Patients who are critically ill have a tendency toward blood clotting disorders, either in the form of uncontrolled bleeding or hyper coagulability. A new retrospective study hopes to change that.

Researchers from the University of Pennsylvania School of Veterinary Medicine (Penn Vet) found that a common diagnostic tool often used to identify patients at risk of bleeding may also be used to identify those predisposed to clot excessively. The study was published in the Journal of Veterinary Medicine and Critical Care on April 13.

The researchers looked through the medical records of hundreds of dogs treated at Penn Vet’s Ryan Veterinary Hospital between 2006 and 2011, searching for animals that had a diagnostic test called a TEG run.

A TEG, or thromboelastogram, is considered the gold standard for evaluating clotting dynamics but is conducted on equipment that is expensive and not commonly found in primary veterinary practices.

Of the 540 dogs the researchers considered, they found 23 that had a shortened PT or aPTT recorded in the same 24-hour period as the TEG test. Twenty-three other dogs with normal PT and aPTT served as a control group.

The researchers then looked at the medical records for indications of a clinical finding of hypercoagulability, such as clots formed within the intravenous catheter or in the circulatory system, or of pulmonary thromboembolism.

Comparing these readings and clinical signs between the group of dogs with shortened PT or aPTT times and the control group, the researchers found statistically significant differences: more dogs with shortened PT and aPTT times had clinical signs of hypercoagulability and suspected pulmonary thromboembolism compared with the control group.

They also found a correlation between dogs with shortened PT and aPTT results and an increased level of D-dimer, a protein fragment that is produced when a clot is being broken down.

“I think based on this retrospective study, we should pay more attention to shortened clotting times and look at them with a degree of diagnostic value,” said senior author Deborah C. Silverstein, DVM, DACVECC.“ In this patient population of critically ill dogs, it may help in identifying patients at risk of thrombosis.”

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