Zeki YILMAZ, Meriç KOCATÜRK, Oya ERALP İNAN, Pınar LEVENT

Thromboelastographic evaluation of hemostatic function in dogs with dilated cardiomyopathy

This study aimed to evaluate the hemostatic function by thromboelastography (TEG) and determine if there was an association between the changes in hemostatic parameters and serum cardiac troponin I (cTnI) in dogs with dilated cardiomyopathy (DCM). DCM was diagnosed by echocardiography in 19 dogs. Ten healthy dogs were selected as controls. Myocardial injury was confirmed by increased serum cTnI levels. Coagulation was assessed by TEG evaluating clot kinetics (reaction time [R] and kinetic time [K]), clot strengthening (alpha [α] angle and G value), platelet function (maximum amplitude [MA] and coagulation-index [CI]), clot stability (LY30, the percentage of lysis 30 min after MA), and global clotting times (activated partial thromboplastin time [aPTT] and prothrombin time [PT]). Dogs with DCM had higher R and K times but lower MA, α-angle, G, and CI compared to controls (P < 0.05). LY30 and PT did not statistically differ between groups, but the aPTT in dogs with DCM was higher than that of the controls. Serum cTnI (median [range], ng/mL) was higher in dogs with DCM (0.25 [0.13-3.1]) than in healthy dogs (0.03 [0.01-0.06]). There was no statistical relation between cTnI and coagulation parameters. This study showed that alterations of the coagulation status in dogs with DCM could develop independently of serum cTnI elevations.

Keywords:

Dilated cardiomyopathy thromboelastography, hemostasis, cardiac troponin I, dog,

PDF

___

Wendy WA. Cardiovascular Disease in Small Animal Medicine. 3rd ed. London, UK: Manson Publishing; 2011.
Martin MW, Stafford Johnson MJ, Strehlau G, King JN. Canine dilated cardiomyopathy: a retrospective study of prognostic findings in 367 clinical cases. J Small Anim Pract 2010; 8: 428- 436.
Oyama MA. Canine cardiomyopathy. In: Smith F, Tilley L, Oyama M, Sleeper M, editors. Manual of Canine and Feline Cardiology. 5th ed. St. Louis, MO, USA: Elsevier; 2016. pp. 141-152.
Dukes-McEwan J, Borgarelli M, Tidholm A, Vollmar AC, Häggström J. Proposed guidelines for the diagnosis of canine idiopathic dilated cardiomyopathy. Journal of Veterinary Cardiology 2003; 5: 7-19.
Maron BJ, Towbin JA, Thiene G, Antzelevitch C, Corrado D, Arnett D, Moss AJ, Seidman CE, Young JB. Contemporary definitions and classification of the cardiomyopathies. Circulation 2006; 11; 113: 1807-1816.
Sbarouni E, Bradshaw A, Andreotti F, Tuddenham E, Oakley CM, Cleland JG. Relationship between hemostatic abnormalities and neuroendocrine activity in heart failure. Am Heart J 1994; 127: 607-612.
De Lorenzo F, Saba N, Kakkar VV. Blood coagulation in patients with chronic heart failure: evidence for hypercoagulable state and potential for pharmacological intervention. Drugs 2003; 63: 565-576.
Tarnow I, Falk T, Tidholm A, Martinussen T, Jensen AL, Olsen LH, Pedersen HD, Kristensen AT. Hemostatic biomarkers in dogs with chronic congestive heart failure. J Vet Intern Med 2007; 21: 451-457.
Lubas G, Caldin M, Wiinber B, Kristensen AT. Laboratory Testing of Coagulation Disorders. In: Weiss DJ, Wardrop KJ, editors. Schalm’s Veterinary Hematology. 6th ed. Ames, IA, USA: Wiley-Blackwell; 2010. pp. 1082-1100.
Bauer N, Eralp O, Moritz A. Establishment of reference intervals for kaolin-activated thromboelastography in dogs including an assessment of the effects of sex and anticoagulant use. J Vet Diagn Invest 2009; 21: 641-648.
Eralp O, Yilmaz Z, Failing K, Moritz A, Bauer N. Effect of experimental endotoxemia on thrombelastography parameters, secondary and tertiary hemostasis in dogs. J Vet Int Med 2011; 25: 524-531.
Kocatürk M, Eralp İnan O, Levent P, Yılmaz Z. Protective effects of S- adenosylmethionine (SAMe) and silybin on hepatorenal and hemostatic functions in dogs with endotoxemia. Turk J Vet Anim Sci 2016; 40: 788-796.
Eralp İnan O, Kocatürk M, Mecitoğlu Z, Yılmaz Z. Thromboelastographic evaluation of coagulation in a dog with anticoagulant rodenticide intoxication. Kafkas Univ Vet Fak 2016; 22: 477-478.
Oyama MA. Using cardiac biomarkers in veterinary practice. Vet Clin North Am Small Anim Pract 2013; 43: 1261-1272.
Çakıroğlu D, Meral Y, Bakırel U, Kazancı D. Cardiac troponin levels in dogs with dilate cardiomyopathy. Kafkas Univ Vet Fak 2009; 15: 13-17.
Güneş V, Uyanık F, Eren M, Kibar M, Aslan Ö, Onmaz AC. The rapid analyses of cardiac troponins in dogs with dilated cardiomyopathy, distemper or parvovirus infection. Kafkas Univ Vet Fak 2014; 20: 921-927.
Wendy WA. Cardiovascular system disorders. In: Nelson RW, Couto CG, editors. Small Animal Internal Medicine. 5th ed. St. Louis, MO, USA: Elsevier; 2013. pp. 130-158.
Boon JA. Veterinary Echocardiography. 2nd ed. Ames, IA, USA: Wiley-Blackwell; 2010.
Mongirdiene A, Kursvietiene L, Kasauskas A. The coagulation system changes in patients with chronic heart failure. Medicina (Kaunas) 2010; 46: 642-647.
Tarnow I, Kristensen AT, Olsen LH, Pedersen HD. Assessment of changes in hemostatic markers in Cavalier King Charles Spaniels with myxomatous mitral valve disease. Am J Vet Res 2004; 65: 1644-1652.
Bédard C, Lanevschi-Pietersma A, Dunn M. Evaluation of coagulation markers in the plasma of healthy cats and cats with asymptomatic hypertrophic cardiomyopathy. Vet Clin Pathol 2007; 36: 167-172.
Davis CJ, Gurbel PA, Gattis WA, Fuzaylov SY, Nair GV, O’Connor CM, Serebruany VL. Hemostatic abnormalities in patients with congestive heart failure: diagnostic significance and clinical challenge. Int J Cardiol 2000; 75: 15-21.
Prihirunkit K, Sastravaha A, Lekcharoensuk C, Chanloinapha P. Hemostatic markers in congestive heart failure dogs with mitral valve disease. Journal of Veterinary Medicine 2014; 2014: 589873.
Otto CM, Rieser TM, Brooks MB, Russell MW. Evidence of hypercoagulability in dogs with parvoviral enteritis. J Am Vet Med Assoc 2000; 217: 1500-1504.
Kristensen AT, Wiinberg B, Jessen LR, Adreasen E, Jensen AL. Evaluation of human recombinant tissue factor-activated thromboelastography in 49 dogs with neoplasia. J Vet Intern Med 2008; 22: 140-147.
Sinnott VB, Otto CM. Use of thromboelastography in dogs with immune- mediated hemolytic anemia: 39 cases (2000– 2008). J Vet Emerg Crit Care 2009; 19: 484-488.
Chung I, Lip GY. Platelets and heart failure. Eur Heart J 2006; 27: 2623-2631.
Tarnow I, Andreasen SHS, Olsen LH, Moesgaard SG, Rasmussen CE, Kristensen AT, Falk BT. Congestive heart failure in dogs is associated with enhanced platelet-leukocyte aggregates - a marker for platelet activation. J of Vet Int Med 2010; 24: 673-673.
Tarnow I, Kristensen A, Olsen LH, Falk T, Haubro L, Pedersen LG, Pedersen HD. Dogs with heart diseases causing turbulent high-velocity blood flow have changes in platelet function and von Willebrand factor multimer distribution. J Vet Intern Med 2005; 19: 515-522.