HEMOSTATIC AND FIBRINOLYTIC INDEXES IN NEONATAL FOALS WITH PRESUMED SEPTICEMIA

Thirteen coagulation tests evaluating hemostatic and fibrinolytic indi ces and serum cytokine and plasma endotoxin concentrations were obtain ed in 34 foals with a positive sepsis score (septic group) and 46 age- matched healthy foals. Compared to healthy foals, the prothrombin, act ivated partial thromboplastin, and whole blood recalcification times w ere significantly longer in septic foals. The fibrinogen and fibrin de gradation products concentrations, percent plasminogen, alpha-2 antipl asmin, and plasminogen activator inhibitor activities, and tumor necro sis factor and interleukin-6 activities were greater in septic foals. Protein C antigen and antithrombin III activity were significantly low er in septic foals. Blood cultures were positive for growth and endoto xin was detected in 19 of 29 and 15 of 30 septic foals, respectively. In septicemic foals with detectable endotoxin in the plasma, the proth rombin and activated partial thromboplastin times were significantly l onger and the plasminogen and antithrombin III activities were signifi cantly less than in septic foals in which endotoxin was not detected. Twenty-three of the 34 septic foals did not survive. Septic foals that did not survive were most likely to have a positive blood culture in which a gram-negative organism was isolated. Histopathologic evidence of hemorrhage was evident in 11 foals at postmortem examination and th rombosis was identified in 2 foals. The prothrombin time was significa ntly longer in foals that had multisite hemorrhage at postmortem exami nation. The results of this study indicate that clinically relevant al ternations in hemostatic and fibrinolytic indices occur in neonatal fo als with septicemia and that derangements can be correlated with the p resence of endotoxin in plasma. Derangements in hemostatic or fibrinol ytic indices were helpful in identification of septic foals with incre ased risk of coagulopathy, but were not helpful in predicting hemorrha ge as compared to thrombus formation. Survival of septicemic foals was correlated with gram-negative bacteremia, but not with the presence o f endotoxin or coagulopathy.