1. Coagulopathy Diagnostic Algorithms
Wendy Blount, DVM

2. Ecchymoses/Petechiae Algorithm
Platelet count
Both prolonged
Low (next slide)
Normal or increased
FDPs, AT3, TT
PT, PTT/ACT
normal
VitK deficiency
All normal
Liver Failure
TT prolonged
AT3 low
Factor 10 deficiency
All normal – blood to Cornell
prothrombin deficiency
Snake Bite
FDP increased
AT3 normal
Chronic Bleeding
FDPs increased
One prolonged
BMBT
PT: congenital def. 7
early antiVitK
PTT: congen def (12)
severe vWDz - 8
heparin toxicity
normal
prolonged
Observe
Work up vasculitis
vWF assays
Work up vasculitis
platelet function
Factor assays to Cornell
vWF assays
Rodenticide tox screen or treat with VitK
Check for MCT, anaphylaxis
vasculitis
or problem resolving
vWDz
Vasculitis
thrombopathia

3. Ecchymoses/Petechiae Algorithm
low platelet count
normal
PT, PTT/ACT
Both prolonged
50-150,000/ul
<50,000/ul
ACT < 10 sec prolonged
FDPs, D-dimers, TT
BMBT
bone marrow
Severe bleeding – platelet consumption
Advanced Vitamin K deficiency
DIC
Increased FDPs, D-dimers, TT
Snake Bite
Increased FDPs, TT
Severe platelet problem
normal
prolonged
neoplasia
rickettsial dz
Aplasia
Infection
toxicity
platelet clumps
hyperlipidemia
Cavalier
mild vasculitis
mild rickettsial
Vasculitis
rickettsial dz
Some thrombocyto-pathias
normal
1o or 2o IMT

4. Ecchymoses/Petechiae Algorithm
FDPs elevated
Platelets, PT, PTT, ACT, BMBT, D-dimers, TT, AT3 normal
Hypercoagulable state
Remember…..
Some animals will have multiple coagulopathies simultaneously
DIC, paraneoplastic coagulopathy
Hypercoagulation
Severe bleeding
Vasculitis

5. Epistaxis Algorithm Onset history of nasal discharge acute onset
History of trauma?
serosanguinous to mucopurulent
hemorrhagic
yes no
check out local processes
Rads, scope, Bx, rhinotomy
supportive and symptomatic care, surgical repair
check blood pressure and go to petechiae-ecchymoses algorithm
No abnormalities
No abnormalities