RESUMO
OBJECTIVE: To characterize in vitro coagulation status in a cohort of dogs with extrahepatic biliary tract obstruction (EHBO) and to evaluate these patients for hypercoagulability by means of thromboelastography. DESIGN: Prospective cohort study. Animals-10 dogs with EHBO and 19 healthy control dogs. PROCEDURES: Partial or complete EHBO was confirmed via exploratory celiotomy. Venous blood samples were collected for evaluation of prothrombin time (PT) and activated partial thromboplastin time (APTT); fibrinogen and D-dimer concentrations; protein C and antithrombin activities; and factor VII, VIII, and XI coagulant activities in plasma as well as thromboelastography in whole blood. Thromboelastography variables were measured from the thromboelastography tracing, and a coagulation index was calculated. Thromboelastography results were compared with those of healthy control dogs previously evaluated by the same laboratory. RESULTS: Hypercoagulability was diagnosed in all dogs with EHBO on the basis of a high coagulation index. Thromboelastography variables, including maximal amplitude, α-angle, and coagulation index, were significantly higher, and K (clot formation time) and R (reaction time) were significantly lower in these dogs than in control dogs. All dogs with EHBO had PT and APTT within respective reference ranges. Plasma D-dimer and fibrinogen concentrations were above reference ranges in 8 and 7 dogs, respectively, and protein C and antithrombin activities were below reference ranges in 3 and 1 dogs, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: In vitro hypercoagulability was commonly detected in dogs with naturally occurring EHBO. The traditional view of EHBO as a disease that causes hypocoagulability may need to be reconsidered.
Assuntos
Ductos Biliares Extra-Hepáticos/patologia , Transtornos da Coagulação Sanguínea/veterinária , Colestase/veterinária , Doenças do Cão/patologia , Tromboelastografia/veterinária , Animais , Transtornos da Coagulação Sanguínea/diagnóstico , Transtornos da Coagulação Sanguínea/etiologia , Colestase/complicações , Colestase/patologia , Doenças do Cão/etiologia , Cães , Feminino , Masculino , Tromboelastografia/métodosRESUMO
OBJECTIVE: To determine if oseltamivir with standard therapy for canine parvoviral enteritis ameliorates disease morbidity, mortality, or both; to document significant adverse effects associated with its use. DESIGN: Prospective, randomized, blinded, placebo-controlled clinical trial. SETTING: University veterinary teaching hospital. ANIMALS: Thirty-five dogs. INTERVENTIONS: Standard therapy was administered to all dogs. Treatment dogs also received oseltamivir, while control dogs received an equivalent volume of placebo. MEASUREMENTS AND MAIN RESULTS: Dogs were monitored daily according to a clinical scoring system, physical parameters, and diagnostic evaluations. Dogs in the treatment group gained a significant percentage of weight during hospitalization (mean, +2.6%; SD, 7.1%) versus the control dogs (mean, -4.5%; SD, 6.9%) (P=0.006). Treatment dogs did not have any significant changes in their white blood cell (WBC) count, while control dogs experienced a significant drop in their WBC counts during their initial stay. In addition, it did not appear that oseltamivir use was associated with any major adverse clinical effects. CONCLUSIONS: While a clear advantage to the use of oseltamivir was not established, a significant weight loss during hospitalization, as well as a significant decrease in WBC count were documented in the control group. No major adverse effects were identified that could be associated with oseltamivir administration. Based on these results, the true role of oseltamivir in the treatment of parvoviral enteritis remains speculative, although it is believed that further investigation is warranted.