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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.
Journal of Feline Medicine and Surgery
|July 17, 2020
Summary
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.
