The effects of hyperglycemia and endotoxemia on coagulation parameters in healthy adult horses.
Authors: McGovern K F, Lascola K M, Smith S A, Clark-Price S C, Wilkins P A, Schaeffer D J, Foreman J H
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary McGovern and colleagues investigated whether elevated blood glucose would amplify the coagulation disturbances triggered by endotoxemia in horses, since human medicine literature suggests this synergistic effect. Twelve healthy horses were divided into two groups receiving lipopolysaccharide (LPS, 20 ng/kg); one group maintained hyperglycaemia (180–240 mg/dL) for six hours via dextrose infusion, whilst controls received saline, with coagulation markers (prothrombin time, activated partial thromboplastin time, thrombin–antithrombin concentration, fibrinogen and thromboelastometry) measured at multiple timepoints over 22 hours. The hyperglycaemic-endotoxaemic group showed modest increases in PT and TAT, whilst the saline-endotoxaemic group exhibited impaired clot formation time and reduced clot strength on thromboelastometry—yet the two groups differed significantly in only one parameter (maximal clot firmness), suggesting hyperglycaemia did not exacerbate endotoxin-induced coagulation changes. These findings indicate that even combined hyperglycaemia and endotoxemia produce relatively minor coagulation alterations in otherwise healthy horses, reassuring practitioners that transient blood glucose elevation during acute systemic illness may not substantially increase thrombotic or haemorrhagic risk, though the clinical relevance of these laboratory parameters warrants further investigation in naturally occurring disease.
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Practical Takeaways
- •In healthy horses with endotoxemia, concurrent hyperglycemia does not significantly worsen coagulation status, unlike findings in human medicine
- •Standard coagulation monitoring may not be necessary in horses with mild hyperglycemia and endotoxemia as changes are subclinical
- •These findings suggest that hyperglycemic management in endotoxemic horses need not be modified based on coagulation concerns alone
Key Findings
- •Hyperglycemia with LPS administration caused increased prothrombin time (PT, P=0.001) and thrombin-antithrombin concentration (TAT, P=0.027)
- •Saline with LPS administration caused increased clot formation time and decreased clot firmness and alpha angle on thromboelastometry
- •Concurrent hyperglycemia and endotoxemia did not produce greater coagulation abnormalities than endotoxemia alone in healthy horses
- •Observed coagulation parameter changes were minor and determined not to be clinically relevant