PhD in Agriculture
Aisin M.
Kazakhstan, Kostanai State University names A. Baytursynov
COMPARATIVE EFFECTIVENESS
AND FRAKSIPARINO HEPARIN COAGULOPATHY DOGS
Important
place in the overall hemostatic disorders Animal Pathology determined not only
by a relatively high frequency , variety and potentially a very high risk of
bleeding and thrombohemorrhagic diseases and syndromes , but also by the fact
that these processes are nouns pathogenesis extremely large number of other
diseases , infectious- septic , immune, cardiovascular , cancer , etc. They are
accompanied by injury , complicate surgery, drug therapy , take a leading role
in the pathogenesis of most types of shock , etc. , in connection with which
the ability to navigate in these issues is necessary for all veterinarians who
treat dogs [1].
How relevant is the
problem became clear after some animals after successful technically surgery to
remove the tumor , surgery in the abdomen or about traumatic bone injuries died
early , and sometimes in the late postoperative periods. An autopsy of the dead
animals showed that the immediate cause of death in all they had pulmonary
embolism .
Reason
for the formation of a thrombus that many of these animals was already present
initially deep vein thrombophlebitis of the pelvic limb , which was not
clinically recognized, and that it was a good starting point flebotromboz
education venous emboli and drift it with blood in the pulmonary artery
branches . Some animals are not suffering from thrombophlebitis , deep vein
pelvic limb were expressed sclerotic that probably made
arrangements tromborezistentnosti insolvent and was threatened
intravascular thrombus . This certainly contributed to the slow blood flow in
the venous bed.
At postmortem
examination was not always possible to find a source localization embolism.
Embologenic thrombus usually localized in the popliteal - femoral segment , as
well as ileokavalnom and even fewer ileofemoralnom .
Given
that about two thirds of all deaths from pulmonary embolism occurred within 30
minutes after the onset of embolism and that 80% of pulmonary embolism occur in
the absence of prior clinical signs of deep vein thrombosis was apparent
futility of treatment. Therefore, required preventive approach to this complex
issue veterinary practice
Theoretical
study of venous thrombogenesis , in particular, the predominant role of a blood
clot in the formation of red ( coagulation ) venous thrombus (unlike blood ) ,
led to the idea of developing a method of efficient to
prevention, which was based on a warning to use of anticoagulants of direct
action . [2]
However , what animal it
is advisable to carry out preventive maintenance and which are not ?
Indeed, the use of
anticoagulants without a special need fraught with the danger of unwanted
effects. Necessary to identify the risk factors , which account would allow
animals to share risk in powers . This - old animal , obesity, schennost and
postnatal period, estrogen ( contraceptives ) , trauma or surgery (especially
in the pelvis , hip , or hind limb ) , malignant tumor (especially in the
pelvis , abdomen or tumor metastases ) cardiac and ( or ) respiratory failure ,
infection .
Then
all the animals partitioned into three groups of risk of thromboembolic
complications .
Low-risk
group :
- Small operation no
risk factors except age ;
- A big operation , old
animal , no other risk factors ;
- Minor or non-surgical
pathology .
Moderate-risk
group :
- A big operation ; old
animal or other risk factors ;
- Serious nonsurgical
disease : heart disease or lung cancer;
- Major trauma or burns
;
- Large emergency
operation , the old animal, oral contraceptives .
High-risk group :
- Fractures or large
operations ( including orthopedic ) in the pelvis , hip , pelvic limb ;
- Major surgery in the
pelvis or abdomen for a malignant tumor.
Preventive
measures should be applied only in the animals category moderate and high risk
. Animals in low-risk measures such conduct is inappropriate. For this purpose,
on the part of these two groups of dogs were used heparin, and the other part -
fraksiparin . Since prevention fraxiparin considerably more expensive than
heparin , it is usually carried elite animals , take into account the social
status of the owner and his attitude to the disease your pet, as well as
ethical issues .
Prevention
of heparin : the animals at high risk of venous thrombotic heparin first
injection was performed at a dose of 100 IU / kg subcutaneously under blade 2
hours prior to surgery and then with 8 -12- hour intervals after surgery.
Injection was stopped after 2 days after surgery. Moderate risk group of
animals with the same multiplicity used twice smaller doses . Injections were
performed under the control of blood clotting time , making sure that it is
2-2.5 times higher than normal, so as not to cause dangerous bleeding or
bleeding. Daily ( only for the period of prevention , typically 2 days) 1 per
day counted the number of platelets in the blood to prevent possible
thrombocytopenia , which can be a trigger factor for both bleeding and
thrombotic events on a background of continued thrombocytopenia. Blood for the
study was collected from the v. saphena.
Prevention Fraxiparine :
high-risk animals with thrombotic fraxiparin first injection conducted in a
dose of 0.01 ml / kg subcutaneously under blade 3 hours prior to surgery and
then at the same dose one time a day every day for 2 more days . Moderate risk
group of animals with the same multiplicity used twice fraxiparin smaller doses
. Determination of clotting time and platelet count in the blood is not carried
out , since according to proprietary annotations on this drug could do .
For
comparative tests took dogs undergoing surgery in a veterinary clinic KSU, as
well as two private veterinary clinics Kostanay .
Studies
have focused on the study of comparative efficacy of the question for the
prevention of venous thrombotic two representatives of the direct action of
anticoagulants : heparin and its low molecular weight fraction - fraxiparin
[3].
In
three veterinary clinics Kostanai all were operated with various diseases 765
dogs. Of them needed in the prevention of venous thrombotic 435 animals ( or
56.9 %). For whatever reasons, the prevention of venous thrombus formation was
carried out 253 of them ( 58.2 %). 166- five of them were carried out with
heparin prophylaxis (or 65.6 %) , and the rest is 87 animals ( 34.4 %) -
fraxiparin .
When comparing the
effectiveness of two methods for the prevention of venous thrombus formation
revealed that prophylaxis fraxiparin significantly more effective than heparin.
So any amount of deep vein thrombophlebitis of the pelvic limbs after surgery
under "cover" fraxiparin decreased 5.5 times , the number of
pulmonary embolism - 3.3 times , serious bleeding - 3.8 times , bruising at the
injection site in 28.5 times , thrombocytopenia - 4.8 times and allergic
reactions manifested by skin rash and itching - 3.3 times. But the most
important indicator that confirms the significant superiority fraksipaina
heparin before - is that mortality from severe complications such as pulmonary
embolism , during prophylaxis fraxiparin decreased 3.3 times , which is an
achievement. Also, significantly more fraksiparin convenient to use than a
heparin ; from packaging ready for use in a sterile disposable syringe and
ending in that it is applied 1 time a day (unlike heparin , which must be used
2-3 times daily) and does not require laboratory monitoring at
geparinoprofilaktike clotting time and platelet counts in peripheral blood.
Every year the number of
dogs in need of prevention of venous thrombus formation of possible surgical
interventions will increase the grounds that : 1) pet owners have been actively
used to prevent unwanted schennosti corticosteroid contraceptives, which,
undoubtedly, is in itself a serious risk factor venous thrombotic events during
surgery , 2) vysoporodistye service dogs destined for activities (hunting,
chasing , fighting , etc.) , live in comfortable apartments and accordingly are
very inactive lifestyle. A number of calories in their diet often exceeds
required for their lifestyle level . Hosts overfeed their pets . Their excess
stored as fat in the fat depots , leading to obesity - as an additional risk
factor of venous thrombotic events.
Therefore,
prevention of venous thrombus formation in dogs in pre-and postoperative
periods must always be given due attention.
These
materials are not obtained in laboratory experiments , and for production
testing , which allows to give preference to the recommendations for the
prevention of venous thrombus formation in dogs Fraksiparino it and recommend
it to practical use in veterinary medicine.
Literature
:
1. GG Shcherbakov , SV
Starchenkov Non-communicable diseases of dogs and cats . St. Petersburg .
Agropromizdat , 1996, 126 p.
2 . Mashkovskii MD Drugs
. M. : New volna.1993.683 with .
3 . Chibunovsky VA
Fraksiparin . A new era in the prevention and treatment phlebothrombosis . A
practical guide . Almaty.2000 , 114 .