Dişi Kedilerde Ovariohisterektomi Sonrası Kan Koagülasyon Profilindeki Değişiklikler

Öz

Amaç: Sağlıklı dişi kedilerde elektif ovariohisterektomi (OHE) sonrası kan koagülasyon sisteminde meydana gelen değişiklikleri değerlendirmek ve cerrahi travmaya bağlı gelişebilecek olası hiperkoagülabilite eğilimini belirlemek. Yöntemler: Toplam yirmi sağlıklı dişi kediden operasyon öncesi, operasyon hemen sonrası ve 24 saat sonrası olmak üzere üç zaman noktasında kan örnekleri alınmıştır. Antitrombin III, fibrinojen, D-dimer, trombin zamanı (TT) ve aktive parsiyel tromboplastin zamanı (aPTT) gibi temel koagülasyon parametreleri analiz edilerek hemostatik yanıt değerlendirilmiştir. Bulgular: Operasyon sonrasında fibrinojen düzeylerinde anlamlı bir artış saptanmış, bu artış 24. saatte başlangıç değerlerine dönmüştür (p = 0.025). TT ve aPTT değerlerinde 24. saatte anlamlı düşüşler gözlenmiş ve bu durum hiperkoagülabilite eğilimini desteklemiştir (p = 0.003 ve p = 0.0437). Antitrombin III düzeylerinde cerrahi sonrası azalma görülmekle birlikte değişim istatistiksel açıdan anlamlı bulunmamıştır (p = 0.056). D-dimer düzeyleri zaman noktaları arasında anlamlı bir farklılık göstermemiştir. Sonuç: Elektif OHE, sağlıklı kedilerde erken postoperatif dönemde koagülasyon parametrelerinde geçici ancak ölçülebilir değişikliklere neden olmaktadır. Bu geçici hemostatik dalgalanmalar, potansiyel trombotik komplikasyonların erken fark edilmesi ve yönetimi açısından klinik açıdan önemli olabilir.

Anahtar Kelimeler

• Antitrombin III
• D-dimer
• Fibrinojen
• Koagülasyon Zamanı
• Ovariohisterektomi.

Changes in The Blood Coagulation Profile After Ovariohysterectomy in Female Cats

Öz

Objective: To evaluate perioperative changes in coagulation parameters and identify potential hypercoagulable tendencies in healthy female cats undergoing elective ovariohysterectomy (OHE). Methods: Twenty healthy female cats undergoing elective OHE were prospectively assessed. Blood samples were collected at three time points: preoperatively, immediately postoperatively, and 24 hours after surgery. Hemostatic markers, including antithrombin III, fibrinogen, D-dimer, thrombin time (TT), and activated partial thromboplastin time (aPTT), were measured to characterize coagulation dynamics. Results: Fibrinogen concentrations increased significantly immediately after surgery and returned to baseline by 24 hours (p = 0.025). TT and aPTT values demonstrated significant decreases at 24 hours (p = 0.003 and p = 0.0437, respectively), consistent with a shift toward hypercoagulability. Antithrombin III levels declined postoperatively but did not reach statistical significance (p = 0.056). No significant changes were observed in D-dimer levels across the three time points. Conclusion: Elective OHE induces transient postoperative alterations in coagulation markers in healthy cats, including increased fibrinogen and reduced TT and aPTT, suggesting a short-term shift toward hypercoagulability. These findings underscore the importance of perioperative coagulation monitoring to anticipate and mitigate possible thrombotic risks.

Anahtar Kelimeler

• Antithrombin III
• Coagulation Time
• D-dimer
• Fibrinogen
• Ovariohysterectomy.

Kaynakça

1. Adin, C. A. (2011). Complications of ovariohysterectomy and orchiectomy in companion animals. Veterinary Clinics of North America: Small Animal Practice, 41, 1023–1039.
2. Anderson, F. A., & Spencer, F. A. (2003). Risk factors for venous thromboembolism. Circulation, 107, I-9–I-16. https://doi.org/10.1161/01.CIR.0000078469.07362.E6
3. Association of Shelter Veterinarians’ Veterinary Task Force to Advance Spay-Neuter; Griffin, B., Bushby, P. A., McCobb, E., White, S. C., Rigdon-Brestle, Y. K., Appel, L. D., Makolinski, K. V., Wilford, C. L., Bohling, M. W., Eddlestone, S. M., Farrell, K. A., Ferguson, N., Harrison, K., Howe, L. M., Isaza, N. M., Levy, J. K., Looney, A., Moyer, M. R., Robertson, S. A., & Tyson, K. (2016). The Association of Shelter Veterinarians’ 2016 veterinary medical care guidelines for spay-neuter programs. Journal of the American Veterinary Medical Association, 249(2), 165–188.
4. Buote, N. J., & Fransson, B. A. (2022). Laparoscopic ovariectomy, ovariohysterectomy, and hysterectomy. In Small Animal Laparoscopy and Thoracoscopy (pp. 254–266). Wiley Online Library.https://doi.org/10.1002/9781119666912.ch22
5. Burrow, R., Batchelor, D., & Cripps, P. (2005). Complications observed during and after OHE of 142 bitches at a veterinary teaching hospital. Veterinary Record, 157, 829–833. https://doi.org/10.1136/vr.157.26.829
6. de Melo, E. H. M., Câmara, D. R., Notomi, M. K., Jabour, F. F., Garrido, R. A., & Nogueira, A. C. J. (2021). Effectiveness of ovariohysterectomy on feline mammary fibroepithelial hyperplasia treatment. Journal of Feline Medicine and Surgery, 23, 351–356. https://doi.org/10.1177/1098612X2095055
7. Feige, K., Kastner, S. B. R., Dempfle, C. E., & Balestra, E. (2003). Changes in coagulation and markers of fibrinolysis in horses undergoing colic surgery. Journal of Veterinary Medicine A: Physiology Pathology Clinical Medicine, 50, 30–36. https://doi.org/10.1046/j.1439-0442.2003.00503.x
8. Fransson, B. A. (2017). Ovaries and uterus. In K. M. Tobias & S. A. Johnston (Eds.), Veterinary Surgery: Small Animal (2nd ed., pp. 5694–5766). Elsevier Saunders.

9. Gupta, P. K., Charan, V. D., & Kumar, H. (2005). Cancer related thrombophilia: Clinical importance and management strategies. Journal of the Association of Physicians of India, 53, 877–882.
10. Hagman, R. (2018). Pyometra in small animals. Veterinary Clinics of North America: Small Animal Practice, 48, 639–661. https://doi.org/10.1016/j.cvsm.2018.03.001
11. Hardie, E. M., Hansen, B. D., & Carrol, G. S. (1997). Behavior after ovariohysterectomy in the dog: What’s normal? Applied Animal Behaviour Science, 51, 111–128. https://doi.org/10.1016/S0168-1591(96)01078-7
12. Johnston, S. D., Root Kustritz, M. V., & Olson, P. S. (2001). Theriogenology. Saunders.
13. Lanevschi, A., Kramer, J. W., Greene, S. A., & Meyers, K. M. (1996). Fibrinolytic activity in dogs after surgically induced trauma. American Journal of Veterinary Research, 57, 1137–1140.
14. Liska, W. D., & Poteet, B. A. (2003). Pulmonary embolism associated with canine total hip replacement. Veterinary Surgery, 32, 178–186. https://doi.org/10.1053/jvet.2003.50016
15. Moldal, E. R., Kristensen, A. T., Peeters, M. E., & Nødtvedt, A. (2012). Hemostatic response to surgical neutering via ovariectomy and ovariohysterectomy in dogs. American Journal of Veterinary Research, 73(9), 1469–1476.
16. Palsgaard-Van Lue, A., Strom, H., Lee, M. H., Jensen, A. L., Birck, M. M., Wiinberg, B., Kjelgaard-Hansen, M., Martinussen, T., & Kristensen, A. T. (2007). Cellular, hemostatic, and inflammatory variables of the surgical stress response in pigs undergoing partial pericardectomy via open thoracotomy or thoracoscopy. Surgical Endoscopy, 21, 785–792.
17. Pastori, D., Cormaci, V. M., Marucci, S., Franchino, G., Del Sole, F., Capozza, A., Fallarino, A., Corso, C., Valeriani, E., Menichelli, D., & Pignatelli, P. (2023). A comprehensive review of risk factors for venous thromboembolism: From epidemiology to pathophysiology. International Journal of Molecular Sciences, 24(4), 3169. https://doi.org/10.3390/ijms24043169
18. Rabbani, A. H., Naseer, O., Hussain, K., Shahid, M., Ullah, Q., Ahmad, A. S., Sohail, M. L., & Wadood, F. (2023). Small animal ovariohysterectomy and avoidance of associated complications in pet practices across Pakistan: A current perspective. Small Animal Advances, 2(4), 38–43. https://doi.org/10.58803/saa.v2i4.18
19. Rafee, M. A., Mahdi, C., Sarvaiya, N. P., Patel, P. B., & Dhami, A. J. (2015). Haematobiochemical changes in bitches during ovariohysterectomy under general anaesthesia. Global Journal of Medical Research, 15(1), 1–4.
20. Reynolds, B. S., Taeymans, O., Aupérin, B., & Gommeren, K. (2012). Evaluation of acute phase proteins and hemostatic markers in dogs undergoing ovariohysterectomy. Theriogenology, 78(8), 1726–1734.
21. Rivera del Álamo, M. M., Hermo, G., Blasi-Brugué, C., Peña, T., & Miró, J. (2014). Haemostatic profile in queens at different stages of the reproductive cycle and during pregnancy. Theriogenology, 82(2), 185–188. https://doi.org/10.1016/j.theriogenology.2014.03.022
22. Root Kustritz, M. V. (2018). Population control in small animals. Veterinary Clinics of North America: Small Animal Practice, 48, 721–732.
23. Sarıtaş, Z. K., Gökçe, E., & Orman, A. (2020). Effects of different neuromuscular blocking agents on blood coagulation in dogs under isoflurane anaesthesia. Indian Journal of Animal Research, 54(12), 1549–1553.
24. Siemens, H. J. G., Brueckner, S., Hagelberg, S., Wagner, T., & Schmucker, P. (1999). Course of molecular hemostatic markers during and after different surgical procedures. Journal of Clinical Anesthesia, 11, 622–629. https://doi.org/10.1016/S0952-8180(99)00119-1
25. Sobiech, P., Sobiech, K., Kułaczkowska, A., & Snarska, A. (2011). Usefulness of selected parameters in evaluation of the hemostatic system in dogs after surgical removal of the ovaries and uterus. Polish Journal of Veterinary Sciences, 14(2), 289–290