Alterations in the hemostatic profiles of dogs with naturally occurring septic peritonitis

Adrienne M. Bentley, Philipp Mayhew, William T Culp, Cynthia M. Otto

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objective: To characterize derangements in the hemostatic profiles of dogs with naturally occurring septic peritonitis and determine if such derangements were predictive of survival. Design: Prospective, observational single cohort study. Setting: University veterinary teaching hospital. Animals: A total of 27 client-owned dogs with naturally occurring septic peritonitis. Interventions: Standard treatment included fluid resuscitation, antimicrobial therapy, supportive care, and surgery provided at the discretion of the primary clinician. Blood was collected preoperatively and on days 1 and 3 postoperatively for platelet count, prothrombin time, activated partial thromboplastin time, D-dimer and fibrinogen concentrations, total protein C (PC) and antithrombin (AT) activities, and thromboelastography. Measurements and Main Results: Sixteen of 27 (59%) dogs survived. Preoperative PC deficiency was identified in 10 of 11 (91%) nonsurvivors and 2 of 15 (13%) survivors. Preoperative AT deficiency was identified in 10 of 11 (91%) nonsurvivors and 14 of 15 (93%) survivors. Compared to survivors, nonsurvivors had lower mean preoperative PC (98 ± 24% versus 49 ± 26%; P < 0.001) and AT (53 ± 9% versus 32 ± 16%; P < 0.001) activities. Anticoagulant activities decreased on day 1 postoperatively. As a predictor of survival, preoperative PC activity of more than 60% achieved a sensitivity of 93% and specificity of 82%. Preoperative AT activity of more than 41.5% achieved a sensitivity of 100% and specificity of 82%. The maximum amplitude, α angle, and coagulation index from preoperative thromboelastograms of survivors were significantly greater (more hypercoagulable) than nonsurvivors (P < 0.01), with the maximum amplitude being the most specific predictor of survival (100%). Conclusions: Deficiencies of PC and AT and hypercoagulability appear to be consistent features of naturally occurring canine sepsis and may be useful prognostic indicators in canine septic peritonitis.

Original languageEnglish (US)
Pages (from-to)14-22
Number of pages9
JournalJournal of Veterinary Emergency and Critical Care
Volume23
Issue number1
DOIs
StatePublished - Jan 2013

Fingerprint

Antithrombins
peritonitis
Hemostatics
Peritonitis
Dogs
Survivors
Protein C
dogs
Protein C Deficiency
Survival
Canidae
proteins
Thrombelastography
anticoagulant activity
Animal Hospitals
Sensitivity and Specificity
protein deficiencies
thromboplastin
prothrombin
Thrombophilia

Keywords

  • Antithrombin
  • Protein C
  • Secondary peritonitis
  • Sepsis
  • Thromboelastography

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Alterations in the hemostatic profiles of dogs with naturally occurring septic peritonitis. / Bentley, Adrienne M.; Mayhew, Philipp; Culp, William T; Otto, Cynthia M.

In: Journal of Veterinary Emergency and Critical Care, Vol. 23, No. 1, 01.2013, p. 14-22.

Research output: Contribution to journalArticle

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abstract = "Objective: To characterize derangements in the hemostatic profiles of dogs with naturally occurring septic peritonitis and determine if such derangements were predictive of survival. Design: Prospective, observational single cohort study. Setting: University veterinary teaching hospital. Animals: A total of 27 client-owned dogs with naturally occurring septic peritonitis. Interventions: Standard treatment included fluid resuscitation, antimicrobial therapy, supportive care, and surgery provided at the discretion of the primary clinician. Blood was collected preoperatively and on days 1 and 3 postoperatively for platelet count, prothrombin time, activated partial thromboplastin time, D-dimer and fibrinogen concentrations, total protein C (PC) and antithrombin (AT) activities, and thromboelastography. Measurements and Main Results: Sixteen of 27 (59{\%}) dogs survived. Preoperative PC deficiency was identified in 10 of 11 (91{\%}) nonsurvivors and 2 of 15 (13{\%}) survivors. Preoperative AT deficiency was identified in 10 of 11 (91{\%}) nonsurvivors and 14 of 15 (93{\%}) survivors. Compared to survivors, nonsurvivors had lower mean preoperative PC (98 ± 24{\%} versus 49 ± 26{\%}; P < 0.001) and AT (53 ± 9{\%} versus 32 ± 16{\%}; P < 0.001) activities. Anticoagulant activities decreased on day 1 postoperatively. As a predictor of survival, preoperative PC activity of more than 60{\%} achieved a sensitivity of 93{\%} and specificity of 82{\%}. Preoperative AT activity of more than 41.5{\%} achieved a sensitivity of 100{\%} and specificity of 82{\%}. The maximum amplitude, α angle, and coagulation index from preoperative thromboelastograms of survivors were significantly greater (more hypercoagulable) than nonsurvivors (P < 0.01), with the maximum amplitude being the most specific predictor of survival (100{\%}). Conclusions: Deficiencies of PC and AT and hypercoagulability appear to be consistent features of naturally occurring canine sepsis and may be useful prognostic indicators in canine septic peritonitis.",
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