Abstract
BackgroundCritically ill horses, such as horses with gastrointestinal (GI) disease, often suffer from hemostatic aberrations. Global hemostatic tests examining the initiation of coagulation, clot strength and fibrinolysis, such as the Calibrated Automated Thrombogram (CAT) and plasma-thromboelastography (TEG) have not been evaluated in horses. This study aimed to evaluate CAT and apply plasma-TEG in horses.Test performance of CAT was evaluated on equine platelet poor plasma with intra- and inter-assay variability (CV) and a heparin dilution curve. To examine clinical performance of both tests, group comparisons were assessed comparing healthy horses, horses with mild and severe GI disease with both CAT and plasma-TEG.ResultsFor CAT, intra- and inter-assay CVs were established for lag-time (1.7, 4.7%), endogenous thrombin potential (1.6, 4.6%), peak (2.6, 3.9%) and time to peak (ttPeak) (1.9, 3.4%). Increasing heparin concentrations led to the expected decrease in thrombin generation. In the group comparison analysis, CAT showed significant higher peak (p = 0.04) and ttPeak (p = 0.008) in the severe GI disease group compared to horses with mild GI disease and healthy horses, respectively. Plasma-TEG showed an increased angle (p = 0.032), maximum amplitude (p = 0.017) and shear elastic force (G) (p = 0.017) in the severe GI disease group compared to healthy horses.ConclusionsCAT performed well in horses. Both CAT and plasma-TEG identified hemostatic aberrations in horses with severe GI disease compared to healthy horses. Further studies including more horses, are needed to fully appreciate the use of CAT and plasma-TEG in this species.
Highlights
Ill horses, such as horses with gastrointestinal (GI) disease, often suffer from hemostatic aberrations
For Calibrated Automated Thrombogram (CAT), intra- and inter-assay Coefficients of variation (CV) were established for lag-time (1.7, 4.7%), endogenous thrombin potential (1.6, 4.6%), peak (2.6, 3.9%) and time to peak (1.9, 3.4%)
In the group comparison analysis, CAT showed significant higher peak (p = 0.04) and time to peak (ttPeak) (p = 0.008) in the severe GI disease group compared to horses with mild GI disease and healthy horses, respectively
Summary
Ill horses, such as horses with gastrointestinal (GI) disease, often suffer from hemostatic aberrations. To examine clinical performance of both tests, group comparisons were assessed comparing healthy horses, horses with mild and severe GI disease with both CAT and plasma-TEG Ill horses, such as horses with ischemic or inflammatory gastrointestinal (GI) disease, often suffer from marked hemostatic aberrations [1,2,3,4,5]. Honoré et al BMC Vet Res (2021) 17:346 thromboplastin (aPTT) time, decreased anti-thrombin (AT) and increased D-dimer [1, 2, 4,5,6] When this consumption coagulopathy overwhelms the inhibitory system, the coagulopathy is said to be uncompensated, and an imbalance arises, that can lead to disseminated intravascular coagulation (DIC) and thrombus formation. There has only been moderate progression in the use of more advanced diagnostic global hemostatic tests in horses [2, 3, 7,8,9,10,11,12,13,14], with more conventional hemostatic markers such as PLT count, aPTT, PT, AT, fibrinogen, and D-dimer concentration still being the most commonly reported parameters [15, 16]
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