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Hemostatic abnormalities in dogs with naturally occurring heatstroke
Yaron Bruchim1, Efrat Kelmer1, Adar Cohen1
1Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, 76100, Israel.
Summary
Hemostatic abnormalities are common in dogs with heatstroke. Prolonged clotting times and low fibrinogen 12-24 hours post-presentation indicate a poorer prognosis, highlighting the need for serial testing.
Area of Science:
- Veterinary Medicine
- Comparative Pathology
- Critical Care
Background:
- Heatstroke is a severe condition in dogs, often leading to multi-organ dysfunction.
- Hemostatic abnormalities are frequently observed in critically ill animals, but their prognostic value in canine heatstroke is not well-defined.
Purpose of the Study:
- To investigate hemostatic analyte abnormalities in dogs with naturally occurring heatstroke.
- To determine the association between these hemostatic changes and mortality.
Main Methods:
- Prospective observational study involving 30 client-owned dogs with heatstroke.
- Serial blood sampling for hemostatic tests (platelet count, PT, aPTT, ATA, tPCA, fibrinogen, D-dimer) at multiple time points post-presentation.
- Statistical analysis to correlate hemostatic analytes and clinical factors with survival outcomes.
Main Results:
- Overall survival rate was 60%. Older age, higher heart rate, higher rectal temperature, and delayed presentation were associated with mortality.
- Prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT) at 12-24 hours post-presentation, lower total protein C activity (tPCA) at 12 hours, and hypofibrinogenemia at 24 hours were significantly associated with mortality.
- Increased D-dimer and low antithrombin activity (ATA) were common but not mortality-associated. Disseminated intravascular coagulation (DIC) developed more frequently in non-survivors but was not directly linked to mortality.
Conclusions:
- Hemostatic derangements are prevalent in canine heatstroke.
- Alterations in PT, aPTT, tPCA, and fibrinogen concentrations at 12-24 hours post-presentation are associated with outcome.
- Serial monitoring of hemostatic parameters is crucial for predicting prognosis in heatstroke patients, even if initial values are within normal limits.
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