Evaluation of Fibrinolysis by Thromboelastography in Dogs With Hemorrhagic Pericardial Effusion
Margot R. Ehrlich, Ian M. DeStefano, Elizabeth A. Rozanski, Scott Taylor, Armelle M. de Laforcade, Claire R. Sharp, John E. RushABSTRACT
Objective
To evaluate dogs presenting with hemorrhagic pericardial effusion (PCE) for the presence of hyperfibrinolysis.
Design
Prospective observational study.
Setting
Single veterinary teaching hospital.
Measurements and Main Results
Dogs with PCE had blood samples collected before pericardiocentesis for PCV, total plasma protein and blood lactate concentrations, venous blood gas, and thromboelastography modified with tissue plasminogen activator (tPA‐TEG). Fibrinolysis was assessed on tPA‐TEG using the percentage of clot lysis at 30 min (LY30) after maximum clot strength (MA). Hyperfibrinolysis was defined as an LY30 of ≥20%. LY30 values were compared with values from a cohort of healthy dogs. Most dogs with PCE (14/16 [87.5%]) were hyperfibrinolytic, whereas no control dogs had hyperfibrinolysis. The median LY30 for dogs with PCE (51.5%, range: 3.0%–77.6%) was significantly higher than that of control dogs (1.3%, range: 0.0%–5.8%; p < 0.001).
Conclusions
Compared with dogs that are healthy, dogs with hemorrhagic PCE are hyperfibrinolytic as assessed by LY30 on tPA‐TEG. Given that dogs with hemorrhagic PCE may experience ongoing hemorrhage after pericardiocentesis, further investigation into the use of antifibrinolytic medications in these patients is warranted.