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Theuerkauf K, Obach-Schröck C, Staszyk C, Moritz A, Roscher KA. Activated platelets and platelet-leukocyte aggregates in the equine systemic inflammatory response syndrome. J Vet Diagn Invest 2022; 34:448-457. [PMID: 35168432 PMCID: PMC9066687 DOI: 10.1177/10406387221077969] [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] [Indexed: 11/17/2022] Open
Abstract
In humans, activated platelets contribute to sepsis complications and to multiple organ failure. In our prospective analytical study of cases of the equine systemic inflammatory response syndrome (SIRS), we adapted a standard human protocol for the measurement of activated platelets and platelet-leukocyte aggregates (PLAs) in equine platelet-leukocyte-rich plasma (PLRP) by flow cytometry, and we investigated the hypothesis that activated platelets and PLAs are increased in clinical cases of SIRS. We included 17 adult horses and ponies fulfilling at least 2 SIRS criteria, and 10 healthy equids as controls. Activation of platelets was determined by increased expression of CD62P on platelets. Activated platelets and PLAs were measured before and after in vitro activation of platelets with collagen. Median expression of CD62P on platelets was significantly increased after activation in the control group: 1.45% (interquartile range [IQR]: 1.08-1.99%) initially versus 8.78% (IQR: 6.79-14.78%, p = 0.002) after activation. The equids with SIRS had significantly more activated platelets and PLAs in native PLRP than controls: CD62P 4.92% (median, IQR: 2.21-12.41%) versus 1.45% in controls (median, IQR: 1.08-1.99%, p = 0.0007), and PLAs 4.16% (median, IQR: 2.50-8.58%) versus 2.95% in controls (median, IQR: 1.57-3.22%, p = 0.048). To our knowledge, increased platelet activation and PLAs have not been demonstrated previously with flow cytometry in clinical cases of equine SIRS.
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Affiliation(s)
| | - Carmen Obach-Schröck
- Equine Clinic, Internal Medicine, Department of Veterinary Clinical Science (Theuerkauf, Roscher), Institute of Veterinary-Anatomy, -Histology and -Embryology (Obach-Schröck, Staszyk), Clinical Pathophysiology and Veterinary Clinical Pathology, Department of Veterinary Clinical Science (Moritz), Justus-Liebig-University, Giessen, Germany
| | - Carsten Staszyk
- Equine Clinic, Internal Medicine, Department of Veterinary Clinical Science (Theuerkauf, Roscher), Institute of Veterinary-Anatomy, -Histology and -Embryology (Obach-Schröck, Staszyk), Clinical Pathophysiology and Veterinary Clinical Pathology, Department of Veterinary Clinical Science (Moritz), Justus-Liebig-University, Giessen, Germany
| | - Andreas Moritz
- Equine Clinic, Internal Medicine, Department of Veterinary Clinical Science (Theuerkauf, Roscher), Institute of Veterinary-Anatomy, -Histology and -Embryology (Obach-Schröck, Staszyk), Clinical Pathophysiology and Veterinary Clinical Pathology, Department of Veterinary Clinical Science (Moritz), Justus-Liebig-University, Giessen, Germany
| | - Katja A Roscher
- Equine Clinic, Internal Medicine, Department of Veterinary Clinical Science (Theuerkauf, Roscher), Institute of Veterinary-Anatomy, -Histology and -Embryology (Obach-Schröck, Staszyk), Clinical Pathophysiology and Veterinary Clinical Pathology, Department of Veterinary Clinical Science (Moritz), Justus-Liebig-University, Giessen, Germany
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Leclere M, Chevalier Z, Dubuc V, Beauchamp G, Bédard C. Assessment of thrombin generation in horses using a calibrated automated thrombogram. Vet Clin Pathol 2022; 51:57-64. [PMID: 35141924 DOI: 10.1111/vcp.13055] [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: 03/19/2021] [Revised: 06/01/2021] [Accepted: 06/22/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The amount of thrombin generated reflects the endogenous thrombin potential (ETP), which depends on the balance of pro- and anticoagulant factors. The calibrated automated thrombogram (CAT) allows for the direct measurement of thrombin generation during the clotting process. OBJECTIVES (1) To describe the results of the CAT assay in horses, (2) to establish intra-assay and intra- and interindividual variation of thrombin generation in healthy horses, and (3) to compare in vitro low-molecular-weight heparin (LMWH) sensitivity between healthy and sick horses. The hypothesis for the last objective is that inhibition of thrombin generation in sick horses requires higher heparin concentrations. METHODS The plasma of 10 healthy mixed breed horses was used for the determination of normal thrombin generation parameters (lag time, time to peak, peak thrombin concentration, and ETP). Five of the healthy horses were compared with five horses with systemic inflammatory response syndrome (SIRS). In vitro heparin sensitivity was determined using LMWH. RESULTS The intra-assay variation was small (<5%) for all parameters. Relatively large intra- and interindividual variation were observed in healthy horses. Four of the five sick horses with SIRS had a thrombogram compatible with a hypercoagulable state. The in vitro heparin sensitivity test suggested decreased sensitivity to LMWH in hypercoagulable states. CONCLUSIONS The CAT assay could detect coagulopathy in horses. In vivo experiments are needed to confirm that it can be used to monitor responses to LMWH therapy.
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Affiliation(s)
- Mathilde Leclere
- Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, QC, Canada
| | - Zoé Chevalier
- Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, QC, Canada
| | - Valérie Dubuc
- Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, QC, Canada
| | - Guy Beauchamp
- Department of Veterinary Biomedicine, Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, QC, Canada
| | - Christian Bédard
- Department of Pathology and Microbiology, Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, QC, Canada
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Nikvand AA, Jalali SM, Ghadrdan Mashhadi A, Razi Jalali M, Hassanpour Amirabadi S. Clinical, hematologic, hemostatic, and serum biochemical findings related to survival in Arabian horses with colic. Vet Clin Pathol 2019; 48:441-448. [PMID: 31531891 DOI: 10.1111/vcp.12779] [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] [Received: 09/24/2018] [Revised: 01/13/2019] [Accepted: 01/18/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The efficacy of clinical examinations, and hematologic, hemostatic, and serum biochemical assessments to determine appropriate early medical or surgical therapy in Arabian horses with colic have not been well-described. OBJECTIVES We aimed to evaluate clinical and hematologic findings, coagulation-fibrinolytic parameters, and organ dysfunction markers in association with survival in horses with colic. METHODS Seventeen Arabian horses with colic and ten healthy horses were enrolled. After clinical examinations, including heart rates (HRs), capillary refill times (CRTs), abdominal sounds, rectal palpations, and nasogastric (NG) reflux assessments in both healthy and diseased horses, blood samples were collected and hematologic parameters, coagulation indices such as the prothrombin time (PT), activated partial thromboplastin time (APTT), plasma d-dimer (PDD), platelet count, fibrinogen, and hepatorenal biomarkers were measured. Based on the outcomes, horses with colic were divided into survival (10) and nonsurvival (7) groups, and all mentioned parameters were compared with the control group horses. RESULTS Unlike HRs, CRTs, and abdominal sounds, rectal palpations (57.1%) and NG reflux (28.6%) findings were least sensitive in being able to determine survival. At least three of the five coagulation indices were significantly abnormal (prolonged PT, increased PDD, and decreased plasma fibrinogen) in 71.4% of the horses in the nonsurvival group compared with the control and survival groups. Significantly increased urea, creatinine, and bilirubin levels, and AST activities were also observed in the survival group compared with the control and nonsurvival groups. CONCLUSIONS The combination of prolonged PT, increased PDD, and hypofibrinogenemia could be a reliable predictor of survival in horses with colic. The significant renal and hepatic dysfunctions in nonsurviving horses with colic appeared to be consistent with disseminated intravascular coagulation (DIC) and a grave prognosis.
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Affiliation(s)
- Ali Abbas Nikvand
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Seyedeh Missagh Jalali
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Alireza Ghadrdan Mashhadi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Mohammad Razi Jalali
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Soroush Hassanpour Amirabadi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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Nomura M, Mizobe F, Kato T, Kuroda T, Urayama S, Muranaka M. Evaluating continuous blood coagulopathy in assessing the severity of acute colitis in Thoroughbred racehorses. J Equine Sci 2018; 29:79-85. [PMID: 30250396 PMCID: PMC6145864 DOI: 10.1294/jes.29.79] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/21/2018] [Indexed: 11/05/2022] Open
Abstract
Although severe blood coagulopathy in horses with acute colitis causes multiple organ
failure, which may be fatal, few studies have focused on the correlation between the
fluctuations of coagulation parameters and severity of colitis. In this study, we
evaluated the fluctuations of coagulation parameters in 14 Thoroughbred racehorses with
acute colitis for 5 days from the day of hospitalization and compared them between 5
survivors and 9 non-survivors. Noteworthy features in the non-survivors were that
antithrombin activity and fibrin degradation products continuously decreased and
increased, respectively, for 4 days or more and that thrombin-antithrombin complexes
increased in the last 2 days before death. Thus, these parameters should be continuously
monitored to observe these fluctuations in assessing the severity of acute colitis.
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Affiliation(s)
- Motoi Nomura
- Racehorse Clinic, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Fumiaki Mizobe
- Racehorse Clinic, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Tomohiro Kato
- Racehorse Clinic, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Taisuke Kuroda
- Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
| | - Shuntaro Urayama
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Masanori Muranaka
- Racehorse Clinic, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
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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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de Solís CN, Reef VB, Slack J, Jose-Cunilleras E. Evaluation of coagulation and fibrinolysis in horses with atrial fibrillation. J Am Vet Med Assoc 2016; 248:201-6. [DOI: 10.2460/javma.248.2.201] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cesarini C, Cotovio M, Ríos J, Armengou L, Jose-Cunilleras E. Association Between Necropsy Evidence of Disseminated Intravascular Coagulation and Hemostatic Variables Before Death in Horses With Colic. J Vet Intern Med 2015; 30:269-75. [PMID: 26581617 PMCID: PMC4913647 DOI: 10.1111/jvim.13659] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 09/10/2015] [Accepted: 10/07/2015] [Indexed: 12/14/2022] Open
Abstract
Background Disseminated intravascular coagulation (DIC) is frequent in horses with severe gastrointestinal disorders. Postmortem studies have found fibrin microthrombi in tissues of these horses, but studies relating these histopathological findings with antemortem hemostatic data are lacking. Hypothesis Antemortem classification of coagulopathy is related to the presence and severity of fibrin deposits observed postmortem in horses with severe gastrointestinal disorders. Animals Antemortem hemostatic profile data and postmortem tissue samples (kidney, lung, liver) from 48 horses with colic. Methods Tissue samples were stained with phosphotungstic acid hematoxylin and immunohistochemical methods for histological examination. A fibrin score (grades 0–4) was assigned for each technique, tissue and horse, as well as the presence or absence of DIC at postmortem examination. D‐dimer concentration, prothrombin time (PT), activated partial thromboplastin time (aPTT), and antithrombin (AT) activity, as well as the clinicopathological evidence of coagulopathy, were determined from plasma samples collected 0–24 hours before death or euthanasia. Histologic and clinicopathologic data from the same horses were compared retrospectively. Results No association was found between antemortem classification of coagulopathy and postmortem diagnosis of DIC based on tissue fibrin deposition. None of the hemostatic parameters was significantly different between horses with or without postmortem diagnosis of DIC. There was no association between horses with fibrin in tissues or different cut‐offs for D‐dimer concentration and postmortem evidence of DIC. Conclusions and Clinical Importance Abnormalities of the routine clotting profile, including D‐dimer concentration, were not useful in predicting histologic evidence of DIC at necropsy in horses with severe gastrointestinal disorders.
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Affiliation(s)
- C Cesarini
- Servei de Medicina Interna Equina, Fundació Hospital Clínic Veterinari and Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Cotovio
- CECAV, Centro de Ciência Animal e Veterinária and Departamento de Ciências Veterinárias, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal
| | - J Ríos
- Laboratory of Biostatistics & Epidemiology, Universitat Autònoma de Barcelona; Statistics and Methodology Support Unit, IDIBAPS, Hospital Clínic, Barcelona, Spain
| | - L Armengou
- Servei de Medicina Interna Equina, Fundació Hospital Clínic Veterinari and Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Jose-Cunilleras
- Servei de Medicina Interna Equina, Fundació Hospital Clínic Veterinari and Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
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Roscher KA, Failing K, Moritz A. Inhibition of platelet function with clopidogrel, as measured with a novel whole blood impedance aggregometer in horses. Vet J 2015; 203:332-6. [PMID: 25736876 DOI: 10.1016/j.tvjl.2014.12.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 11/21/2014] [Accepted: 12/27/2014] [Indexed: 10/24/2022]
Abstract
This study aimed to validate a loading and maintenance clopidogrel dosing scheme for the inhibition of platelet function, measured by whole blood impedance aggregometry in healthy adult horses. Ten Warmblood horses received oral clopidogrel once daily. Doses were based on 50 kg weight categories and resulted in one loading dose of 6-6.5 mg/kg bodyweight and maintenance doses of 1.2-1.4 mg/kg over the next 4 days. Platelet function was measured via whole blood multiple electrode impedance aggregometry prior to (T0) and at 6, 12, 24, 48, 72, 96, 144, 192 and 240 h following the loading dose. Aggregometries for collagen (COLtest), arachidonic acid (ASPItest), adenosine diphosphate (ADPtest) and ADP with prostaglandin E1 (ADPtestHS) were performed. Statistical analyses included one way repeated measures ANOVAs and subsequent Dunnett's tests. Platelet aggregation induced by collagen remained unchanged. There were significant inhibitions in the ASPItest (P <0.01 at 192 h, and P <0.05 at 240 h) and the ADPtest and ADPtestHS (P < 0.01, with the exception of 240 h). The loading dose of clopidogrel induced rapid inhibition of platelet function within hours, and the low dose was suitable for maintaining the inhibition over the 4 days of therapy. Recovery of platelet function was restored 6 days after the cessation of medication, determined with the ADPtest and ADPtestHS, but remained inhibited with the ASPItest. The prolonged effect of clopidogrel may indicate differences in the activation of platelets between horses and humans that were previously unknown.
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Affiliation(s)
- Katja A Roscher
- Equine Clinic, Internal Medicine, Department of Veterinary Clinical Sciences, Justus-Liebig-University, Frankfurter Str. 126, 35392 Giessen, Germany.
| | - Klaus Failing
- Unit for Biomathematics and Data Processing, Justus-Liebig-University, Frankfurter Str. 95, 35392 Giessen, Germany
| | - Andreas Moritz
- Clinical Pathophysiology and Veterinary Clinical Pathology, Department of Veterinary Clinical Sciences, Justus-Liebig-University, Frankfurter Str. 126, 35392 Giessen, Germany
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9
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Cook VL, Blikslager AT. The use of nonsteroidal anti-inflammatory drugs in critically ill horses. J Vet Emerg Crit Care (San Antonio) 2014; 25:76-88. [PMID: 25521286 DOI: 10.1111/vec.12271] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 09/15/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To review the physiology of the cyclooxygenase (COX) enzymes with reference to the beneficial effects of nonsteroidal anti-inflammatory drugs (NSAIDs) related to their analgesic and antiendotoxic properties as well as the mechanisms responsible for adverse gastrointestinal, renal, and coagulation effects. DATA SOURCES Human and veterinary peer reviewed literature VETERINARY DATA SYNTHESIS NSAIDs are frequently administered to critically ill horses for their analgesic and anti-inflammatory effects. However, NSAIDs have significant side effects principally on the gastrointestinal mucosa and kidneys. These side effects may be exacerbated in critically ill horses if they have gastrointestinal damage or are volume depleted CONCLUSIONS This review provides important information for equine veterinarians and criticalists on the advantages and disadvantages of using traditional NSAIDs and newer equine COX-2 selective NSAIDs for the management of different conditions in critically ill horses.
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Affiliation(s)
- Vanessa L Cook
- From the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI (Cook); and
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10
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Dunkel B, Corley KTT. Pathophysiology, diagnosis and treatment of neonatal sepsis. EQUINE VET EDUC 2014. [DOI: 10.1111/eve.12234] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- B. Dunkel
- Department of Clinical Science and Services; Equine Referral Hospital; The Royal Veterinary College; North Mymms UK
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Abstract
Although primary coagulopathies are rare in horses, changes in coagulation and fibrinolysis are commonly associated with inflammatory diseases. A clear understanding of the pathophysiology of normal and abnormal hemostasis is required to be able to choose and interpret diagnostic tests evaluating coagulation and fibrinolysis. After diagnosis, treatment of the underlying disease must occur regardless of whether clinical manifestations (excessive bleeding or thrombosis) of the coagulopathy are present or not. Specific treatment may be initiated if there are clinical signs of coagulopathy.
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Affiliation(s)
- Kira L Epstein
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, 501 DW Brooks Dr, Athens, GA 30602, USA.
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12
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Whelchel DD, Tennent-Brown BS, Giguère S, Epstein KL. Pharmacodynamics of multi-dose low molecular weight heparin in healthy horses. Vet Surg 2013; 42:448-54. [PMID: 23574511 DOI: 10.1111/j.1532-950x.2013.12008.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 11/14/2011] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To compare the pharmacodynamics of once daily and twice daily administration of low molecular weight heparin (LMWH) administration in horses. STUDY DESIGN Randomized cross over study. ANIMALS Adult mixed breed healthy mares (n = 6). METHODS LMWH (dalteparin) was administered (50 U/kg subcutaneously) either every 12 or 24 hours for 3 consecutive days. Anti-factor Xa activity was measured before and at select time points after LMWH administration. Packed cell volume (PCV), platelet count, partial thromboplastin time (PTT), and anti-thrombin (AT) activity were monitored throughout the study. RESULTS No changes in PCV, platelet count, or AT activity were detected with either frequency of daily LMWH administration. Values for PTT increased throughout the study but never exceeded the normal reference interval. Anti-factor Xa activity was maintained within or above the suggested thromboprophylactic range (0.1-0.2 U/mL) when LMWH was administered twice daily, but fell below this range ≈ 16 hours after administration when given once daily. For both once and twice daily LMWH administration, the area under the curve was significantly greater after the last dose of LMWH when compared to the first dose. CONCLUSIONS Administration of LMWH once or twice daily for 3 consecutive days appears to be safe in healthy adult horses. Anti-factor Xa activity was maintained within or above the suggested thromboprophylactic range for 24 hours with twice daily LMWH administration but not with once daily administration.
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Affiliation(s)
- Dorothy D Whelchel
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
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13
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Thrombelastographic characterization of coagulation/fibrinolysis in horses. Blood Coagul Fibrinolysis 2013; 24:273-8. [DOI: 10.1097/mbc.0b013e32835bfd6e] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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14
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Affiliation(s)
- B. Dunkel
- Equine Referral Hospital; Department of Veterinary Clinical Sciences; The Royal Veterinary College; North Mymms; Herts; UK
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15
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Nath LC, Anderson GA, Hinchcliff KW, Savage CJ. Clinicopathologic evidence of myocardial injury in horses with acute abdominal disease. J Am Vet Med Assoc 2012; 241:1202-8. [DOI: 10.2460/javma.241.9.1202] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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16
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Treatment with aspirin or clopidogrel does not affect equine platelet expression of P selectin or platelet–neutrophil aggregates. Vet Immunol Immunopathol 2012; 149:119-25. [DOI: 10.1016/j.vetimm.2012.05.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Revised: 05/23/2012] [Accepted: 05/31/2012] [Indexed: 12/17/2022]
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17
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Sasaki T, Yoshimoto N, Sugimoto K, Takada K, Murayama N, Yamazaki H, Yamamoto K, Ishii H. Intravenous and oral administrations of DD2 [7-Amino-2-(sulfanylmethyl)heptanoic acid] produce thrombolysis through inhibition of plasma TAFIa in rats with tissue factor-induced microthrombosis. Thromb Res 2012; 130:e222-8. [PMID: 22795218 DOI: 10.1016/j.thromres.2012.06.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 06/03/2012] [Accepted: 06/13/2012] [Indexed: 12/24/2022]
Abstract
Thrombin-activatable fibrinolysis inhibitor (TAFI) is a plasma zymogen that is activated by thrombin in plasma. In fibrinolytic processes, carboxy-terminal lysine (Lys) residues in partially degraded fibrin are important sites for plasminogen binding and activation, and an active form of TAFI (TAFIa) inhibits fibrinolysis by eliminating these residues proteolytically. We synthesized DD2 [7-Amino-2-(sulfanylmethyl)heptanoic acid], a Lys analogue containing sulfur, as an inhibitor of TAFIa and investigated its pharmacological profile and pathophysiological role in thrombolysis via in vitro and in vivo studies. DD2 specifically inhibited plasma TAFIa activity with an apparent IC(50) (50% inhibitory concentration) value of 3.4×10(-8)M under the present experimental condition and enhanced tissue plasminogen activator-mediated clot lysis in a concentration-dependent manner. In order to study tissue factor (TF)-induced microthrombosis in an animal model, rats were given intravenous injection (2.5mg/kg and higher) or oral administration (10mg/kg and higher) of DD2. This attenuated TF-induced glomerular fibrin deposition and increased the plasma levels of fibrin degradation products and D-dimer in a dose-dependent manner. A DD2 dose approximately 4X higher than the dose used in intravenous injections was required to achieve an equivalent thrombolytic effect to that seen following oral administration. Moreover, the oral absorption efficiency of DD2 into the vasculature was 29.8%. These results indicate that both intravenous and oral administration of DD2 enhanced endogenous fibrinolysis and reduced thrombi in a TF-induced microthrombosis model.
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Affiliation(s)
- Tomoyuki Sasaki
- High Technology Research Center, Showa Pharmaceutical University, 3-3165 Higashi Tamagawa Gakuen, Machida, Tokyo 194-8543, Japan
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Barrett EJ, Munsterman AS. Parainguinal laparotomy as an alternative surgical approach for removal of an enterolith in the small colon of a horse. EQUINE VET EDUC 2012. [DOI: 10.1111/j.2042-3292.2012.00427.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mendez-Angulo JL, Mudge MC, Couto CG. Thromboelastography in equine medicine: Technique and use in clinical research. EQUINE VET EDUC 2011. [DOI: 10.1111/j.2042-3292.2011.00338.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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20
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Underwood C, Southwood LL, Walton RM, Johnson AL. Hepatic and metabolic changes in surgical colic patients: a pilot study. J Vet Emerg Crit Care (San Antonio) 2010; 20:578-86. [DOI: 10.1111/j.1476-4431.2010.00597.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Brainard B, Epstein K, LoBato D, Kwon S, Papich M, Moore J. Effects of Clopidogrel and Aspirin on Platelet Aggregation, Thromboxane Production, and Serotonin Secretion in Horses. J Vet Intern Med 2010; 25:116-22. [DOI: 10.1111/j.1939-1676.2010.0647.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Dunkel B, Chan D, Boston R, Monreal L. Association between Hypercoagulability and Decreased Survival in Horses with Ischemic or Inflammatory Gastrointestinal Disease. J Vet Intern Med 2010; 24:1467-74. [DOI: 10.1111/j.1939-1676.2010.0620.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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23
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Cesarini C, Monreal L, Armengou L, Delgado M, Ríos J, Jose-Cunilleras E. Association of Admission Plasma D-Dimer Concentration with Diagnosis and Outcome in Horses with Colic. J Vet Intern Med 2010; 24:1490-7. [DOI: 10.1111/j.1939-1676.2010.0618.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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24
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Mendez-Angulo JL, Mudge MC, Vilar-Saavedra P, Stingle N, Couto CG. Thromboelastography in healthy horses and horses with inflammatory gastrointestinal disorders and suspected coagulopathies. J Vet Emerg Crit Care (San Antonio) 2010; 20:488-93. [DOI: 10.1111/j.1476-4431.2010.00576.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Armengou L, Monreal L, Delgado M, Ríos J, Cesarini C, Jose-Cunilleras E. Low-Molecular-Weight Heparin Dosage in Newborn Foals. J Vet Intern Med 2010; 24:1190-5. [DOI: 10.1111/j.1939-1676.2010.0568.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Abstract
The most common coagulopathy in horses with colic is a hypercoagulable state associated with disseminated intravascular coagulation. The intensity of this coagulopathy depends on the severity and duration of the gastrointestinal lesion, with the ischemic and inflammatory problems and peritonitis being the most frequently affected by coagulopathies. Early initiation of prophylactic therapy significantly reduces the severe hypercoagulable state in horses with intestinal conditions which are recognized to be at high risk for disseminated intravascular coagulation. In addition to the systemic coagulopathy observed in horses with colic, a peritoneal coagulopathy independent from that occurring in blood has been observed, and its recognition and assessment may have clinical usefulness in the diagnosis of the gastrointestinal diseases and outcome.
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Affiliation(s)
- Luis Monreal
- Servei de Medicina Interna Equina, Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.
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Delgado MA, Monreal L, Armengou L, Ríos J, Segura D. Peritoneal D-dimer concentration for assessing peritoneal fibrinolytic activity in horses with colic. J Vet Intern Med 2009; 23:882-9. [PMID: 19566853 DOI: 10.1111/j.1939-1676.2009.0344.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Plasma D-dimer concentration is a useful marker to assess systemic coagulation and fibrinolytic activities in humans, dogs, and horses. Peritoneal fibrinolytic activity increases in horses with colic, especially in horses with endotoxin in the peritoneal fluid. HYPOTHESIS/OBJECTIVES Peritoneal D-dimer concentration can be used to assess peritoneal fibrinolytic activity in horses with severe gastrointestinal (GI) disorders and altered peritoneal fluid. ANIMALS Two hundred and twenty-one colic horses and 15 control horses. METHODS Prospective observational clinical study. Blood and peritoneal fluid were collected on admission. Horses were grouped according to diagnosis, peritoneal fluid analysis, and outcome. Peritoneal D-dimer concentration was determined, together with peritoneal tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI-1) activities. Plasma D-dimer concentration also was measured. RESULTS Peritoneal D-dimer concentration was significantly higher in all colic groups compared with controls, and in horses with enteritis, peritonitis, and ischemic disorders compared with horses with large intestinal obstructions. Peritoneal D-dimer concentration was significantly higher in horses with altered peritoneal fluid (modified transudate and exudate) compared with horses with normal peritoneal fluid analysis. Plasma D-dimer concentration also was significantly higher in the peritonitis group, and in horses with altered peritoneal fluid analysis. Peritoneal and plasma D-dimer concentrations also were significantly higher in nonsurvivors. Peritoneal d-dimer concentration was significantly correlated with decreased peritoneal t-PA activity and increased peritoneal PAI-1 activity. CONCLUSIONS AND CLINICAL IMPORTANCE Peritoneal D-dimer concentration is markedly higher in severe GI disorders, and it can be used to assess peritoneal fibrinolytic activity in horses with colic.
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Affiliation(s)
- M A Delgado
- Servei de Medicina Interna Equina, Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
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Dallap Schaer BL, Epstein K. Coagulopathy of the critically ill equine patient. J Vet Emerg Crit Care (San Antonio) 2009; 19:53-65. [DOI: 10.1111/j.1476-4431.2009.00390.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cotovio M, Monreal L, Armengou L, Prada J, Almeida JM, Segura D. Fibrin deposits and organ failure in newborn foals with severe septicemia. J Vet Intern Med 2008; 22:1403-10. [PMID: 18783354 DOI: 10.1111/j.1939-1676.2008.0178.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Septicemia in human neonates frequently is complicated by activation of the coagulation system, disseminated intravascular coagulation (DIC) and multiple organ failure syndrome, which may contribute to high mortality. In adult horses with DIC, the lung has been the organ most frequently affected by fibrin deposits. In addition, in vivo studies suggest that hemostatic mechanisms may be immature in foals < 1-day old. HYPOTHESIS Newborn foals with severe septicemia have fibrin deposits in their tissues independently of their age, and these fibrin deposits are associated with organ failure. ANIMALS Thirty-two septic and 4 nonseptic newborn foals euthanized for poor prognosis. METHODS Tissue samples (kidney, lung, and liver) collected on postmortem examination were stained with phosphotungstic acid hematoxylin (PTAH) and immunohistochemistry (IHC) for blind histologic examination. A fibrin score (grades 0-4) was established for each tissue sample and for each foal. Medical records were reviewed for assessing clinical evidence of organ failure during hospitalization. RESULTS Fibrin deposits were found in most septic foals (28/32 when using IHC and 21/32 when using PTAH), independently of the age of the foal. The lung was the most affected tissue (97% of the septic foals). Additionally, organ failure was diagnosed in 18/32 septic foals (8 with respiratory failure, 14 with renal failure), although a statistical association with severe fibrin deposition was not identified. CONCLUSIONS AND CLINICAL IMPORTANCE Nonsurviving septic foals have fibrin deposits in their tissues, a finding consistent with capillary microthrombosis and DIC.
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Affiliation(s)
- M Cotovio
- Departamento de Ciências Veterinárias, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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Cotovio M, Monreal L, Navarro M, Segura D, Prada J, Alves A. Detection of Fibrin Deposits in Horse Tissues by Immunohistochemistry. J Vet Intern Med 2007. [DOI: 10.1111/j.1939-1676.2007.tb03068.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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