Thromboelastography in Dogs with Suspected Primary Brain Tumors

Abstract

Thromboelastography in dogs with suspected primary brain tumors Vikram Kahlon (Academic Abstract) Background: Dogs with primary brain tumors typically have chronic progressive clinical signs, but some dogs will decline suddenly and unexpectedly. It is currently unknown if dogs with primary brain tumors experience hemostatic derangements. Dogs can be screened for hypercoagulability using a whole blood test called thromboelastography (TEG). Hypothesis: Dogs with suspected primary brain tumors have TEG alterations consistent with hypercoagulability compared to healthy control dogs, characterized by one or more of the following: shortened R and K values, increased α-angle, and increased MA. Animals: Thirty-seven dogs were prospectively enrolled with suspected primary brain tumors. Following MRI evaluation, ten dogs met inclusion criteria, and twenty-seven were excluded due to the absence of intracranial neoplasia. Forty healthy adult dogs from a previously established control population were used for comparison. Prospective observational preliminary study. Thromboelastography will be performed on all dogs with the Haemonetics TEG 6s system using the global hemostasis cartridge. Dogs will be diagnosed with a primary brain tumor if they have clinical signs and exam findings suggestive of intracranial disease and brain MRI results consistent with a primary brain tumor. Dogs must have a blood chemistry, complete blood count (CBC), and urinalysis within 1 week of brain MRI to exclude concurrent disease that would affect hemostasis. Dogs receiving medications known to alter hemostasis within 2 weeks of enrollment will be excluded. Healthy adult dogs from a previously established control population were used for comparison. Power analysis indicated that nine dogs per group were required. Thromboelastography parameters were compared between groups using appropriate parametric or non-parametric statistical tests, with significance set at p < 0.05. Results: Results revealed that 30% (3/10) of dogs with primary brain tumors had a prolonged R value. Additionally, R was significantly prolonged in dogs with primary brain tumors compared to healthy dogs (p = 0.0003). RapidTEG MA was significantly increased in dogs with primary brain tumors compared to healthy dogs (p = 0.0266). No significant differences were identified between groups for K, α-angle, or MA. Conclusions: Overall, dogs with primary brain tumors have TEG features of hypocoagulability. The clinical significance of increased RapidTEG MA with normal MA in dogs with primary brain tumors is unclear.