2015 ACVIM Forum Research Abstract Program

HEPATITIS. Whitney Fry 1 , Carrie Lester 1 , Nahv Etedali 1 , Armelle DeLaforcade 1 , Cynthia Webster 1 . 1 Cumming School of Veterinary Medicine at Tufts University, Grafton, MA, USA Due to the liver's role in synthesis of the majority of pro-and anti-coagulants as well as most regulators of fibrinolysis, a complex rebalance of coagulation exists in dogs with chronic hepatitis (CH). On conventional plasma based coagulation testing thrombocytopenia, prolongations in prothrombin (PT) and activated partial thromboplastin time (aPTT) as well as decreases in fibrinogen have been reported in dogs with CH. Despite these alterations which should result in hypocoagulability, spontaneous bleeding is rare. In fact, CH is a risk factor for portal vein thrombosis presumably related to decreased production of anticoagulants or to endothelial dysfunction secondary to portal hypertension. The aim of the current study was to gain a better perspective on the state of coagulation in dogs with CH by performing thromboelastography (TEG) and comparing it with conventional coagulation testing. Seventeen dogs with biopsy proven CH and 3 dogs with clinical evidence of end stage liver disease were recruited. PT, aPTT, platelet count, PCV and kaolin activated TEG were performed according to published standards. In some dogs fibrinogen, anti-thrombin activity (AT), protein C activity (PC), D-dimers and vWF activity was performed. Eleven breeds with a mean age of 7.3 AE 3 yrs were enrolled. All dogs had PCV's in the normal range. When compared to reference ranges dogs with CH had longer R (5.4s AE 2s, P = 0.009) and K (3.64s AE 3.2s, P = 0.002) values, smaller angles (55.0 0 AE 14.5 0 , P = 0.006) and an increase in LY30 (4.26% +/-10.4%, P = 0.018). Fibrinogen (P = 0.03), AT activity (P = 0.0001) and PC activity (P = 0.021) were significantly decreased. TEG G value defined 8/20, 7/20 and 5/20 dogs as normocoagulable, hypercoagulable and hypocoagulable, respectively. G was positively correlated with PC activity (P = 0.688, P = 0.02) and negatively correlated with PT (-0.459, P = 0.05) and aPTT (-0.443, P = 0.05). Four dogs were hyperfibrinolytic with mean Ly30 of 20.9%, AE 15.2%. In conclusion, on TEG analysis dogs with CH have a variety of coagulation states. PT, aPTT and PC activity predict the state of coagulation as determined by TEG. Some dogs with CH are hyperfibrinolytic a condition that would be missed on conventional coagulation testing.