The effect of ε‐aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogs
Abstract Background No treatment other than platelet administration is known to protect against spontaneous hemorrhage in thrombocytopenic dogs. Objectives Primary: determine if treatment with ε‐aminocaproic acid (EACA) decreases the requirement for blood transfusions and improves outcome in dogs wi...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.16977 |
| _version_ | 1797263088247898112 |
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| author | Johanna Wolf Laura K. Ruterbories Ian Handel Bernie Hansen |
| author_facet | Johanna Wolf Laura K. Ruterbories Ian Handel Bernie Hansen |
| author_sort | Johanna Wolf |
| collection | DOAJ |
| description | Abstract Background No treatment other than platelet administration is known to protect against spontaneous hemorrhage in thrombocytopenic dogs. Objectives Primary: determine if treatment with ε‐aminocaproic acid (EACA) decreases the requirement for blood transfusions and improves outcome in dogs with severe thrombocytopenia. Secondary: find evidence of hyperfibrinolysis and determine the effect EACA administration on rapid (rTEG) and tissue plasminogen activator‐spiked (tPA‐rTEG) thromboelastography parameters. Animals Twenty‐seven dogs with severe thrombocytopenia were treated with EACA, and data from an additional 33 were obtained from the hospital database as historical control (HC) cohort. Methods Single arm clinical trial with HCs. The EACA group dogs received EACA (100 mg/kg IV followed by a constant‐rate infusion [CRI] of 400 mg/kg/24 hours). Thromboelastography before and during EACA infusion, hospitalization days, number of transfusions, and mortality were compared. Results No difference was found in number of transfusions per dog (median, interquartile range; 1, 0‐2.5 vs 0.9, 0‐2; P = .5) and hospitalization days (4, 4‐6 vs 4.5, 3.75‐6; P = .83) between HC and EACA groups, respectively, and no difference in survival was identified by log‐rank analysis (P = .15). Maximum amplitude on both rTEG and tPA‐rTEG increased after EACA administration (rTEG baseline: 23.6, 9.6‐38.9; post‐EACA: 27.3, 19.8‐43.2; P < .001; tPA‐rTEG baseline: 23, 10.9‐37.2; post‐EACA: 24.7, 16.7‐44.8; P < .002). Conclusions and Clinical Importance Although EACA increased clot strength, there was no effect on outcome. Treatment with EACA at this dosage cannot be recommended as a routine treatment but may be considered for dogs with severe ongoing hemorrhage. |
| first_indexed | 2024-04-25T00:07:27Z |
| format | Article |
| id | doaj.art-d484e5255afa4d0e986ce9e19e384e41 |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-04-25T00:07:27Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-d484e5255afa4d0e986ce9e19e384e412024-03-14T04:25:21ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762024-03-013821013102110.1111/jvim.16977The effect of ε‐aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogsJohanna Wolf0Laura K. Ruterbories1Ian Handel2Bernie Hansen3Royal (Dick) School of Veterinary Studies University of Edinburgh, Easter Bush Campus Midlothian UKDepartment of Clinical Sciences, College of Veterinary Medicine North Carolina State University Raleigh North Carolina USARoyal (Dick) School of Veterinary Studies University of Edinburgh, Easter Bush Campus Midlothian UKDepartment of Clinical Sciences, College of Veterinary Medicine North Carolina State University Raleigh North Carolina USAAbstract Background No treatment other than platelet administration is known to protect against spontaneous hemorrhage in thrombocytopenic dogs. Objectives Primary: determine if treatment with ε‐aminocaproic acid (EACA) decreases the requirement for blood transfusions and improves outcome in dogs with severe thrombocytopenia. Secondary: find evidence of hyperfibrinolysis and determine the effect EACA administration on rapid (rTEG) and tissue plasminogen activator‐spiked (tPA‐rTEG) thromboelastography parameters. Animals Twenty‐seven dogs with severe thrombocytopenia were treated with EACA, and data from an additional 33 were obtained from the hospital database as historical control (HC) cohort. Methods Single arm clinical trial with HCs. The EACA group dogs received EACA (100 mg/kg IV followed by a constant‐rate infusion [CRI] of 400 mg/kg/24 hours). Thromboelastography before and during EACA infusion, hospitalization days, number of transfusions, and mortality were compared. Results No difference was found in number of transfusions per dog (median, interquartile range; 1, 0‐2.5 vs 0.9, 0‐2; P = .5) and hospitalization days (4, 4‐6 vs 4.5, 3.75‐6; P = .83) between HC and EACA groups, respectively, and no difference in survival was identified by log‐rank analysis (P = .15). Maximum amplitude on both rTEG and tPA‐rTEG increased after EACA administration (rTEG baseline: 23.6, 9.6‐38.9; post‐EACA: 27.3, 19.8‐43.2; P < .001; tPA‐rTEG baseline: 23, 10.9‐37.2; post‐EACA: 24.7, 16.7‐44.8; P < .002). Conclusions and Clinical Importance Although EACA increased clot strength, there was no effect on outcome. Treatment with EACA at this dosage cannot be recommended as a routine treatment but may be considered for dogs with severe ongoing hemorrhage.https://doi.org/10.1111/jvim.16977antifibrinolyticshyperfibrinolysisplateletsthrombocytopenia |
| spellingShingle | Johanna Wolf Laura K. Ruterbories Ian Handel Bernie Hansen The effect of ε‐aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogs Journal of Veterinary Internal Medicine antifibrinolytics hyperfibrinolysis platelets thrombocytopenia |
| title | The effect of ε‐aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogs |
| title_full | The effect of ε‐aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogs |
| title_fullStr | The effect of ε‐aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogs |
| title_full_unstemmed | The effect of ε‐aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogs |
| title_short | The effect of ε‐aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogs |
| title_sort | effect of ε aminocaproic acid on blood product requirement outcome and thromboelastography parameters in severely thrombocytopenic dogs |
| topic | antifibrinolytics hyperfibrinolysis platelets thrombocytopenia |
| url | https://doi.org/10.1111/jvim.16977 |
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