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Clinical experience of anti-Xa monitoring in critically ill dogs receiving dalteparin

Lynch, A.M., de Laforcade, A.M. and Sharp, C.R.ORCID: 0000-0002-1797-9783 (2014) Clinical experience of anti-Xa monitoring in critically ill dogs receiving dalteparin. Journal of Veterinary Emergency and Critical Care, 24 (4). pp. 421-428.

Link to Published Version: https://doi.org/10.1111/vec.12206
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Abstract

Objectives

To describe a population of critically ill dogs receiving dalteparin monitored with an anti‐Xa assay, to assess the potential utility of serial monitoring, and to investigate the association between pre‐treatment thromboelastography (TEG) and the ability to achieve targeted anti‐Xa activity.

Design

Descriptive retrospective study.

Setting

Veterinary teaching hospital.

Animals

Thirty‐eight client‐owned dogs receiving dalteparin and monitored with an anti‐Xa assay.

Interventions

None.

Measurements and Main Results

Medical records were retrospectively reviewed for signalment, underlying disease, clinicopathological data, occurrence of thromboembolic events, complications, and outcome. Thirty‐eight dogs receiving dalteparin were monitored with an anti‐Xa assay. Diseases included hematological disease, protein‐losing disease, neoplastic disease, and septic processes. Pretreatment hypercoagulability was present in 34/35 dogs by assessment of TEG. Five cases of thromboembolism were confirmed prior to starting treatment and 4 cases occurred during hospitalization. Bleeding complications were rare (3/38) and 29/38 dogs survived to discharge. Interpretation of the anti‐Xa assay allowed for dose adjustment although reliable achievement of target anti‐Xa activity was not demonstrated. Dogs with higher G values on pretreatment TEG were significantly less likely to achieve the target anti‐Xa activity (ie, be above or below the target range).

Conclusions

Dalteparin was well tolerated in a heterogeneous population of dogs. However, dose adjustment in response to anti‐Xa activity interpretation inconsistently resulted in subsequent attainment of the target anti‐Xa range. Development of guidelines may be warranted to more consistently achieve the target range. Dogs that appear more hypercoagulable on pre‐treatment TEG may require closer monitoring and greater dose adjustment to achieve the target anti‐Xa range.

Item Type: Journal Article
Publisher: Wiley
Copyright: © Veterinary Emergency and Critical Care Society 2014
URI: http://researchrepository.murdoch.edu.au/id/eprint/53503
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