HP04 - Point-of-Care Viscoelastometric Evaluation of Dogs with Congenital Intrahepatic Portosystemic Shunts

Abstract: Background – Abnormal liver function that occurs in dogs with congenital portosystemic shunts (CPSS) can lead to various hemostatic abnormalities. Plasma-based coagulation tests cannot reliably identify abnormalities such as hypercoagulability and hyperfibrinolysis.
Objective – Evaluate hemostasis in dogs with intrahepatic CPSS (IHPSS) using a point-of-care viscoelastic coagulometer (VCM Vet™) and compare the findings to traditional plasma-based coagulation tests.
Animals – 42 healthy control dogs (HC) and 19 dogs with IHPSS.
Methods – Observational cross-sectional study. Prothrombin time (PT), partial thromboplastin time (PTT), concentrations of fibrinogen and D-dimers, antithrombin activity (AT), platelet count (PLT), and viscoelastic coagulometer parameters were concurrently evaluated before shunt attenuation. Results were compared between HC and IHPSS dogs using Mann-Whitney U-tests or t-tests, as appropriate, with corrections for multiple comparisons.
Results – In 7 of 10 (70%) IHPSS dogs PT was prolonged, in 2/10 (20%) PTT was prolonged, and 4/19 (21.1%) showed viscoelastometric abnormalities that were classified as: hypocoagulable 3/19 (15.8%), hypercoagulable 1/19 (5.3%), and hyperfibrinolytic 2/19 (10.5%). AT and PLT were significantly decreased, and clotting time significantly increased in IHPSS dogs compared to HC (Table 1).
Conclusions and clinical importance – Some IHPSS dogs showed viscoelastometric abnormalities. This suggests a variety of hemostatic states, such as hypercoagulability and hyperfibrinolysis, that might not be reliably identified by plasma-based coagulation testing in these patients.