Fig. 1

Thromboelastography-guided transfusion of four dogs with hypocoagulable disorders. a Dog with rodenticide poisoning (case 1): Thromboelastography (TEG) was performed at admission (black line) at which point the tracing flat-lined. A TEG with in vitro addition of 50 µL fresh frozen plasma (FFP-TEG), corresponding to a 10 mL/kg FFP transfusion, was shown to markedly improve the tracing (green line). Following a FFP transfusion of 10 mL/kg, a post-transfusion TEG (pink line) showed results similar to the FFP-TEG. b Dog with angiostrongylosis (case 2): TEG was performed at admission (black line) showing hypocoagulability. A FFP-TEG with addition of 50 µL FFP was shown to normalize R, K, and α and to improve MA (green line). A FFP-TEG with 75 µL FFP showed negligible additional improvement (pink line). Following transfusion with 10 mL/kg FFP, a post-transfusion TEG showed improved results (brown line), although not quite to the extent predicted in vitro, likely due to ongoing consumption of coagulation factors. c Dog with suspected disseminated intravascular coagulation (case 3): TEG was performed at admission (black line), showing severe hypocoagulability. A FFP-TEG with addition of 50 µL FFP was shown to improve, although not normalize all parameters of the TEG (green line). A FFP-TEG with 100 µL FFP showed no additional improvement (pink line). Following an FFP transfusion of 10 mL/kg, a post-transfusion TEG (brown line) showed results similar to the FFP-TEG. d Dog with primary immune-mediated thrombocytopenia (case 4): TEG was performed at admission (black line), showing severe hypocoagulability. A FFP-TEG with addition of 50 or 100 µL FFP did not cause any improvement (green and pink lines). The dog was provided with a fresh whole blood (WB) transfusion, and post-transfusion TEG revealed improvement, although not normalization of all TEG parameters (brown line). A follow-up TEG 3 days later revealed normalization of the tracing (blue line)