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Evaluation of Fibrinolysis by Thromboelastography in Dogs With Hemorrhagic Pericardial Effusion
Margot R Ehrlich1, Ian M DeStefano1, Elizabeth A Rozanski1
1Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA.
Objective:
To evaluate dogs presenting with hemorrhagic pericardial effusion (PCE) for the presence of hyperfibrinolysis.
Design:
Prospective observational study.
Setting:
Single veterinary teaching hospital.
Measurements And Main Results:
Dogs with PCE had blood samples collected before pericardiocentesis for PCV, total plasma protein and blood lactate concentrations, venous blood gas, and thromboelastography modified with tissue plasminogen activator (tPA-TEG). Fibrinolysis was assessed on tPA-TEG using the percentage of clot lysis at 30 min (LY30) after maximum clot strength (MA). Hyperfibrinolysis was defined as an LY30 of ≥20%. LY30 values were compared with values from a cohort of healthy dogs. Most dogs with PCE (14/16 [87.5%]) were hyperfibrinolytic, whereas no control dogs had hyperfibrinolysis. The median LY30 for dogs with PCE (51.5%, range: 3.0%-77.6%) was significantly higher than that of control dogs (1.3%, range: 0.0%-5.8%; p < 0.001).
Conclusions:
Compared with dogs that are healthy, dogs with hemorrhagic PCE are hyperfibrinolytic as assessed by LY30 on tPA-TEG. Given that dogs with hemorrhagic PCE may experience ongoing hemorrhage after pericardiocentesis, further investigation into the use of antifibrinolytic medications in these patients is warranted.
