Open AccessThrombelastography in Horses with Acute Gastrointestinal Disease
Author(s) -
Epstein K.L.,
Brainard B.M.,
GomezIbanez S.E.,
Lopes M.A.F.,
Barton M.H.,
Moore J.N.
Publication year - 2011
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/j.1939-1676.2010.0673.x
Subject(s) - medicine , gastroenterology , coagulopathy , fibrinogen , prothrombin time , systemic inflammatory response syndrome , sepsis
Background: Coagulopathies in horses with gastrointestinal disease are frequently identified and associated with morbidity and fatality. Objective: Determine if thrombelastography (TEG) identifies abnormalities associated with lesion type, presence of systemic inflammatory response syndrome (SIRS), morbidity, and fatality more consistently than traditional coagulation testing. Animals: One‐hundred and one horses examined for gastrointestinal disease and 20 healthy horses. Methods: TEG, tissue factor (TF)‐TEG, and traditional coagulation panels parameters and percentages of horses with coagulopathies were compared for lesion type, presence of SIRS, complications, and survival. Results: Changes in individual parameters and increased incidence of coagulopathies were associated with fatality (R, P = .007; k‐value [K], P = .004; clot lysis [CL]30, P = .037; CL60, P = .050; angle [Ang], P = .0003; maximum amplitude [MA], P = .006; lysis [Ly]30, P = .042; Ly60, P = .027; CI, P = .0004; ≥ 2 TEG coagulopathies, P = .013; ≥ 3 TEG coagulopathies, P = .038; TF‐R, P = .037; TF‐K, P = .004; TF‐CL30, P < .0001; TF‐CL60, P < .0001; TF‐Ang, P = .005; TF‐Ly30, P = .0002; TF‐Ly60, P < .0001; TF‐CI, P = .043; ≥ 1 TF‐TEG coagulopathies, P = .003; ≥ 2 TF‐TEG coagulopathies, P = .0004; prothrombin tme [PT], P < .0001; activated partial throboplastin time [aPTT], P = .021), inflammatory lesions (MA, P = .013; TF‐CL30, P = .033; TF‐CL60, P = .010; TF‐Ly60, P = .011; ≥ 1 TF‐TEG coagulopathy, P = .036; ≥ 2 TF‐TEG coagulopathy, P = .0007; PT, P = .0005; fibrinogen, P = .019), SIRS (MA, P = .004; TF‐CL30, P = .019; TF‐CL60, P = .013; TF‐Ly30, P = .020; TF‐Ly60, P = .010; PT, P < .0001; aPTT, P = .032; disseminated intravascular coagulation, P = .005), and complications (ileus: aPTT, P = .020; diarrhea: TF‐CL30, P = .040; TF‐Ly30, P = .041; thrombophlebitis: ≥ 1 TF‐TEG coagulopathy, P = .018; laminitis: MA, P = .004; CL60, P = .045; CI, P = .036; TF‐MA, P = .019; TF‐TEG CI, P = .019). Abnormalities in TEG and TF‐TEG parameters were indicative of hypocoagulation and hypofibrinolysis. Conclusions and Clinical Importance: TEG identifies changes in coagulation and fibrinolysis associated with lesion type, SIRS, morbidity, and fatality in horses with gastrointestinal disease.