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Coagulopathy Diagnostic Algorithms

Coagulopathy Diagnostic Algorithms. Wendy Blount, DVM. Ecchymoses/Petechiae Algorithm. Platelet count. Both prolonged. Low (next slide). Normal or increased. FDPs, AT3, TT. PT, PTT/ACT. normal. VitK deficiency All normal Liver Failure TT prolonged AT3 low Factor 10 deficiency

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Coagulopathy Diagnostic Algorithms

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  1. Coagulopathy Diagnostic Algorithms Wendy Blount, DVM

  2. Ecchymoses/Petechiae Algorithm Platelet count Both prolonged Low (next slide) Normal or increased FDPs, AT3, TT PT, PTT/ACT normal VitK deficiency • All normal Liver Failure • TT prolonged • AT3 low Factor 10 deficiency • All normal – blood to Cornell prothrombin deficiency • TT prolonged Snake Bite • FDP increased • TT prolonged • AT3 normal Chronic Bleeding • FDPs increased One prolonged BMBT • PT: congenital def. 7 early antiVitK • PTT: congen def 8 9 11 (12) severe vWDz - 8 heparin toxicity normal prolonged vWF assays Work up vasculitis platelet function Observe Work up vasculitis Factor assays to Cornell vWF assays Rodenticide tox screen or treat with VitK Check for MCT, anaphylaxis vasculitis or problem resolving vWDz Vasculitis thrombopathia

  3. Ecchymoses/Petechiae Algorithm low platelet count normal PT, PTT/ACT Both prolonged 50-150,000/ul <50,000/ul FDPs, D-dimers, TT ACT < 10 sec prolonged BMBT bone marrow Severe bleeding – platelet consumption • Advanced Vitamin K deficiency DIC • Increased FDPs, D-dimers, TT Snake Bite • Increased FDPs, TT Severe platelet problem normal prolonged neoplasia rickettsial dz Aplasia Infection toxicity platelet clumps hyperlipidemia Cavalier mild vasculitis mild rickettsial Vasculitis rickettsial dz Some thrombocyto-pathias normal 1o or 2o IMT

  4. Ecchymoses/Petechiae Algorithm FDPs elevated Platelets, PT, PTT, ACT, BMBT, D-dimers, TT, AT3 normal Hypercoagulable state • Remember….. • Some animals will have multiple coagulopathies simultaneously • DIC, paraneoplastic coagulopathy • Hypercoagulation • Severe bleeding • Vasculitis

  5. Epistaxis Algorithm Onset history of nasal discharge acute onset History of trauma? serosanguinous to mucopurulent hemorrhagic yes no check out local processes Rads, scope, Bx, rhinotomy supportive and symptomatic care, surgical repair check blood pressure and go to petechiae-ecchymoses algorithm No abnormalities No abnormalities

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