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Changes in coagulation and markers of fibrinolysis in horses undergoing colic surgery
K Feige1, S B R Kästner, C E Dempfle
1Equine Clinic, Faculty of Veterinary Medicine, University of Zurich, Zurich, Switzerland. kfeige@vetclinics.unizh.ch
Insights
Colic surgery in horses activates coagulation, impacting both the disease and surgical trauma. This study found significant changes in coagulation markers like activated partial thromboplastin time (aPTT) and D-Dimer (DD) post-surgery.
Area of Science:
- Veterinary Medicine
- Equine Surgery
- Hemostasis and Thrombosis
Background:
- Coagulation activation is common in horses with colic.
- Surgical trauma alone can also induce coagulation changes in humans.
- The specific impact of colic versus surgery on equine coagulation requires elucidation.
Purpose of the Study:
- To investigate coagulation and fibrinolysis changes in horses undergoing colic surgery.
- To differentiate between colic-induced and surgery-induced hemostatic alterations.
- To assess the role of wound healing in post-operative coagulation status.
Main Methods:
- Comparative study involving horses with colic surgery and a control group undergoing standardized surgical trauma (Forssell's procedure).
- Daily physical examinations over 10 days.
- Measurement of activated partial thromboplastin time (aPTT), prothrombin time, thrombin time, fibrin monomer (FM), D-Dimer (DD), and antithrombin (AT) III.
Main Results:
- Activated partial thromboplastin time (aPTT) was significantly prolonged in colic surgery patients compared to controls, both pre- and post-operatively.
- Hyperfibrinogenaemia was observed in all surgical groups post-operatively.
- Increased fibrin monomer (FM) and D-Dimer (DD) concentrations were noted in colic groups post-surgery, alongside a decrease in antithrombin (AT) III activity.
Conclusions:
- Activated coagulation is an expected outcome following colic surgery in horses.
- Both the underlying colic disease and the surgical procedure contribute to post-operative coagulation activation.
- Antithrombin III activity reduction suggests consumption during the activated coagulation process.
Abstract:
Activation of coagulation can be frequently found in horses with colic. However, it has also been demonstrated as a sequela of surgical trauma alone in humans. The purpose of the present study was to determine changes in coagulation and fibrinolysis in horses that underwent colic surgery and to evaluate whether these changes were secondary to the colic or the surgery and wound healing. Thirty horses that underwent colic surgery with uncomplicated recovery were included. Ten horses with a Forssell's procedure served as control group with a standardized surgical trauma. Besides daily physical examinations during the observation period of 10 days, activated partial thromboplastin time (aPTT), prothrombin time and thrombin time as well as fibrin monomer (FM), D-Dimer (DD) and antithrombin (AT) III were determined. Compared with the control group the aPTT was the only standard coagulation test that was significantly prolonged before and after the event of colic surgery. After surgery, hyperfibrinogenaemia occurred in all groups. In colic groups FM and DD concentrations were within reference range at admission,and were significantly greater than in control horses after surgery. AT III activity decreased after colic surgery, but did not change in the control group. It was concluded that an activated coagulation state after colic surgery has to be expected, resulting not only from the colic disease, but also from the event of surgery.
