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对被南加州本土响尾蛇咬伤的狗进行血栓弹力图评估。

Thromboelastographic evaluation of dogs bitten by rattlesnakes native to southern California.

作者信息

Lieblick Beth A, Bergman Philip J, Peterson Nathan W

出版信息

Am J Vet Res. 2018 May;79(5):532-537. doi: 10.2460/ajvr.79.5.532.

DOI:10.2460/ajvr.79.5.532
PMID:29688784
Abstract

OBJECTIVE To validate that dogs become hypocoagulable following rattlesnake envenomation and to determine whether thromboelastographic abnormalities are correlated with envenomation severity for dogs bitten by rattlesnakes native to southern California. ANIMALS 14 dogs with observed or suspected rattlesnake envenomation (envenomated dogs) and 10 healthy control dogs. PROCEDURES For each dog, a citrate-anticoagulated blood sample underwent kaolin-activated thromboelastography. For each envenomated dog, a snakebite severity score was assigned on the basis of clinical findings, and prothrombin time, activated partial thromboplastin time, and platelet count were determined when the attending clinician deemed it necessary and owner finances allowed. RESULTS For 12 of 14 envenomated dogs, the thromboelastographically determined clot strength was below the 25th percentile for the clot strength of control dogs, which was indicative of a hypocoagulable state. No envenomated dog had thromboelastographic results indicative of a hypercoagulable state. One envenomated dog had a prolonged prothrombin time, but the activated partial thromboplastin time and all thromboelastographic variables were within the respective reference ranges for that dog. Seven of 13 envenomated dogs were thrombocytopenic (platelet count, ≤ 170,000 platelets/μL). Snakebite severity score was negatively correlated with platelet count but was not correlated with any thromboelastographic variable. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dogs generally become hypocoagulable following rattlesnake envenomation. Thromboelastography might provide an objective measure of the coagulation status of envenomated dogs and aid in the identification of dogs that are in a hypocoagulable state and in need of antivenin treatment prior to the onset of progressive clinical signs.

摘要

目的 验证犬被响尾蛇咬伤后是否会出现低凝状态,并确定对于被南加州本地响尾蛇咬伤的犬,血栓弹力图异常是否与中毒严重程度相关。动物 14 只观察到或疑似被响尾蛇咬伤的犬(中毒犬)和 10 只健康对照犬。方法 对每只犬,采集枸橼酸盐抗凝的血液样本进行高岭土激活血栓弹力图检测。对每只中毒犬,根据临床发现给予蛇咬伤严重程度评分,当主治医生认为必要且主人经济条件允许时,测定凝血酶原时间、活化部分凝血活酶时间和血小板计数。结果 14 只中毒犬中有 12 只,血栓弹力图测定的凝血强度低于对照犬凝血强度的第 25 百分位数,这表明处于低凝状态。没有中毒犬的血栓弹力图结果表明处于高凝状态。1 只中毒犬凝血酶原时间延长,但活化部分凝血活酶时间和所有血栓弹力图变量均在该犬各自的参考范围内。13 只中毒犬中有 7 只血小板减少(血小板计数≤170,000 个/μL)。蛇咬伤严重程度评分与血小板计数呈负相关,但与任何血栓弹力图变量均无相关性。结论及临床意义 结果表明犬被响尾蛇咬伤后通常会出现低凝状态。血栓弹力图可能为中毒犬的凝血状态提供客观测量,并有助于识别处于低凝状态且在出现进行性临床症状之前需要抗蛇毒血清治疗的犬。

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