Use of viscoelastic coagulation testing to monitor low molecular weight heparin administration to healthy horses.
Abstract: 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 maximum amplitude (MA), and Sonoclot activated clot time (ACT), clot rate (CR), and platelet function (PF) were measured in whole blood 30 min after sample collection. Change (Δ) and percentage change (%Δ) from baseline of each TEG and Sonoclot variable were subsequently calculated. Anti-factor Xa activity and activated partial thromboplastin time (aPTT) were assayed in harvested plasma. The association between anti-factor Xa activity and TEG and Sonoclot (measured and calculated) variables was assessed by calculating correlation coefficients and multiple regression analysis. The ability of measured and calculated TEG and Sonoclot variables to predict when anti-factor Xa activity fell below suggested thromboprophylactic levels was assessed using receiver operating characteristic curve analysis. Results: The correlation between aPTT and anti-factor Xa activity was weak (r = 0.343). Changes in TEG and Sonoclot variables following LMWH administration were consistent with hypocoagulation. All measured and calculated TEG variables were significantly correlated with anti-factor Xa activity. Sonoclot ACT, ΔACT, CR, ΔCR, and %ΔCR were also significantly correlated with anti-factor Xa activity. TEG ΔR and %ΔR best predicted anti-factor Xa activity below the suggested thromboprophylactic level. Conclusions: Although correlations were modest, serial measurement of TEG variables may be used to monitor LMWH therapy in horses; however, further research is required in sick horses.
© Veterinary Emergency and Critical Care Society 2013.
Publication Date: 2013-05-08 PubMed ID: 23656212DOI: 10.1111/vec.12049Google Scholar: Lookup
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- Journal Article
- Randomized Controlled Trial
- Research Support
- Non-U.S. Gov't
Summary
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This research explored the effectiveness of utilizing viscoelastic coagulation tests, specifically thromboelastography (TEG) and Sonoclot analyses, in monitoring the impacts of low molecular weight heparin (LMWH) administration in healthy horses.
Research Goals and Methodology
- The research aimed to assess the usefulness of TEG and Sonoclot in tracking the effects of low molecular weight heparin (LMWH) when administered to healthy horses.
- Conducted in a veterinary teaching hospital, the experiment involved six adult mixed breed healthy mares in a randomized crossover study.
- LMWH was given subcutaneously at a frequency of either 12 or 24 hours for three consecutive days.
- Researchers collected blood samples at specific intervals before and after the administration of LMWH for analysis.
- Figures such as Thromboelastography derived R-time, K-time, angle, and maximum amplitude, along with Sonoclot activated clot time, clot rate, and platelet function were taken into consideration.
- These measurements were taken 30 minutes after each blood sample collection.
- Change and percentage change from baseline of each TEG and Sonoclot variable were also calculated and compared.
Findings and Conclusions
- The study found that the correlation between activated partial thromboplastin time (aPTT) and anti-factor Xa activity was weak.
- Nevertheless, changes in TEG and Sonoclot measures following LMWH administration suggested hypocoagulation, showing the impacts of the given medicine.
- All factors measured and computed from the TEG variables correlated significantly with anti-factor Xa activity.
- Sonoclot measures such as activated clot time, change in clot time, clot rate, change in clot rate, and percentage change in clot rate also showed significant correlation with anti-factor Xa activity.
- Best predictors of anti-factor Xa activity below the suggested thromboprophylactic level were TEG ΔR and %ΔR.
- Based on these findings, even though correlations were modest, it was concluded that consistent measurement of TEG variables could be employed to monitor LMWH therapy in horses.
- However, the researchers clarified that further research is required in sick horses as this study involved only healthy ones.
Cite This Article
APA
Tennent-Brown BS, Epstein KL, Whelchel DD, Giguère S.
(2013).
Use of viscoelastic coagulation testing to monitor low molecular weight heparin administration to healthy horses.
J Vet Emerg Crit Care (San Antonio), 23(3), 291-299.
https://doi.org/10.1111/vec.12049 Publication
Researcher Affiliations
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA, USA. bretttbrown@gmail.com
MeSH Terms
- Animals
- Anticoagulants / pharmacology
- Area Under Curve
- Cross-Over Studies
- Dalteparin / pharmacology
- Female
- Horses / blood
- Partial Thromboplastin Time / veterinary
- Rheology / methods
- Sensitivity and Specificity
Citations
This article has been cited 2 times.- Mersich I, Bishop RC, Diaz Yucupicio S, Nobrega AD, Austin SM, Barger AM, Fick ME, Wilkins PA. Decreased Circulating Red Cell Mass Induced by Intravenous Acepromazine Administration Alters Viscoelastic and Traditional Plasma Coagulation Testing Results in Healthy Horses. Animals (Basel) 2024 Oct 28;14(21).
- Vernemmen I, Buschmann E, Van Steenkiste G, Demeyere M, Verhaeghe LM, De Somer F, Devreese KMJ, Schauvliege S, Decloedt A, van Loon G. Intracardiac ultrasound-guided transseptal puncture in horses: Outcome, follow-up, and perioperative anticoagulant treatment. J Vet Intern Med 2024 Sep-Oct;38(5):2707-2717.
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