title: Thrombelastography in horses with acute gastrointestinal disease.
abstract: BACKGROUND
  Coagulopathies in horses with gastrointestinal disease are frequently identified and associated with morbidity and fatality.
  
  
  OBJECTIVE
  Determine if thrombelastography (TEG) identifies abnormalities associated with lesion type, presence of systemic inflammatory response syndrome (SIRS), morbidity, and fatality more consistently than traditional coagulation testing.
  
  
  METHODS
  One-hundred and one horses examined for gastrointestinal disease and 20 healthy horses.
  
  
  METHODS
  TEG, tissue factor (TF)-TEG, and traditional coagulation panels parameters and percentages of horses with coagulopathies were compared for lesion type, presence of SIRS, complications, and survival.
  
  
  RESULTS
  Changes in individual parameters and increased incidence of coagulopathies were associated with fatality (R, P= .007; k-value [K], P= .004; clot lysis [CL]30, P= .037; CL60, P= .050; angle [Ang], P= .0003; maximum amplitude [MA], P= .006; lysis [Ly]30, P= .042; Ly60, P= .027; CI, P= .0004; ≥ 2 TEG coagulopathies, P= .013; ≥ 3 TEG coagulopathies, P= .038; TF-R, P= .037; TF-K, P= .004; TF-CL30, P < .0001; TF-CL60, P < .0001; TF-Ang, P= .005; TF-Ly30, P= .0002; TF-Ly60, P < .0001; TF-CI, P= .043; ≥ 1 TF-TEG coagulopathies, P= .003; ≥ 2 TF-TEG coagulopathies, P= .0004; prothrombin tme [PT], P < .0001; activated partial throboplastin time [aPTT], P= .021), inflammatory lesions (MA, P= .013; TF-CL30, P= .033; TF-CL60, P= .010; TF-Ly60, P= .011; ≥ 1 TF-TEG coagulopathy, P= .036; ≥ 2 TF-TEG coagulopathy, P= .0007; PT, P= .0005; fibrinogen, P= .019), SIRS (MA, P= .004; TF-CL30, P= .019; TF-CL60, P= .013; TF-Ly30, P= .020; TF-Ly60, P= .010; PT, P < .0001; aPTT, P= .032; disseminated intravascular coagulation, P= .005), and complications (ileus: aPTT, P= .020; diarrhea: TF-CL30, P= .040; TF-Ly30, P= .041; thrombophlebitis: ≥ 1 TF-TEG coagulopathy, P= .018; laminitis: MA, P= .004; CL60, P= .045; CI, P= .036; TF-MA, P= .019; TF-TEG CI, P= .019). Abnormalities in TEG and TF-TEG parameters were indicative of hypocoagulation and hypofibrinolysis.
  
  
  CONCLUSIONS
  TEG identifies changes in coagulation and fibrinolysis associated with lesion type, SIRS, morbidity, and fatality in horses with gastrointestinal disease.
authors.affiliation: Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA. kirae@uga.edu
authors.forename: K L
authors.initials: KL
authors.lastname: Epstein
authors.forename: B M
authors.initials: BM
authors.lastname: Brainard
authors.forename: S E
authors.initials: SE
authors.lastname: Gomez-Ibanez
authors.forename: M A F
authors.initials: MA
authors.lastname: Lopes
authors.forename: M H
authors.initials: MH
authors.lastname: Barton
authors.forename: J N
authors.initials: JN
authors.lastname: Moore
mesh_terms: D000818:Animals; D001777:Blood Coagulation / Q000502:physiology*; D001779:Blood Coagulation Factors / Q000378:metabolism; D001780:Blood Coagulation Tests / Q000379:methods / Q000662:veterinary; D016022:Case-Control Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000662:veterinary*; D006487:Hemostasis; D006734:Horse Diseases / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D006736:Horses; D008297:Male; D011446:Prospective Studies; D016019:Survival Analysis; D013916:Thrombelastography / Q000662:veterinary*; D013925:Thromboplastin / Q000737:chemistry
chemical_list: D001779:Blood Coagulation Factors; D013925:Thromboplastin