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In people, the antifibrinolytic drug tranexamic acid reduces bleeding and the need for blood products with both normal and exaggerated fibrinolysis without increasing the number of thromboembolic events. In dogs, in addition to prevention and treatment of bleeding, higher doses of tranexamic acid can be used to induce vomiting. The objective of this study was to evaluate the effect of a high dose of tranexamic acid on the coagulation of healthy Beagle dogs. A prospective trial was conducted in eight healthy Beagles receiving tranexamic acid for a concurrent trial evaluating different antiemetics. Rotational thromboelastometry (ROTEM) analysis (EXTEM, APTEM, FIBTEM, INTEM) was performed before and 30 minutes after intravenous administration of 50 mg/kg tranexamic acid. ROTEM parameters before and after tranexamic acid administration and between EXTEM and APTEM were compared with Wilcoxon matched-pairs signed rank test and data is presented as median (range). After tranexamic acid administration, FIBTEM clotting time became significantly shorter (p=0.03) from 37 s (28-124 s) to 33 s (27-40 s) and INTEM clot formation time significantly decreased (p=0.02) from 82 s (47-132 s) to 60 s (43-107 s). After tranexamic acid APTEM MCF was significantly weaker (p=0.01) with 45 mm (30-63 mm) than EXTEM MCF with 55 mm (43-69 mm) and than APTEM MCF before tranexamic acid with 55 mm (43-69 mm) (p=0.02). All other analysed parameters including maximum lysis did not change after administration of tranexamic acid. The administration of 50 mg/kg intravenous tranexamic acid resulted in small changes in ROTEM profiles without inducing a hypercoagulable clot. In conclusion, tranexamic acid can safely be administered to healthy dogs with normal coagulation profiles. As an additional finding, APTEM parameters measured in the current study do not support the use of this test in dogs.Der antifibrinolytische Wirkstoff Tranexamsäure reduziert beim Menschen Blutungen und den Bedarf an Blutprodukten, dies sowohl bei normaler als auch bei übertriebener Fibrinolyse und ohne die Anzahl der thromboembolischen Ereignisse zu erhöhen. Bei Hunden können höhere Dosen von Tranexamsäure neben der Vorbeugung und Behandlung von Blutungen auch zur Induktion von Erbrechen verwendet werden. Ziel dieser Studie war es, die Wirkung einer hohen Dosis Tranexamsäure auf die Koagulation von gesunden ­Beagle-Hunden zu bewerten. Die prospektive Studie wurde bei acht gesunden Beagles durchgeführt, die Tranexamsäure während einer Studie zur Bewertung verschiedener Antiemetika erhielten. Rotations-Thromboelastometrie (ROTEM) Analyse (EXTEM, APTEM, FIBTEM, INTEM) wurde vor und 30 Minuten nach intravenöser Verabreichung von 50 mg/kg Tranexamsäure durchgeführt. Die ROTEM-Parameter vor und nach der Verabreichung von Tranexamsäure und zwischen EXTEM und APTEM wurden mit dem Wilcoxon-Matched-Pair-Test verglichen und der Medianwert (Range) angegeben. Nach der Verabreichung von Tranexamsäure wurde die Gerinnungszeit von FIBTEM von 37 s (28-124 s) auf 33 s (27-40 s) signifikant verkürzt (p = 0,03) und die Bildung der INTEM-Gerinnsel reduzierte sich signifikant (p = 0,02) von 82 s ( 47-132 s) auf 60 s (43-107 s). Nach Tranexamsäure war APTEM MCF mit 45 mm (30-63 mm) signifikant schwächer (p = 0,01) als EXTEM MCF mit 55 mm (43-69 mm) und als APTEM MCF vor Tranexamsäure mit 55 mm (43-69 mm) (p = 0,02). Alle anderen analysierten Parameter einschließlich der maximalen Lyse änderten sich nach Verabreichung von Tranexamsäure nicht. Die Verabreichung von 50 mg/kg intravenöser Tranexamsäure führte zu kleinen Änderungen der ­ROTEM-Profile, ohne ein hyperkoagulierbares Gerinnsel zu induzieren. Zusammenfassend kann Tranexamsäure gesunden Hunden mit normalen Gerinnungsprofilen sicher verabreicht werden. Als zusätzliches Ergebnis der aktuellen Studie konnten die gemessenen APTEM-Parameter die Verwendung dieses Tests bei Hunden nicht bestätigen.Chez l’homme présentant une fibrinolyse normale et exagérée, l’acide tranexamique, un agent antifibrinolytique, réduit les saignements et le besoin de produits sanguins sans augmenter le nombre d’événements thromboemboliques. Chez les chiens, en plus de la prévention et du traitement des saignements, des doses plus élevées d’acide tranexamique peuvent être utilisées pour provoquer des vomissements. L’objectif de cette étude était d’évaluer l’effet d’une dose élevée d’acide tranexamique sur la coagulation de chiens Beagle en bonne santé. Un essai prospectif a été mené chez huit Beagles en bonne santé recevant de l’acide tranexamique dans le cadre d’un essai simultané évaluant différents antiémétiques. Une analyse de la thromboélastométrie rotationnelle (ROTEM) (EXTEM, APTEM, FIBTEM, INTEM) a été réalisée avant et 30 minutes après l’administration intraveineuse de 50 mg/kg d’acide tranexamique. Les paramètres ROTEM avant et après l’administration d’acide tranexamique et entre EXTEM et APTEM ont été comparés au test de rang de Wilcoxon à paires appariées et les données sont présentées sous forme de médiane. Après administration de l’acide tranexamique, le temps de coagulation de FIBTEM est devenu significativement plus court (p = 0,03) de 37 s (28-124 s) à 33 s (27-40 s) et le temps de formation du caillot INTEM a été significativement réduit (p = 0,02) de 82 s (47-132 s) à 60 s (43-107 s). Après l’acide tranexamique, APTEM MCF était significativement plus faible (p = 0,01) avec 45 mm (30-63 mm) que EXTEM MCF avec 55 mm (43-69 mm) et qu’APTEM MCF avant l’acide tranexamique avec 55 mm (43-69 mm) (p = 0,02). Tous les autres paramètres analysés, y compris la lyse maximale, n’ont pas changé après l’administration d’acide tranexamique. L’administration de 50 mg/kg d’acide tranexamique par voie intraveineuse a entraîné de légers changements dans les profils ROTEM sans induire de caillot hypercoagulable. En conclusion, l’acide tranexamique peut être administré en toute sécurité à des chiens en bonne santé présentant des profils de coagulation normaux. Autre constatation supplémentaire, les paramètres APTEM mesurés dans la présente étude n’appuient pas l’utilisation de ce test chez le chien.Nelle persone, il farmaco antifibrinolitico acido tranexamico riduce l’emorragia e la necessità di prodotti ematici con fibrinolisi normale ed esagerata senza aumentare il numero di eventi tromboembolici. Nei cani, oltre alla prevenzione e al trattamento dell’emorragia, dosi più elevate di acido tranexamico possono essere utilizzate per indurre il vomito. L’obiettivo di questo studio è stato quello di valutare l’effetto di un’alta dose di acido tranexamico sulla coagulazione dei cani Beagle sani. È stato condotto uno studio prospettico in otto Beagle sani a cui veniva somministrato acido tranexamico per uno studio concomitante che valutava diversi antiemetici. L’analisi tromboelastografica rotazionale (ROTEM) (EXTEM, APTEM, FIBTEM, INTEM) è stata eseguita prima e 30 minuti dopo la somministrazione endovenosa di 50 mg/kg di acido tranexamico. I parametri ROTEM prima e dopo la somministrazione di acido tranexamico e tra EXTEM e APTEM sono stati confrontati con il test di Wilcoxon dei ranghi con segno con misure accoppiate e i dati sono stati presentati come mediana (rango). Dopo la somministrazione di acido tranexamico, il tempo di coagulazione FIBTEM è diventato significativamente più breve (p=0.03) da 37 s (28-124 s) a 33 s (27-40 s) e il tempo di formazione del coagulo INTEM è diminuito significativamente (p=0.02) da 82 s (47-132 s) a 60 s (43-107 s). Dopo la somministrazione dell’acido tranexamico APTEM MCF era significativamente più debole (p=0.01) con 45 mm (30-63 mm) di EXTEM MCF con 55 mm (43-69 mm) e di APTEM MCF prima dell’acido tranexamico con 55 mm (43-69mm) (p=0.02). Tutti gli altri parametri analizzati, compresa la lisi massima, non sono cambiati dopo la somministrazione di acido tranexamico. La somministrazione di 50 mg/kg di acido tranexamico per via endovenosa ha portato a piccole modifiche nei profili ROTEM senza indurre un coagulo trombofilo. In conclusione, l’acido tranexamico può essere somministrato con sicurezza nei cani sani con profili di coagulazione normali. Come ulteriore risultato, i parametri APTEM misurati nello studio attuale non supportano l’uso di questo test nei cani. Parole chiave: Antifibrinolitico, canino, emetico, acido tranexamico, test di coagulazione viscoelastica, vomito.

Angiostrongylus vasorum infection has been associated with coagulopathies including hyperfibrinolysis. We compared coagulation status including thromboelastometry (ROTEM) parameters in dogs naturally infected with A. vasorum versus healthy dogs to determine clinicopathological parameters associated with bleeding, hypocoagulopathy, and hyperfibrinolysis. Clinical signs, white blood cell count, platelet count, hematocrit, plasmatic coagulation tests (PT, aPTT, fibrinogen concentration), D-dimer, and ROTEM S parameters (Ex-tem, In-tem, Fib-tem, Ap-tem) were analysed and compared between bleeding, nonbleeding, and control dogs and between hypo- and normocoagulable animals. Clinical signs of bleeding were present in 6/9 (67%) hypocoagulable and 1/9 (11%) normocoagulable dogs. PT, fibrinogen concentration, and several ROTEM parameters were significantly different between hypocoagulable and normocoagulabe A. vasorum infected dogs. Hyperfibrinolysis was identified in 44% of infected dogs and was significantly more common in bleeding and hypocoagulable dogs. Hyperfibrinolysis was significantly associated with low MCFFib-tem but not with low fibrinogen concentration or increased D-dimers. CFTEx-tem &gt, 248 swas 100% sensitive and 89% specific to predict hyperfibrinolysis. Hyperfibrinolysis, hypocoagulability and bleeding are common in A. vasorum infected dogs. Only Ex-tem and Fib-tem parameters and potentially PT were associated with bleeding or hypocoagulability. Ex-tem analysis enables detection of bleeding, hypocoagulability and hyperfibrinolysis within minutes.

Objective The aim of this study was to determine the prevalence of acute traumatic coagulopathy (ATC) and identify associated clinical and laboratory parameters including rotational thromboelastometry. Study Design Dogs presenting within 6 hours after trauma were allocated to the ATC or non-ATC group based on thromboelastometry analysis (ex-tem S, in-tem S, fib-tem S). ATC was defined as ≥2 hypocoagulable parameters in 1 profile and ≥ 1 hypocoagulable parameter in an additional profile. Parameters used were ex-tem and in-tem clotting time (CT), clot formation time (CFT), maximum clot firmness (MCF), maximum lysis and fib-tem MCF. Clinical and laboratory parameters at presentation, animal trauma triage (ATT) score, transfusion requirement and outcome were compared. Logistic regression was used to identify independent factors associated with ATC. Results Eleven of 33 dogs presented with ATC and showed ex-tem CT and CFT prolongation and reduced MCF amplitude in all profiles (all p Conclusion Acute traumatic coagulopathy is more common in traumatized dogs than previously reported. Acute traumatic coagulopathy was associated with acidosis, Animal trauma triage score, time after trauma and higher transfusion needs. Coagulation abnormalities include ex-tem CT and CFT prolongations and decreased clot strength.

The objectives of this prospective study were determination of reference intervals (RI) for rotational thromboelastometry (ROTEM) parameters in single use reagents and to evaluate correlations between plasmatic coagulation times and ROTEM parameters. Blood was sampled from a jugular vein in 49 client-owned healthy dogs and ex-tem S, in-tem S, fib-tem S and ap-tem S parameters, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, haematology, blood chemistry and venous blood gas analysis was performed. Determination of RI was performed using Excel add-in Reference Value Advisor and correlations between PT, aPTT and fibrinogen with selected ROTEM parameters were determined by Spearman correlation. Ex-tem S maximum clot firmness (MCF) RI are smaller compared to RI in people and liquid ex-tem in dogs while maximum lysis was comparable to those in people but smaller than previously reported in dogs. A strong correlation was found between fibrinogen measured by Clauss and fib-tem S and in-tem S MCF (r = 0.541, P

Rotational thromboelastometry (ROTEM) is a viscoelastic coagulation test that allows the evaluation of haemostasis from clot formation to clot dissolution. The aim of this retrospective study was to describe the changes in haemostasis using ROTEM parameters in dogs presenting with spontaneous or traumatic haemoperitoneum and to evaluate any associations between clinical and laboratory parameters at presentation with the ROTEM. We hypothesized that the dogs would show signs of hypocoagulability and hyperfibrinolysis and that these changes would correlate with the degree of hypoperfusion. Clinical records were searched for a period of 5 years for dogs presenting with a haemoperitoneum und for whom a -ROTEM analysis at presentation was carried out. Forty dogs were identified, and various clinical and laboratory parameter (heart rate, blood pressure, blood glucose, lactate, serum albumin concentration, PCV (venous and abdominal), ionized calcium, pH and base excess) were retrieved. The following ROTEM parameters were analysed: extrinsic clotting time (ExTEM CT), clot formation time (ExTEM CFT), clot firmness (ExTEM MCF) and maximum lysis (ExTEM ML), as well as fibrinogen (FibTEM) CT and MCF. Compared to institutional reference intervals, dogs with haemoabdomen showed prolongation of ExTEM and FibTEM CT, ExTEM CFT and 50% were hypocoagulable and 62% thrombocytopenic. No hyperfibrinolysis could be detected. Multiple linear regression models showed an association between decreased base excess, trauma and ROTEM signs for hypocoagulability. Furthermore, age was associated with a stronger fibrin clot. In conclusion, 50% of the dogs presented hypocoagulable and changes in ROTEM parameters are similar to those seen with consumption coagulopathy. Base excess and trauma were associated with hypocoagulability, while increasing age was associated with a stronger fibrin clot.Als viskoelastisches Verfahren kann die Rotationsthromboelastometrie (ROTEM) die Hämostase von der Gerinnselbildung bis hin zur -auflösung aufzeichnen. Das Ziel dieser retrospektiven Studie war es die Veränderungen in der Hämostase an Hand von ROTEM Parametern bei Hunden zu beschreiben, die mit spontanem oder traumatischem Hämoabdomen vorgestellt wurden. Weiter wurde der Zusammenhang zwischen den ROTEM Parametern und ausgewählten klinischen und Labor-Parametern untersucht. Wir stellten die Hypothese auf, dass die Hunde Zeichen von Hypokoagulabilität und Hyperfibrinolyse aufweisen, und diese Veränderungen mit der Ausprägung der Hypoperfusion korrelieren. Innerhalb des 5-jährigen Untersuchungsrahmens wurden vierzig Hunde mit Hämoabdomen vorgestellt, für die bei Vorstellung eine ROTEM-Analyse durchgeführt wurde. Bei diesen Hunden wurden aus den Krankengeschichten klinische Parameter wie Herzfrequenz, Blutdruck, Glukose und Laktat, Serumalbumin, peripherer und abdominaler Hämatokrit, ionisiertes Kalzium, pH und Basenüberschuss herausgesucht. Die folgenden ROTEM Parameter wurden evaluiert: extrinsische Gerinnungszeit (ExTEM CT), Gerinnselbildungszeit (ExTEM CFT), Gerinnselstärke (ExTEM MCF) und maximale Lyse (ExTEM ML) sowie Fibrinogen (fib-tem) CT und MCF. Im Vergleich zu den Referenzintervallen zeigten die Hunde verlängerte ExTEM und FibTEM CT und verlängerte ExTEM CFT, 50% waren hypokoaguabel und 62% thrombozytopenisch. Hyperfibrinolyse konnte nicht dargestellt werden. ­Multiple lineare Regressionsmodelle haben einen ­Zusammenhang zwischen einem verminderten Basenüberschuss, Trauma und ROTEM Zeichen für Hypokoagulabilität dargestellt. Weiter war Alter mit einem stärkeren Fibrin-Gerinnsel assoziiert. Zusammenfassend präsentierten sich 50% der Hunde hypokoaguabel und die ROTEM Veränderungen entsprechen am ehesten einer Verbrauchskoagulopathie.La thromboélastométrie rotationnelle (ROTEM) est un test de coagulation viscoélastique qui permet d’évaluer l’hémostase depuis la formation du caillot jusqu’à sa dissolution. Le but de cette étude rétrospective était de décrire les changements de l’hémostase à l’aide des paramètres ROTEM chez des chiens présentant un hémopéritoine spontané ou traumatique et d’évaluer d’éventuelles association entre les paramètres cliniques et de laboratoire lors de la présentation avec le ROTEM. Nous avons émis l’hypothèse que les chiens montreraient des signes d’hypocoagulabilité et d’hyperfibrinolyse et que ces changements seraient en corrélation avec le degré d’hypoperfusion. Les dossiers cliniques ont été recherchés surune période de 5 ans pour les chiens présentant un hémopéritoine et pour lesquels une analyse ROTEM à la présentation avait été effectuée. Quarante chiens ont été identifiés et divers paramètres cliniques et de laboratoire (fréquence cardiaque, tension artérielle, glycémie, lactate, concentration d’albumine sérique, PCV (veineux et abdominal), calcium ionisé, pH et excès basique) ont été relevés. Les paramètres ­ROTEM suivants ont été analysés: temps de coagulation extrinsèque (ExTEM CT), temps de formation de caillot (ExTEM CFT), fermeté du caillot (ExTEM MCF) et lyse maximale (ExTEM ML), ainsi que fibrinogène ­(FibTEM) CT et MCF. Par rapport aux intervalles de référence admis, les chiens avec hémoabdomen ont montré une prolongation d’ExTEM et FibTEM CT, ExTEM CFT, 50% étaient hypocoagulables et 62% thrombocytopéniques. Aucune hyperfibrinolyse n’a pu être détectée. Plusieurs modèles de régression linéaire ont montré une association entre une diminution de l’excès basique, des traumatismes et des signes ROTEM d’hypocoagulabilité. De plus, l’âge était associé à un caillot de fibrine plus fort. En conclusion, 50% des chiens présentaient une hypocoagulabilité et les changements dans les paramètres ROTEM sont similaires à ceux observés lors de coagulopathie de consommation. Un excès basique et un traumatisme étaient associés à une hypocoagulabilité, tandis qu’une augmentation de l’âge était associée à un caillot de fibrine plus fort.Come metodo viscoelastico, la tromboelastometria rotazionale (ROTEM) può registrare l’emostasi dalla formazione del coagulo alla dissoluzione. Lo scopo di questo studio retrospettivo era quello di descrivere le modifiche nell’emostasi nei cani presentati con emoaddome spontaneo o traumatico utilizzando i parametri REDEM. Oltre a ciò è stata analizzata la relazione tra i parametri ROTEM e selezionati parametri clinici e di laboratorio. Abbiamo ipotizzato che i cani mostravano segni di ipocoagulabilità e iperfibrinolisi e che questi cambiamenti erano correlati al grado di ipoperfusione. Quaranta cani con emoaddome sono stati presentati nell’ambito dei 5 anni di studio e alla loro presentazione è stata effettuata un’analisi ROTEM. Per questi cani si sono analizzati i parametri clinici come la frequenza cardiaca, la pressione sanguigna, il glucosio e il lattato, l’albumina sierica, l’ematocrito periferico e addominale, il calcio ionizzato, il pH e la base in eccesso. Sono stati valutati i seguenti parametri ROTEM: tempo di coagulazione estrinseca (ExTEM CT), tempo di formazione del coagulo (ExTEM CFT), forza del coagulo (ExTEM MCF) e lisi massima (ExTEM ML) nonché fibrinogeno (fib-tem) CT e MCF. Rispetto agli intervalli di riferimento, i cani hanno mostrato una TAC ExTEM e FibTEM CT prolungata e una CFT ExTEM anch’essa prolungata, il 50% era ipocoagulabile e il 62% trombocitopenica. Non è stato possibile dimostrare l’iperfibrinolisi. I modelli di regressione lineare multipla hanno evidenziato una relazione tra la diminuzione dell’eccesso di base, il trauma e i segni ROTEM di ipocoagulabilità. Inoltre, l’età è stata associata ad un coagulo di fibrina più forte. In sintesi, il 50% dei cani presentava un’ipocoagulazione e i cambiamenti ROTEM si avvicinavano a una coagulopatia da consumo.

Background Correlation of plasma fibrinogen concentration (fibrinogenClauss) with rotational thromboelastometry (ROTEM) parameters has not been investigated in dogs. Objectives To determine the correlation between plasma coagulation tests and fibrinogenClauss with ROTEM parameters and to evaluate their ability to predict bleeding in dogs. Animals Ninety‐seven dogs with concurrent determination of fibrinogenClauss and fibrin polymerization test (FIBTEM) analysis. Methods Signalment, pretreatment, clinical signs of bleeding, fibrinogenClauss, plasma coagulation test results, hematocrit, platelet count, FIBTEM, extrinsic (EXTEM) and intrinsic (INTEM) activated ROTEM assays were retrieved retrospectively. Correlations between fibrinogenClauss and FIBTEM maximum clot firmness (MCFFIBTEM) and between prothrombin time (PT) or activated partial thromboplastin time (aPTT) and ROTEM parameters were determined. Dogs were further assigned to groups with or without clinical signs of bleeding. The prognostic significance of significantly different parameters to predict bleeding was evaluated. Results FibrinogenClauss showed strong correlation with MCFFIBTEM (r = 0.860, n = 97, P 149 seconds was 100% sensitive to detect bleeding. Conclusions and Clinical Importance The MCFFIBTEM can be used to evaluate the effect of fibrinogen on hemostasis as an alternative to determination of fibrinogenClauss. In addition, CTEXTEM and CTINTEM are strongly correlated with PT and aPTT, respectively.

Tranexamic acid (TXA) is an antifibrinolytic drug that is used for uncontrolled bleeding of various origin. This retrospective study investigated the effect of tranexamic acid administration on bleeding tendency in dogs with surgically managed hemoperitoneum. Thirty dogs were treated with (TXA group) and 25 dogs without (CTR group) tranexamic acid prior to surgery. Various parameters (decrease in haematocrit, number of transfusions, shock index and changes in abdominal fluid accumulation) were used for characterization of bleeding tendency and compared between groups. Groups were similar at presentation and prior to surgery. None of the dogs undergoing rotational thromboelastography analysis showed hyperfibrinolysis prior to surgery. Overall transfusion and erythrocyte transfusion requirements as well as bleeding tendency, hospitalisation time and hospital discharge rate were similar between groups. Dogs of the TXA group received significantly more intraoperative plasma transfusions (P=0.013) and showed a higher systolic and mean arterial blood pressure (P=0.002 and 0.050) and lower shock index (P=0.028) with less dogs being in shock (P=0.012) at 24h. In summary, in this study population of dogs with surgically managed spontaneous hemoperitoneum dogs treated with tranexamic acid received more plasma transfusions intraoperatively and showed a lower shock index 24h after presentation. In dogs with surgically treated hemoabdomen tranexamic acid administration prior to surgery does not reduce red blood cell transfusion requirements or postoperative bleeding tendency.Tranexamsäure ist ein Fibrinolysehemmer, welcher bei unkontrollierten Blutungen verschiedener Ursachen eingesetzt wird. In dieser retrospektiven Studie wurde die Wirkung von Tranexamsäure auf die Blutungstendenz von Hunden mit chirurgisch stabilisiertem Hämoperitoneum untersucht. Dreissig Hunde wurden mit (Gruppe TXA) und 25 ohne Tranexamsäure (Kontrolle) behandelt. Verschiedene Parameter (Hämatokritabfall, Anzahl Transfusionen, Schockindex, Verlauf von abdominaler Flüssigkeit) wurden als Parameter für die Blutungstendenz zwischen den Gruppen verglichen. Bei Präsentation sowie präoperativ waren die Hunde beider Gruppen in allen untersuchten Parametern vergleichbar. Keiner der untersuchten Hunde zeigte Hyperfibrinolyse vor der Operation. Hämatokritabfall, Anzahl Erythrozytentransfusionen, Menge an abdominaler Flüssigkeit postoperativ, Hospitalisationzeit und Entlassungsrate zeigten keinen Unterschied zwischen den zwei Gruppen. Die Hunde der Gruppe TXA benötigten intraoperativ mehr Plasma-Transfusionen (P-Wert 0.013) und zeigten nach der Operation einen signifikant höheren systolischen und mittleren Blutdruck (P-Wert 0.002 und 0.050), einen tieferen Schockindex (P-Wert 0.028) und weniger Hunde waren im Schock (P=0.012). Zusammengefasst konnte in dieser Population von Hunden mit chirurgisch behandeltem spontanen Hämoabdomen kein reduzierter Transfusionsbedarf und keine Verminderung der postoperativen Blutungstendenz nach Therapie mit Tranexamsäure nachgewiesen werden. Tranexamsäure therapierte Hunde zeigten einen niedrigeren Schockindex 24h nach Präsentation und bekamen intraoperativ signifikant mehr Plasmatransfusionen verabreicht was die Interpretation der Resultate schwierig macht und keine eindeutige Aussage über den Nutzen von Tranexamsäure zulässt.L’acide tranexamique (TXA) est un médicament antifibrinolytique utilisé lors d’hémorragies incontrôlées d’origines diverses. Cette étude rétrospective analyse les effets de l’administration d’acide tranexamique sur la tendance aux hémorragies sur des chiens souffrant d’un hémopéritoine traité chirurgicalement. Trente chiens ont été traités avec de l’acide tranexamique avant chirurgie (groupe TXA) et vingt- cinq ne l’ont pas été (groupe CTR). Divers paramètres (baisse de l’hématocrite, nombre de transfusions, index de choc et modification de l’accumulation de fluide intrapéritonéal) ont été utilisés pour caractériser la tendance à l’hémorragie et effectuer une comparaison entre les deux groups. Les deux groupes étaient semblables lors de l’admission et avant la chirurgie. Aucun des chiens soumis à une analyse par thromboélastométrie rotationnelle ne montrait une hyper fibrinolyse avant la chirurgie. Les besoins en matière de transfusions en général ou de transfusions d’érythrocytes de même que la tendance aux hémorragies, la durée d’hospitalisation et le taux de sortie d’hospitalisation étaient semblables entre les deux groupes. Les chiens du groupe TXA ont reçu significativement plus de transfusions de plasma intra opératives (P=0.013) et présentaient des pressions systoliques et moyennes plus élevées (P=0.002 and 0.050) de même qu’un index de choc plus bas (P=0.028) avec moins de chiens souffrant de choc à 24 heures (P=0.012). En résumé, dans cette étude, la population de chiens présentant un hémopéritoine spontané traité chirurgicalement et ayant reçu de l’acide tranexamique a reçu plus de transfusions de plasma intra opératives et présentait un indexe de choc plus bas 24 heures après l’admission. Chez les chiens traités chirurgicalement pour un hémoabdomen, l’administration d’acide tranexamique avant l’opération n’a pas réduit les besoins en matière de transfusions d’érythrocytes ou la tendance aux hémorragies post-opératoires.L’acido tranexamico (TXA) è un farmaco antifibrinolitico usato nei casi di sanguinamento incontrollato di varia origine. Questo studio retrospettivo ha esaminato l’effetto della somministrazione di acido tranexamico sulla tendenza al sanguinamento nei cani con emoperitoneo trattato chirurgicamente. Prima dell’intervento chirurgico, trenta cani sono stati trattati con l’acido tranexamico (gruppo TXA) e 25 senza di esso (gruppo CTR). Vari parametri sono stati usati per caratterizzare la tendenza al sanguinamento e sono stati confrontati tra i gruppi (diminuzione dell’ematocrito, numero di trasfusioni, indice di shock e modifiche nell’accumulo di liquidi nell’addome). I gruppi erano simili alla presentazione e prima dell’intervento chirurgico. Nessun cane sottoposto a tromboelastografia rotazionale ha mostrato iperfibrinolisi prima dell’intervento. I requisiti generali di trasfusione e di trasfusione di eritrociti, così come la tendenza al sanguinamento, la durata dell’ospedalizzazione e la percentuale di dimissione ospedaliera erano simili tra i gruppi. I cani del gruppo TXA hanno ricevuto trasfusioni di plasma intraoperatorie significativamente più elevate (P = 0.013), hanno mostrato una pressione arteriosa sistolica e media più alta (P = 0.002 e 0.050) e un indice di shock inferiore (P = 0.028) con meno cani in stato di shock su 24 ore (P = 0.012). In sintesi, nella popolazione di questo studio, i cani affetti da emoperitoneo spontaneo gestito chirurgicamente e trattati con acido tranexamico hanno ricevuto più trasfusioni di plasma intraoperatorie e hanno mostrato un indice di shock inferiore 24 ore dopo la presentazione. Nei cani con emoaddome trattato chirurgicamente la somministrazione di acido tranexamico prima dell’intervento chirurgico non ha ridotto la quantità di trasfusione di eritrociti o la tendenza al sanguinamento postoperatorio.

OBJECTIVE: To establish and compare the repeatability and reproducibility of activated thromboelastography (TEG) and thromboelastometry (ROTEM) assays. DESIGN: Multicenter in vitro test standardization. SETTING: Veterinary academic centers. ANIMALS: Test samples were obtained from normal, healthy dogs. Sixty identical 5 mL aliquots of canine platelet-rich plasma collected by apheresis, frozen in 6% dimethyl sulfoxide, were tested initially. Sixty identical 6 mL aliquots of canine fresh frozen plasma with admixed cryoprecipitate were subsequently evaluated. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Frozen study samples, quality controls, reagents, and consumables were distributed to participating centers (7 TEG and 3 ROTEM). TEG centers analyzed study samples with kaolin and tissue factor activated assays; ROTEM centers ran proprietary ellagic acid activated and tissue factor activated assays. All machines underwent quality control prior to sample analysis. Within- and between-center coefficients of variation (CVs) were calculated and compared using Mann-Whitney tests and calculation of intraclass correlation coefficients. Within and between centers, individual parameters for both TEG and ROTEM assays were comparable. Both within-center and between-center CVs varied markedly (0.7-120.5% and 1.4-116.5%, respectively) with assay type, instrument, and parameter. CVs for equivalent parameters were not significantly different between the 2 platforms. Intraclass correlation coefficients suggested moderate agreement between centers. In general, individual parameter CVs for platelet-rich plasma samples were lower in TEG centers, while CVs for canine fresh frozen plasma with admixed cryoprecipitate samples were lower in ROTEM centers. CONCLUSIONS: More variation within and between centers was identified than anticipated, but some parameters such as alpha angle were repeatable and reproducible. Sample types for future multicenter standardization efforts will require further optimization and may need to be adapted separately to each platform. Individual centers using viscoelastic tests for evaluation and management of clinical patients should take steps to minimize preanalytical and analytical sources of variation.

Background Hydroxyethyl-starch (HES) solutions might have renal adverse effects in humans and dogs. Objective To determine if administration of 6% HES-130/0.4 is associated with an increase in serum creatinine concentration and development of acute kidney injury (AKI) in nonazotemic cats. Animals A total of 62 critically ill cats; 26 HES exposed and 36 unexposed. Methods Retrospective cohort study (2012–2015). Serum creatinine concentrations were recorded and changes in serum creatinine concentrations before exposure (baseline) and 2–10 and 11–90 days, respectively, were determined. Development of AKI was defined as a > 150% increase or >26 μmol/L increase in serum creatinine concentration from baseline. Risk factors, such as HES administration, cumulative volume of HES (mL/kg) and number of days of HES administration leading to development of AKI, and change in serum creatinine were analyzed. Results Cats in the HES cohort received a mean volume of 98.5 ± 76.2 mL/kg (range, 8–278 mL/kg) HES over a median of 4 (range, 1–11) days, resulting in a median dose of 20.1 (range, 8–40.5) mL/kg per day. Short-term %change in serum creatinine concentration (P = 0.40) and development of AKI (P = 0.32) were not significantly different between cohorts. Multivariable logistic regression did not identify HES dose in mL/kg (P = 0.33) and number of days of HES application (P = 0.49) as a risk factor for development of AKI. Conclusion and Clinical Importance Hydroxyethyl-starch administration to critically ill nonazotemic cats seems to be safe. A larger prospective study is required to determine the effect of HES administration at higher dosages and for prolonged time periods.

Background The pathomechanism of Angiostrongylus vasorum infection-associated bleeding diathesis in dogs is not fully understood. Objective To describe rotational thromboelastometry (ROTEM) parameters in dogs naturally infected with A. vasorum and to compare ROTEM parameters between infected dogs with and without clinical signs of bleeding. Animals A total of 21 dogs presented between 2013 and 2016. Methods Dogs with A. vasorum infection and ROTEM evaluation were retrospectively identified. Thrombocyte counts, ROTEM parameters, clinical signs of bleeding, therapy, and survival to discharge were retrospectively retrieved from patient records and compared between dogs with and without clinical signs of bleeding. Results Evaluation by ROTEM showed hyperfibrinolysis in 8 of 12 (67%; 95% CI, 40–86%) dogs with and 1 of 9 (11%; 95% CI, 2–44%) dogs without clinical signs of bleeding (P = .016). Hyperfibrinolysis was associated with severe hypofibrinogenemia in 6 of 10 (60%; 95% CI, 31–83%) of the cases. Hyperfibrinolysis decreased or resolved after treatment with 10–80 mg/kg tranexamic acid. Fresh frozen plasma (range, 14–60 mL/kg) normalized follow-up fibrinogen function ROTEM (FIBTEM) maximal clot firmness in 6 of 8 dogs (75%; 95% CI, 41–93%). Survival to discharge was 67% (14/21 dogs; 95% CI, 46–83%) and was not different between dogs with and without clinical signs of bleeding (P = .379). Conclusion and Clinical Importance Hyperfibrinolysis and hypofibrinogenemia were identified as an important pathomechanism in angiostrongylosis-associated bleeding in dogs. Hyperfibrinolysis and hypofibrinogenemia were normalized by treatment with tranexamic acid and plasma transfusions, respectively.

OBJECTIVE: To characterize and evaluate risk factors for comorbidities and death of cats with pelvic fractures. STUDY DESIGN: Retrospective case study. ANIMALS: Cats (n = 280). METHODS: Medical records were reviewed for cats in which pelvic fractures had been diagnosed (January 2003 to November 2016). Retrieved data included signalment, mechanism of injury, clinical findings, diagnostic imaging investigations, type and number of concurrent injuries based on anatomical location, type of therapy, and survival. Pelvic fractures were classified according to location and severity. Descriptive statistics were performed, and logistic regression models were constructed to examine associations between risk factors and outcome. RESULTS: Cases consisted of 280 cats with no (9%), unilateral (43%), and bilateral (48%) involvement of the weight-bearing axis. Sacral fractures were found in 12% of cats. Surgical treatment and mortality rates increased progressively with the severity of the pelvic fractures (P

Objective The aim of this study was to describe coagulation abnormalities and incidence of acute traumatic coagulopathy (ATC) in traumatized cats over the first 24 hours after admission. Study Design This was a prospective observational study at the university teaching hospital including 26 cats with acute ( Results The incidence of ATC was 15% and the most common ROTEM abnormalities in cats with ATC were clotting time and CFT prolongation in both extrinsic and intrinsic ROTEM profiles. After 24 hours, compared with presentation, significantly more cats were hypercoagulable (p = 0.047) and none of the cats showed hypocoagulopathy. Cats with ATC received significantly more blood transfusions (p = 0.008). Conclusion The incidence of ATC in cats is higher than previously reported. Clotting time and CFT prolongations seem to be more common than hyperfibrinolysis and 53% of the cats became hypercoagulable within 24 hours. While the clinical relevance of ATC in cats needs to be investigated, cats diagnosed with ATC required significantly more blood transfusions.

The study objectivs were to evaluate the correlation between platelet count (PLT) and rotational thromboelastometry (ROTEM) parameters and to determine ROTEM cut-off values for identification of thrombocytopenia in dogs. Medical records of 113 dogs with concurrent EXTEM (ROTEM activated by proprietary tissue factor), FIBTEM (EXTEM with added cytochalasin D) analysis and PLT were retrospectively reviewed. Signalment, treatment prior to analysis, hematocrit (HCT), EXTEM/FIBTEM maximum clot firmness (MCFEXTEM, MCFFIBTEM), EXTEM/FIBTEM maximum clot elasticity (MCEEXTEM, MCEFIBTEM) and EXTEM maximum lysis (MLEXTEM) were extracted from patient records and ROTEM database. Delta (Δ) MCF was calculated as MCFEXTEM−MCFFIBTEM and ΔMCE as MCEEXTEM−MCEFIBTEM. The PLT was correlated to MCFEXTEM, MCEEXTEM, ΔMCF and ΔMCE using Spearman-Rho analysis. Correlations were further analyzed in thrombocytopenic dogs. The ability to predict thrombocytopenia was evaluated with receiver operating characteristics (ROC). Thirty-seven samples (32.7%) showed thrombocytopenia ( 97% for all 4 parameters. In conclusion, PLT in dogs correlated moderately but significantly with all evaluated ROTEM parameters. All parameters were able to rule out thrombocytopenia

Hyperfibrinolysis (HFL) is a pathophysiological mechanism that has not been described in dogs or cats extensively. The aim of this study was to describe rotational thromboelastometry (ROTEM) parameters and underlying diagnosis in dogs and cats with HFL and evaluate association with bleeding diathesis. The ROTEM database was retrospectively searched for EXTEM (ROTEM activated with proprietary tissue factor) tracings with maximum lysis at 60min ≥15%. Concurrent ROTEM and plasma coagulation tests, thrombocyte number, diagnosis and survival to hospital discharge were extracted from medical records. Analysis of differences between dogs and cats and of factors associated with bleeding, fulminant HFL (clot breakdown within 30min) and survival to hospital discharge were performed. Hyperfibrinolysis was detected in eight cats presenting with haemoabdomen or haemothorax (n=4/8, 50%) and trauma (n=3/8, 38%) and in 36 dogs with angiostrongylosis (n=12, 33%), neoplasia (n=7, 19%), liver disease (n=4, 11%) and others including apparently healthy dogs (n=3, 8%). Hyperfibrinolysis was associated with prolonged EXTEM and APTEM (EXTEM with added apoprotein for inhibition of HFL) clotting time and decreased FIBTEM (EXTEM with added cytochalasin D for inhibition of thrombocytes) maximum clot firmness (MCF) in dogs and cats and with decreased EXTEM MCF in dogs. Bleeding dogs had significantly hypocoagulable EXTEM tracings. Fulminant HFL was associated with severe hypofibrinogenaemia in dogs (P=0.005) and was not associated with survival to hospital discharge. Evidence of HFL was demonstrated in dogs and cats with bleeding, trauma, parasitic and neoplastic disease. HFL is associated with late and weak clot formation.

The aim of this study was to determine reference intervals (RI) for venous blood parameters determined with the RAPIDPoint 500 (RP500) blood gas analyzer using blood gas syringes (BGS) and to determine whether immediate analysis of venous blood collected into lithium heparin (LH) tubes can replace anaerobic blood sampling into BGS. The null hypothesis was that canine venous blood samples collected in BGS and in LH tubes are comparable. Jugular blood was collected from 51 healthy dogs into a BGS and a LH tube. The BGS was immediately analyzed followed by the LH tube. The RI were calculated from BGS results. The BGS and LH tubes results were compared using paired t-test or Wilcoxon matched-pairs signed-rank test and Bland-Altman analysis. To assess clinical relevance, the bias between BGS and LH tubes was compared with the allowable total error (TEa). Values derived from LH tubes showed no significant difference for standard bicarbonate (HCO3std), whole blood base excess (BE B), Na, K, Cl, glucose and hemoglobin (tHb). The pH, partial pressure of carbon dioxide and oxygen, actual bicarbonate, extracellular base excess, ionized Ca, anion gap and lactate were significantly (p.Ziel dieser Studie war es, Referenzintervalle (RI) für den Blutgasanalysator RAPIDPoint 500 (RP500) für venöses Blut in Blutgasspritzen (BGS) zu bestimmen, sowie festzustellen, ob eine sofortige Analyse von Blut, das in Lithiumheparin-Röhrchen (LH) gesammelt wurde, die anaerobe Blutentnahme in BGS ersetzen könnte. Die Hypothese ist, dass Blutproben in BGS und LH-Röhrchen vergleichbar sind. Von 51 gesunden Hunden wurde Jugularblut in BGS und LH entnommen, sofort auf dem RP500 analysiert und RI aus BGS Resultaten berechnet. Die BGS und LH Resultate wurden mittels gepaarten t-Test- oder Wilcoxon-Vorzeichen-Rang-Test sowie Bland- Altman-Analyse verglichen. Um die klinische Relevanz zu beurteilen, wurde der Bias zwischen BGS und LH mit dem zulässigen Gesamtfehler (TEa) verglichen. Zwischen BGS und LH ergaben sich keine signifikanten Unterschiede für Standard-Bikarbonat (HCO3std), Vollblut- Basenüberschuss (BE B), Na, K, Cl, Glukose und Hämoglobin (tHb). Der pH, der Kohlendioxid- und Sauerstoffpartialdruck, das tatsächliche Bikarbonat, der extrazelluläre Basenüberschuss, das ionisierte Ca, die Anionenlücke und das Laktat waren signifikant (p.Le but de la présente étude était de déterminer l’intervalle de référence (RI) de l’analyseur de gaz du sang RAPIDPoint 500 (RP500) pour du sang veineux prélevé dans des seringues pour gaz du sang (BGS) ainsi que de voir si une analyse immédiate du sang collecté dans des tubes à l’héparine de lithium (LH) pouvait remplacer la collecte anaérobe dans des seringues BGS. L’hypothèse était que les échantillons sanguins dans les seringues BGS et dans les tubes LH sont comparables. On a prélevé du sang de la veine jugulaire sur BGS et LH chez 51 chiens en bonne santé, on l’a analysé immédiatement avec l’analyseur RP500 et on a calculé les intervalles de référence pour les résultats des prélèvements sur BGS. Les résultats des prélèvements sur BGS et sur LH ont été comparés au moyen de t-test appariés ou d’un test de Wilcoxon signé ainsi que par une analyse de Bland-Altman. Pour juger de la signification clinique, on a comparé le biais entre BGS et LH avec une erreur globale admissible (TEa). Il n’y avait pas de différence significative entre BGS et LH en ce qui concerne le bicarbonate standard, l’excès basique du sang total, le sodium, le potassium, le glucose et l’hémoglobine. Le pH, les pressions partielles de gaz carbonique et d’oxygène, le bicarbonate effectif, l’excès basique extracellulaire, le calcium ionisé, le trou anionique et le lactate étaient significativement (p.Lo scopo di questo studio è di determinare gli intervalli di riferimento (IR) per l’emogasanalizzatore RAPID Point 500 (RP500) per i gas venosi utilizzando siringhe per gas ematico (BGS) e di accertare se un’analisi ematica immediata raccolta in tubi di litio eparina (LH) potrebbe sostituire il prelievo sanguigno anaerobio con BGS. Viene ipotetizzato che i campioni di sangue prelevati con tubi BGS e tubi LH siano paragonabili. Da 51 cani sani è stato prelevato sangue con BGS e LH dalla giugulare, quindi è stato analizzato immediatamente con il RP500 e calcolato un IR dei risultati con BGS. I risultati dei tubi BGS e LH sono stati paragonati con il t-test appaiato o con il test dei ranghi con segno Wilcoxon infine con l’analisi Bland-Altman. Per valutare la rilevanza clinica, la distorsione tra tubi BGS e LH è stata comparata con l’errore totale ammissibile (TEA). Tra BGS e LH non sono state rilevate differenze significative tra bicarbonato standard, eccesso di basi nel sangue intero, Na, K, Cl, glucosio ed emoglobina. Il pH, la pressione parziale dell’anidride carbonica e dell’ossigeno, il bicarbonato standard, l’eccesso di basi extracellurari, il Ca ionizzato, l’interruzione degli anioni e il lattato erano significatamente differenti (p.

A 4-year old male Australian Cattle Dog involved in a road traffic accident was presented with severe polytrauma to the Small Animal Clinic, University of Zurich. He was presented in hemorrhagic shock, with an initial lactate of 10.3mmol/l and ongoing bleeding from multiple injury sites. Acute traumatic coagulopathy diagnosed with ROTEM within one hour after accident showed marked hypocoagulation and hyperfibrinolysis. Treatment with a total dose of 40mg/kg of tranexamic acid intravenously resulted in successful elimination of hyperfibrinolysis in the following, serially measured ROTEM tracings.Ein 4-jähriger, männlicher Australian Cattle Dog wurde mit schwerem Polytrauma nach einem Verkehrsunfall an der Kleitierklinik der Universität Zürich vorgestellt. Er war in hämorrhagischem Schock, hatte mehrere blutende Wunden und ein Laktat von 10.3mmol/l bei Eintritt. Die akute Traumatische Koagulopathie (ATC) wurde mittels Rotationeller Thromboelastometrie ( ROTEM) diagnostiziert und zeigte sich in markanter Hypokoagulabilität und Hyperfibrinolyse. Die Behandlung mit insgesamt 40mg/kg Tranexamsäure i.v. resultierte in einer erfolgreichen Therapie der Hyperfibrinolyse in den folgenden, seriell gemessenen ROTEM Untersuchungen.

The use of synthetic colloids (SCs), particularly hydroxyethyl starch (HES), in people has changed in recent years following new evidence raising concerns about their efficacy and safety. Although fluid therapy guidelines for small animals are often extrapolated from human medicine, little information exists on current practice in veterinary medicine. The objective of the present study was to investigate current fluid selection, use of plasma volume expanders including SCs, and recent changes in their use in small animal practice. An Internet-based survey was conducted, inviting veterinarians to report their practices in fluid resuscitation and colloid osmotic pressure support, their choice of SC, and perceived adverse effects and contraindications associated with SC use. There were 1,134 respondents from 42 countries, including 46% general practitioners and 38% diplomates. Isotonic crystalloids, HES, and hypertonic saline were chosen by most respondents for fluid resuscitation, and HES by 75% of respondents for colloid osmotic support. Dextran and gelatin were used by some European respondents. Human serum albumin was used more than canine albumin but 45% of respondents, particularly those from Australia and New Zealand, used no albumin product. The majority (70%) of respondents changed their practice regarding SCs in recent years (mostly by limiting their use), largely due to safety concerns. However, only 27% of respondents worked in an institution that had a general policy on SC use. Impaired renal function, coagulopathy, and hypertension were most often considered contraindications; impaired coagulation tests and increased respiratory rate were the most frequently perceived adverse effects. The use of HES remains widespread practice in small animals, regardless of geographic location. Nevertheless, awareness of safety issues and restrictions on the use of SCs imposed in human medicine seems to have prompted a decrease in use of SCs by veterinarians. Given the paucity of evidence regarding efficacy and safety, and differences in cohorts between human and veterinary critical care patients, studies are needed to establish evidence-based guidelines specific for dogs and cats.

ObjectivesThe aim of this study was to determine in-house reference intervals (RIs) for venous blood analysis with the RAPIDPoint 500 blood gas analyser using blood gas syringes (BGSs) and to determine whether immediate analysis of venous blood collected into lithium heparin (LH) tubes can replace anaerobic blood sampling into BGSs.MethodsVenous blood was collected from 24 healthy cats and directly transferred into a BGS and an LH tube. The BGS was immediately analysed on the RAPIDPoint 500 followed by the LH tube. The BGSs and LH tubes were compared using paired t-test or Wilcoxon matched-pairs signed-rank test, Bland–Altman and Passing–Bablok analysis. To assess clinical relevance, bias or percentage bias between BGSs and LH tubes was compared with the allowable total error (TEa) recommended for the respective parameter.ResultsBased on the values obtained from the BGSs, RIs were calculated for the evaluated parameters, including blood gases, electrolytes, glucose and lactate. Values derived from LH tubes showed no significant difference for standard bicarbonate, whole blood base excess, haematocrit, total haemoglobin, sodium, potassium, chloride, glucose and lactate, while pH, partial pressure of carbon dioxide and oxygen, actual bicarbonate, extracellular base excess, ionised calcium and anion gap were significantly different to the samples collected in BGSs ( P Conclusions and relevanceAssessment of actual and standard bicarbonate, whole blood base excess, haematocrit, total haemoglobin, sodium, potassium, chloride, glucose and lactate can be made based on blood collected in LH tubes and analysed within 5 mins. For pH, partial pressure of carbon dioxide and oxygen, extracellular base excess, anion gap and ionised calcium the clinically relevant alterations have to be considered if analysed in LH tubes.

Background Hydroxyethyl starch (HES) solutions may cause acute kidney injury (AKI) in humans. Objective To compare AKI grades in 94 dogs exposed and 90 dogs that were unexposed to 6% HES-130/0.4. Animals Dogs receiving 6% HES-130/0.4 (HES cohort) or crystalloids (unexposed cohort) between 2013 and 2015. Methods Historical cohort study. Diagnosis, total cumulative dose and total mL/kg of HES administered, time frame of HES administration and serum creatinine concentrations up to 90 days after initiation of HES treatment were retrospectively reviewed. The AKI grades were retrospectively determined by IRIS guidelines. Results Exposed dogs received a median cumulative dose of 69.4 mL/kg (range, 2–429 mL/kg) HES over a median of 4 (range, 1–16) days, resulting in a median dose of 20.7 (range, 2–87) mL/kg/d. Although the cohorts differed in terms of age and diagnosis, AKI grades were not significantly different at the evaluated short- and long-term time points. Results of ordinal logistic regression identified the number of days of HES administration as significantly associated with an increase in AKI grade within 10 days (P = .038), whereas there was no significant association among HES exposure, HES mL/kg/d, and an increase in AKI grade. Conclusions and Clinical Importance HES-130/0.4-treated dogs were not more prone to develop AKI than HES-untreated, but the number of HES days was significantly associated with an increase in AKI grade within 10 days post-HES administration. The time frame of HES treatment should be kept short. Prospective, randomized clinical trials are required to assess the effect of HES on renal function in dogs.

Objectives – To devise a veterinary triage list (VTL) and to determine whether the application of this VTL results in more accurate categorization of emergency patients compared with intuitive triage. Design – Prospective and retrospective observational study. Setting – Private veterinary emergency clinic. Animals – Four hundred and eighty-five client-owned dogs and cats. Interventions – None. Measurements and main results – A VTL was composed using a human triage system and data from medical records of the study group. Target waiting times were prospectively determined using intuition by veterinary nurses (TWT-N). Target waiting times were subsequently determined retrospectively by the use of the VTL (TWT-VTL). Both TWT-N and TWT-VTL were compared against target waiting times determined by a review team (TWT-R), which was considered the gold standard. TWT categories included 0, 15, 30–60, and 120 minutes, and were associated with triage categories red, orange, yellow, and green, respectively. Differences in agreement were tested for significance. One hundred and eighty-five dogs and 300 cats fulfilled the inclusion criteria. TWTN and TWT-R agreed on 30 cases of 67 (44.8%) in triage category red and 22 of 89 (24.7%) in category orange. TWT-VTL and TWT-R agreed on 64 cases of 67 (95.5%) in category red and 75 of 89 (84.3%) in category orange. Agreement between TWT-VTL and TWT-R (Pearson’s R = 0.848) was significantly greater (P < 0.001) than agreement between TWT-N and TWT-R (Pearson’s R = 0.519). Conclusions – Intuitive triage performed by veterinary nurses showed significantly less correlation with TWTR than triage performed with the VTL. A short physical examination in all emergency patients appears to be essential in recognizing critical disease. The use of a standardized VTL can help to categorize veterinary emergency patients.

OBJECTIVE: To assess the utility of nasotracheal tubes in postoperative oxygen supplementation in dogs following corrective surgery for brachycephalic syndrome. DESIGN: Retrospective study 2003-2007. SETTING: University teaching hospital. ANIMALS: Thirty-six client-owned dogs that underwent corrective surgery for brachycephalic syndrome. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Medical records were reviewed for animals that underwent surgical interventions for brachycephalic syndrome including palatoplasty, ventriculectomy, and rhinoplasty. Data collected included signalment, presenting complaints, analgesic and surgical interventions, type of supplemental oxygen therapy, complications and mortality occurring during hospitalization. A nasotracheal tube (NTT) was placed in 20 dogs at the end of surgery; 16 dogs received other forms of oxygen supplementation (8) or no oxygen supplementation (8) during recovery. The total number of postoperative complications was similar in both groups (8/20 dogs with NTTs and 7/16 in those without NTTs). However, respiratory distress was observed in 5 dogs without NTTs but was not observed in any dog while an NTT was in place. One dog in each group died postoperatively. CONCLUSION: Placement of an NTT was found to be easy and may offer benefit in dogs with brachycephalic syndrome as a noninvasive means of delivering oxygen. The use of NTT may minimize severe postoperative morbidity, in particular by reducing postoperative respiratory distress.