Related Experiment Video
Updated: Dec 14, 2025
Identification of Neutrophil Extracellular Traps in Paraffin-Embedded Feline Arterial Thrombi using Immunofluorescence Microscopy
Published on: March 29, 2020
Thromboelastography in cats with cholestatic liver disease
Neketa Kakar1, Gideon Daniel2, Claire Fellman3
1Small Animal Internal Medicine, Cummings School of Veterinary Medicine at Tufts University, Grafton, MA, USA.
Insights
Thromboelastography (TEG) reveals varied coagulation in cholestatic cats, with synthetic failure linked to hypocoagulable and hyperfibrinolytic states, and high disease activity associated with hypocoagulability.
Area of Science:
- Veterinary Internal Medicine
- Hepatology
- Hemostasis and Thrombosis
Background:
- Thromboelastography (TEG) is crucial for understanding hemostasis in liver disease.
- TEG has not been previously explored in cats with cholestatic liver disease (CLD).
Purpose of the Study:
- To characterize TEG parameters in cats with CLD.
- To compare TEG findings with conventional coagulation tests and biochemical markers.
- To correlate coagulation profiles with liver disease severity.
Main Methods:
- Prospective enrollment of 18 cats with CLD.
- Vitamin K1 administration prior to kaolin-activated TEG, prothrombin time (PT), and activated partial thromboplastin time (aPTT) analysis.
- Correlation of TEG results with clinical and biochemical data.
Main Results:
- TEG identified hypercoagulable (50%), normocoagulable (28%), and hypocoagulable (22%) states.
- TEG global clot strength (G) correlated inversely with PT, aPTT, and alkaline phosphatase (ALP), and positively with total solids.
- Hyperfibrinolysis (LY 60 >15.3%) was observed in 28% of cats and correlated positively with PT.
Conclusions:
- Cats with CLD exhibit diverse coagulation profiles on TEG, even after vitamin K1 therapy.
- Synthetic dysfunction correlated with hypocoagulable and hyperfibrinolytic TEG patterns.
- Elevated ALP, indicating high disease activity, was associated with a hypocoagulable state.
Objectives:
While thromboelastography (TEG) has helped define a complex state of hemostasis in dogs and humans with hepatobiliary disease, it has not been explored in cats with cholestatic liver disease (CLD). The objective of this study was to describe TEG parameters in cats with CLD and to compare these parameters with conventional plasma-based coagulation tests, white blood cell (WBC) count and biochemical indicators of liver disease grade and severity.
Methods:
Eighteen cats with CLD, defined by a serum bilirubin ⩾3 mg/dl and a greater than two-fold increase in serum alanine aminotransferase (ALT) and/or alkaline phosphatase (ALP) activity, were prospectively enrolled. All cats received vitamin K1 subcutaneously for 24-36 h prior to acquisition of blood for kaolin-activated TEG analysis, prothrombin time (PT) and activated partial thromboplastin time (aPTT). Patient total solids, packed cell volume, platelet count, WBC count, and serum liver enzymes and bilirubin were extracted from the medical record and correlated with coagulation test results.
Results:
TEG global clot strength (TEG G) values defined 9/18 (50%), 5/18 (28%) and 4/18 (22%) cats as hypercoagulable, normocoagulable or hypocoagulable, respectively. TEG G was significantly negatively correlated with PT, aPTT and serum ALP activity and positively correlated with total solids. Five cats (5/18, 28%) were hyperfibrinolytic with clot lysis at 60 mins (LY 60) >15.3%. LY 60 was significantly positively correlated with PT.
Conclusions And Relevance:
By TEG analysis, cholestatic cats replete with vitamin K1 display a variety of coagulation profiles. Indications of synthetic failure (prolonged PT and aPTT) were associated with hypocoagulable and hyperfibrinolytic TEG parameters. High disease activity (serum ALP) was associated with a hypocoagulable state.
