title: Serial viscoelastic and traditional coagulation testing in horses with gastrointestinal disease.
abstract: OBJECTIVE
  Objectives of this study were to compare the ability of serial thromboelastography, Sonoclot, and traditional coagulation panels to detect coagulopathies associated with disease category, systemic inflammatory response syndrome (SIRS), complications, and nonsurvival in horses with gastrointestinal disease.
  
  
  METHODS
  Prospective clinical evaluation.
  
  
  METHODS
  University referral hospital.
  
  
  METHODS
  One hundred twenty-one horses admitted as emergencies for gastrointestinal disease and 28 healthy adult horses.
  
  
  METHODS
  Blood samples were collected ≤4 times from emergency horses (admission and if surviving and hospitalized on days 2-4) and once from healthy horses. Thromboelastography (with and without tissue factor activation), Sonoclot, and a traditional coagulation panel were performed on each sample.
  
  
  RESULTS
  Emergency horses were grouped based on disease category (ie, nonstrangulating medical, nonstrangulating surgical, strangulating, and inflammatory), survival to discharge, SIRS at admission, requirement for exploratory celiotomy, ileus, diarrhea, fever, thrombophlebitis, and laminitis. Changes over time were evaluated individually and compared between disease groups. Horses with gastrointestinal disease had dynamic changes in coagulation and fibrinolysis during the first 4 days of hospitalization that were correlated with disease category, SIRS, complications, and fatality. The multivariate logistic regression model for nonsurvival included activated partial thromboplastin time on day 2 and LY30 on day 3 (overall model significance P < 0.0001). The odds of nonsurvival were 23.75 times higher if activated partial thromboplastin time was >85.6 s on day 2 and 9.38 times higher if LY30 was >1% on day 3.
  
  
  CONCLUSIONS
  Horses with gastrointestinal disease have activation of coagulation and fibrinolysis. Magnitude of change in these parameters is small and predictive value moderate, making application of these tests to direct therapy in clinical patients difficult. Effect of specific treatments (eg, surgery) on these tests and coagulation has not been determined. Further studies are required to determine if these tests could be used to help monitor response to treatment in individual animals or specific disease states.
authors.affiliation: Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602.
authors.forename: Kira L
authors.initials: KL
authors.lastname: Epstein
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Brainard
authors.forename: Steeve
authors.initials: S
authors.lastname: Giguere
authors.forename: Zachary
authors.initials: Z
authors.lastname: Vrono
authors.forename: James N
authors.initials: JN
authors.lastname: Moore
mesh_terms: D000818:Animals; D001777:Blood Coagulation / Q000502:physiology*; D001780:Blood Coagulation Tests / Q000379:methods / Q000662:veterinary*; D005260:Female; D005767:Gastrointestinal Diseases / Q000097:blood / Q000150:complications / Q000662:veterinary*; D006734:Horse Diseases / Q000097:blood*; D006736:Horses; D008297:Male; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000662:veterinary
keywords: coagulopathy; gastrointestinal disease; horses; sonoclot; thromboelastography