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

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Cell Count / veterinary
  • Blood Coagulation / physiology*
  • Dog Diseases / blood
  • Dog Diseases / etiology*
  • Dogs
  • Female
  • Hemostasis / physiology*
  • Male
  • Nickel
  • Peritonitis / blood
  • Peritonitis / veterinary*
  • Sepsis / blood
  • Sepsis / complications
  • Sepsis / veterinary*
  • Thrombelastography / veterinary
  • Titanium

Substances

  • titanium nickelide
  • Nickel
  • Titanium