Hemostatic and thromboelastographic parameters in dogs with renal azotemia

Research (Published online: 05-06-2023)

5. Hemostatic and thromboelastographic parameters in dogs with renal azotemia

Hendryk Fischer, Vera Geisen, Roswitha Dorsch, Katrin Hartmann, and René Dörfelt

Veterinary World, 16(6): 1214-1221

Hendryk Fischer: LMU Small Animal Clinic, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany.

Vera Geisen: LMU Small Animal Clinic, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany.

Roswitha Dorsch: LMU Small Animal Clinic, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany.

Katrin Hartmann: LMU Small Animal Clinic, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany.

René Dörfelt: LMU Small Animal Clinic, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany.

doi: 10.14202/vetworld.2023.1214-1221

Article history: Received: 13-02-2023, Accepted: 02-05-2023, Published online: 05-06-2023

Corresponding author: René Dörfelt

E-mail: r.doerfelt@medizinische-kleintierklinik.de

Citation: Fischer H, Geisen V, Dorsch R, Hartmann K, and Dörfelt R (2023) Hemostatic and thromboelastographic parameters in dogs with renal azotemia, Veterinary World, 16(6): 1214-1221.

Abstract

Background and Aim: Humans and dogs with azotemia can develop coagulation disorders. Therefore, this study aimed to evaluate the coagulation profiles and thromboelastographic parameters in dogs with acute kidney injury (AKI) and chronic kidney disease (CKD).

Materials and Methods: In this prospective study, 31 client-owned dogs with renal azotemia (creatinine >220 µmol/L) were enrolled. Clinical signs of hemostatic disorders, complete blood count, coagulation profile, D-dimers, thromboelastography, and 28-day survival data were obtained and analyzed using the t-test, Mann–Whitney U test, and Chi-square test. Statistical significance was set at p < 0.05.

Results: Seventeen dogs with AKI, 10 with CKD, and four with acute-on-chronic kidney injury (AoC) were enrolled. Ten dogs (AKI, 8/17; CKD, 2/10) had thrombocytopenia. Prothrombin time was prolonged in four dogs with AKI and longer in dogs with AKI than in dogs with CKD (p = 0.004). The activated partial thromboplastin time was prolonged in 23 dogs (AKI, 14/17; CKD, 7/10; AoC, 3/4) and was longer in azotemic dogs than in healthy control dogs (p = 0.003). Thromboelastographic tracings were hypocoagulable in three dogs with AKI and hypercoagulable in 16 dogs (AKI 4/17, CKD 9/10, AoC 3/4). The thromboelastographic values for maximum amplitude (p < 0.001) and global clot strength (p < 0.001) were lower in dogs with AKI than in those with CKD.

Conclusion: Hypercoagulable thromboelastographic tracings were observed in dogs with CKD, whereas coagulation times were prolonged in dogs with AKI. However these findings should be validated by further studies.

Keywords: acute kidney injury, canine, chronic kidney disease, coagulation, platelet function, viscoelastic test.