Topic:Coagulation
Coagulation in horses refers to the complex process by which blood forms clots, a critical function that prevents excessive bleeding following injury. This process involves a series of enzymatic reactions that lead to the transformation of liquid blood components into a stable clot. Key elements in equine coagulation include platelets, clotting factors, and fibrinogen. Abnormalities in the coagulation process can result in disorders such as excessive bleeding or thrombosis. Research in this area focuses on understanding the mechanisms of coagulation, identifying potential genetic or environmental influences, and developing diagnostic and therapeutic strategies for coagulation-related disorders in horses. This page compiles peer-reviewed research studies and scholarly articles that explore the mechanisms, regulation, and clinical implications of coagulation in equine health.
Hemorrhage and blood loss-induced anemia associated with an acquired coagulation factor VIII inhibitor in a Thoroughbred mare. A 23-year-old Thoroughbred mare was evaluated because of a coagulopathy causing hemoperitoneum, hematomas, and signs of blood loss-induced anemia. Results: The mare had tachycardia, pallor, hypoperfusion, and a large mass in the right flank. The mass was further characterized ultrasonographically as an extensive hematoma in the body wall with associated hemoabdomen. Coagulation testing revealed persistent, specific prolongation of the activated partial thromboplastin time (> 100 seconds; reference interval, 24 to 44 seconds) attributable to severe factor VIII deficiency (12%; reference inte...
Coagulation, oncotic and haemodilutional effects of a third-generation hydroxyethyl starch (130/0.4) solution in horses. Clinical indications for hydroxyethyl starches (HES) in horses include rapid plasma volume expansion and oncotic support during periods of hypoproteinaemia. Side effects such as coagulopathies associated with HES administration pose limitations to their use in veterinary medicine. In man, tetrastarch (130/0.4) has demonstrated less profound effects on coagulation compared with first- and second-generation HES. Objective: To evaluate the haemostatic and oncotic effects of tetrastarch (130/0.4) administered at 10, 20 and 40 ml/kg bwt in healthy horses. Methods: Randomised crossover experiment....
Systematic evaluation of evidence on veterinary viscoelastic testing part 1: System comparability. To systematically examine the evidence on system comparability between the thromboelastography and the rotational thromboelastometry viscoelastic point-of-care instruments and to identify knowledge gaps. Methods: Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Methods: Academic and referral veterinary medical centers. Results: Medline via PubMed, CAB abstracts, and Google Scholar were searched. A total of 8 rele...
Hemostatic profile during late pregnancy and early postpartum period in mares. Hemostasis is a physiological process that prevents excessive blood loss and represents a protective mechanism at the time of delivery. Peripartum hemorrhage is a recurring hazardous condition to mare's health; therefore, we aimed to study mares' hemostatic profile to investigate whether physiological adjustments occur during late pregnancy and early postpartum. Fifteen pregnant mares have been monitored from the 34th week of pregnancy until the third week after foaling. Fifteen nonpregnant mares were used as control group. Jugular blood samples were analyzed for platelet count (Plt), prothrom...
Cardiovascular, colloid osmotic pressure, and hemostatic effects of 2 formulations of hydroxyethyl starch in healthy horses. Lower molecular weight and molar substitution formulations of hydroxyethyl starch (HES) solutions might maximize cardiovascular function and colloid osmotic pressure (COP) and minimize adverse effects on coagulation. Objective: To compare effects of 1 low and 1 high molecular weight and molar substitution HES solution on cardiovascular variables, COP, and hemostasis in normal horses. Methods: Eight healthy adult horses. Methods: Randomized, crossover designed study: 10 mL/kg bolus of 6% HES (600/0.75) (hetastarch) (HS), 6% HES (130/0.4) tetrastarch (TS), and 0.9% NaCl (NS). Variables recorded ...
Training-induced changes in clotting parameters of athletic horses. The purpose of this study was to investigate the effects of training on prothrombin time, activated partial thromboplastin time, and fibrinogen (Fb) concentrations in horses to assess potential adaptive response to training. Fifteen clinically healthy horses were enrolled in the present study and equally divided into three groups. Group A completed an intense training program, group B participated in a light training program, and group C included sedentary horses. After 5 weeks, group B was subjected to the same training program completed by group A and renamed group B1. Blood samples were col...
Therapeutic plasma concentrations of epsilon aminocaproic acid and tranexamic acid in horses. Antifibrinolytic drugs such as epsilon aminocaproic acid (EACA) and tranexamic acid (TEA) are used to treat various bleeding disorders in horses. Although horses are hypofibrinolytic compared to humans, dosing schemes have been derived from pharmacokinetic studies targeting plasma concentrations in humans. Objective: We hypothesized therapeutic plasma concentrations of antifibrinolytic drugs in horses would be significantly lower than in humans. Our objective was to use thromboleastography (TEG) and an in vitro model of hyperfibrinolysis to predict therapeutic concentrations of EACA and TEA in...
Plasma D-dimer concentrations during experimental EHV-1 infection of horses. Central nervous system blood vessel thrombosis is a part of the pathogenesis of equid herpesvirus-associated myeloencephalopathy (EHM). D-dimers (DD) are stable breakdown products of cross-linked fibrin, and increased DD-plasma concentrations could reflect the degree of systemic coagulation during EHV-1 infection. Objective: We hypothesized that blood DD concentrations will be increased during periods of EHV-1 fever and viremia, reflecting an activated coagulation cascade with fibrinolysis. Methods: Twenty-eight equids were infected with EHV-1 in 3 experimental infection studies. Three (uninfe...
Comparison of components of biological variation between 3 equine thromboelastography assays. There is a paucity of information about the analytical performance of thromboelastography (TEG) in horses, specifically concerning components of variation among different analytical methods. Such data may be obtained by nested analysis of repetitive standardized sampling of healthy individuals. Objective: The objectives were (1) to assess the relative susceptibility to sources of preanalytical variation in a highly standardized setting, (2) to directly compare and evaluate the observed analytical variation, and (3) to assess the applicability of population-based reference intervals. Methods: B...
Serial viscoelastic and traditional coagulation testing in horses with gastrointestinal disease. Objectives of this study were to compare the ability of serial thromboelastography, Sonoclot, and traditional coagulation panels to detect coagulopathies associated with disease category, systemic inflammatory response syndrome (SIRS), complications, and nonsurvival in horses with gastrointestinal disease. Methods: Prospective clinical evaluation. Methods: University referral hospital. Methods: One hundred twenty-one horses admitted as emergencies for gastrointestinal disease and 28 healthy adult horses. Methods: Blood samples were collected ≤4 times from emergency horses (admission and if s...
Pharmacokinetics and thrombolytic effects of the recombinant tissue-type plasminogen activator in horses. To test the efficacy of the recombinant tissue-type plasminogen activator (rt-PA) alteplase in horses, the thrombolytic effect was tested in in vitro generated equine thrombi. The extent of lysis was determined by measuring the decrease in thrombi weight over a period of 4 hours. In vivo pharmacokinetics of alteplase were determined in 6 healthy horses. A single dose (1 mg/kg) was applied via intravenous infusion over a period of 30 minutes Coagulation-related variables, blood count and clinical parameters were taken before the treatment and until 48 h after treatment. In addition, plasma rt-P...
[Study on the reproducibility of ACTH concentrations in plasma of horses with and without equine Cushing syndrome]. The evaluation of plasma ACTH and the dexamethasone suppression test are considered the methods of choice to evaluate the course of therapy of pituitary pars intermedia dysfunction (PPID). Sampling protocols as well as vacutainers for analysis differ between the laboratories. To evaluate the reproducability of plasma ACTH measurement between four different laboratories (A, B, C, D) in Germany as well as within the laboratories themselves, ten horses with previously diagnosed PPID and four healthy horses were sampled and analyzed. Each laboratory received two differently labeled samples of each...
Changes in blood coagulation induced by exercise training in young athletic horses. Prothrombin Time (PT), Activated Partial Prothrombin Time (APTT), Fibrinogen concentration (Fbg) and Platelet number (Plt) were evaluated in 20 young athletic horses during a training program. A standardized exercise test (SET) was performed every month for three months. The V4 variations (the speed, in m/min, reached at the blood lactate concentration of 4 mmol/l) obtained for each test were calculated to assess the effect of training program on athletic performance. Blood samples were collected at 20-day intervals over a period of 80 days from the beginning of the training program. The V4 (P...
Jugular thrombophlebitis in horses: a review of fibrinolysis, thrombus formation, and clinical management. Thrombophlebitis of the jugular vein is commonly observed in horses, particularly during intensive care, and leads to local and systemic inflammatory responses as well as head and neck circulatory impairment. Thrombolytic therapy is widely used in human practice with the aim of thrombus dissolution and recanalization of the injured vessels. There are similarities between human and horse coagulation and fibrinolytic processes. This review examines the fibrinolytic system, thrombus formation, and the clinical management of jugular thrombophlebitis, including thrombolytic therapy. There is eviden...
Use of viscoelastic coagulation testing to monitor low molecular weight heparin administration to healthy horses. To evaluate the utility of thromboelastography (TEG) and Sonoclot analyses to monitor the effects of low molecular weight heparin (LMWH) administration to healthy horses. Methods: Randomized crossover study. Methods: Large animal veterinary teaching hospital. Methods: Six adult mixed breed healthy mares. Methods: LMWH (dalteparin) was administered (50 U/kg subcutaneously) either every 12 or 24 h for 3 consecutive days. Blood samples were collected before LMWH administration and then at selected time points for analysis. Thromboelastography derived R-time (R), K-time (K), angle (ANG), and maxim...
In vitro effects of three formulations of hydroxyethyl starch solutions on coagulation and platelet function in horses. To investigate the in vitro effects of 3 hydroxyethyl starch (HES) solutions on viscoelastic coagulation testing and platelet function in horses. Methods: Blood samples collected from 7 healthy adult horses. Methods: Blood samples were diluted with various crystalloid and HES solutions to approximate the dilution of blood in vivo that occurs with administration of a 10 and 20 mL/kg fluid bolus to a horse (1:8 and 1:4 dilutions, respectively). Diluted samples were analyzed through optical platelet aggregometry, platelet function analysis, thromboelastography, and dynamic viscoelastic coagulomet...
Pharmacodynamics of multi-dose low molecular weight heparin in healthy horses. To compare the pharmacodynamics of once daily and twice daily administration of low molecular weight heparin (LMWH) administration in horses. Methods: Randomized cross over study. Methods: Adult mixed breed healthy mares (n = 6). Methods: LMWH (dalteparin) was administered (50 U/kg subcutaneously) either every 12 or 24 hours for 3 consecutive days. Anti-factor Xa activity was measured before and at select time points after LMWH administration. Packed cell volume (PCV), platelet count, partial thromboplastin time (PTT), and anti-thrombin (AT) activity were monitored throughout the study. Result...
Equine herpesvirus type 1 infection induces procoagulant activity in equine monocytes. The alphaherpesvirus, equine herpesvirus type 1 (EHV-1), is a highly prevalent cause of equine infectious abortion and encephalomyelopathy. These syndromes have been attributed to ischemic necrosis from thrombosis in placental and neural vessels, although the mechanisms underlying thrombosis are unknown. After inhalation, EHV-1 establishes a peripheral blood mononuclear cell-associated viremia, with monocytes being a target of infection. Monocytes are also the main source of tissue factor (TF) in diseased states. Since TF is the primary activator of coagulation, increased monocyte TF expressio...
The effects of hyperglycemia and endotoxemia on coagulation parameters in healthy adult horses. Hyperglycemia and endotoxemia have been associated with coagulation abnormalities in horses. Studies in humans suggest greater disturbances in coagulation with hyperglycemia and concurrent endotoxemia. Objective: To compare coagulation parameters in horses administered with lipopolysaccharide (LPS) with and without concurrent hyperglycemia. Methods: Twelve healthy adult horses. Methods: Hyperglycemia (180-240 mg/dL) was maintained for 6 hours in 6 horses (GLU-LPS) using 140 mg/kg IV bolus of dextrose followed by a 20% dextrose constant rate infusion. A similar volume of saline was administe...
Proteomic comparison of equine and bovine milks on renneting. Rennet-induced coagulation of bovine milk is a complex mechanism in which chymosin specifically hydrolyzes κ-casein, the protein responsible for the stability of the casein micelle. In equine milk, this mechanism is still unclear, and the protein targets of chymosin are unknown. To reveal the proteins involved, the rennetability of equine milk by calf chymosin was examined using gel-free and gel-based proteomic analysis and compared to bovine milk. RP-HPLC analysis of bovine and equine milks showed the release of several peptides following chymosin incubation. The hydrolyses of equine and bov...
Thrombelastographic characterization of coagulation/fibrinolysis in horses: role of carboxyheme and metheme states. Carboxyheme and metheme states modulate hemostasis in humans and other species. Further, carbon monoxide and/or nitric oxide production increase in inflammatory disorders involving the gastrointestinal tract, with associated hypercoagulability or hypocoagulability. In particular, the horse suffers both thrombotic or coagulopathic complications during acute gastrointestinal disease. This investigation characterized the thrombelastographic response to carboxyheme (via CORM-2) or metheme (via phenylhydroxylamine, PHA) states without/with addition of tissue type plasminogen activator. Citrated pla...
Synovial fluid D-dimer concentration in horses with osteochondritis dissecans and osteoarthritis. To assess the synovial fibrinolytic pathway activation in adult horses with developmental and degenerative arthropathies such as osteochondritis dissecans (OCD) and osteoarthritis (OA) by measuring synovial D-dimer concentrations. Methods: Prospective observational clinical study of horses admitted for OCD or OA. Synovial fluid was collected during lameness examination or prior to the surgical procedure, and D-dimer concentration and routine synovial fluid analysis were performed. Results: Fifty-eight horses (14 with OCD, 10 with OA and 34 controls) were included in this study. Synovial D-dime...
Plasma proteomics shows an elevation of the anti-inflammatory protein APOA-IV in chronic equine laminitis. Equine laminitis is a devastating disease that causes severe pain in afflicted horses and places a major economic burden on the horse industry. In acute laminitis, the disintegration of the dermal-epidermal junction can cause the third phalanx to detach from the hoof wall, leaving the horse unable to bear weight on the affected limbs. Horses that survive the acute phase transition into a chronic form of laminitis, which is often termed "founder". Some evidence suggests that chronic laminar inflammation might be associated with alterations in the endocrine and immune systems. We investigated th...
Assessment of acute moderate hyperglycemia on traditional and thromboelastometry coagulation parameters in healthy adult horses. To determine whether experimentally induced acute moderate hyperglycemia is associated with coagulation activation in healthy adult horses. Methods: Prospective experimental study. Methods: University veterinary teaching hospital. Methods: Six healthy adult horses. Methods: Hyperglycemia (10.0-13.3 mmol/L [180-240 mg/dL]) was induced and maintained for 6 hours using a hyperglycemic clamp technique. Blood glucose concentrations were assessed using a point of care (POC) glucometer at 10- and 20-minute intervals throughout the hyperglycemic clamp procedure. Platelet count, fibrinogen concentratio...
Effect of intraperitoneal PERIDAN™ concentrate adhesion reduction device on clinical findings, infection, and tissue healing in an adult horse jejunojejunostomy model. To evaluate the effect of PERIDAN™ Concentrate on clinical findings, infection, and tissue healing in adult horses undergoing celiotomy and jejunojejunostomy. Methods: Block randomized blinded experimental in vivo study. Methods: Adult horses (n = 12). Methods: Horses had jejunojejunostomy at 2 sites and were administered 5 L of diluted PERIDAN™ Concentrate (6 horses) or Lactated Ringer's Injection (LRS) control intraperitoneally (6 horses) before body wall closure. Postoperative monitoring comprised physical examinations, serial hematology, coagulation and chemistry panels, and ultrasonog...
Plasma protein changes in horse after prolonged physical exercise: a proteomic study. Physical exercise induces various stress responses and metabolic adaptations that have not yet been completely elucidated. Novel biomarkers are needed in sport veterinary medicine to monitor training levels and to detect subclinical conditions that can develop into exercise-related diseases. In this study, protein modifications in horse plasma induced by prolonged, aerobic physical exercise were investigated by using a proteomic approach based on 2-DE and combined mass spectrometry procedures. Thirty-eight protein spots, associated with expression products of 13 genes, showed significant quant...
Gambling on putative biomarkers of osteoarthritis and osteochondrosis by equine synovial fluid proteomics. Osteoarthritis (OA) and osteochondrosis (OC) are two of the main challenges in orthopedics, whose definitive diagnosis is usually based on radiographic/arthroscopic evidences. Their early diagnosis should allow preventive or timely therapeutic actions, which are generally precluded from the poor relationships occurring between symptomatologic and radiographic evidences. These limitations should be overcome by improving the knowledge on articular tissue metabolism and on molecular factors regulating its normal homeostasis, also identifying novel OA and OC biomarkers suitable for their earlier d...
Thromboelastography in healthy, sick non-septic and septic neonatal foals. To evaluate citrated recalcified thromboelastography (TEG) in healthy newborn foals, and to determine intra-assay, inter-individual and intra-individual (at 12 h, 24 h and 7 days after birth) variations. Additionally, to compare TEG variables, haematological values and conventional coagulation profiles from healthy, sick non-septic, and septic foals. Methods: Prospective study. Methods: The study group comprised 18 healthy, 15 sick non-septic and 17 septic foals. Two citrated (3.2%; 1 : 9 anticoagulant : blood ratio) blood samples were submitted for haemostatic evaluation using a TEG analyser ...
Plasma therapy in foals and adult horses. Although a range of plasma-based products (e.g., cryoprecipitate, albumin, platelet-rich plasma, individual coagulation factors) are available to human physicians, equine veterinarians are largely restricted to using whole blood, frozen plasma, and fresh frozen plasma for transfusions. The indications for frozen or fresh frozen plasma in human medicine are relatively limited, and there is little evidence supporting the efficacy of these products in many cases. Furthermore, many human physicians have concerns regarding disease transmission and anaphylactic reactions after administration of any ...
Stimulus-dependent release of tissue-regenerating factors by equine platelets. Platelet-rich plasma (PRP) is increasingly used for treatment of orthopaedic injuries. However, the effects of different stimuli on the release pattern of regenerative and proinflammatory factors from equine platelets are largely unknown and an optimal treatment protocol remains to be established. Objective: The aim of this study was to identify a stimulus that enhanced release of histopromotive factors (platelet-derived growth factor BB [PDGF] and transforming growth factor 1β[TGF]) without causing concurrent release of a proinflammatory mediator (CCL5). Methods: Washed platelets were prepar...