Systematic evaluation of evidence on veterinary viscoelastic testing Part 5: Nonstandard assays

Abstract

To systematically examine the evidence on nontraditional uses of viscoelastic coagulation monitoring in veterinary species. Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Academic and referral veterinary medical centers. Databases searched included Medline, CAB abstracts, and Google Scholar. Nontraditional assays identified included thrombelastography (TEG)-PlateletMapping (PM), functional fibrinogen assessment, and rapid-TEG (r-TEG). Direct veterinary evidence was found for only the ADP-activated PM, which appears to generate valid data in dogs but not cats or horses. Arachidonic acid activated PM shows high variability and requires further assessment and validation in veterinary species. Functional fibrinogen assays may be performed in veterinary species but may require modification due to species differences in response to abciximab. While tissue factor (TF)-activated TEG has been well described in the veterinary literature, the specific r-TEG assay has not been assessed, but presumably would be effective for generating TEG tracings and values for maximum amplitude and angle in shorter periods of time than some traditional assays.