Retrospective Evaluation of Treatment of Coagulopathy Secondary to Suspected Vitamin K Antagonist Rodenticide Intoxication With Cryosupernatant Transfusion in Seven Dogs (2000-2017).

Abstract

OBJECTIVE: To report the use of cryosupernatant (CS) transfusion for the treatment of suspected vitamin K antagonist rodenticide (VKAR)-associated coagulopathy in dogs and its impact on coagulation times. DESIGN: Retrospective case series (2000-2017). SETTING: University teaching hospital. ANIMALS: Seven dogs with hemorrhage associated with suspected VKAR intoxication treated with CS transfusion. INTERVENTIONS: CS transfusion. MEASUREMENTS AND MAIN RESULTS: The median age was 3.0 years, with a median weight of 17.7 kg. Initial coagulation testing revealed median one-stage prothrombin time and activated partial thromboplastin time of 697% and 393%, respectively, above control/average of the reference range (CARR). The median dose of CS was 11.0 mL/kg. One-stage prothrombin time decreased (p = 0.043) after CS transfusion to a median of 98% of CARR. Activated partial thromboplastin time (n = 3) decreased to 114% of CARR (sample size precluded statistical analysis) upon recheck. All dogs received vitamin K supplementation, with an initial median subcutaneous dose of 4.11 mg/kg. Initial median PCV and total plasma protein concentration were 27.0% and 4.5 g/dL (45 g/L), respectively, with posttransfusion PCV and total plasma protein concentration of 22.0% and 4.9 g/dL, respectively. Six dogs showed resolution of observed clinical hemorrhage and were discharged. One dog was euthanized due to multi-organ dysfunction. No transfusion reactions were reported. CONCLUSIONS: Dogs with suspected VKAR intoxication showed resolution of clinical hemorrhage after CS transfusion. Compared with fresh frozen plasma, CS is an option for treating VKAR-associated coagulopathy, despite lower factor IX activity.