Effect of storage conditions on prothrombin time, activated partial thromboplastin time and fibrinogen concentration on canine plasma samples

The present study was to assess the effect of storage conditions on prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen concentration in blood samples of healthy dogs. Thirty-five dogs of various breeds were included in the study. Citrated blood samples were obtained and plasma was divided into four aliquots to assess selected clotting parameters by means of a coagulometer. The first aliquot was analysed within 1 h after collection, while the remaining 3 were stored at 8℃ for 4, 8 and 24 h, respectively. One-way repeated measures analysis of variance documented a significant decreasing effect on PT at 24 h compared to 8 h and on fibrinogen concentration after 8 and 24 h compared to sampling time and at 4 and 24 h compared to 8 h post sampling. In conclusion, the results of this study indicate that only fibrinogen appears prone to significant decrease. In fact, aPTT is not substantially affected by refrigeration for at least 24 h post sampling and PT showed a statistical difference that does not necessary indicate biological significance as the results obtained were within reference intervals for the dog.     

Evaluation of a bench-top coagulation analyzer for measurement of prothrombin time, activated partial thromboplastin time, and fibrinogen concentrations in healthy dogs

OBJECTIVE: To evaluate a bench-top coagulation analyzer for determination of prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen concentration in healthy dogs. ANIMALS: 55 healthy adult dogs. PROCEDURES: PT, APTT, and fibrinogen concentration were determined by use of the coagulation analyzer. Values were compared with results obtained independently by a conventional laboratory. RESULTS: Correlations (with 95% confidence intervals) between the coagulation analyzer and conventional laboratory values were 0.760 (0.610 to 0.857), 0.700 (0.448 to 0.721), and 0.896 (0.878 to 0.918) for PT, APTT, and fibrinogen concentration, respectively. Using linear regression, comparison of data from the coagulation analyzer and the conventional laboratory provided equations relating the coagulation analyzer values with values from the conventional laboratory and suggested that APTT and fibrinogen values from the coagulation analyzer and conventional laboratory were approximately the same within expected random variation. Prothrombin time values for the coagulation analyzer were significantly offset from the PT values for the conventional laboratory but still were correlated reasonably well with the conventional laboratory values. CONCLUSIONS AND CLINICAL RELEVANCE: By use of the mechanical method of analysis, fibrinogen concentrations obtained with a bench-top coagulation analyzer correlated well with results for a conventional laboratory, indicating that the coagulation analyzer is a reliable instrument for determination of this coagulation variable. Coagulation analyzer results for PT and APTT correlated less strongly with those for the conventional laboratory, but they would still be considered clinically reliable.     

Effects of haemolysis, lipaemia and bilirubinaemia on prothrombin time, activated partial thromboplastin time and thrombin time in plasma samples from healthy dogs

Interferences caused by haemolysis, lipaemia and bilirubinaemia on prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT in normal canine plasma samples were studied using commercially available reagents and a steel ball coagulometer. Haemolysis significantly interfered with APTT (P = 0.0076) and TT (P = 0.0292). Regression analysis showed that TT was significantly shortened as haemoglobin concentrations increased. Lipaemia increased as demonstrated by regression analysis. Bilirubin significantly interfered with PT (P=0.0003) and APTT (P=0.002). Although statistically significant, none of the differences found were of clinical relevance.     

Evaluation of a point-of-care coagulation analyzer for measurement of prothrombin time, activated partial thromboplastin time, and activated clotting time in dogs

OBJECTIVE: To evaluate a point-of-care coagulation analyzer (PCCA) in dogs with coagulopathies and healthy dogs. ANIMALS: 27 healthy and 32 diseased dogs with and without evidence of bleeding. PROCEDURE: Prothrombin time (PT), activated partial thromboplastin time (aPTT), and activated clotting time (ACT) were determined, using a PCCA and standard methods. RESULTS: Using the PCCA, mean (+/- SD) PT of citrated whole blood (CWB) from healthy dogs was 14.5+/-1.2 seconds, whereas PT of nonanticoagulated whole blood (NAWB) was 10.4+/-0.5 seconds. Activated partial thromboplastin time using CWB was 86.4+/-6.9 seconds, whereas aPTT was 71.2+/-6.7 seconds using NAWB. Reference ranges for PT and aPTT using CWB were 12.2 to 16.8 seconds and 72.5 to 100.3 seconds, respectively. Activated clotting time in NAWB was 71+/-11.8 seconds. Agreement with standard PT and aPTT methods using citrated plasma was good (overall agreement was 93% for PT and 87.5% for aPTT in CWB). Comparing CWB by the PCCA and conventional coagulation methods using citrated plasma, sensitivity and specificity were 85.7 and 95.5% for PT and 100 and 82.9% for aPTT, respectively. Overall agreement between the PCCA using NAWB and the clinical laboratory was 73% for PT and 88% for aPTT. Using NAWB for the PCCA and citrated plasma for conventional methods, sensitivity and specificity was 85.7 and 68.4% for PT and 86.7 and 88.9% for aPTT, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: The PCCA detected intrinsic, extrinsic, and common pathway abnormalities in a similar fashion to clinical laboratory tests.     

Submitting canine blood for prothrombin time and partial thromboplastin time determinations

Practitioners commonly submit samples from dogs for partial thromboplastin time and prothrombin time determinations. Controversy exists as to the necessity for rapid separation of plasma and cells, and submission of the plasma on ice (or frozen). The purpose of this study was to address three questions. First, is it better to submit plasma or is whole blood satisfactory? Second, is it necessary to refrigerate the sample or is maintenance at room temperature (20° C) adequate? Third, does the sample have to arrive at the laboratory within a few hours of collection or can reliable partial thromboplastin time/prothrombin time determinations be made on samples up to 48 hours old?It has been shown by this study that reliable partial thromboplastin time and prothrombin time determinations can be carried out on canine plasma for up to 48 hours after collection regardless of whether or not the plasma is separated immediately; however the samples must be kept at 4°C. If the samples are maintained at room temperature, reliable prothrombin time determinations can be obtained for up to six hours after collection regardless of whether or not the plasma is separated immediately. Reliable partial thromboplastin time determinations can be made on plasma stored at 20°C for up to 24 hours after collection and possibly longer (up to 48 hours) if the plasma has been separated immediately.     

One-stage prothrombin time, activated partial thromboplastin time, thrombin time, fibrin degradation product concentration, and antithrombin activity in healthy adult alpacas

Background: Alpacas are increasingly presented to veterinarians for evaluation and care. Reports of alpaca reference intervals for one‐stage prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), concentration of fibrin degradation products (FDP), and antithrombin (AT) activities are scarce or nonexistent. Objective: The aim of this study was to determine values for blood coagulation times (PT, aPTT, and TT), FDP concentrations, and AT activities in healthy adult alpacas. Methods: Of blood samples collected from 35 clinically healthy adult alpacas via jugular venipuncture and placed into sodium citrate and FDP tubes, 29 samples were assayable for coagulation testing. PT, aPTT, and TT were determined by physical (mechanical) clot detection; AT activity was determined using a thrombin‐specific chromogenic substrate end‐point assay; and FDP concentrations were determined by the slide agglutination method. Results: Median values and ranges (minimum–maximum) were determined for PT (8.7 seconds, 6.6–11.2 seconds), aPTT (17.3 seconds, 11.9–22.5 seconds), TT (10.2 seconds, 5.4–16.0 seconds), and AT activity (123.3%, 104.8–144.2%). The mean concentration of FDP was <8 μg/mL. Conclusion: These values for coagulation times, FDP concentration, and AT activity will provide a useful starting point in the diagnostic evaluation of ill adult alpacas.     

Measurement of prothrombin time (PT) and activated partial thromboplastin time (APTT) on canine citrated plasma samples following different storage conditions

Samples from 75 clinically ill dogs were utilised in the study. APTT and PT tests were performed immediately on fresh citrated plasma samples (Fresh). The remaining plasma was stored at -20 degrees C for less than 4 months (n=36 samples) or between 4 and 7 months (n=39 samples). In batches of five, frozen samples were thawed rapidly and APTT and PT tests were performed on the thawed samples immediately (0RT) and after storage at room temperature (23 degrees C, range: 22-25 degrees C) for 24h (24RT) and 48h (48RT). The median APTT value from the (0RT) samples was significantly longer than that obtained from fresh samples (15s vs. 13.2s) but the PT value was not statistically different (7.8s vs. 7.6s). The median APTT (15s) and PT (7.5s) results from the (24RT) samples were not statistically different to those from the (0RT) samples (APTT: 15s, PT: 7.6s) but both tests were significantly longer (APTT: 16.5s, PT: 9.2s) from the (48RT) samples. We concluded that long term batching and freezing of clinical samples at -20 degrees C is acceptable for measurement of PT but not of APTT. We demonstrated that APTT and PT results do not change following storage of samples at room temperature for 24h but storage for 48h may lead to statistically and clinically significant changes (values at least 25% higher than the high value of the laboratory's reference interval) in both clotting times.     

Effect of sodium heparin and antithrombin III concentration on activated partial thromboplastin time in the dog

Regulation of blood coagulation was studied in 12 dogs, using subcutaneous administration of sodium heparin. Dosage of heparin needed to achieve the desired 1.5- to 2.5-fold increase in the activated partial thromboplastin time (APTT) was 250 to 500 IU/kg of body weight. Increased APTT lasted less than 6 hours. Repeated heparin administration, using the lowest dosage (250 IU/kg) every 6 hours, induced an unacceptable prolongation of clotting times during the first 2 days of treatment. Prolonged administration at a dosage of 200 IU/kg every 6 hours adequately maintained the desired hypocoagulative state initially; after 2 days, however, the prolonged APTT steadily decreased. The decreasing effect was proportionate to a decrease in plasma antithrombin III (AT III). To sustain a correctly balanced hypocoagulative state from prolonged subcutaneous administration of heparin, APTT values should be determined regularly to monitor therapy. In addition, transfusion of AT III-rich donor plasma may be necessary when low plasma AT III reduces the effects of heparin.     

Comparison of hematologic and biochemical values for blood samples obtained via jugular venipuncture and via vascular access ports in cats

OBJECTIVE: To determine whether hematologic and serum biochemical values for blood samples obtained from cats via vascular access ports (VAP) are comparable to those for samples obtained by direct venipuncture. DESIGN: Prospective study. ANIMALS: 14 healthy cats. PROCEDURE: A VAP was surgically implanted in a jugular vein in each cat. Blood samples were obtained from the VAP and by direct venipuncture of the contralateral jugular vein 10 weeks after VAP placement. Results of hematologic and serum biochemical analyses were compared by use of a paired t-test. The Pvalue to reject the null hypothesis was adjusted to account for multiple comparisons by using the Bonferroni procedure in which the nominal P-to-reject value is divided by the number of comparisons (0.05/24 = 0.002). RESULTS: Paired samples (VAP and venipuncture) obtained 10 weeks after VAP placement were evaluated for each cat. Of the 24 measured analytes, only potassium, total protein, and albumin concentrations differed significantly (P< 0.001 for all 3) between VAP and venipuncture samples. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that samples obtained from VAP are suitable for routine hematologic monitoring of feline cancer patients. Sample hemolysis may account for a slight increase in potassium, total protein, and albumin concentrations obtained from VAP samples. However, the values of variables most critical for monitoring of patients receiving chemotherapy (ie, mature neutrophil and platelet counts) are comparable. If proper techniques are used, VAP may be used for administration of chemotherapy as well as for blood collection in cats undergoing cancer treatment.     

Comparison of bacteriology and cytology of tracheal fluid samples collected by percutaneous transtracheal aspiration or via an endoscope using a plugged, guarded catheter.

Cytological and bacteriological results from tracheal fluid samples obtained endoscopically using a telescoping, plugged catheter (TPC) were compared with results from samples collected by percutaneous transtracheal aspiration (PTA). The TPC technique and PTA were performed in random order on 9 healthy Standardbred geldings. Three weeks later the procedures were performed on the same horses in the reverse order. The presence of oropharyngeal contamination was determined by quantitative bacteriology and quantification of squamous epithelial cells (SEC)/ml sample. The relative numbers of macrophages, haemosiderophages, giant cells, neutrophils, lymphocytes and eosinophils did not differ between techniques. The number of SEC/ml was greater in samples with more colony forming units/ml indicating that quantification of SEC provides evidence of the probable degree of oropharyngeal contamination. Fifteen out of the 18 TPC samples were free of contamination, indicating that the TPC can provide adequate samples for bacteriology. The results also indicate that tracheoscopy sometimes results in oropharyngeal contamination of the trachea, but that this does not affect the results of the TPC sample.     

Heparin in vitro sensitivity of the activated partial thromboplastin time in canine plasma depends on reagent.

The in vitro heparin sensitivity of 6 different commercial activated partial thromboplastin time (APTT) reagents was investigated based on artificial plasma samples prepared by addition of sodium heparin at different activities (0-1.5 IU/ml) to pooled normal canine plasma. Statistical analysis using 2-way analysis of variance was based on APTT ratios (APTT/mean APTT control). Significant differences between the APTT ratios of different APTT reagents (P < 0.00001) were found, which also depended on heparin activity (interaction between the factors; P < 0.00001). For example, mean APTT ratio at 0.7 IU/ml heparin varied between 1.2 and 2.5. The results of this study indicate that recommendations for the control of heparin therapy in dogs by APTT ratio should be reagent specific.     

Serum concentration and safety of intravenous drip versus subcutaneous administration of carboplatin in dogs

Carboplatin is used to treat certain cancers in dogs and cats and is routinely administered via intravenous drip (IVD). Subcutaneous (SC) administration has also been described. However, the toxicity, serum concentrations, and area under blood concentration-time curves (AUCs) of SC carboplatin are unknown. This study aimed to compare serum carboplatin concentrations in dogs after SC and IVD and to monitor any adverse events. In this crossover study, five dogs received SC or IV carboplatin (300 mg/m²). After a minimum of 3 weeks, each dog received the other treatment. No gross skin toxicity or abnormal clinical signs were observed in any of the dogs. Blood test abnormalities were detected in most dogs. Decreased neutrophil and platelet counts, and increased C-reactive protein (CRP) levels were found. There was no significant difference in the neutropenia, thrombocytopenia, and CRP scores between the groups. Systemic toxicities of SC carboplatin were comparable to those of IVD carboplatin. The time to maximum carboplatin concentration after SC was longer than that after IVD (P<0.001). SC carboplatin remained in the serum longer than IVD carboplatin (P=0.008). The AUC of SC was less than that of IVD (P=0.002). The AUC and time taken to reach the maximum concentration of SC carboplatin were lower than those of IVD carboplatin. This study suggests that SC carboplatin may be an efficacious option for the treatment of tumors in dogs, particularly where IVD administration is challenging.     

Comparison of direct and indirect blood pressure measurements in anesthetized dogs.

The precision and accuracy of an indirect oscillometric blood pressure measurement technique (Dinamap 8100) was assessed in 11 anesthetized Beagle dogs weighing 8 to 11.5 kg. Direct blood pressure measurements were made by catheterization of the lingual artery, and simultaneous indirect measurements were determined by placing a cuff over the median artery (midradial area). Blood pressure measurements at 2 different planes of anesthesia (light and deep) were recorded in triplicate. At a light plane of anesthesia, the Dinamap 8100 underestimated diastolic and mean arterial pressure, and at a deep anesthetic plane overestimated systolic pressure. The indirect technique had good repeatability of systolic pressures. Regression analysis for the 2 techniques showed excellent correlation (r = 0.93). The results indicate that the indirect oscillometric blood pressure measurement technique provides a good estimate of systolic, diastolic, and mean arterial pressure in dogs weighing 8-11.5 kg.