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Home / Equine Research Bank / BMC Vet Res / A pilot study evaluating the Calibrated Automated Thrombogra...
BMC veterinary research2021; 17(1); 346; doi: 10.1186/s12917-021-03058-7

A pilot study evaluating the Calibrated Automated Thrombogram assay and application of plasma-thromboelastography for detection of hemostatic aberrations in horses with gastrointestinal disease.

Abstract: Critically ill horses, such as horses with gastrointestinal (GI) disease, often suffer from hemostatic aberrations. Global hemostatic tests examining the initiation of coagulation, clot strength and fibrinolysis, such as the Calibrated Automated Thrombogram (CAT) and plasma-thromboelastography (TEG) have not been evaluated in horses. This study aimed to evaluate CAT and apply plasma-TEG in horses. Test performance of CAT was evaluated on equine platelet poor plasma with intra- and inter-assay variability (CV) and a heparin dilution curve. To examine clinical performance of both tests, group comparisons were assessed comparing healthy horses, horses with mild and severe GI disease with both CAT and plasma-TEG. Results: For CAT, intra- and inter-assay CVs were established for lag-time (1.7, 4.7%), endogenous thrombin potential (1.6, 4.6%), peak (2.6, 3.9%) and time to peak (ttPeak) (1.9, 3.4%). Increasing heparin concentrations led to the expected decrease in thrombin generation. In the group comparison analysis, CAT showed significant higher peak (p = 0.04) and ttPeak (p = 0.008) in the severe GI disease group compared to horses with mild GI disease and healthy horses, respectively. Plasma-TEG showed an increased angle (p = 0.032), maximum amplitude (p = 0.017) and shear elastic force (G) (p = 0.017) in the severe GI disease group compared to healthy horses. Conclusions: CAT performed well in horses. Both CAT and plasma-TEG identified hemostatic aberrations in horses with severe GI disease compared to healthy horses. Further studies including more horses, are needed to fully appreciate the use of CAT and plasma-TEG in this species.
© 2021. The Author(s).
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Publication Date: 2021-11-08 PubMed ID: 34749707PubMed Central: PMC8573990DOI: 10.1186/s12917-021-03058-7Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research investigates the use of two hemostatic tests – the Calibrated Automated Thrombogram (CAT) and plasma-thromboelastography (TEG) – for identifying coagulation problems in horses with gastrointestinal (GI) disease. The study concludes that both tests effectively detected hemostatic aberrations in critically ill horses compared to healthy ones, indicating their potential application in veterinary science.

Methodology

  • The researchers evaluated the performance of CAT on equine platelet poor plasma and measured intra- and inter-assay variability, as well as creating a heparin dilution curve.
  • Both CAT and plasma-TEG tests were used in group comparisons, which included healthy horses and horses with mild and severe GI diseases.

Results

  • For the CAT test, the researchers were able to establish intra- and inter-assay CVs for different metrics including lag-time, endogenous thrombin potential, peak, and time to peak (ttPeak).
  • The study observed that increasing concentrations of heparin, an anticoagulant, unsurprisingly resulted in a decrease in thrombin generation.
  • When comparing groups, the CAT test showed a significantly higher peak and time to peak in the severe GI disease group compared to both the mild GI disease group and the healthy group.
  • Similar observations were made using the plasma-TEG test: the severe GI disease group showed an increase in the angle, maximum amplitude, and shear elastic force (G) compared to the healthy group.

Conclusion

  • The performance of the CAT test in horses was satisfactory, indicating the test’s applicability in this species.
  • Both CAT and plasma-TEG tests successfully identified hemostatic aberrations in horses with severe GI disease compared to healthy animals.
  • The researchers recommend more extensive studies with larger horse populations to better understand and validate the use of CAT and plasma-TEG tests in this species.

Cite This Article

APA
Honoré ML, Pihl TH, Nielsen LN. (2021). A pilot study evaluating the Calibrated Automated Thrombogram assay and application of plasma-thromboelastography for detection of hemostatic aberrations in horses with gastrointestinal disease. BMC Vet Res, 17(1), 346. https://doi.org/10.1186/s12917-021-03058-7

Publication

BMC veterinary research
ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 17
Issue: 1
Pages: 346
PII: 346

Researcher Affiliations

Honoré, Marie Louise
  • Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences (SUND), University of Copenhagen, Hoejbakkegaard Allé 5a, 2630, Taastrup, Denmark. mlhj@sund.ku.dk.
Pihl, Tina Holberg
  • Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences (SUND), University of Copenhagen, Hoejbakkegaard Allé 5a, 2630, Taastrup, Denmark.
Nielsen, Lise Nikolic
  • Section for Internal Medicine, Oncology and Clinical Pathology, Faculty of Health and Medical Sciences (SUND), University of Copenhagen, Dyrlaegevej 16, 1870, Frederiksberg C, Denmark.

MeSH Terms

  • Animals
  • Blood Coagulation Tests / methods
  • Blood Coagulation Tests / veterinary
  • Female
  • Gastrointestinal Diseases / blood
  • Gastrointestinal Diseases / veterinary
  • Hemostasis
  • Horse Diseases / blood
  • Horses
  • Male
  • Pilot Projects
  • Thrombelastography / methods
  • Thrombelastography / veterinary

Conflict of Interest Statement

The authors declare that they have no competing interests.

References

This article includes 56 references
  1. Dallap BL, Dolente B, Boston R. Coagulation profiles in 27 horses with large colon volvulus. J Vet Emerg Crit Care 2003;13(4):215–225.
  2. Dunkel B, Chan DL, Boston R, Monreal L. Association between hypercoagulability and decreased survival in horses with ischemic or inflammatory gastrointestinal disease.. J Vet Intern Med 2010 Nov-Dec;24(6):1467-74.
    pubmed: 21054544doi: 10.1111/j.1939-1676.2010.0620.xgoogle scholar: lookup
  3. Epstein KL, Brainard BM, Gomez-Ibanez SE, Lopes MA, Barton MH, Moore JN. Thrombelastography in horses with acute gastrointestinal disease.. J Vet Intern Med 2011 Mar-Apr;25(2):307-14.
    pubmed: 21314719doi: 10.1111/j.1939-1676.2010.0673.xgoogle scholar: lookup
  4. Cesarini C, Monreal L, Armengou L, Delgado MÁ, Ríos J, Jose-Cunilleras E. Progression of plasma D-dimer concentration and coagulopathies during hospitalization in horses with colic.. J Vet Emerg Crit Care (San Antonio) 2014 Nov-Dec;24(6):672-80.
    pubmed: 25123566doi: 10.1111/vec.12211google scholar: lookup
  5. Cesarini C, Monreal L, Armengou L, Delgado MÁ, Ríos J, Jose-Cunilleras E. Association of admission plasma D-dimer concentration with diagnosis and outcome in horses with colic.. J Vet Intern Med 2010 Nov-Dec;24(6):1490-7.
    pubmed: 20946373doi: 10.1111/j.1939-1676.2010.0618.xgoogle scholar: lookup
  6. Monreal L, Cesarini C. Coagulopathies in horses with colic.. Vet Clin North Am Equine Pract 2009 Aug;25(2):247-58.
    pubmed: 19580937doi: 10.1016/j.cveq.2009.04.001google scholar: lookup
  7. Hyldahl Laursen S, Andersen PH, Kjelgaard-Hansen M, Wiinberg B. Comparison of components of biological variation between 3 equine thromboelastography assays.. Vet Clin Pathol 2013 Dec;42(4):443-50.
    pubmed: 24102554doi: 10.1111/vcp.12079google scholar: lookup
  8. Leclere M, Lavoie JP, Dunn M, Bédard C. Evaluation of a modified thrombelastography assay initiated with recombinant human tissue factor in clinically healthy horses.. Vet Clin Pathol 2009 Dec;38(4):462-6.
    pubmed: 19548973doi: 10.1111/j.1939-165x.2009.00157.xgoogle scholar: lookup
  9. Hron G, Kollars M, Binder BR, Eichinger S, Kyrle PA. Identification of patients at low risk for recurrent venous thromboembolism by measuring thrombin generation.. JAMA 2006 Jul 26;296(4):397-402.
    pubmed: 16868297doi: 10.1001/jama.296.4.397google scholar: lookup
  10. Hemker HC, Giesen P, AlDieri R, Regnault V, de Smed E, Wagenvoord R, Lecompte T, Béguin S. The calibrated automated thrombogram (CAT): a universal routine test for hyper- and hypocoagulability.. Pathophysiol Haemost Thromb 2002 Sep-Dec;32(5-6):249-53.
    pubmed: 13679651doi: 10.1159/000073575google scholar: lookup
  11. Deppe AC, Weber C, Zimmermann J, Kuhn EW, Slottosch I, Liakopoulos OJ, Choi YH, Wahlers T. Point-of-care thromboelastography/thromboelastometry-based coagulation management in cardiac surgery: a meta-analysis of 8332 patients.. J Surg Res 2016 Jun 15;203(2):424-33.
    pubmed: 27363652doi: 10.1016/j.jss.2016.03.008google scholar: lookup
  12. Fenty RK, Delaforcade AM, Shaw SE, O'Toole TE. Identification of hypercoagulability in dogs with primary immune-mediated hemolytic anemia by means of thromboelastography.. J Am Vet Med Assoc 2011 Feb 15;238(4):463-7.
    pubmed: 21320015doi: 10.2460/javma.238.4.463google scholar: lookup
  13. Allegret V, Dunn M, Bédard C. Monitoring unfractionated heparin therapy in dogs by measuring thrombin generation.. Vet Clin Pathol 2011 Mar;40(1):24-31.
    pubmed: 21299582doi: 10.1111/j.1939-165x.2011.00282.xgoogle scholar: lookup
  14. Scruggs JL, Flatland B, McCormick KA, Reed A. Biological variation of thromboelastrography variables in 10 clinically healthy horses.. J Vet Emerg Crit Care (San Antonio) 2016 Jan-Feb;26(1):80-4.
    pubmed: 26479874doi: 10.1111/vec.12410google scholar: lookup
  15. Dallap BL. Coagulopathy in the equine critical care patient.. Vet Clin North Am Equine Pract 2004 Apr;20(1):231-51.
    pubmed: 15062467doi: 10.1016/j.cveq.2003.11.002google scholar: lookup
  16. Pihl TH, Nielsen MK, Jacobsen S. Changes in hemostatic indices in foals naturally infected with strongylus vulgaris. J Equine Vet Sci 2017;54:1–7.
    doi: 10.1016/j.jevs.2017.02.002google scholar: lookup
  17. Lancé MD. A general review of major global coagulation assays: thrombelastography, thrombin generation test and clot waveform analysis.. Thromb J 2015;13:1.
    pmc: PMC4417204pubmed: 25937820doi: 10.1186/1477-9560-13-1google scholar: lookup
  18. Spahn DR, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernández-Mondéjar E, Filipescu D, Hunt BJ, Komadina R, Nardi G, Neugebauer E, Ozier Y, Riddez L, Schultz A, Vincent JL, Rossaint R. Management of bleeding and coagulopathy following major trauma: an updated European guideline.. Crit Care 2013 Apr 19;17(2):R76.
    pmc: PMC4056078pubmed: 23601765doi: 10.1186/cc12685google scholar: lookup
  19. Mendez-Angulo JL, Mudge MC, Vilar-Saavedra P, Stingle N, Couto CG. Thromboelastography in healthy horses and horses with inflammatory gastrointestinal disorders and suspected coagulopathies.. J Vet Emerg Crit Care (San Antonio) 2010 Oct;20(5):488-93.
    pubmed: 20955299doi: 10.1111/j.1476-4431.2010.00576.xgoogle scholar: lookup
  20. Wiinberg B, Jensen AL, Kjelgaard-Hansen M, Rojkjaer R, Johansson PI, Gade LP, Gram DX, Kristensen AT. Study on biological variation of haemostatic parameters in clinically healthy dogs.. Vet J 2007 Jul;174(1):62-8.
    pubmed: 16815052doi: 10.1016/j.tvjl.2006.05.003google scholar: lookup
  21. Krogh AK, Brunse A, Thymann T, Kristensen AT, Nielsen LN. Plasma thromboelastography in septic preterm pigs and full-term pigs at birth and 11 days post-partum. Joint Congress of Veterinary Pathology and Veterinary Clinical Pathology 25–28 September 2019 | Arnhem, the Netherlands 2019;p. 287.
  22. Contreras-García A, Merhi Y, Ruiz JC, Wertheimer MR, Hoemann CD. Thromboelastography (TEG) cups and pins with different PECVD coatings: effect on the coagulation cascade in platelet-poor blood plasma. Plasma Process Polym 2013;10(9):817–828.
  23. Ostrowski SR, Berg RM, Windeløv NA, Meyer MA, Plovsing RR, Møller K, Johansson PI. Discrepant fibrinolytic response in plasma and whole blood during experimental endotoxemia in healthy volunteers.. PLoS One 2013;8(3):e59368.
    pmc: PMC3598702pubmed: 23555024doi: 10.1371/journal.pone.0059368google scholar: lookup
  24. Wexels F, Dahl OE, Pripp AH, Seljeflot I. Thrombin Generation in Patients With Suspected Venous Thromboembolism.. Clin Appl Thromb Hemost 2017 Jul;23(5):416-421.
    pubmed: 28335612doi: 10.1177/1076029617700999google scholar: lookup
  25. Dargaud Y, Wolberg AS, Luddington R, Regnault V, Spronk H, Baglin T, Lecompte T, Ten Cate H, Negrier C. Evaluation of a standardized protocol for thrombin generation measurement using the calibrated automated thrombogram: an international multicentre study.. Thromb Res 2012 Dec;130(6):929-34.
    pubmed: 22909826doi: 10.1016/j.thromres.2012.07.017google scholar: lookup
  26. Rose LJ, Dunn ME, Allegret V, Bédard C. Effect of prednisone administration on coagulation variables in healthy Beagle dogs.. Vet Clin Pathol 2011 Dec;40(4):426-434.
    pubmed: 22093028doi: 10.1111/j.1939-165x.2011.00364.xgoogle scholar: lookup
  27. Machlus KR, Colby EA, Wu JR, Koch GG, Key NS, Wolberg AS. Effects of tissue factor, thrombomodulin and elevated clotting factor levels on thrombin generation in the calibrated automated thrombogram.. Thromb Haemost 2009 Nov;102(5):936-44.
    pmc: PMC2904819pubmed: 19888532doi: 10.1160/th09-03-0180google scholar: lookup
  28. Hemker HC, Giesen P, Al Dieri R, Regnault V, de Smedt E, Wagenvoord R, Lecompte T, Béguin S. Calibrated automated thrombin generation measurement in clotting plasma.. Pathophysiol Haemost Thromb 2003;33(1):4-15.
    pubmed: 12853707doi: 10.1159/000071636google scholar: lookup
  29. Hudák R, Székely EG, Kovács KR, Nagy A, Hofgárt G, Berényi E, Csiba L, Kappelmayer J, Bagoly Z. Low thrombin generation predicts poor prognosis in ischemic stroke patients after thrombolysis.. PLoS One 2017;12(7):e0180477.
    pmc: PMC5503253pubmed: 28692682doi: 10.1371/journal.pone.0180477google scholar: lookup
  30. Jensen AL, Kjelgaard-hansen M. Diagnostic Test Validation. Schalm’s Vet Hematol 2010;6:1027–1033.
  31. Jeong JC, Kim JE, Ryu JW, Joo KW, Kim HK. Plasma haemostatic potential of haemodialysis patients assessed by thrombin generation assay: hypercoagulability in patients with vascular access thrombosis.. Thromb Res 2013 Nov;132(5):604-9.
    pubmed: 24060191doi: 10.1016/j.thromres.2013.09.002google scholar: lookup
  32. Rose L, Dunn ME, Bédard C. Effect of canine hyperadrenocorticism on coagulation parameters.. J Vet Intern Med 2013 Jan-Feb;27(1):207-11.
    pubmed: 23278831doi: 10.1111/jvim.12005google scholar: lookup
  33. . Thrombinoscope: methods and products. Accessed 13 Mar 2020.
  34. Mischke R, Teuber M, Tiede A. Measurements of endogenous thrombin potential using the CAT method in cats: Reference values and influence of the direct factor Xa inhibitor apixaban.. Res Vet Sci 2019 Dec;127:113-121.
    pubmed: 31693942doi: 10.1016/j.rvsc.2019.08.030google scholar: lookup
  35. McMichael MA, O'Brien M, Smith SA. Hypercoagulability in dogs with blastomycosis.. J Vet Intern Med 2015 Mar-Apr;29(2):499-504.
    pmc: PMC4895520pubmed: 25818206doi: 10.1111/jvim.12538google scholar: lookup
  36. Tournier A, Wahl D, Chaouat A, Max JP, Regnault V, Lecompte T, Chabot F. Calibrated automated thrombography demonstrates hypercoagulability in patients with idiopathic pulmonary arterial hypertension.. Thromb Res 2010 Dec;126(6):e418-22.
    pubmed: 20888030doi: 10.1016/j.thromres.2010.08.020google scholar: lookup
  37. Regnault V, Hemker HC, Wahl D, Lecompte T. Phenotyping the haemostatic system by thrombography--potential for the estimation of thrombotic risk.. Thromb Res 2004;114(5-6):539-45.
    pubmed: 15507289doi: 10.1016/j.thromres.2004.06.017google scholar: lookup
  38. Stępień E, Gruszczyński K, Kapusta P, Kowalik A, Wybrańska I. Plasma centrifugation does not influence thrombin-antithrombin and plasmin-antiplasmin levels but determines platelet microparticles count.. Biochem Med (Zagreb) 2015;25(2):222-9.
    pmc: PMC4470109pubmed: 26110034doi: 10.11613/bm.2015.022google scholar: lookup
  39. Chamouard P, Desprez D, Hugel B, Kunzelmann C, Gidon-Jeangirard C, Lessard M, Baumann R, Freyssinet JM, Grunebaum L. Circulating cell-derived microparticles in Crohn's disease.. Dig Dis Sci 2005 Mar;50(3):574-80.
    pubmed: 15810645doi: 10.1007/s10620-005-2477-0google scholar: lookup
  40. Pamuk GE, Vural O, Turgut B, Demir M, Umit H, Tezel A. Increased circulating platelet-neutrophil, platelet-monocyte complexes, and platelet activation in patients with ulcerative colitis: a comparative study.. Am J Hematol 2006 Oct;81(10):753-9.
    pubmed: 16941615doi: 10.1002/ajh.20655google scholar: lookup
  41. Donahue SM, Otto CM. Thromboelastography: a tool for measuring hypercoagulability, hypocoagulability, and fibrinolysis. J Vet Emerg Crit Care 2005;15(1):9–16.
  42. Kupcinskiene K, Trepenaitis D, Petereit R, Kupcinskas J, Gudaityte R, Maleckas A, Macas A. Monitoring of Hypercoagulability by Thromboelastography in Bariatric Surgery.. Med Sci Monit 2017 Apr 15;23:1819-1826.
    pmc: PMC5402836pubmed: 28411285doi: 10.12659/msm.900769google scholar: lookup
  43. Müller MC, Meijers JC, Vroom MB, Juffermans NP. Utility of thromboelastography and/or thromboelastometry in adults with sepsis: a systematic review.. Crit Care 2014 Feb 10;18(1):R30.
    pmc: PMC4056353pubmed: 24512650doi: 10.1186/cc13721google scholar: lookup
  44. Salooja N, Perry DJ. Thrombelastography.. Blood Coagul Fibrinolysis 2001 Jul;12(5):327-37.
    pubmed: 11505075doi: 10.1097/00001721-200107000-00001google scholar: lookup
  45. Epstein KL, Brainard BM, Giguere S, Vrono Z, Moore JN. Serial viscoelastic and traditional coagulation testing in horses with gastrointestinal disease.. J Vet Emerg Crit Care (San Antonio) 2013 Sep-Oct;23(5):504-16.
    pubmed: 24028350doi: 10.1111/vec.12095google scholar: lookup
  46. Moore BR, Hinchcliff KW. Heparin: a review of its pharmacology and therapeutic use in horses.. J Vet Intern Med 1994 Jan-Feb;8(1):26-35.
    pubmed: 8176660doi: 10.1111/j.1939-1676.1994.tb03192.xgoogle scholar: lookup
  47. Duncan SG, Reed SM. Heparin anticoagulant therapy in equine colic.. Mod Vet Pract 1984 Aug;65(8):601-5.
    pubmed: 6493204
  48. Kjelgaard-Hansen M, Jacobsen S. Assay validation and diagnostic applications of major acute-phase protein testing in companion animals.. Clin Lab Med 2011 Mar;31(1):51-70.
    pubmed: 21295722doi: 10.1016/j.cll.2010.10.002google scholar: lookup
  49. Adcock DM, Hoefner DM, Kottke-Marchant K, Marlar RA, Szamosi DI, Warunek DJ. Collection , transport, and processing of blood specimens for testing plasma-based coagulation assays and molecular hemostasis assays; CLSI approved guideline-fifth edition. H21-A5. Clin Lab Stand Inst 2008;28(5):H21–HA5.
  50. Nielsen LN, Wiinberg B, Kjelgaard-Hansen M, Kristensen AT. The presence of antiphospholipid antibodies in healthy Bernese Mountain Dogs.. J Vet Intern Med 2011 Nov-Dec;25(6):1258-63.
    pubmed: 22092614doi: 10.1111/j.1939-1676.2011.00823.xgoogle scholar: lookup
  51. Hanel RM, Chan DL, Conner B, Gauthier V, Holowaychuk M, Istvan S, Walker JM, Wood D, Goggs R, Wiinberg B. Systematic evaluation of evidence on veterinary viscoelastic testing part 4: Definitions and data reporting.. J Vet Emerg Crit Care (San Antonio) 2014 Jan-Feb;24(1):47-56.
    pubmed: 24472100doi: 10.1111/vec.12145google scholar: lookup
  52. Saliba W, Awad K, Ron G, Elias M. The Effect of Vitamin D Supplementation on Thrombin Generation Assessed by the Calibrated Automated Thrombogram.. Clin Appl Thromb Hemost 2016 May;22(4):340-5.
    pubmed: 25376616doi: 10.1177/1076029614556745google scholar: lookup
  53. Wang Z, Li J, Cao Q, Wang L, Shan F, Zhang H. Comparison Between Thromboelastography and Conventional Coagulation Tests in Surgical Patients With Localized Prostate Cancer.. Clin Appl Thromb Hemost 2018 Jul;24(5):755-763.
    pmc: PMC6714867pubmed: 28870084doi: 10.1177/1076029617724229google scholar: lookup
  54. Lemon AV, Goddard A, Hooijberg EH. Effects of storage time and temperature on thromboelastographic analysis in dogs and horses.. Vet Clin Pathol 2021 Mar;50(1):9-19.
    pubmed: 33622027doi: 10.1111/vcp.12980google scholar: lookup
  55. Thakur M, Ahmed AB. A review of thromboelastography. Int J Perioper Ultrasound Appl Technol 2012;1(1):25–29.
  56. Armengou L, Monreal L, Tarancón I, Navarro M, Ríos J, Segura D. Plasma D-dimer concentration in sick newborn foals.. J Vet Intern Med 2008 Mar-Apr;22(2):411-7.
    pubmed: 18312557doi: 10.1111/j.1939-1676.2008.0050.xgoogle scholar: lookup

Citations

This article has been cited 1 times.
  1. Honoré ML, Pihl TH, Busk-Anderson TM, Flintrup LL, Nielsen LN. Investigation of two different human d-dimer assays in the horse. BMC Vet Res 2022 Jun 15;18(1):227.
    doi: 10.1186/s12917-022-03313-5pubmed: 35705958google scholar: lookup
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