Evaluation of Fibrinolysis by Thromboelastography in Dogs With Hemorrhagic Pericardial Effusion.

Dogs with hemorrhagic pericardial effusion exhibit significant hyperfibrinolysis, warranting investigation of antifibrinolytic therapy.

This prospective observational study evaluated fibrinolytic activity in dogs presenting with hemorrhagic pericardial effusion (PCE) using thromboelastography modified with tissue plasminogen activator (tPA-TEG). Sixteen dogs with hemorrhagic PCE had blood samples collected prior to pericardiocentesis, with fibrinolysis assessed via percentage of clot lysis at 30 minutes (LY30) after maximum amplitude (MA). Hyperfibrinolysis was defined as LY30 ≥20%. Results were compared against a cohort of healthy control dogs. The findings demonstrated that 87.5% of dogs with hemorrhagic PCE (14/16) exhibited hyperfibrinolysis, while no healthy control dogs met this threshold. The median LY30 in PCE dogs was markedly elevated at 51.5% (range: 3.0–77.6%) compared to 1.3% (range: 0.0–5.8%) in controls, a difference that was statistically significant (p < 0.001). These results suggest that hemorrhagic PCE in dogs is associated with a significant hyperfibrinolytic state, which may contribute to ongoing or recurrent hemorrhage following pericardiocentesis. The authors propose that this hyperfibrinolysis could have clinical implications for patient management, particularly regarding the potential utility of antifibrinolytic agents such as aminocaproic acid or tranexamic acid. While the study is limited by its small sample size and single-center design, the data provide a compelling rationale for future investigations into antifibrinolytic therapy in dogs with hemorrhagic PCE to potentially reduce post-procedural bleeding complications.

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