Progression of plasma D-dimer concentration and coagulopathies during hospitalization in horses with colic.

This research study aims to investigate changes in plasma D-dimer concentrations, a marker of blood clotting, and the incidence of coagulopathies, or disorders that affect the ability of the blood to clot, in horses hospitalized with colic. They found that changes in D-dimer concentrations and the prevalence of coagulopathies varied depending on the specific type of colic, with surgical obstructions and ischemic lesions showing more significant changes than medical obstructions and inflammatory conditions.

Methodology

• The study was a prospective observational study carried out over a period of four years (from March 2004-September 2008) at a veterinary university teaching hospital.
• Only horses that were admitted to the hospital for colic and were hospitalized for more than 48 hours were considered for the study.
• The horses were classified into four groups according to the type of colic they presented with: medical obstructive conditions (MO), surgical obstructive conditions (SO), inflammatory conditions, and ischemic lesions (IS).
• Three blood samples were taken from each horse at three different stages: upon admission, after 24-48 hours (or post-surgery), and upon discharge from the hospital.
• Different parameters relating to blood coagulation were measured in each blood sample, which included plasma D-dimer concentration, prothrombin time, activated partial thromboplastin time, antithrombin activity, and the presence of subclinical disseminated intravascular coagulation (a serious condition causing blood clots and bleeding).

Results

• When comparing the median D-dimer concentrations at admission and after 24-48 hours, it was found that horses with MO colic and those with inflammatory conditions had stable D-dimer levels. In contrast, horses with SO and IS showed increases roughly 10-fold and 5-fold respectively in D-dimer concentrations post-surgery.
• By the time patients reached 24-48 hours of hospitalization, a higher percentage of horses in most classes exhibited coagulopathy, with respective increases in MO, SO, and IS groups.
• Furthermore by the time of discharge, a large majority of horses with SO and IS colic had some form of documented coagulopathy.

Conclusions

• Horses with MO type of colic exhibited less severe coagulopathy and lower plasma D-dimer concentrations as opposed to horses with other forms of colic.
• Upon admission, the majority of horses with inflammatory conditions presented some level of coagulopathy.
• As horses reached 24-48 hours of hospitalization and underwent surgery, their hemostatic profiles could differ significantly from the profile on admission.