Correlation of plasma coagulation tests and fibrinogenwith rotational thromboelastometry parameters and prediction of bleeding in dogs.

Abstract

BACKGROUND: Correlation of plasma fibrinogen concentration (fibrinogen) with rotational thromboelastometry (ROTEM) parameters has not been investigated in dogs. OBJECTIVES: To determine the correlation between plasma coagulation tests and fibrinogenwith ROTEM parameters and to evaluate their ability to predict bleeding in dogs. ANIMALS: Ninety-seven dogs with concurrent determination of fibrinogenand fibrin polymerization test (FIBTEM) analysis. METHODS: Signalment, pretreatment, clinical signs of bleeding, fibrinogen, plasma coagulation test results, hematocrit, platelet count, FIBTEM, extrinsic (EXTEM) and intrinsic (INTEM) activated ROTEM assays were retrieved retrospectively. Correlations between fibrinogenand FIBTEM maximum clot firmness (MCF) and between prothrombin time (PT) or activated partial thromboplastin time (aPTT) and ROTEM parameters were determined. Dogs were further assigned to groups with or without clinical signs of bleeding. The prognostic significance of significantly different parameters to predict bleeding was evaluated. RESULTS: Fibrinogenshowed strong correlation with MCF(r&#x2009;=&#x2009;0.860, n&#x2009;=&#x2009;97, P&#x2009;<&#x2009;.001). PT showed strong correlation with EXTEM clotting time (CT) (r&#x2009;=&#x2009;0.839, n&#x2009;=&#x2009;53, P&#x2009;<&#x2009;.001), and aPTT was strongly correlated with INTEM CT (CT) (r&#x2009;=&#x2009;0.664, n&#x2009;=&#x2009;31, P&#x2009;<&#x2009;.001). Platelet count, PT/aPTT, EXTEM clot formation time (CFT), MCF, EXTEM maximum clot elasticity (MCE), and CTwere significantly different between groups. A CT>149&#x2009;seconds was 100% sensitive to detect bleeding. CONCLUSIONS AND CLINICAL IMPORTANCE: The MCFcan be used to evaluate the effect of fibrinogen on hemostasis as an alternative to determination of fibrinogen. In addition, CTand CTare strongly correlated with PT and aPTT, respectively.