Progression of plasma D-dimer concentration and coagulopathies during hospitalization in horses with colic.

Abstract

To assess the progression of plasma D-dimer concentrations and coagulation status in horses with different types of colic. Prospective clinical observational study performed between March 2004 and September 2008. Veterinary university teaching hospital. Horses admitted and treated for colic and hospitalized for >48 hours were considered. Animals were classified by diagnosis into medical obstructive conditions (MO), surgical obstructive conditions (SO), inflammatory conditions, and ischemic lesions (IS). Three blood samples were obtained from each horse (admission, at 24-48 h [or after surgery] and upon discharge). For each sample, plasma D-dimer concentration, prothrombin time, activated partial thromboplastin time, antithrombin activity, and the presence of subclinical disseminated intravascular coagulation were determined. When median plasma D-dimer concentration values at admission and after 24-48 hours were compared, they were different but stable in horses with MO (1.29-1.95 nmol/L) and inflammatory conditions (5.70-6.69 nmol/L). However, 10-fold and 5-fold increases were observed, respectively, in SO (2.08 to 16.38 nmol/L) and IS (3.08 to 15.91 nmol/L) in the postoperative period. By 24-48 hours, the percentage of horses with coagulopathy increased in most groups (MO, 43 to 58%; SO, 50 to 96%, IS, 53 to 90%). By the time of discharge, 87% of horses with SO problems and 89% of horses with IS still had some form of coagulopathy documented. Throughout hospitalization, horses with MO problems had less severe coagulopathy and lower plasmatic D-dimer concentrations compared to other groups of horses. On admission, most horses with inflammatory conditions presented with coagulopathy. At 24-48 hours of hospitalization and following surgery, the hemostatic profile can differ markedly when compared to admission values.