Up to 60% of the mortality in dogs with immune-mediated hemolytic anemia (IMHA) is associated with thrombosis or disseminated intravascular coagulation. No conventional hemostatic test is accurate to evaluate the risk for hypercoagulability. Viscoelastic testing has been proven to be influenced by anemia, and might not reliably assess hemostasis in IMHA patients. Calibrated automated thrombography (CAT) is a thrombin generation (TG) assay that has been validated in clinically healthy dogs. The objective of the study was to assess the suitability of TG in the assessment of hypercoagulability in IMHA patients. IMHA was determined by the presence of anemia, spherocyte and positive slide agglutination test or positive Coomb's Test. CBC, coagulation profile and CAT parameters (lag time, time to peak, peak, endogenous thrombin potential) were performed in all IMHA patients, at the time of diagnosis and then at 48 and 96 h. Lag time was prolonged for IMHA patients at day 0 (D0) and D2; and time to peak was higher on D0 but not statistically different on D2 or D4 compared to healthy dogs. Peak was higher in dogs with IMHA at D0, D2 and D4. There was no statistical difference in the endogenous thrombin potential between IMHA and healthy dogs. No correlation between the CAT parameters and blood cell count, coagulation parameters or the likelihood for the patient to be discharged. Prolonged lag time and time to peak indicate hypocoagulation in IMHA dogs early in the disease onset; however, based on peak value, IMHA patients appear to generate more thrombin once coagulation is initiated compared to normal dogs. TG was not useful in predicting patient outcomes.

Disclosures

No disclosures to report.