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Published on: September 7, 2018
ClotPro viscoelastic testing in coagulation disorders in dogs: a retrospective analysis
Pavlos G Doulidis1, Carolina Frizzo-Ramos2, Larissa J Prankch1
1Clinical Unit of Small Animal Internal Medicine, Department for Companion Animals and Horses, University of Veterinary Medicine, 1210 Vienna, Austria.
Background:
Viscoelastic testing provides whole-blood assessment of coagulation, but clinical data on the performance of the ClotPro in dogs with naturally occurring diseases are limited.
Hypothesis/Objectives:
To evaluate pathway coherence of ClotPro variables with routine coagulation tests and to explore disease-associated viscoelastic phenotypes, fibrinolysis, and hypercoagulability.
Animals:
Eighty-four client-owned dogs admitted to a university hospital.
Methods:
Retrospective cohort study. ClotPro variables (clotting time, amplitude at 10 min, maximum clot firmness, maximum lysis across extrinsic pathway test [EX], intrinsic pathway test [IN], fibrinogen test channel, aprotinin test [AP] channels) were compared with prothrombin time (PT), activated partial thromboplastin time (aPTT), platelet count (PLT), and D-dimer using Spearman correlation with Benjamini-Hochberg adjustment. Group differences were assessed with Kruskal-Wallis and Dunn's post hoc. Hyperfibrinolysis (HF) was defined using paired EX-AP. A hypercoagulability index (HCI) and platelet/fibrin-adjusted residual firmness were derived.
Results:
PT correlated with clotting time in EX channel (ρ = 0.48, q = 0.002) and aPTT with clotting time in IN channel (ρ = 0.42, q = 0.007). PLT correlated with maximum clot firmness in EX channel (EX_MCF) (ρ = 0.50, q = 0.001). maximum clot firmness in FIB channel correlated with EX_MCF (ρ = 0.58, q < 0.001) and maximum clot firmness in IN channel (ρ = 0.47, q = 0.003). maximum lysis in EX channel (EX_ML) correlated inversely with EX_MCF (ρ = -0.35, q = 0.028). D-dimer correlated with EX_ML (ρ = 0.30, q = 0.049). Group-level distributions overlapped substantially. HF was infrequent among cases (33% in dogs with hepatopathy and 21% in dogs with hemorrhagic diarrhea). The HCI differed across diseases (P = .0002), whereas platelet/fibrin-adjusted residual firmness did not.
Conclusions And Clinical Importance:
ClotPro variables demonstrated pathway-specific coherence with routine coagulation testing and consistent fibrinolysis patterns. Disease states did not define discrete viscoelastic phenotypes, supporting case-level interpretation.
