Richardson Rae, Todd Jeffrey M, Sharkey Leslie C, Washabau Robert J, Williams Kevin D, Little Kim J, Rendahl Aaron
Department of Veterinary Clinical Sciences (Todd, Sharkey, Washabau), Veterinary Medical Center (Williams, Little), College of Veterinary Medicine (Richardson), University of Minnesota, St Paul, MN School of Statistics, University Minnesota, Minneapolis, MN (Rendahl).
J Vet Emerg Crit Care (San Antonio). 2018 Nov;28(6):551-558. doi: 10.1111/vec.12775. Epub 2018 Oct 15.
To characterize disseminated intravascular coagulation (DIC), liver failure (LF), post-hepatic cholestasis (PHC), and anticoagulant rodenticide intoxication (ROD) in dogs using an immunoturbidimetric coagulation analyzer and to characterize the relationship between clinical bleeding and bleeding parameters.
Retrospective study (August 2014-July 2015).
University teaching hospital.
Forty-seven client-owned dogs diagnosed with DIC (n = 24), LF (n = 9), PHC (n = 5), or ROD (n = 9) based on history, clinical pathology, cytology, histopathology. or exploratory surgery.
None.
Median prothrombin time (PT), activated partial thromboplastin time (aPTT), and quantitative fribrinogen assay (QFA) were above the reference interval for DIC, LF, PHC and ROD with the exception of a normal QFA for LF. Clot curve analysis for DIC was characterized by elevated PT Delta, PT first derivative, and aPTT Delta, and normal for aPTT second derivative; all LF parameters were within the RI; all PHC parameters were above the RI; and ROD had elevated aPTT delta, but low aPTT second derivative. Coagulopathic bleeding recognized within the DIC group was characterized by median PT delta in mABS (milliabsorbance), first derivative and aPTT delta values in mABS within the RI at 35.0, 55.5 and 38, respectively. The nonbleeding DIC group median values of these same parameters were 189.5, 586.5 and 288, respectively.
The classically utilized indicators of secondary hemostasis, PT and aPTT, were prolonged within all 4 groups; DIC, LF, PHC and ROD as expected. Fibrinogen concentration was increased in both PHC and ROD, decreased in LF and increased but with a bimodal distribution in DIC that correlated with clinical bleeding. The degree of PT and aPTT prolongation did not correlate with clinical bleeding in the DIC group, however clot curve analysis, did reveal an association.
使用免疫比浊凝血分析仪对犬的弥散性血管内凝血（DIC）、肝功能衰竭（LF）、肝后性胆汁淤积（PHC）和抗凝血灭鼠剂中毒（ROD）进行特征描述，并描述临床出血与出血参数之间的关系。
回顾性研究（2014年8月至2015年7月）。
大学教学医院。
47只客户拥有的犬，根据病史、临床病理学、细胞学、组织病理学或 exploratory 手术诊断为DIC（n = 24）、LF（n = 9）、PHC（n = 5）或ROD（n = 9）。
无。
除LF的定量纤维蛋白原测定（QFA）正常外，DIC、LF、PHC和ROD组的凝血酶原时间（PT）中位数、活化部分凝血活酶时间（aPTT）和定量纤维蛋白原测定（QFA）均高于参考区间。DIC的凝血曲线分析特征为PT Delta、PT一阶导数和aPTT Delta升高，aPTT二阶导数正常；所有LF参数均在参考区间内；所有PHC参数均高于参考区间；ROD的aPTT delta升高，但aPTT二阶导数较低。DIC组内识别出的凝血病性出血特征为mABS（毫吸光度）中的PT delta中位数、一阶导数和RI内mABS中的aPTT delta值，分别为35.0、55.5和38。这些相同参数的非出血DIC组中位数分别为189.5、586.5和288。
如预期的那样，在所有4组中，即DIC、LF、PHC和ROD组中，经典使用的二期止血指标PT和aPTT均延长。PHC和ROD组纤维蛋白原浓度升高，LF组降低，DIC组升高但呈双峰分布，且与临床出血相关。DIC组中PT和aPTT延长程度与临床出血无关，然而凝血曲线分析确实揭示了一种关联。
