OBJECTIVE To determine whether critically ill dogs had increased platelet activation and whether the proportion of activated platelets correlated with severity of illness.
ANIMALS 82 dogs in the intensive care unit of a veterinary teaching hospital and 24 healthy control dogs.
PROCEDURES Flow cytometry with monoclonal mouse anti-human CD61 and CD62 antibodies in resting and ADP-treated samples and kaolin-activated thromboelastography were used to compare platelet activation in blood samples of critically ill and control dogs. Serum antithrombin, von Willebrand factor, fibrinogen, and activated protein C concentrations; prothrombin time (PT); and activated partial thromboplastin time (aPTT) were measured. Revised survival prediction index, acute patient physiology and laboratory evaluation, systemic inflammatory response syndrome, and multiple organ dysfunction syndrome scores were used to estimate severity of illness. Severity of illness scores and platelet activation measurements were compared with survival time and duration and cost of hospitalization.
RESULTS Critically ill and control dogs had no differences in platelet activation for non–ADP-treated samples measured. Critically ill dogs had significantly increased platelet activation in response to 2, 6, and 10μM ADP. Critically ill dogs had significantly increased maximum amplitude, α angle, and global clot strength and significantly decreased clot formation time. Critically ill dogs had significantly increased fibrinogen concentration, PT, and aPTT and significantly decreased antithrombin concentration. Survivors and nonsurvivors had similar flow cytometry and thromboelastography values. Three dogs developed macrothrombosis.
CONCLUSIONS AND CLINICAL RELEVANCE In this study, critically ill dogs had hyperreactive platelets, which may have contributed to a high incidence of hypercoagulability in this patient population.
To determine the frequency and severity of thrombocytosis and thromboelastographic evidence of hypercoagulability during the first 2 weeks after splenectomy in dogs with splenic masses and to investigate relationships between platelet counts and thromboelastography values.
34 dogs undergoing splenectomy for splenic masses.
Blood samples for platelet counts and thromboelastography were obtained at induction of anesthesia (day 0) prior to splenectomy and on days 2, 7, and 14.
Mean platelet counts were 167.9 × 103/μL, 260.4 × 103 μ/L, 715.9 × 103/μL, and 582.2 × 103/μL on days 0, 2, 7, and 14, respectively, and were significantly higher at all postoperative assessment points than on day 0. Thrombocytosis was observed in 3% (1/34), 6% (2/33), 81% (21/26), and 69% (18/26) of dogs on days 0, 2, 7, and 14. Platelet counts > 1,000 × 103/μL were observed in 1 dog on day 2 and in 5 dogs on day 7. One or more thromboelastography values suggestive of hypercoagulability were observed in 45% (15/33), 84% (26/31), 89% (24/27), and 84% (21/25) of dogs on days 0, 2, 7, and 14. At each assessment point, higher platelet counts were correlated with thromboelastography values suggestive of hypercoagulability.
CONCLUSIONS AND CLINICAL RELEVANCE
Marked thrombocytosis and thromboelastography values suggestive of hypercoagulability were common during the first 2 weeks after splenectomy for the dogs of this study. If present, hypercoagulability could increase the risk for development of postsplenectomy thrombotic conditions such as portal system thrombosis and pulmonary thromboembolism.
Objective—To describe a population of dogs with vehicular trauma and to determine whether age, type and severity of injury, or preexisting disease were associated with outcome.
Design—Retrospective case series.
Animals—239 dogs evaluated at a university referral hospital after vehicular trauma over a 12-month period.
Procedures—Patient characteristics, including age, outcome, animal trauma triage (ATT) score, treatments performed, hospital stay, cost, and preexisting disease, were recorded from medical records of dogs that had vehicular trauma. Dogs were assigned to a young, middle-aged, or geriatric age group. Categoric and continuous variables were compared between survivors and nonsurvivors to identify possible associations.
Results—239 dogs (126 males and 113 females) were evaluated following vehicular trauma during 2001: young (n = 149), middle-aged (68), and geriatric (22). The median ATT score was 3 (range, 0 to 15). Sixteen dogs had preexisting disease. Hospital stay ranged from < 1 to 28 days (median, 3 days). Cost ranged from $77 to $10,636 (median, $853). Two hundred six dogs were discharged. Twenty-six dogs were euthanatized, and 7 died. Dogs that died or were euthanatized had significantly higher ATT scores. The ATT score also was associated with a significantly higher cost of care. Dogs with multiple injuries had significantly higher ATT scores, had increased cost of care, and were significantly more likely to die or be euthanatized.
Conclusions and Clinical Relevance—Increased injury severity in dogs was associated with increased mortality rates and higher cost of treatment.
Objective—To evaluate the clinical course of dogs with hemophilia A (factor VIII deficiency) and to determine whether factor VIII coagulant activity (FVIII:C) was associated with severity of clinical signs and outcome.
Sample—Respondent information for 39 client-owned dogs with FVIII deficiency.
Procedures—Information was obtained via a survey distributed to the American College of Veterinary Internal Medicine and American College of Veterinary Emergency and Critical Care email list serves and to the Veterinary Information Network community to identify dogs with hemophilia A (FVIII:C ≤ 20%). Severity of FVIII deficiency was classified as mild (FVIII:C, 6% to 20%), moderate (FVIII:C, 2% to 5%), or severe (FVIII:C, < 2%).
Results—Data for 39 dogs (38 males and 1 female) were compiled. Mixed-breed dogs, German Shepherd Dogs, and Labrador Retrievers were most commonly affected. In most (34/39) dogs, disease was diagnosed at < 1 year of age. Bleeding associated with teething, minor trauma, vaccination, and elective surgical procedures most commonly prompted FVIII:C testing. Affected dogs had similar signs of spontaneous hemorrhage regardless of the magnitude of FVIII deficiency. Four dogs were euthanized without treatment at the time of diagnosis. Thirty dogs received ≥ 1 blood transfusion; FVIII:C did not appear to influence transfusion requirements.
Conclusions and Clinical Relevance—Results indicated that dogs with hemophilia A have variations in clinical course of the disease and may have a good long-term prognosis. Residual FVIII:C may not be useful for predicting severity of clinical signs, transfusion needs, or long-term prognosis.