Veterinary Clinical Medicine-I (General and Systemic)

DISSEMINATED INTRAVASCULAR COAGULATION (DIC)

• Without being able to remove the trigger and treat the underlying disease (infection, cancer, IMHA, heat stroke), any therapeutic intervention seems futile. Administration of electrolyte fluids to maintain tissue perfusion and attempts to correct acidosis and hyper-/hypothermia are considered important supportive measures. However, the approaches to stop intravascular coagulation and supplement coagulation factors are highly controversial. No controlled studies in human patients and animals have documented their benefit.
• Heparin at a dose of 50-250 IU/kg either every 4 hours or by constant infusion have been recommended; the goal has been a 1-2 fold prolongation of the PT time above normal, but direct serum drug concentration measurements may also be helpful. Low molecular weight heparin has also been used, but cannot be monitored by the routine PTT. Other anti-thrombotic agents are also being investigated. Despite the assessment of various therapeutic strategies none have been documented to be effective in clinical practice in animals with DIC.