Comparison of unfractioned and low molecular weight heparin for prophylaxis of coagulopathies in 52 horses with colic: a randomised double-blind clinical trial.
Authors: Feige K, Schwarzwald C C, Bombeli Th
Journal: Equine veterinary journal
Summary
# Editorial Summary: Heparin Prophylaxis in Equine Colic Coagulopathy remains a serious complication in colic cases, and whilst unfractioned heparin (UFH) has long been the standard prophylactic agent, its adverse effects have prompted investigation into alternative anticoagulants. Feige and colleagues conducted a randomised, double-blind trial comparing UFH and low molecular weight heparin (dalteparin) in 52 colic horses, with UFH administered at 150 iu/kg initially then 125 iu/kg twice daily for three days followed by 100 iu/kg twice daily, versus dalteparin at 50 iu/kg once daily. Notably, dalteparin proved significantly superior in limiting side effects: horses receiving UFH developed considerably more jugular vein changes and experienced a marked decrease in packed cell volume within the first few days, whilst those on dalteparin showed neither effect; additionally, UFH produced prolonged activated partial thromboplastin time and thrombin time, indicating systemic anticoagulation, whereas dalteparin did not alter these parameters. For equine practitioners managing colic cases, these findings suggest dalteparin represents a safer alternative for thromboprophylaxis, offering comparable or superior protective efficacy without the vascular and haematological complications associated with conventional UFH protocols.
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Practical Takeaways
- •Consider LMWH (dalteparin) as preferred heparin choice for colic patients requiring anticoagulation prophylaxis due to superior safety profile
- •Monitor packed cell volume carefully in colic horses receiving UFH, as significant early decline may occur within first few days of treatment
- •LMWH offers simpler once-daily dosing (50 iu/kg q24h) compared to UFH's variable q12h regimen, potentially improving compliance and reducing injection site problems
Key Findings
- •LMWH (dalteparin) produced significantly fewer jugular vein changes compared to UFH in colic horses
- •Packed cell volume decreased significantly in UFH-treated horses within first few days but remained stable with LMWH treatment
- •aPTT and thrombin time were prolonged with UFH but not with LMWH, indicating differential coagulation effects
- •LMWH demonstrated markedly fewer side effects overall compared to UFH for coagulation prophylaxis in colic cases