2015 ACVIM Forum Research Abstract Program

This new blood scoring system might prove useful for the clinician to early classify patients with LF and pursue a liver biopsy as part of further investigation. Despite correction of prothrombin time (PT) and activated partial thromboplastin time (PTT) with parenteral vitamin K and the presence of normal platelet counts, many cats with cholestatic hepatobiliary disease develop progressive anemia while hospitalized or after provocative procedures. We hypothesized that bleeding tendencies in these cats might be associated with decreased clot strength or fibrinolysis both which can be monitored with thromboelastography (TEG). Thus this study was conducted to compare TEG analysis in cats with cholestasis with conventional coagulation tests. Seventeen cats with serum hyperbilirubinemia > 3 times the upper limit of normal, serum alanine aminotransferase (ALT) activity > 2 times the upper limit of normal and a PCV greater than 28% were recruited. All cats were treated with 3 doses of vitamin K1 subcutaneously for 36 hrs prior to coagulation testing. The mean values for the TEG parameters (R, K, angle, MA), PT, aPTT and platelet count in cholestatic cats did not differ significantly from the reference range. The one excep-tion was a significantly increased G (10.1 AE 5.6 dynes/s vs 6.9 AE 1.9 dynes/sec, P = 0.038). The TEG G value labeled 8/17, 6/17 and 3/17 cats as hypercoagulable, normocoagulable or hypocoagulable, respectively. Compared to normal cats, hypercoagulable cats had a significant decrease in aPTT (15.4s AE 2.1s vs 18.3s+/-6.8s, P = 0.014) and K (1.23 AE 0.43s vs 1.63 AE 0.54s, P = .031) and an increase in angle (74.1 AE 5.6 0 vs 66.5 AE 8.7 0 , P < 0.006). Compared to normal cats, hypocoagulable cats had significantly lower platelet counts (224 K/uL AE 42 K/uL vs 377 K/uL AE 195 K/uL, P = 0.02), prolonged K (4.1s AE 0.41s vs 1.62s AE 0.54s, P < 0.001) and decreases in angle (52.8 AE 11 0 vs 66.5 AE 8.6 0 , P = 0.016). LY30 was increased in only one cat (32%, normal <20%)) that was hypocoagulable. In conclusion, by TEG analysis cholestatic cats replete with vitamin K rarely have hyperfibrinolysis, but have a variety of coagulation profiles with a tendency to be normo-or hypercoagulable.