Experimental infection of horses with African horse sickness virus results in overt disseminated intravascular coagulation.
Abstract: African horse sickness (AHS), caused by the vector-borne African horse sickness virus (AHSV), is endemic to sub-Saharan Africa and infection results in high mortality in naïve equine populations. Clinical signs include submucosal petechiae and prolonged bleeding post venepuncture indicative of hypocoagulation. Pathological activation of haemostasis may result from tissue factor expression as a result of vascular endothelial damage or dysfunction, the proposed pathologic mechanism in AHS, potentially resulting in disseminated intravascular coagulation (DIC). Objective: To describe haemostatic changes during experimental AHSV infection and to characterise DIC using plasma-based and viscoelastic assays. Methods: In vivo experiments. Methods: Four horses were experimentally infected with AHSV. Blood samples were obtained before infection, then every 24 h until humane euthanasia. Haematology and thromboelastography (TEG) were performed and prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and D-dimer concentrations, as well as activities of antithrombin (AT) and coagulation factors II, VII, VIII, X, and XII were measured. Results: Over the disease course, TEG variables showed increased clot initiation time (R) and decreased α-angle, maximum amplitude (MA), and clot strength (G). The velocity curve showed decreased maximum rate of thrombus generation (MRTG) and thrombus generation (TG), and increased time to maximum rate of thrombus generation (TMRTG). Prothrombin time, aPTT and D-dimer concentration increased while AT activity decreased. All horses developed severe thrombocytopenia. Conclusions: Horses experimentally infected with AHSV developed a consumptive coagulopathy with a bleeding phenotype. These findings fulfil the criteria of overt DIC characterised by procoagulant activation, inhibitor consumption and increased fibrinolytic activity.
© 2026 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Publication Date: 2026-01-22 PubMed ID: 41572601PubMed Central: PMC12892386DOI: 10.1002/evj.70134Google Scholar: Lookup
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Summary
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Overview
- The study investigated blood clotting changes in horses experimentally infected with African horse sickness virus (AHSV).
- It demonstrated that infection leads to overt disseminated intravascular coagulation (DIC), a severe disorder of blood clotting and bleeding.
Background
- African horse sickness (AHS) is a viral disease transmitted by insects, primarily affecting horses in sub-Saharan Africa.
- The causative agent is the African horse sickness virus (AHSV), which causes high death rates in horses with no prior immunity.
- Clinical signs include bleeding under mucous membranes (petechiae) and prolonged bleeding after venepuncture, indicating problems with blood clotting (hypocoagulation).
- The underlying pathology likely involves vascular damage leading to abnormal activation of the blood clotting cascade.
- This pathological clotting activation can result in disseminated intravascular coagulation (DIC), where widespread clotting and bleeding occur simultaneously.
Objective
- To describe changes in the blood clotting system during experimental AHSV infection in horses.
- To characterize the features of DIC using detailed laboratory tests including plasma-based coagulation assays and viscoelastic testing (thromboelastography, TEG).
Methods
- Four horses were experimentally infected with AHSV under controlled conditions.
- Blood samples were collected prior to infection and then every 24 hours until humane euthanasia was necessary.
- Laboratory tests performed on the blood samples included:
- Haematology to monitor blood cell counts.
- Thromboelastography (TEG) to evaluate the dynamics of clot formation and breakdown in whole blood.
- Coagulation assays measuring prothrombin time (PT) and activated partial thromboplastin time (aPTT), which assess function of the clotting pathways.
- Measurement of fibrinogen and D-dimer concentrations, markers of clot formation and breakdown.
- Activity levels of key anticoagulant and clotting factors including antithrombin (AT) and coagulation factors II, VII, VIII, X, and XII.
Results
- TEG revealed a progression toward impaired clotting:
- Increased clot initiation time (R), meaning it took longer to start forming clots.
- Decreased α-angle and maximum amplitude (MA), indicating slower and weaker clot formation.
- Reduced clot strength (G), showing overall weaker clots.
- The velocity curve parameters showed a reduction in the rate and amount of thrombus (clot) formation and a delay in reaching maximum thrombus generation.
- Traditional coagulation tests showed prolonged PT and aPTT, consistent with impaired clotting ability.
- Plasma D-dimer levels increased, indicating enhanced breakdown of fibrin clots and thus active fibrinolysis.
- Antithrombin activity decreased, showing consumption of natural anticoagulants.
- All horses developed severe thrombocytopenia (low platelet counts), contributing to bleeding risk.
Conclusions
- Infection with AHSV in horses causes consumptive coagulopathy — a condition where clotting factors and platelets are used up extensively, impairing normal clotting.
- The bleeding symptoms observed are due to this consumptive coagulopathy combined with active breakdown of clots (fibrinolysis).
- The laboratory features meet criteria for overt disseminated intravascular coagulation (DIC), involving three main characteristics:
- Activation of procoagulant pathways.
- Consumption of clotting inhibitors like antithrombin.
- Increased fibrinolytic activity leading to clot breakdown.
- This research provides valuable insight into the pathophysiology of AHS in horses and offers potential targets for monitoring and treatment of coagulopathy during the disease.
Cite This Article
APA
Schliewert EC, Hooijberg EH, Goddard A.
(2026).
Experimental infection of horses with African horse sickness virus results in overt disseminated intravascular coagulation.
Equine Vet J, 58(2), 619-629.
https://doi.org/10.1002/evj.70134 Publication
Researcher Affiliations
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Medicine, University of Pretoria, Onderstepoort, South Africa.
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Medicine, University of Pretoria, Onderstepoort, South Africa.
- Nationwide Laboratories, Little Singleton, Poulton-le-Fylde, UK.
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Medicine, University of Pretoria, Onderstepoort, South Africa.
MeSH Terms
- Animals
- Horses
- Disseminated Intravascular Coagulation / veterinary
- Disseminated Intravascular Coagulation / virology
- Disseminated Intravascular Coagulation / etiology
- African Horse Sickness / virology
- African Horse Sickness / blood
- African Horse Sickness / complications
- African Horse Sickness Virus / physiology
- Male
Conflict of Interest Statement
The authors have declared no conflicting interests.
References
This article includes 46 references
- Calisher CH, Mertens PP. Taxonomy of African horse sickness viruses. Arch Virol Suppl. 1998;14:3–11. 10.1007/978-3-7091-6823-3_1
- Skowronek AJ, LaFranco L, Stone‐Marschat MA, Burrage TG, Rebar AH, Laegreid WW. Clinical pathology and hemostatic abnormalities in experimental African horse sickness. Vet Pathol. 1995;32(2):112–121. 10.1177/030098589503200203
- Gomez‐Villamandos JC, Sanchez C, Carrasco L, et al. Pathogenesis of African horse sickness: ultrastructural study of the capillaries in experimental infection. J Comp Pathol. 1999;121(2):101–116. 10.1053/jcpa.1999.0305
- Foley JH, Conway EM. Cross talk pathways between coagulation and inflammation. Circ Res. 2016;118(9):1392–1408. 10.1161/CIRCRESAHA.116.306853
- Braune S, Kupper JH, Jung F. Effect of prostanoids on human platelet function: an overview. Int J Mol Sci. 2020;21(23):9020. 10.3390/ijms21239020
- Grignani G, Maiolo A. Cytokines and hemostasis. Haematologica. 2000;85(9):967–972.
- Nawroth PP, Stern DM. Modulation of endothelial cell hemostatic properties by tumor necrosis factor. J Exp Med. 1986;163(3):740–745. 10.1084/jem.163.3.740
- Nawroth PP, Handley DA, Esmon CT, Stern DM. Interleukin 1 induces endothelial cell procoagulant while suppressing cell‐surface anticoagulant activity. Proc Natl Acad Sci U S A. 1986;83(10):3460–3464. 10.1073/pnas.83.10.3460
- nCostello RA, Nehring SM. Disseminated intravascular coagulation. Treasure Island, FL: nn; 2022.
- Iba T, Levi M, Thachil J, Levy JH. Disseminated intravascular coagulation: the past, present, and future considerations. Semin Thromb Hemost. 2022;48(8):978–987. 10.1055/s-0042-1756300
- Taylor FB, Toh CH, Hoots WK, et al. Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost. 2001;86(5):1327–1330.
- Gando S, Levi M, Toh CH. Disseminated intravascular coagulation. Nat Rev Dis Primers. 2016;2:16037. 10.1038/nrdp.2016.37
- Goggs R, Mastrocco A, Brooks MB. Retrospective evaluation of 4 methods for outcome prediction in overt disseminated intravascular coagulation in dogs (2009‐2014): 804 cases. J Vet Emerg Crit Care (San Antonio). 2018;28(6):541–550. 10.1111/vec.12777
- Wiinberg B, Jensen AL, Johansson PI, Rozanski E, Tranholm M, Kristensen AT. Thromboelastographic evaluation of hemostatic function in dogs with disseminated intravascular coagulation. J Vet Intern Med. 2008;22(2):357–365. 10.1111/j.1939-1676.2008.0058.x
- Holcomb JB, Minei KM, Scerbo ML, Radwan ZA, Wade CE, Kozar RA, et al. Admission rapid thrombelastography can replace conventional coagulation tests in the emergency department: experience with 1974 consecutive trauma patients. Ann Surg. 2012;256(3):476–486. 10.1097/SLA.0b013e3182658180
- Schliewert EC, Hooijberg EH, Steyn JS, Potgieter C, Fosgate GT, Goddard A. Experimental infection with African horse sickness virus in horses induces only mild temporal hematologic changes and acute phase reactant response. Am J Vet Res. 2022;83(11):1–11. 10.2460/ajvr.22.08.0123
- Percie du Sert N, Hurst V, Ahluwalia A, Alam S, Avey MT, Baker M, et al. The ARRIVE guidelines 2.0: updated guidelines for reporting animal research. PLoS Biol. 2020;18(7):e3000410. 10.1371/journal.pbio.3000410
- van Rijn PA, Maris‐Veldhuis MA, Boonstra J, van Gennip RGP. Diagnostic DIVA tests accompanying the disabled infectious single animal (DISA) vaccine platform for African horsesickness. Vaccine. 2018;36(25):3584–3592. 10.1016/j.vaccine.2018.05.044
- Lemon AV, Goddard A, Hooijberg EH. Effects of storage time and temperature on thromboelastographic analysis in dogs and horses. Vet Clin Pathol. 2021;50(1):9–19. 10.1111/vcp.12980
- Newsholme SJ. A morphological study of the lesions of African horsesickness. Onderstepoort J Vet Res. 1983;50(1):7–24.
- Loizou E, Mayhew DJ, Martlew V, Murthy BVS. Implications of deranged activated partial thromboplastin time for anaesthesia and surgery. Anaesthesia. 2018;73(12):1557–1563. 10.1111/anae.14344
- 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. 2010;20(5):488–493. 10.1111/j.1476-4431.2010.00576.x
- Smith SA, McMichael MA, Gilor S, Galligan AJ, Hoh CM. Correlation of hematocrit, platelet concentration, and plasma coagulation factors with results of thromboelastometry in canine whole blood samples. Am J Vet Res. 2012;73(6):789–798. 10.2460/ajvr.73.6.789
- van Rooyen LJ, Hooijberg EH, Schoeman JP, Goddard A. Thromboelastographic platelet mapping in dogs with complicated Babesia rossi infection. Vet Clin Pathol. 2019;48(1):11–18. 10.1111/vcp.12689
- Yun SH, Sim EH, Goh RY, Park JI, Han JY. Platelet activation: the mechanisms and potential biomarkers. Biomed Res Int. 2016;2016:9060143. 10.1155/2016/9060143
- DeNotta SL, Brooks MB. Coagulation assessment in the equine patient. Vet Clin North Am Equine Pract. 2020;36(1):53–71. 10.1016/j.cveq.2019.12.001
- Hanel RM, Chan DL, Conner B, Gauthier V, Holowaychuk M, Istvan S, et al. Systematic evaluation of evidence on veterinary viscoelastic testing part 4: definitions and data reporting. J Vet Emerg Crit Care. 2014;24(1):47–56. 10.1111/vec.12145
- Bowbrick VA, Mikhailidis DP, Stansby G. Influence of platelet count and activity on thromboelastography parameters. Platelets. 2003;14(4):219–224. 10.1080/0953710031000118849
- Licari LG, Kovacic JP. Thrombin physiology and pathophysiology. J Vet Emerg Crit Care. 2009;19(1):11–22. 10.1111/j.1476-4431.2009.00383.x
- Esmon CT. Natural anticoagulants and their pathways. In: Uprichard ACG, Gallagher KP, editors. Antithrombotics Handbook of Experimental Pharmacology. Vol. 132 Berlin Heidelberg: Springer; 1999. p. 447–476. 10.1007/978-3-642-59942-2_16
- Bone RC. Modulators of coagulation. A critical appraisal of their role in sepsis. Arch Intern Med. 1992;152(7):1381–1389. 10.1001/archinte.152.7.1381
- Mammen EF. Antithrombin: its physiological importance and role in DIC. Semin Thromb Hemost. 1998;24(1):19–25. 10.1055/s-2007-995819
- Schlommer C, Brandtner A, Bachler M. Antithrombin and its role in host defense and inflammation. Int J Mol Sci. 2021;22(8):4283. 10.3390/ijms22084283
- Levi M, van der Poll T, Buller HR. Bidirectional relation between inflammation and coagulation. Circulation. 2004;109(22):2698–2704. 10.1161/01.CIR.0000131660.51520.9A
- Levy JH, Sniecinski RM, Welsby IJ, Levi M. Antithrombin: anti‐inflammatory properties and clinical applications. Thromb Haemost. 2016;115(4):712–728. 10.1160/TH15-08-0687
- Longstaff C, Kolev K. Basic mechanisms and regulation of fibrinolysis. J Thromb Haemost. 2015;13(Suppl 1):S98–S105. 10.1111/jth.12935
- Cesarini C, Monreal L, Armengou L, Delgado MA, Rios 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;24(6):672–680. 10.1111/vec.12211
- Cesarini C, Monreal L, Armengou L, Delgado MA, Rios J, Jose‐Cunilleras E. Association of admission plasma D‐dimer concentration with diagnosis and outcome in horses with colic. J Vet Intern Med. 2010;24(6):1490–1497. 10.1111/j.1939-1676.2010.0618.x
- Goehring LS, Soboll Hussey G, Gomez Diez M, Benedict K, Maxwell LK, Morley PS, et al. Plasma D‐dimer concentrations during experimental EHV‐1 infection of horses. J Vet Intern Med. 2013;27(6):1535–1542. 10.1111/jvim.12203
- Genet GF, Ostrowski SR, Sorensen AM, Johansson PI. Detection of tPA‐induced hyperfibrinolysis in whole blood by RapidTEG, KaolinTEG, and functional fibrinogenTEG in healthy individuals. Clin Appl Thromb Hemost. 2012;18(6):638–644. 10.1177/1076029611434527
- Raza I, Davenport R, Rourke C, et al. The incidence and magnitude of fibrinolytic activation in trauma patients. J Thromb Haemost. 2013;11(2):307–314. 10.1111/jth.12078
- Goggs R, Davis S, Brooks MB. Tissue plasminogen activator modified thromboelastography identifies fibrinolysis resistance in dogs with immune‐mediated hemolytic anemia. Front Vet Sci. 2025;12:1571683. 10.3389/fvets.2025.1571683
- Spodsberg EH, Wiinberg B, Jessen LR, Marschner CB, Kristensen AT. Endogenous fibrinolytic potential in tissue‐plasminogen activator‐modified thromboelastography analysis is significantly decreased in dogs suffering from diseases predisposing to thrombosis. Vet Clin Pathol. 2013;42(3):281–290. 10.1111/vcp.12068
- Tsantes AG, Parastatidou S, Tsantes EA, Bonova E, Tsante KA, Mantzios PG, et al. Sepsis‐induced coagulopathy: an update on pathophysiology, biomarkers, and current guidelines. Life (Basel). 2023;13(2):350. 10.3390/life13020350
- Cesarini C, Cotovio M, Rios J, Armengou L, Jose‐Cunilleras E. Association between necropsy evidence of disseminated intravascular coagulation and hemostatic variables before death in horses with colic. J Vet Intern Med. 2016;30(Jan‐Feb):269–275. 10.1111/jvim.13659
- Neubauer K, Zieger B. Endothelial cells and coagulation. Cell Tissue Res. 2022;387(3):391–398. 10.1007/s00441-021-03471-2
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