Correlation of plasma coagulation tests and fibrinogen Clauss with rotational thromboelastometry parameters and prediction of bleeding in dogs.

Background: Correlation of plasma fibrinogen concentration (fibrinogen _Clauss ) with rotational thromboelastometry (ROTEM) parameters has not been investigated in dogs.
Objectives: To determine the correlation between plasma coagulation tests and fibrinogen _Clauss with ROTEM parameters and to evaluate their ability to predict bleeding in dogs.
Animals: Ninety-seven dogs with concurrent determination of fibrinogen _Clauss and fibrin polymerization test (FIBTEM) analysis.
Methods: Signalment, pretreatment, clinical signs of bleeding, fibrinogen _Clauss , plasma coagulation test results, hematocrit, platelet count, FIBTEM, extrinsic (EXTEM) and intrinsic (INTEM) activated ROTEM assays were retrieved retrospectively. Correlations between fibrinogen _Clauss and FIBTEM maximum clot firmness (MCF _FIBTEM ) and between prothrombin time (PT) or activated partial thromboplastin time (aPTT) and ROTEM parameters were determined. Dogs were further assigned to groups with or without clinical signs of bleeding. The prognostic significance of significantly different parameters to predict bleeding was evaluated.
Results: Fibrinogen _Clauss showed strong correlation with MCF _FIBTEM (r = 0.860, n = 97, P < .001). PT showed strong correlation with EXTEM clotting time (CT _EXTEM ) (r = 0.839, n = 53, P < .001), and aPTT was strongly correlated with INTEM CT (CT _INTEM ) (r = 0.664, n = 31, P < .001). Platelet count, PT/aPTT, EXTEM clot formation time (CFT _EXTEM ), MCF _EXTEM , EXTEM maximum clot elasticity (MCE _EXTEM ), and CT _INTEM were significantly different between groups. A CT _INTEM >149 seconds was 100% sensitive to detect bleeding.
Conclusions and Clinical Importance: The MCF _FIBTEM can be used to evaluate the effect of fibrinogen on hemostasis as an alternative to determination of fibrinogen _Clauss . In addition, CT _EXTEM and CT _INTEM are strongly correlated with PT and aPTT, respectively.
(© 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)