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Highlights • Hyperfibrinolysis, as determined by rotational thromboelastometry (ROTEM) analysis, occurs in both dogs and cats. • In cats, hyperfibrinolysis occurs with trauma and cavitary bleeding. • In dogs, hyperfibrinolysis can occur in angiostrongylosis, cavitary bleeding, neoplasia, liver disease and other conditions. • Hyperfibrinolysis is associated with EXTEM (ROTEM activated by tissue factor) hypocoagulability in bleeding dogs. Abstract Hyperfibrinolysis (HFL) is a pathophysiological mechanism that has not been described in dogs or cats extensively. The aim of this study was to describe rotational thromboelastometry (ROTEM) parameters and underlying diagnosis in dogs and cats with HFL and evaluate association with bleeding diathesis. The ROTEM database was retrospectively searched for EXTEM (ROTEM activated with proprietary tissue factor) tracings with maximum lysis at 60 min ≥15%. Concurrent ROTEM and plasma coagulation tests, thrombocyte number, diagnosis and survival to hospital discharge were extracted from medical records. Analysis of differences between dogs and cats and of factors associated with bleeding, fulminant HFL (clot breakdown within 30 min) and survival to hospital discharge were performed. Hyperfibrinolysis was detected in eight cats presenting with haemoabdomen or haemothorax (n = 4/8, 50%) and trauma (n = 3/8, 38%) and in 36 dogs with angiostrongylosis (n = 12, 33%), neoplasia (n = 7, 19%), liver disease (n = 4, 11%) and others including apparently healthy dogs (n = 3, 8%). Hyperfibrinolysis was associated with prolonged EXTEM and APTEM (EXTEM with added apoprotein for inhibition of HFL) clotting time and decreased FIBTEM (EXTEM with added cytochalasin D for inhibition of thrombocytes) maximum clot firmness (MCF) in dogs and cats and with decreased EXTEM MCF in dogs. Bleeding dogs had significantly hypocoagulable EXTEM tracings. Fulminant HFL was associated with severe hypofibrinogenaemia in dogs (P = 0.005) and was not associated with survival to hospital discharge. Evidence of HFL was demonstrated in dogs and cats with bleeding, trauma, parasitic and neoplastic disease. HFL is associated with late and weak clot formation. [ABSTRACT FROM AUTHOR]

Background: The pathomechanism of Angiostrongylus vasorum infection-associated bleeding diathesis in dogs is not fully understood. Objective: To describe rotational thromboelastometry (ROTEM) parameters in dogs naturally infected with A. vasorum and to compare ROTEM parameters between infected dogs with and without clinical signs of bleeding. Animals: A total of 21 dogs presented between 2013 and 2016. Methods: Dogs with A. vasorum infection and ROTEM evaluation were retrospectively identified. Thrombocyte counts, ROTEM parameters, clinical signs of bleeding, therapy, and survival to discharge were retrospectively retrieved from patient records and compared between dogs with and without clinical signs of bleeding. Results: Evaluation by ROTEM showed hyperfibrinolysis in 8 of 12 (67%; 95% CI, 40–86%) dogs with and 1 of 9 (11%; 95% CI, 2–44%) dogs without clinical signs of bleeding (P = .016). Hyperfibrinolysis was associated with severe hypofibrinogenemia in 6 of 10 (60%; 95% CI, 31–83%) of the cases. Hyperfibrinolysis decreased or resolved after treatment with 10–80 mg/kg tranexamic acid. Fresh frozen plasma (range, 14–60 mL/kg) normalized follow-up fibrinogen function ROTEM (FIBTEM) maximal clot firmness in 6 of 8 dogs (75%; 95% CI, 41–93%). Survival to discharge was 67% (14/21 dogs; 95% CI, 46–83%) and was not different between dogs with and without clinical signs of bleeding (P = .379). Conclusion and Clinical Importance: Hyperfibrinolysis and hypofibrinogenemia were identified as an important pathomechanism in angiostrongylosis-associated bleeding in dogs. Hyperfibrinolysis and hypofibrinogenemia were normalized by treatment with tranexamic acid and plasma transfusions, respectively. [ABSTRACT FROM AUTHOR]