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Shropshire SB, Olver CS, Twedt DC, Jablonski Wennogle SA. Multiplate platelet aggregometry in dogs undergoing laparoscopic liver biopsy for diagnosis of chronic hepatopathy. J Small Anim Pract 2021; 63:389-396. [DOI: 10.1111/jsap.13466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/21/2021] [Accepted: 11/27/2021] [Indexed: 11/29/2022]
Affiliation(s)
- S. B. Shropshire
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical SciencesColorado State UniversityFort CollinsColoradoUSA
| | - C. S. Olver
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical SciencesColorado State UniversityFort CollinsColoradoUSA
| | - D. C. Twedt
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical SciencesColorado State UniversityFort CollinsColoradoUSA
| | - S. A. Jablonski Wennogle
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical SciencesColorado State UniversityFort CollinsColoradoUSA
- S. A. Jablonski Wennogle's current address is Department of Small Animal Clinical Sciences, College of Veterinary MedicineMichigan State UniversityEast LansingMichiganUSA
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2
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Boyd CJ, Brainard BM, Smart L. Intravenous Fluid Administration and the Coagulation System. Front Vet Sci 2021; 8:662504. [PMID: 33937383 PMCID: PMC8081828 DOI: 10.3389/fvets.2021.662504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/15/2021] [Indexed: 12/30/2022] Open
Abstract
Intravenous fluid administration in veterinary patients can alter coagulation function by several mechanisms. Both crystalloid and colloid fluids cause hemodilution, reducing platelet count and plasma coagulation protein concentrations. Hemodilution is associated with a hypercoagulable effect at low dilutions and a hypocoagulable effect at higher dilutions. Composition of crystalloid fluids likely has a minor effect, primarily dependent on fluid ion composition. Hypertonic crystalloids may also cause hypocoagulability. Colloids, both synthetic and natural, can cause hypocoagulability by several mechanisms beyond the effects of hemodilution. These include impaired platelet function, decreased plasma coagulation factor activity, impaired fibrin formation and crosslinking, and accelerated fibrinolysis. The vast majority of the veterinary literature investigates the hypocoagulable effects of hydroxyethyl starch-containing fluids using in vitro, experimental, and clinical studies. However, results are inconsistent, likely due to the varying doses and physicochemical properties of the specific fluid products across studies. In addition, some evidence exists for hypocoagulable effects of gelatin and albumin solutions. There is also evidence that these colloids increase the risk of clinical bleeding in people. Limitations of the veterinary evidence for the hypocoagulable effects of colloid fluids include a predominance of in vitro studies and in vivo studies using healthy subjects, which exclude the interaction of the effects of illness. Therefore, clinical relevance of these effects, especially for low-molecular-weight hydroxyethyl starch, is unknown. Firm recommendations about the most appropriate fluid to use in clinical scenarios cannot be made, although it is prudent to limit the dose of synthetic colloid in at-risk patients. Clinicians should closely monitor relevant coagulation assays and for evidence of hemorrhage in at-risk patients receiving any type of fluid therapy, especially in large volumes.
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Affiliation(s)
- Corrin J Boyd
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Lisa Smart
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
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3
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Gant P, McBride D, Humm K. Abnormal platelet activity in dogs and cats - impact and measurement. J Small Anim Pract 2020; 61:3-18. [PMID: 31919851 DOI: 10.1111/jsap.13092] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 05/06/2019] [Accepted: 10/28/2019] [Indexed: 01/08/2023]
Abstract
Abnormal platelet activity can either lead to bleeding tendencies or inappropriate thrombus formation and can occur secondarily to a wide variety of disease processes, with a range of clinical consequences and severity. This article will discuss the pathophysiology of platelet function abnormalities and consider a logical diagnostic approach applicable to veterinary practice. Recent advances in platelet function testing will then be discussed, with regards to detection of platelet dysfunction and tailoring of pharmacological manipulation. Although many of these tests are still confined to research or academic institutions, techniques for indirectly assessing platelet function are starting to become more widely available. Although we still require further research to develop guidelines for the use of these tests in clinical decision-making, the recent advances in this field are an exciting step forward in being able to detect and manage platelet dysfunction in both primary care and referral practice.
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Affiliation(s)
- P Gant
- Queen Mother Hospital for Animals (QMHA), The Royal Veterinary College, Hatfield, Hertfordshire, AL9 7TA, UK
| | - D McBride
- Queen Mother Hospital for Animals (QMHA), The Royal Veterinary College, Hatfield, Hertfordshire, AL9 7TA, UK
| | - K Humm
- Queen Mother Hospital for Animals (QMHA), The Royal Veterinary College, Hatfield, Hertfordshire, AL9 7TA, UK
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Iwanaga T, Miura N, Brainard BM, Brooks MB, Goggs R. A Novel Microchip Flow Chamber (Total Thrombus Analysis System) to Assess Canine Hemostasis. Front Vet Sci 2020; 7:307. [PMID: 32582782 PMCID: PMC7282356 DOI: 10.3389/fvets.2020.00307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/05/2020] [Indexed: 01/27/2023] Open
Abstract
Hemorrhagic diseases are common in dogs. Current coagulation assays do not model all aspects of in vivo hemostasis and may not predict bleeding risk. The Total-Thrombus Analysis System (T-TAS) is a novel hemostasis assay system in which whole blood flows through microfluidic channels at defined shear rates to provide qualitative and quantitative evaluation of platelet function (PL-chip) and coagulation function (AR-chip). The present study evaluated the T-TAS in dogs with hereditary bleeding disorders and with acquired hemorrhagic syndromes (Group 1), and healthy controls (Group 2). Hereditary defects included von Willebrand's disease (VWD; n = 4), hemophilia A (n = 2), and canine Scott syndrome (n = 2). Acquired hemorrhagic disorders included neoplastic hemoperitoneum (n = 2) and acute hemorrhagic diarrhea syndrome (n = 1). Citrate anticoagulated samples were collected from diseased dogs (Group 1, n = 11) and controls (Group 2, n = 11) for coagulation screening tests, fibrinogen analyses, D-dimer concentration, antithrombin activity, von Willebrand Factor antigen, PFA-100 closure time (PFA-CT), and thromboelastography (TEG). Citrate and hirudin anticoagulated samples were used for T-TAS analyses at two shear rates. Qualitative thrombus formation in each chip was recorded using the T-TAS video camera. Numeric parameters, derived from the instrument software, included occlusion start time (OST; time to 10 kPa), occlusion time (OT; time to 60 kPa (PL-chip) or 80 kPa (AR-chip)), and area under the pressure curve (AUC). Correlations between continuous variables were evaluated by Spearman's rank. Continuous variables were compared between groups by Student's t-test or the Mann-Whitney U-test. Alpha was set at 0.05. In combined analyses of all dogs, significant correlations were identified between T-TAS variables, between the PFA-CT and PL-chip parameters and between TEG variables and AR-chip parameters. The prothrombin time correlated with the AR-chip AUC at both shear rates. In Group 1 dogs, the AR-chip AUC at low shear was significantly reduced compared with Group 2 dogs. Aberrant thrombus formation was seen in video images recorded from dogs with VWD and hemophilia A. The T-TAS AR-chip analysis distinguished dogs with bleeding risk compared to healthy controls. Initial evaluations of the T-TAS suggest it may aid characterization of hemostasis in patients at-risk of bleeding and assist with delineating bleeding phenotypes.
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Affiliation(s)
- Tomoko Iwanaga
- Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima, Japan
| | - Naoki Miura
- Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima, Japan
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Marjory B Brooks
- Department of Population Medicine and Diagnostic Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
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Movia D, Di Cristo L, Alnemari R, McCarthy JE, Moustaoui H, Lamy de la Chapelle M, Spadavecchia J, Volkov Y, Prina-Mello A. The curious case of how mimicking physiological complexity in in vitro models of the human respiratory system influences the inflammatory responses. A preliminary study focused on gold nanoparticles. ACTA ACUST UNITED AC 2017. [DOI: 10.1002/jin2.25] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Dania Movia
- Laboratory for Biological Characterization of Advanced Materials (LBCAM), Trinity Translational Medicine Institute; School of Medicine, Trinity College; Dublin Ireland
| | - Luisana Di Cristo
- Laboratory for Biological Characterization of Advanced Materials (LBCAM), Trinity Translational Medicine Institute; School of Medicine, Trinity College; Dublin Ireland
| | - Roaa Alnemari
- Department of Clinical Medicine; School of Medicine, Trinity College; Dublin Ireland
| | | | - Hanane Moustaoui
- CNRS, UMR 7244, CSPBAT; Laboratoire de Chimie, Structures et Propriétés de Biomateriaux et d'Agents Therapeutiques Université Paris 13, Sorbonne Paris Cité, Bobigny, France CNRS; Paris France
| | - Marc Lamy de la Chapelle
- CNRS, UMR 7244, CSPBAT; Laboratoire de Chimie, Structures et Propriétés de Biomateriaux et d'Agents Therapeutiques Université Paris 13, Sorbonne Paris Cité, Bobigny, France CNRS; Paris France
| | - Jolanda Spadavecchia
- CNRS, UMR 7244, CSPBAT; Laboratoire de Chimie, Structures et Propriétés de Biomateriaux et d'Agents Therapeutiques Université Paris 13, Sorbonne Paris Cité, Bobigny, France CNRS; Paris France
| | - Yuri Volkov
- Laboratory for Biological Characterization of Advanced Materials (LBCAM), Trinity Translational Medicine Institute; School of Medicine, Trinity College; Dublin Ireland
- Department of Clinical Medicine; School of Medicine, Trinity College; Dublin Ireland
- CRANN Institute, AMBER Centre; Trinity College; Dublin Ireland
| | - Adriele Prina-Mello
- Laboratory for Biological Characterization of Advanced Materials (LBCAM), Trinity Translational Medicine Institute; School of Medicine, Trinity College; Dublin Ireland
- Department of Clinical Medicine; School of Medicine, Trinity College; Dublin Ireland
- CRANN Institute, AMBER Centre; Trinity College; Dublin Ireland
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Li RHL, Chan DL. Evaluation of platelet function using multiple electrode platelet aggregometry in dogs with septic peritonitis. J Vet Emerg Crit Care (San Antonio) 2016; 26:630-8. [PMID: 27428542 DOI: 10.1111/vec.12508] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 11/18/2015] [Accepted: 12/05/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess platelet function via multiple electrode platelet aggregometry (MEPA) in dogs with septic peritonitis and in healthy dogs. The secondary aim was to determine if there is prognostic significance to changes in platelet function observed in septic dogs. DESIGN Prospective, observational cohort study conducted from January 2012 to March 2014. SETTING University teaching hospital. ANIMALS Twenty dogs with septic peritonitis and 23 healthy dogs. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS MEPA using arachidonic acid, adenosine diphosphate, and collagen (COL) as agonists was measured within 24 hours of diagnosis of sepsis. Compared to healthy dogs, platelet aggregation was reduced in dogs with septic peritonitis for all agonists (P < 0.01). Overall mortality rate was 40%. MEPA in response to COL was significantly reduced in nonsurvivors compared to survivors (P = 0.019). Using receiver-operating characteristic curve statistics, a COL-activated MEPA less than 43.5 aggregation units had a sensitivity and specificity of 85.7% and 90.9%, respectively, for predicting nonsurvival in dogs with septic peritonitis. CONCLUSIONS Circulating platelets from dogs with septic peritonitis have diminished aggregation in response to multiple platelet agonists. MEPA may serve as an assessment tool for illness severity in this patient population.
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Affiliation(s)
- Ronald H L Li
- Section of Emergency and Critical Care, Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK. .,Dr. Li's current address: Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, UC Davis, Davis, CA.
| | - Daniel L Chan
- Section of Emergency and Critical Care, Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
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Chaari A, Abdel Hakim K, Bousselmi K, Etman M, El Bahr M, El Saka A, Hamza E, Ismail M, Khalil EM, Kauts V, Casey WF. Pancreatic injury in patients with septic shock: A literature review. World J Gastrointest Oncol 2016; 8:526-531. [PMID: 27559431 PMCID: PMC4942740 DOI: 10.4251/wjgo.v8.i7.526] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 04/26/2016] [Accepted: 05/27/2016] [Indexed: 02/05/2023] Open
Abstract
Sepsis and septic shock are life threatening condition associated with high mortality rate in critically-ill patients. This high mortality is mainly related to the inadequacy between oxygen delivery and cellular demand leading to the onset of multiorgan dysfunction. Whether this multiorgan failure affect the pancreas is not fully investigated. In fact, pancreatic injury may occur because of ischemia, overwhelming inflammatory response, oxidative stress, cellular apoptosis and/or metabolic derangement. Increased serum amylase and/or lipase levels are common in patients with septic shock. However, imaging test rarely reveal significant pancreatic damage. Whether pancreatic dysfunction does affect the prognosis of patients with septic shock or not is still a matter of debate. In fact, only few studies with limited sample size assessed the clinical relevance of the pancreatic injury in this group of patients. In this review, we aimed to describe the epidemiology and the physiopathology of pancreatic injury in septic shock patients, to clarify whether it requires specific management and to assess its prognostic value. Our main finding is that pancreatic injury does not significantly affect the outcome in septic shock patients. Hence, increased serum pancreatic enzymes without clinical features of acute pancreatitis do not require further imaging investigations and specific therapeutic intervention.
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Blois SL, Lang ST, Wood RD, Monteith G. Biologic variability and correlation of platelet function testing in healthy dogs. Vet Clin Pathol 2015; 44:503-10. [DOI: 10.1111/vcp.12290] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Shauna L. Blois
- Department of Clinical Studies; Ontario Veterinary College; University of Guelph; Guelph ON Canada
| | - Sean T. Lang
- Department of Clinical Studies; Ontario Veterinary College; University of Guelph; Guelph ON Canada
| | - R. Darren Wood
- Department of Pathobiology; Ontario Veterinary College; University of Guelph; Guelph ON Canada
| | - Gabrielle Monteith
- Department of Clinical Studies; Ontario Veterinary College; University of Guelph; Guelph ON Canada
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Kuntz JA, Berent AC, Weisse CW, Bagley DH. Double pigtail ureteral stenting and renal pelvic lavage for renal-sparing treatment of obstructive pyonephrosis in dogs: 13 cases (2008-2012). J Am Vet Med Assoc 2015; 246:216-25. [PMID: 25554938 DOI: 10.2460/javma.246.2.216] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the technical aspects and clinical outcome of endoscopic- and fluoroscopic-guided ureteropelvic lavage and ureteral stent placement for treatment of obstructive pyonephrosis in dogs. DESIGN Retrospective case series. ANIMALS 13 client-owned dogs (14 obstructed ureters). PROCEDURES All patients with obstructive pyonephrosis were treated with a ureteral stent. Medical records were reviewed for history, clinical signs, pre- and postprocedural clinical and imaging data, and short- and long-term outcomes. RESULTS 13 dogs (14 ureters) had unilateral or bilateral ureteral obstructions and pyonephrosis due to ureterolithiasis (n = 13) or a suspected ureteral stricture (1). Eleven dogs had positive results of bacteriologic culture of urine obtained from the bladder, renal pelvis, or both. Ten were thrombocytopenic, and 8 were azotemic. Stents were placed fluoroscopically with endoscopic (n = 11) or surgical (3) assistance. Median hospitalization time was 48 hours (range, 6 to 260 hours). Median follow-up time was 480 days (range, 2 to 1,460 days). Intraoperative complications occurred in 2 patients (stent occlusion from shearing of a guide wire, and wire penetration of the ureter at the location of a stone). Short-term complications included a bladder hematoma (n = 1) and transient dysuria (1). Long-term complications included stent encrustation (n = 1), stent migration (1), and tissue proliferation at the ureterovesicular junction (5), which had no clinical implications. Recurrent urinary tract infections were documented in 7 dogs. CONCLUSIONS AND CLINICAL RELEVANCE Ureteral stenting was a successful renal-sparing treatment for obstructive pyonephrosis in dogs and could often be performed in a minimally invasive manner. There were few major complications. This technique may be considered as an effective treatment option for this condition in dogs.
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Affiliation(s)
- Jodi A Kuntz
- Department of Internal Medicine, Animal Medical Center, 510 E 62nd St, New York, NY 10065
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Kara S, Emeksiz Z, Alioğlu B, Dallar Bilge Y. Effects of neonatal sepsis on thrombocyte tests. J Matern Fetal Neonatal Med 2015; 29:1406-8. [DOI: 10.3109/14767058.2015.1049523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Hamzeh-Cognasse H, Damien P, Chabert A, Pozzetto B, Cognasse F, Garraud O. Platelets and infections - complex interactions with bacteria. Front Immunol 2015; 6:82. [PMID: 25767472 PMCID: PMC4341565 DOI: 10.3389/fimmu.2015.00082] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 02/11/2015] [Indexed: 12/29/2022] Open
Abstract
Platelets can be considered sentinels of vascular system due to their high number in the circulation and to the range of functional immunoreceptors they express. Platelets express a wide range of potential bacterial receptors, including complement receptors, FcγRII, Toll-like receptors but also integrins conventionally described in the hemostatic response, such as GPIIb–IIIa or GPIb. Bacteria bind these receptors either directly, or indirectly via fibrinogen, fibronectin, the first complement C1q, the von Willebrand Factor, etc. The fate of platelet-bound bacteria is questioned. Several studies reported the ability of activated platelets to internalize bacteria such as Staphylococcus aureus or Porphyromonas gingivalis, though there is no clue on what happens thereafter. Are they sheltered from the immune system in the cytoplasm of platelets or are they lysed? Indeed, while the presence of phagolysosome has not been demonstrated in platelets, they contain antimicrobial peptides that were shown to be efficient on S. aureus. Besides, the fact that bacteria can bind to platelets via receptors involved in hemostasis suggests that they may induce aggregation; this has indeed been described for Streptococcus sanguinis, S. epidermidis, or C. pneumoniae. On the other hand, platelets are able to display an inflammatory response to an infectious triggering. We, and others, have shown that platelet release soluble immunomodulatory factors upon stimulation by bacterial components. Moreover, interactions between bacteria and platelets are not limited to only these two partners. Indeed, platelets are also essential for the formation of neutrophil extracellular traps by neutrophils, resulting in bacterial clearance by trapping bacteria and concentrating antibacterial factors but in enhancing thrombosis. In conclusion, the platelet–bacteria interplay is a complex game; its fine analysis is complicated by the fact that the inflammatory component adds to the aggregation response.
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Affiliation(s)
| | - Pauline Damien
- GIMAP-EA3064, Université de Lyon , Saint-Etienne , France
| | - Adrien Chabert
- GIMAP-EA3064, Université de Lyon , Saint-Etienne , France
| | - Bruno Pozzetto
- GIMAP-EA3064, Université de Lyon , Saint-Etienne , France
| | - Fabrice Cognasse
- GIMAP-EA3064, Université de Lyon , Saint-Etienne , France ; Etablissement Français du Sang Auvergne-Loire , Saint-Etienne , France
| | - Olivier Garraud
- GIMAP-EA3064, Université de Lyon , Saint-Etienne , France ; Institut National de la Transfusion Sanguine , Paris , France
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