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J Vet Emerg Crit Care (San Antonio). 2013 Jan-Feb;23(1):14-22. doi: 10.1111/vec.12013. Epub 2013 Jan 14.

Alterations in the hemostatic profiles of dogs with naturally occurring septic peritonitis.

Author information

1
Department of Clinical Studies, Matthew J Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.

Abstract

OBJECTIVE:

To characterize derangements in the hemostatic profiles of dogs with naturally occurring septic peritonitis and determine if such derangements were predictive of survival.

DESIGN:

Prospective, observational single cohort study.

SETTING:

University veterinary teaching hospital.

ANIMALS:

A total of 27 client-owned dogs with naturally occurring septic peritonitis.

INTERVENTIONS:

Standard treatment included fluid resuscitation, antimicrobial therapy, supportive care, and surgery provided at the discretion of the primary clinician. Blood was collected preoperatively and on days 1 and 3 postoperatively for platelet count, prothrombin time, activated partial thromboplastin time, D-dimer and fibrinogen concentrations, total protein C (PC) and antithrombin (AT) activities, and thromboelastography.

MEASUREMENTS AND MAIN RESULTS:

Sixteen of 27 (59%) dogs survived. Preoperative PC deficiency was identified in 10 of 11 (91%) nonsurvivors and 2 of 15 (13%) survivors. Preoperative AT deficiency was identified in 10 of 11 (91%) nonsurvivors and 14 of 15 (93%) survivors. Compared to survivors, nonsurvivors had lower mean preoperative PC (98 ± 24% versus 49 ± 26%; P < 0.001) and AT (53 ± 9% versus 32 ± 16%; P < 0.001) activities. Anticoagulant activities decreased on day 1 postoperatively. As a predictor of survival, preoperative PC activity of more than 60% achieved a sensitivity of 93% and specificity of 82%. Preoperative AT activity of more than 41.5% achieved a sensitivity of 100% and specificity of 82%. The maximum amplitude, α angle, and coagulation index from preoperative thromboelastograms of survivors were significantly greater (more hypercoagulable) than nonsurvivors (P < 0.01), with the maximum amplitude being the most specific predictor of survival (100%).

CONCLUSIONS:

Deficiencies of PC and AT and hypercoagulability appear to be consistent features of naturally occurring canine sepsis and may be useful prognostic indicators in canine septic peritonitis.

PMID:
23317011
DOI:
10.1111/vec.12013
[Indexed for MEDLINE]

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