Brief Clinical Communication
Journal of Veterinary Emergency and Critical Care 28(2) 2018, pp 168–172
In vitro assessment of the effect of acidemia
on coagulation in dogs
Andrew G. Burton, BVSc, DACVP; Julie Burges, BS, MS; Angela Borchers, DVM, DACVIM,
DACVECC and Kate Hopper, BVSc, PhD, DACVECC
Objective – Minimal data are available assessing the effect of acidemia on coagulation in dogs. The objective
of this study was to assess the effect of in vitro acidiﬁcation of canine blood on coagulation as measured via
thromboelastography (TEG) and traditional tests of coagulation. We hypothesized that worsening acidemia
would lead to progressive impairment on coagulation.
Design – Prospective study.
Setting – University teaching hospital.
Animals – Six client-owned dogs.
Interventions – None.
Measurements and Main Results – Blood was collected into 3.2% sodium citrate vacutainer tubes. The pH
of blood was adjusted from baseline using hydrochloric acid to create weak acidemia and strong acidemia.
Coagulation was assessed using TEG, prothrombin time, and activated partial thromboplastin time. Kruskal–
Wallis tests with Dunn’s post hoc comparison tests were used to compare groups.
Strong acidemia samples were signiﬁcantly more acidic than baseline based on pH (P < 0.0005), HCO
(P < 0.0062), pCO
(P < 0.0001), and base excess (P < 0.0001). Using TEG, in vitro acidiﬁcation of blood caused
signiﬁcant, progressive impairment of maximum amplitude (P = 0.0282) and alpha angle (P = 0.0312). Acidi-
ﬁcation of blood had no signiﬁcant effect on prothrombin time (P = 0.345) or activated partial thromboplastin
time (P = 0.944).
Conclusions – In vitro acidiﬁcation of canine whole blood results in hypocoagulability as measured by some
(J Vet Emerg Crit Care 2018; 28(2): 168–172) doi: 10.1111/vec.12697
acid-base, acidosis, coagulopathy, hypocoagulable, thromboelastography
aPTT activated partial thromboplastin time
MA maximum amplitude
PT prothrombin time
SA strong acidemia
WA weak acidemia
From the William R. Pritchard Veterinary Medical Teaching Hospital
(Burton, Borchers) and the Department of Surgical and Radiological Sciences
(Hopper), School of Veterinary Medicine; and the Regenerative Medicine
Laboratory (Burges), University of California, Davis, CA.
The authors declare no conﬂicts of interest.
Address correspondence and reprint requests to
Dr. Andrew G. Burton, IDEXX Laboratories, Inc., North Grafton, MA.
Submitted January 10, 2016; Accepted May 22, 2016.
Coagulopathies are a frequent ﬁnding in patients with
These complex hemostatic disorders are likely
multifactorial, as hemostasis may be affected by acid
base status, effective circulating volume, body tem-
perature, presence of inﬂammation, and therapeutic
Acidemia is thought to play a major role
in the etiology of coagulopathy of trauma and may lead
to increased mortality in human patients. The limited
number of studies that evaluate the impact of acidemia
on coagulation in people and experimental animals
found conﬂicting results.
There is evidence to support
that acidemia may contribute to a hypocoagulable state,
but some studies could not demonstrate coagulopathy
during acidemia, or only found hemostatic abnormal-
ities when acidemia occurred in combination with hy-
pothermia. Two currently published studies of acute
traumatic coagulopathy in dogs further add to the con-
fusion. One prospective, observational study reported
Veterinary Emergency and Critical Care Society 2018