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ItemViscoelastic coagulation changes in dogs with tiger snake envenomationStanley, Monique Kirstie ( 2018)Snake venom induced consumption coagulopathy (SVICC) is an important yet poorly described clinical syndrome in the field of veterinary medicine. Publications referencing humans, on the other hand, are numerous in comparison, especially since the establishment of the Australian Snakebite Project. Since the introduction of Australian snake-specific antivenoms, SVICC has become the most common underlying reason for human fatality from snake envenomation in Australia.1 The annual canine snakebite caseload in Australia alone is vast and could be established as a model for the human condition. The overall objective of this study is to extend the scientific literature on SVICC in veterinary medicine, namely the role of thromboelastography (TEG) in tiger snake envenomed dogs. The study assessed the changing clot kinetics of canine whole blood after natural tiger snake envenomation using an established technique called thromboelastography (TEG). Specifically, we will be determining the TEG changes in dogs at several time points: T0 = time of presentation; T1 = 1 hour after antivenom administration; T18 = 18 hours after antivenom administration; and, finally, T24 = 24 hours after antivenom administration. Tiger snake venom caused alterations in TEG parameters, specifically the prolongation of R time (time to initiation of clot formation) during the first 24 hours of envenomation.2 No clinical benefit exists in using TEG over classical coagulation parameters in the identification of SVICC in tiger snake envenomed dogs. Hypercoagulability occurs for 24 hours after envenomation and VetSVICC appears to resolve 18–24 hours after antivenom, which is suggestive of a shorter period to apparent clinical recovery compared to humans, suggesting that VetSVICC may be a unique clinical syndrome. This project is a stepping stone to future research into both SVICC and tiger snake envenomation in veterinary medicine, including establishing an accessible and reliable diagnostic test for SVICC and further delineation of its importance regarding the severity of illness and outcome.
ItemThe effects of intravenous fluids on thromboelastrographic variables in dogsChan, Adelina ( 2018)Intravenous fluid resuscitation plays a fundamental role in treating dogs in haemorrhagic shock, as it can rapidly replenish lost intravascular volume and improve tissue perfusion. However, a consequence of intravenous fluid therapy is interference with haemostasis, which has a detrimental effect to trauma patients that are already haemostatically compromised. In people, intravenous fluid therapy can effect haemostasis and subsequently can increase haemorrhage, transfusion needs and mortality. The effects of intravenous fluids on haemostasis in dogs have not been widely established. More recently, viscoelastic devices like thromboelastography have been used to examine haemostasis. Compared to conventional coagulation testing, viscoelastic devices have the advantages to be able to assess the speed and kinetics of clot formation, clot strength and even the breakdown of the clot. The aim of our study was to determine the effects of intravenous fluids on coagulation in dogs with the use of thromboelastography. The objective of our study was to determine the effect of dilution of canine whole blood with clinically relevant doses of common intravenous fluids on thrombelastographic variables. Our hypothesis was that in vitro dilution of canine whole blood from healthy dogs with intravenous fluids will induce dose-dependent changes in thromboelastographic variables consistent with hypocoagulability. Further, we hypothesized that the characteristics of the fluids, such as its ionic strength and osmolality, will effect thromboelastographic variables in addition to those of dilution alone. The results of our study showed that in vitro dilution of canine whole blood with commonly used intravenous fluids lead to thromboelastographic changes consistent with hypocoagulability in a dose dependent manner. Besides dilution percentage, viscoelastic changes were influenced by fluid characteristics, specifically ionic strength, osmolality and colloidal properties. In our study, 7% hypertonic saline had the most severe effects on coagulation, followed by 20% Mannitol then 3.4% hypertonic saline. Hydroxyethyl starch 130/0.4 had minimal effects on coagulation besides a dilutional effect. The differential effect of fluid characteristics should be taken into consideration when resuscitating dogs with large fluid volumes, but clinical studies are still required to further delineate the importance of different resuscitation fluids and volumes on haemostasis in dogs.