [PMID: 33140186 DOI: 10.1007/s00244-020-00763-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
Anticoagulant rodenticides (ARs) are commonly used to control rodent pests. However, worldwide, their use is associated with secondary and tertiary poisoning of nontarget species, especially predatory and scavenging birds. No medical device can rapidly test for AR exposure of avian wildlife. Prothrombin time (PT) is a useful biomarker for AR exposure, and multiple commercially available point-of-care (POC) devices measure PT of humans, and domestic and companion mammals. We evaluated the potential of one commercially available POC device, the Coag-Sense® PT/INR Monitoring System, to rapidly detect AR exposure of living birds of prey. The Coag-Sense device delivered repeatable PT measurements on avian blood samples collected from four species of raptors trapped during migration (Intraclass Correlation Coefficient > 0.9; overall intra-sample variation CV: 5.7%). However, PT measurements reported by the Coag-Sense system from 81 ferruginous hawk (Buteo regalis) nestlings were not correlated to those measured by a one-stage laboratory avian PT assay (r = - 0.017, p = 0.88). Although precise, the lack of agreement in PT estimates from the Coag-Sense device and the laboratory assay indicates that this device is not suitable for detecting potential AR exposure of birds of prey. The lack of suitability may be related to the use of a mammalian reagent in the clotting reaction, suggesting that the device may perform better in testing mammalian wildlife.
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Affiliation(s)
- Ariana J Dickson
- Department of Biological Sciences, Boise State University, 1910 University Drive, Boise, ID, 83725, USA.
- Raptor Research Center, Boise State University, 1910 University Drive, Boise, ID, 83725, USA.
| | - James R Belthoff
- Department of Biological Sciences, Boise State University, 1910 University Drive, Boise, ID, 83725, USA
- Raptor Research Center, Boise State University, 1910 University Drive, Boise, ID, 83725, USA
| | - Kristen A Mitchell
- Department of Biological Sciences, Boise State University, 1910 University Drive, Boise, ID, 83725, USA
| | - Brian W Smith
- Division of Migratory Birds, U.S. Fish and Wildlife Service, Denver, CO, USA
| | - Zachary P Wallace
- Wyoming Natural Diversity Database, University of Wyoming, Dept. 3381, Laramie, WY, USA
| | - Matthew J Stuber
- Division of Migratory Birds, U.S. Fish and Wildlife Service, Medford, OR, USA
| | | | - Barnett A Rattner
- U.S. Geological Survey, Patuxent Wildlife Research Center, Beltsville, MD, USA
| | - Todd E Katzner
- U.S. Geological Survey, Forest and Rangeland Ecosystem Center, Boise, ID, USA
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Berlin N, Kelmer E, Segev G, Aroch I, Kelmer G. Assessment of the CoaguChek-XS portable prothrombin time point-of-care analyzer for horses. J Vet Diagn Invest 2019; 31:448-452. [PMID: 30852982 DOI: 10.1177/1040638719832340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Coagulopathies in horses are common and potentially life-threatening. In equine field medicine, a portable point-of-care (POC) prothrombin time (PT) testing device could be useful to identify early changes in extrinsic clotting. The CoaguChek-XS (Roche Diagnostics) is a small, portable POC PT analyzer used in human medicine. Our preliminary study assessed the suitability of CoaguChek-XS for testing PT in horses and established the PT reference interval (PT RI) in healthy horses using this instrument. Blood samples collected from 102 healthy and ill horses were analyzed with the CoaguChek-XS and compared to a semi-automated coagulometric analyzer (SACA) as the gold standard. There was a significant positive correlation between the 2 measurement methods ( r = 0.765, p < 0.01), and very good agreement, with 97% of the samples falling within limits of agreement. The mean CoaguChek-XS PT coefficient of variation was 0.8%, indicating high precision. With high precision and good agreement with the coagulometric PT, the CoaguChek-XS should be further validated for PT measurement in horses.
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Affiliation(s)
- Noa Berlin
- Departments of Small Animal Emergency and Critical Care (Berlin, E Kelmer).,Small Animal Internal Medicine (Segev, Aroch).,Large Animal Medicine and Surgery (G Kelmer).,The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Efrat Kelmer
- Departments of Small Animal Emergency and Critical Care (Berlin, E Kelmer).,Small Animal Internal Medicine (Segev, Aroch).,Large Animal Medicine and Surgery (G Kelmer).,The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Gilad Segev
- Departments of Small Animal Emergency and Critical Care (Berlin, E Kelmer).,Small Animal Internal Medicine (Segev, Aroch).,Large Animal Medicine and Surgery (G Kelmer).,The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Itamar Aroch
- Departments of Small Animal Emergency and Critical Care (Berlin, E Kelmer).,Small Animal Internal Medicine (Segev, Aroch).,Large Animal Medicine and Surgery (G Kelmer).,The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Gal Kelmer
- Departments of Small Animal Emergency and Critical Care (Berlin, E Kelmer).,Small Animal Internal Medicine (Segev, Aroch).,Large Animal Medicine and Surgery (G Kelmer).,The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
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Hyatt CE, Brainard BM. Point of Care Assessment of Coagulation. Top Companion Anim Med 2016; 31:11-7. [PMID: 27451044 DOI: 10.1053/j.tcam.2016.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/19/2016] [Indexed: 11/11/2022]
Abstract
Disorders of hemostasis can be difficult to fully elucidate but can severely affect patient outcome. The optimal therapy for coagulopathies is also not always clear. Point of care (POC) testing in veterinary medicine can assist in the diagnosis of hemostatic disorders and also direct treatment. Advantages of POC testing include rapid turnaround times, ease of use, and proximity to the patient. Disadvantages include differences in analytic performance compared with reference laboratory devices, the potential for operator error, and limited test options per device. Conventional coagulation tests such as prothrombin time, activated partial thromboplastin time, and activated clotting time can be measured by POC devices and can accurately diagnose hypocoagulability, but they cannot detect hypercoagulability or disorders of fibrinolysis. Viscoelastic POC coagulation testing more accurately evaluates in vivo coagulation, and can detect hypocoagulability, hypercoagulability, and alterations in fibrinolysis. POC platelet function testing methodologies can detect platelet adhesion abnormalities including von Willebrand disease, and can be used to monitor the efficacy of antiplatelet drugs. It is unlikely that a single test would be ideal for assessing the complete coagulation status of all patients; therefore, the ideal combination of tests for a specific patient needs to be determined based on an understanding of the underlying disease, and protocols must be standardized to minimize interoperator and interinstitutional variability.
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Affiliation(s)
- Clare E Hyatt
- Phoenix Veterinary Referral and Emergency, Phoenix, AZ, USA
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
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Kelmer E, Segev G, Codner C, Bruchim Y, Klainbart S, Aroch I. Assessment of a portable prothrombin time analyzer (CoaguChek-XS) in dogs. J Vet Emerg Crit Care (San Antonio) 2014; 24:455-60. [PMID: 25039332 DOI: 10.1111/vec.12200] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 05/25/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the performance of a portable prothrombin time (PT) analyzer (CoaguChek-XS) in dogs. ANIMALS Ninety-seven dogs composed of 20 healthy dogs, 45 ill dogs, and 32 ill dogs with altered coagulation. PROCEDURES Samples were concurrently obtained and PT was measured using the CoaguChek-XS and an automated coagulation analyzer. Agreement between methods was assessed using Spearman's correlation and Bland-Altman analysis. RESULTS The reference interval for PT using the CoaguChek-XS was 9.6-11.5 s. The CoaguChek-XS was easy to use, required a small volume of whole blood, and gave results within 1 min. The mean difference in PT between the 2 methods was 2.58 s (SD 3.10), and 94% of the samples fell within limits of agreement. The correlation was moderate, but significant (r = 0.35, P < 0.001). Sensitivity and specificity of the CoaguCheck-XS PT compared to analyzer PT were 92% and 56%, respectively, and increased to 95% and 77% on intent to treat basis. The coefficient of variance was 0.72%. The CoaguChek-XS identified all 8 dogs with anticoagulant rodenticide intoxication, although a discrepancy was noted from the analyzer results. In anemic dogs (PCV≤25%), the CoaguChek-XS did not display accurate results. CONCLUSIONS The CoaguChek-XS is a simple, user-friendly, highly precise PT analyzer. Results had moderate correlation and good agreement with a standard method. It can be used reliably for screening dogs when the PT is normal. However, when the CoaguChek-XS PT is prolonged or when the PCV is ≤25%, results should be confirmed using a standard method.
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Affiliation(s)
- Efrat Kelmer
- Department of Small Animal Emergency and Critical Care, the Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Rehovot, Israel
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