Dionne Trysta L, Ishak Anthony M, Cochran Lauren A
BluePearl Veterinary Partners-Tampa, Tampa, Florida, USA.
J Vet Emerg Crit Care (San Antonio). 2023 Jan;33(1):81-90. doi: 10.1111/vec.13262. Epub 2022 Dec 1.
To compare viscoelastic parameters between healthy control dogs and dogs with primary immune-mediated hemolytic anemia (pIMHA) using a new, point-of-care viscoelastic coagulation monitor (VCM). DESIGN: Retrospective study from 2017 to 2021.
Three regional private referral centers.
Eighteen client-owned dogs with pIMHA and 33 healthy control dogs. pIMHA dogs were defined based on established criteria.
None.
Medical records of dogs with pIMHA and VCM performed at diagnosis from 2017 to 2021 and apparently healthy control dogs voluntarily enrolled in the blood donor program from 2017 to 2018 were reviewed. For the healthy control dogs, consent was obtained to perform VCM in addition to traditional screening. Compared to healthy control dogs, dogs with pIMHA had mean VCM parameters consistent with hypercoagulability, demonstrated by lower mean (SD) clot formation time (108 s [30] vs 233 s [55]; P < 0.0001), higher mean alpha angle (62 degrees [6] vs 52 degrees [6]; P < 0.0001), higher mean maximum clot formation (49 VCM units [11] vs 32 VCM units [5]; P < 0.0001), higher mean amplitude at 10 minutes (40 VCM units [11] vs 19 VCM units [3]; P < 0.0001), and higher mean amplitude at 20 minutes (47 VCM units [11] vs 25 VCM units [4]; P < 0.0001). pIMHA dogs also had significantly higher median (interquartile range) lysis index at 30 minutes (100% [100-100] vs 98% [90-100]; P < 0.0001). When compared to 3 established normal canine reference intervals, dogs with pIMHA had a significantly higher proportion of VCM variables (48%-57%) consistent with hypercoagulability, and a significant percentage of pIMHA dogs (78%-89%) had VCM tracings consistent with hypercoagulability overall, irrespective of the interval utilized for interpretation.
This study demonstrates hypercoagulability in dogs with pIMHA when compared to healthy control dogs using VCM. Prospective evaluation is warranted to further characterize these findings as well as to evaluate their clinical impact.
使用一种新型的即时床旁粘弹性凝血监测仪（VCM），比较健康对照犬和患有原发性免疫介导性溶血性贫血（pIMHA）的犬的粘弹性参数。
2017年至2021年的回顾性研究。
三个地区性私人转诊中心。
18只患pIMHA的客户拥有犬和33只健康对照犬。pIMHA犬根据既定标准定义。
无。
回顾了2017年至2021年诊断时进行VCM检查的pIMHA犬的病历，以及2017年至2018年自愿参加献血计划的明显健康对照犬的病历。对于健康对照犬，除传统筛查外，还获得了进行VCM检查的同意。与健康对照犬相比，pIMHA犬的平均VCM参数与高凝状态一致，表现为平均（标准差）凝血形成时间较低（108秒[30]对233秒[55]；P<0.0001），平均α角较高（62度[6]对52度[6]；P<0.0001），平均最大凝血形成较高（49个VCM单位[11]对32个VCM单位[5]；P<0.0001），10分钟时平均振幅较高（40个VCM单位[11]对19个VCM单位[3]；P<0.0001），20分钟时平均振幅较高（47个VCM单位[11]对25个VCM单位[4]；P<0.0001）。pIMHA犬在30分钟时的中位（四分位间距）溶解指数也显著更高（100%[100-100]对98%[90-100]；P<0.0001）。与3个既定的正常犬参考区间相比，pIMHA犬中与高凝状态一致的VCM变量比例显著更高（48%-57%），并且无论用于解释的区间如何，相当比例的pIMHA犬（78%-89%）的VCM描记图总体上与高凝状态一致。
本研究表明，与使用VCM的健康对照犬相比，pIMHA犬存在高凝状态。有必要进行前瞻性评估，以进一步描述这些发现，并评估其临床影响。
