Laboratory evaluation and interpretation of haemostasis in small animals


Published: Dec 21, 2017
Keywords:
Blood coagulation individual coagulation factors platelet count platelet function analysis preanalytics screening test
R. MISCHKE
Abstract

This review deals with indications for performing haemostasis tests, methodical aspects of blood sampling and handling of sample material, selection of appropriate tests and basic principles of test interpretation. Indications for laboratory evaluation of haemostasis in small animals include spontaneous bleeding or bleeding disproportionate to the degree of trauma, bleeding from multiple sites and diseases which are frequently associated with haemostatic disorders. Patient history and clinical findings can deliver clues for the type of haemorrhagic diathesis. Important preanalytical issues include prevention of prolonged venous stasis, order of drawing and appropriate filling of the collection tubes and careful mixing of blood with anticoagulant. Initial screening can be performed by global tests of haemostasis including viscoelastic testing using thrombelastography and rotation thrombelastometry and/or a “basic examination profile” including platelet count, capillary bleeding time (optional in cases of suspected functional platelet disorders) and group tests prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin (clotting) time (optionally in cases of prolonged PT and aPTT). This procedure allows a rational evaluation of the haemostatic system and a specific use of further tests including individual coagulation factor activities, inhibitor activities, activation markers, examination of von Willebrand factor, and platelet function analyses. It is important (1) to use species- and method specific reference values for interpretation and (2) to consider the limitations of tests when performed according to the standard test procedure optimised for human sample material (e.g., low sensitivity of PT test for canine and feline samples).

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References
Ameri M, Schnaars HA, Sibley JR, Honor DJ (2011) Determination of plasma fibrinogen concentrations in beagle dogs, cynomolgus monkeys, New Zealand white rabbits, and Sprague-Dawley rats by using Clauss and prothrombin-time-derived assays. J Am Assoc Lab Anim Sci 50:864-867.
Aumann M, Rossi V, Le Boedec K, Diquélou A (2013) Comparison of the buccal mucosal bleeding time in dogs using 3 differentsized lancet devices. Vet Clin Pathol 42:451-457.
Bateman SW, Mathews KA, Abrams-Ogg ACG, Lumsden JH, Johnstone IB, Hillers TK (1999) Evaluation of point-of-care tests for diagnosis of disseminated intravascular coagulation in dogs admitted to an intensive care unit. J Am Vet Med Assoc 215:805-810.
Boudreaux MK (2008) Characteristics, diagnosis, and treatment of inherited platelet disorders in mammals. J Am Vet Med Assoc 8:1251–1258.
Botsch V, K üchenhoff H, Hartmann K, Hirschberger J (2009) Retrospective study of 871 dogs with thrombocytopenia. Vet Rec 164:647-651.
Boutet P, Heath F, Archer J Villiers E (2009) Comparison of quantitative immunoturbidimetric and semiquantitative latex-agglutination assays for D-dimer measurement in canine plasma. Vet Clin Pathol 38:78-82.
Brainard BM, K leine SA, Papich MG, Budsberg SC (2010) Pharmacodynamic and pharmacokinetic evaluation of clopidogrel and the carboxylic acid metabolite SR 26334 in healthy dogs. Am J Vet Res 71:822-830.
Burgess H, Wood D (2008) Validation of a von Willebrand factor antigen enzyme-linked immunosorbent assay and newly developed collagen-binding assay. Can J Vet Res 72:420-427.
Callan MB, Giger U (2001) Assessment of a point-of-care instrument for identification of primary hemostatic disorders in dogs. Am J Vet Res 62:652-658.
Cowan SM, Bartges JW, Gompf RE, Hayes JR, Moyers TD, Snider CC, Gerard DA, Craft RM, Muenchen RA, Carroll RC (2004) Giant platelet disorder in the Cavalier King Charles Spaniel. Exp Hematol 32:344-350.
Dewhurst E, Cue S, Crawford E, Papasouliotis K (2008) A retrospective study of canine D-dimer concentrations measured using an immunometric “Point-of-Care” test. J Small Anim Pract 49:344-348.
Dircks BH, Schuberth HJ, Mischke R (2009) Underlying diseases and clinicopathologic variables of thrombocytopenic dogs with and without platelet-bound antibodies detected by use of a flow cytometric assay: 83 cases (2004-2006). J Am Vet Med Assoc 235:960-966
.
Dixon-Jimenez AC, Brainard BM, Cathcart CJ, Koenig A (2013) Evaluation of a point-of-care coagulation analyzer (Abaxis VSPro) for identification of coagulopathies in dogs. J Vet Emerg Crit Care 23:402-407.
Dyszkiewicz-Korpanty AM, Frenkel EP, Sarode R (2005) Approach to the assessment of platelet function: Comparison between optical-based platelet-rich plasma and impedance-based whole blood platelet aggregation methods. Clin Appl Thromb/Hemost 11:25-35.
Feldman BF, Madewell BR, O’Neill S (1981) Disseminated intravascular coagulation: antithrombin, plasminogen, and coagulation abnormalities in 41 dogs. J Am Vet Med Assoc 179:151-154.
Furlanello T, Caldin M, Stocco A, Tudone E, Tranquillo V, Lubas G, Solano-Gallego L (2006) Stability of stored canine plasma for hemostasis testing. Vet Clin Pathol 35:204-207.
Hackner SG (1995) Approach to the diagnosis of bleeding disorders. Comp Cont Educ Pract Vet 17:331-349.
Herring J, McMichael M (2012) Diagnostic approach to small animal bleeding disorders. Top Companion Anim Med 27:73-80.
Jergens AE, Turrentine MA, Kraus KH, Johnson GS (1987) Buccal mucosal bleeding time of healthy dogs and of dogs in various pathological states, including thrombocytopenia, uremia and von Willebrand’s disease. Am J Vet Res 48:337-1342.
Johnstone IB (1984) The activated partial thromboplastin time of diluted plasma: variability due to method of fibrin detection. Can J Comp Med 48:198-201.
Johnstone IB, Keen J, Halbert A, Crane S (1991) Stability of factor VIII and von Willebrand factor in canine blood samples during storage. Can Vet J 32:173-175.
Kalbantner K, Baumgarten A, Mischke R (2010) Measurement of platelet function in dogs using a novel impedance aggregometer. Vet J 185:144-151.
Kol A, Borjesson DL (2010) Application of thrombelastography/ thromboelastometry to veterinary medicine. Vet Clin Pathol 39: 405-416.
Laga AC, Cheves TA, Sweeney JD (2006) The effect of specimen hemolysis on coagulation test results. Am J Clin Pathol 126:748-755.
Lawrence J, Chang Y-MR, Szladovits B, Davison LJ, Garden OA (2013) Breed-specific hematological phenotypes in the dog: A natural resource for the genetic dissection of hematological parameters in a mammalian species. PLoS ONE 8(11): e81288. doi:10.1371/journal.pone.0081288
Lippi G, Salvagno GL, Montagnana M, Lima-Oliveira G, Guidi GC, Favaloro EJ (2012) Quality standards for sample collection in coagulation testing. Semin Thromb Hemost 38: 565-575.
Maeckelbergh VA, Acierno MJ (2008) Comparison of prothrombin time, activated partial thromboplastin time, and fibrinogen concentration in bloodsamples collected via an intravenous catheter versus direct venipuncture in dogs. Am J Vet Res 69:868-873.
Mandell CP, O’Neill SL, Feldman BF (1991) Antithrombin III concentrations associated with L-asparaginase administration. Vet Clin Pathol 21:68-70.
Maunder CL, Costa M, Cue SM, Crawford EM, Papasouliotis K, Murphy KF (2012) Measurement of prothrombin time and activated partial thromboplastin time in citrated whole blood samples from clinically ill dogs following storage. J Small Anim Pract 53:531-535.
McConnell MF (2000) Haemostatic diagnostic techniques. In: Day M, Mackin A, Littlewood J (eds) Manual of canine and feline haematology and transfusion medicine. Quedgeley, British Small Animal Veterinary Association Publication, p. 173-181.
Mischke R (2000) Activated partial thromboplastin time as a screening test of minor or moderate coagulation factor deficiencies for canine plasma: sensitivity of different commercial reagents. J Vet Diagn Invest 12:433-437.
Mischke R (2001) Optimization of coagulometric tests that incorporate human plasma for determination of coagulation factor activities in canine plasma. Am J Vet Res 62:625-629.
Mischke R (2002) Commercial variants of the prothrombin time test as a screening test of acquired coagulation factor II, VII, and X deficiencies in dogs. Res Vet Sci 73:165-170.
Mischke R (2010) Prothrombin time standardisation in canine samples with regard to inter-batch and inter-reagent variability. Vet J 188:301-306.
Mischke R (2013) Haemophilia A and B in dogs. Comp Contin Ed Pract Vet 23:42-53.
Mischke R, Jacobs C (2001) The monitoring of heparin administration by screening tests in experimental dogs. Res Vet Sci 70:101-108.
Mischke R, Keidel A (2002) Preclinical studies for the use of the platelet function analyser PFA-100 with the collagen/ADP cartridge in dogs. Dtsch Tieraerztl Wochenschr 109:235-238.
Mischke R, Keidel A (2003) Influence of platelet count, acetylsalicylic acid, von Willebrand`s disease, coagulopathies, and haematocrit on results obtained using a platelet function analyser in dogs. Vet J 165:43-52.
Mischke R, Nolte I (1997) Optimization of prothrombin time measurements in canine plasma. Am J Vet Res 58:236-241.
Mischke R, Schulze U (2004) Studies on platelet aggregation using the Born method in normal and uraemic dogs. Vet J 168:270-275.
Mischke R, Wolling H (2000) Influence of fibrinogen degradation products on thrombin time, activated partial thromboplastin time and prothrombin time of canine plasma. Haemostasis 30:123-130.
Mischke R, Deniz A, Nolte I (1996) Influence of sample predilution on the sensitivity of prothrombin time in feline plasma. Zentralbl Veterinaermed A 43:155-162.
Mischke R, Busse L, Bartels D, Glaser S, K reienbrock L (2002) Quantification of thrombopoietic activity in bone marrow aspirates of dogs. Vet J 164:269-274.
Moreno P, Ginel PJ (1999) Effects of haemolysis, lipaemia and bilirubinaemia on prothrombin time, activated partial thromboplastin time and thrombin time in plasma samples from healthy dogs. Res Vet Sci 67:273-276.
Nelson OL, Andreasen C (2003) The utility of plasma D-dimer to identify thromboembolic disease in dogs. J Vet Intern Med 17:830-834.
Nolte I, Niemann C, Bowry SK, Failing K, Müller-Berghaus G (1997) A method for measuring capillary bleeding time in nonanaesthetized dogs. Prolongation of the bleeding time by acetylsalicylic acid. J Vet Med Series A 44:625-628.
O’Marra SK, Delaforcade AM, Shaw SP (2011) Treatment and predictors of outcome in dogs with immune-mediated thrombocytopenia. J Am Vet Med Assoc 238:346-352.
Parker MT, Collier LL, Kier AB, Johnson GS (1988) Oral mucosal bleeding times of normal cats and cats with Chediak-Higashi syndrome or Hageman trait (factor XII deficiency). Vet Clin Pathol 17:9-12.
Piccione G, Casella S, Giannetto C, Giudice E (2010) Effect of storage conditions on prothrombin time, activated partial thromboplastin time and fibrinogen concentration on canine plasma. J Vet Sci 11: 121-124.
Reneke J, Etzell J, Leslie S, Ng VL, Gottfried EL (1998) Prolonged prothrombin time and activated partial thromboplastin time due to underfilled specimen tubes with 109 mmol/L (3.2%) citrate anticoagulant. Am J Clin Pathol. 109:754-757.
Tasker S, Cripps PJ, Mackin AJ (2001) Evaluation of methods of platelet counting in the cat. J Small Anim Pract. 42:326-332.
Tvedten H, Lilliehöök I, Hillström A, Häggström J (2008) Plateletcrit is superior to platelet count for assessing platelet status in Cavalier King Charles Spaniels. Vet Clin Pathol 37:266- 271.
Tvedten HW, Lilliehöök IE, Öberg J, Häggström J, Höglund K, Ljungvall I (2012) Validation of Advia plateletcrit for assessing platelet mass in dogs, including Cavalier King Charles Spaniels. Vet Clin Pathol 41:336-343.
Wiinberg B, Jensen AL, Johansson PI, Rozanski E, Tranholm M, Kristensen AT (2008) Thrombelastographic evaluation of hemostatatic function in dogs with disseminated intravascular coagulation. J Vet Intern Med 22:357-365.
Wondratschek C, Weingart C, K ohn B (2010) Primary immunemediated thrombocytopenia in cats. J Am Anim Hosp Assoc 46:12-19.