Establishment of Reference Intervals for Kaolin-Activated Thromboelastography in Dogs Including an Assessment of the Effects of Sex and Anticoagulant Use

Abstract

Tissue factor (TF)- and kaolin-activated thromboelastography (TEG) have been performed in a small number of healthy dogs, but reference intervals have not been assessed in a larger number of dogs. The goal of the current study was to establish reference intervals and assess intra-assay repeatability for kaolin-activated TEG in dogs. Additionally, the impact of sex and the influence of anticoagulant (native blood vs. recalcified citrate anticoagulated blood) were evaluated. Thromboelastography analyses were performed in 56 healthy dogs including German Shepherd Dogs (n = 19), Beagles (n = 15), and others (n = 22). Median age was 2 years (range: 1-6 years) and sex was evenly distributed (31 males and 25 females). To establish reference intervals, citrated whole-blood samples were collected, and TEG was performed 1 hr after sampling. Five TEG variables (R = reaction time; K = clot formation time; alpha = angle alpha; MA = maximal amplitude; G-value reflecting clot stability) were evaluated, and reference intervals were defined as the mean +/- 1.96-fold standard deviation. Intra-assay repeatability was assessed by calculating the pooled variance estimate in duplicate measurements of 6 healthy dogs. The effect of anticoagulant was assessed in 17 specimens. Reference intervals were as follows: R = 1.8-8.6 min; angle alpha = 36.9-74.6 degrees; K = 1.3-5.7 min; MA = 42.9-67.9 mm, and G = 3.2-9.6 Kdyn/cm(2). Coefficients of variation for R, K, angle alpha, MA, and G were 7.6%, 17.7%, 7.4%, 2.9%, and 6.6%, respectively. There was no significant impact of sex or anticoagulant on results. Interindividual variation was higher in native samples than in citrated whole blood. A limitation of the current study was that most of the samples were obtained from Beagles and German Shepherd Dogs. This study provides useful reference intervals for kaolin-activated TEG.