Use of a test for proteins induced by vitamin K absence or antagonism in diagnosis of anticoagulant poisoning in dogs: 325 cases (1987-1997).
OBJECTIVE
To determine usefulness of the test for proteins induced by vitamin K absence or antagonism (PIVKA) to identify anticoagulant-poisoned dogs, compared with one-stage prothrombin time (OSPT) and activated partial thromboplastin time (APTT) tests.


METHODS
Retrospective study.


METHODS
325 dogs.


METHODS
Comparisons of results of PIVKA, OSPT, and APTT measurements in dogs with anticoagulant poisoning, hepatic disease, disseminated intravascular coagulation, other blood-related disorders, immune-mediated diseases, or other chronic and acute diseases were performed. Median, quartile, and range values were determined.


RESULTS
PIVKA tests with a 150-second critical value had > 98% specificity and > 90% sensitivity for diagnosis of anticoagulant poisoning versus > 99% specificity and > 79% sensitivity with a 300-second critical value. Comparison of PIVKA values among diagnostic groups revealed significant differences between dogs with anticoagulant poisoning and all other groups.


CONCLUSIONS
The PIVKA test with a 150-second critical value is diagnostically useful for distinguishing anticoagulant poisoning from other coagulopathies. Severe liver disease can cause false-positive results. Administration of vitamin K1 or early evaluation (within a few hours of ingesting anticoagulant) may cause false-negative results. Dogs with PIVKA test values > 150 seconds and clinical signs of anticoagulant poisoning can confidently be considered to have anticoagulant poisoning because of the high test sensitivity and specificity.
Mount
Michael E
ME
Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, California 95616, USA.
Kim
Brian U
BU
Kass
Philip H
PH
D000818:Animals; D000925:Anticoagulants / Q000506:poisoning*; D001778:Blood Coagulation Disorders / Q000097:blood / Q000175:diagnosis / Q000662:veterinary; D001779:Blood Coagulation Factors / Q000032:analysis*; D003937:Diagnosis, Differential; D004283:Dog Diseases / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis*; D004285:Dogs; D005188:False Negative Reactions; D005189:False Positive Reactions; D010314:Partial Thromboplastin Time / Q000662:veterinary; D011041:Poisoning / Q000175:diagnosis / Q000662:veterinary; D011498:Protein Precursors / Q000032:analysis*; D011517:Prothrombin Time / Q000662:veterinary; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014812:Vitamin K / Q000037:antagonists & inhibitors / Q000378:metabolism*
D000925:Anticoagulants; D001779:Blood Coagulation Factors; D011498:Protein Precursors; D014812:Vitamin K