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Sotos KE, Goggs R, Stablein AP, Brooks MB. Increased thrombin activatable fibrinolysis inhibitor activity is associated with hypofibrinolysis in dogs with sepsis. Front Vet Sci 2023; 10:1104602. [PMID: 36876005 PMCID: PMC9978197 DOI: 10.3389/fvets.2023.1104602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction Disorders of coagulation are well-recognized in dogs with sepsis, but data regarding fibrinolysis disorders are limited. We aimed to characterize fibrinolysis in dogs with sepsis compared to healthy controls. We hypothesized that dogs with sepsis would be hypofibrinolytic, and that hypofibrinolysis would be associated with non-survival. Methods This was a prospective observational cohort study. We enrolled 20 client-owned dogs with sepsis admitted to the Cornell University Hospital for Animals and 20 healthy pet dogs. Coagulation and fibrinolytic pathway proteins including antiplasmin activity (AP), antithrombin activity (AT), thrombin activatable fibrinolysis inhibitor activity (TAFI), D-dimer concentration, fibrinogen concentration, and plasminogen activity were measured and compared between groups. Overall coagulation potential, overall fibrinolysis potential, and overall hemostatic potential were calculated from the curve of fibrin clot formation and lysis over time. Results Compared to healthy controls, dogs with sepsis had lower AT (P = 0.009), higher AP (P = 0.002), higher TAFI (P = 0.0385), and higher concentrations of fibrinogen (P < 0.0001) and D-dimer (P = 0.0001). Dogs with sepsis also had greater overall coagulation potential (P = 0.003), overall hemostatic potential (P = 0.0015), and lower overall fibrinolysis potential (P = 0.0004). The extent of fibrinolysis was significantly negatively correlated with TAFI. No significant differences were observed between survivors and non-survivors. Discussion Dogs with sepsis were hypercoagulable and hypofibrinolytic compared to healthy dogs, suggesting potential utility of thromboprophylaxis in this patient population. The association between high TAFI and low overall fibrinolysis potential might provide a potential mechanism for this hypofibrinolysis.
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Affiliation(s)
- Katherine E Sotos
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Alyssa P Stablein
- Comparative Coagulation Laboratory, Animal Health Diagnostic Center, Cornell University, Ithaca, NY, United States
| | - Marjory B Brooks
- Comparative Coagulation Laboratory, Animal Health Diagnostic Center, Cornell University, Ithaca, NY, United States
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Jeffery U, Brooks MB, LeVine DN. Development of a fibrinolysis assay for canine plasma. Vet J 2017; 229:19-25. [PMID: 29183569 DOI: 10.1016/j.tvjl.2017.10.020] [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: 02/02/2017] [Revised: 07/11/2017] [Accepted: 10/25/2017] [Indexed: 11/28/2022]
Abstract
Unbalanced coagulation and fibrinolysis leads to hemorrhage or thrombosis. Thromboelastography has been used to characterize hypo- and hyper-fibrinolysis in dogs, however the technique requires specialized instrumentation and proprietary reagents that limit its availability. The aim of this study was to develop a simple microplate method for assessment of fibrinolysis in canine plasma. Plasma from healthy dogs was mixed in a microwell plate with tissue factor, calcium, phospholipid and tissue plasminogen activator. Light absorbance was measured at regular intervals until return to baseline. Peak optical density (milli-absorption units, mAU), formation velocity (mAU/s), lysis velocity (mAU/s) and area under the curve (mAU.s) were calculated. The influence of potential interferents, variation in fibrinogen and ex vivo addition of heparin and aminocaproic acid on assay performance was determined. Inter-day coefficients of variation were ≤15% for all variables. Bilirubin≤1.88mg/dL and hemoglobin≤0.09mg/dL did not interfere with assay variables. Aminocaproic acid (40μg/mL) and heparin (0.125U/mL) caused almost complete inhibition of fibrinolysis and coagulation, respectively. All variables except lysis velocity (R2=0.08) were associated with fibrinogen concentration (R2>0.8). This assay showed acceptable performance characteristics for measurement of fibrinolysis in normal canine plasma. The assay utilizes small volume citrate plasma samples and readily available instrumentation and reagents, is not influenced by mild to moderate hemolysis or icterus and detects the presence of fibrinolysis inhibitors.
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Affiliation(s)
- U Jeffery
- Veterinary Microbiology and Preventative Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA.
| | - M B Brooks
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - D N LeVine
- Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
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Brooks MB, Stablein AP, Johnson L, Schultze AE. Preanalytic processing of rat plasma influences thrombin generation and fibrinolysis assays. Vet Clin Pathol 2017; 46:496-507. [DOI: 10.1111/vcp.12534] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Marjory B. Brooks
- Departments of Population Medicine and Diagnostic Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY USA
| | - Alyssa P. Stablein
- Departments of Population Medicine and Diagnostic Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY USA
| | - Lynn Johnson
- Cornell Statistical Consulting Unit; Cornell University; Ithaca NY USA
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Dengate AL, Morel-Kopp MC, Beatty JA, Barrs V, Braddock JA, Churcher RK, Wilson BJ, Ward CM. Differentiation between dogs with thrombosis and normal dogs using the overall hemostasis potential assay. J Vet Emerg Crit Care (San Antonio) 2016; 26:446-52. [PMID: 26808263 DOI: 10.1111/vec.12442] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 08/03/2014] [Accepted: 08/29/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine whether the overall hemostasis potential (OHP) and calibrated automated thrombogram (CAT) were significantly different between dogs with thrombosis and normal dogs. ANIMALS Ten dogs with clinical evidence of thromboembolic disease had both OHP and CAT performed. Forty healthy control dogs had OHP performed, and 23 of these also had CAT performed. MEASUREMENTS AND MAIN RESULTS Dogs with thrombosis had significantly higher OHP (P = 0.003), overall coagulation potential (P = 0.0001), and maximum optical density (Max OD, P < 0.0001) than normal dogs, and a significantly longer delay in the start of clot formation (P = 0.01). Max OD was higher than established reference intervals in 80% of the dogs with thrombosis. Using the CAT assay, dogs with thrombosis had a significantly longer lag time than normal dogs (P < 0.001). Plasma fibrinogen concentration correlated positively with overall coagulation potential, OHP, Max OD, and the slope of the OHP curve (P < 0.05), and was increased in 90% of dogs with thrombosis. CONCLUSIONS The OHP assay findings were significantly different between normal dogs and those with thrombosis. CAT did not detect any significant differences between these populations of dogs, other than the lag time of the assay.
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Affiliation(s)
- Anna L Dengate
- Northern Blood Research Centre, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW, 2065, Australia.,Faculty of Veterinary Science, University of Sydney, B10, Camperdown, NSW, 2006, Australia.,North Shore Veterinary Specialist Centre, Crows Nest, NSW, 2065, Australia
| | - Marie-Christine Morel-Kopp
- Northern Blood Research Centre, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW, 2065, Australia.,Department of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Julia A Beatty
- Faculty of Veterinary Science, University of Sydney, B10, Camperdown, NSW, 2006, Australia
| | - Vanessa Barrs
- Faculty of Veterinary Science, University of Sydney, B10, Camperdown, NSW, 2006, Australia
| | - Jody A Braddock
- North Shore Veterinary Specialist Centre, Crows Nest, NSW, 2065, Australia
| | - Richard K Churcher
- North Shore Veterinary Specialist Centre, Crows Nest, NSW, 2065, Australia
| | - Bethany J Wilson
- Faculty of Veterinary Science, University of Sydney, B10, Camperdown, NSW, 2006, Australia
| | - Christopher M Ward
- Northern Blood Research Centre, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW, 2065, Australia.,Department of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
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