Retrospective Characterization of Clot Waveform Analysis in Canine Immune-Mediated Hemolytic Anemia Using the Turbidimetric ACL-TOP 300 Analyzer (2018-2022): 35 Cases.

CWA identifies hypercoagulability in nearly all canine IMHA patients, potentially guiding antithrombotic therapy decisions.

This retrospective study characterized clot waveform analysis (CWA) parameters in 35 dogs diagnosed with immune-mediated hemolytic anemia (IMHA) using a turbidimetric optical clot detection-based analyzer (ACL-TOP 300) at a university teaching hospital between 2018 and 2022. CWA evaluates the optical density changes during clot formation, generating delta and derivative values that reflect the kinetics and magnitude of coagulation. Results demonstrated that CWA parameters were abnormally elevated in nearly all IMHA patients: PT delta was increased in 100% of dogs, while PT first derivative, aPTT delta, and aPTT second derivative were elevated in 97.1%. Standard coagulation testing showed PT prolongation and elevated fibrinogen in most patients, whereas aPTT remained within reference intervals in the majority. D-dimers, performed in 18 of 35 patients, were elevated above the reference interval in 94.4% of those cases, supporting a prothrombotic state. These findings collectively indicate that dogs with IMHA exhibit a hypercoagulable profile detectable by CWA, even when conventional coagulation parameters such as aPTT appear normal. The clinical significance lies in CWA's potential to identify IMHA patients at increased thrombotic risk who may benefit from antithrombotic therapy. Limitations include the retrospective design, single-institution setting, and variable completeness of D-dimer data. CWA may serve as a valuable adjunct to standard coagulation testing in the clinical management of canine IMHA.

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