We use cookies to help you navigate efficiently and perform certain functions. You will find detailed information about all cookies under each consent category below.
The cookies that are categorized as "Necessary" are stored on your browser as they are essential for enabling the basic functionalities of the site. ...
Necessary cookies are required to enable the basic features of this site, such as providing secure log-in or adjusting your consent preferences. These cookies do not store any personally identifiable data.
Functional cookies help perform certain functionalities like sharing the content of the website on social media platforms, collecting feedback, and other third-party features.
Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics such as the number of visitors, bounce rate, traffic source, etc.
Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.
Advertisement cookies are used to provide visitors with customized advertisements based on the pages you visited previously and to analyze the effectiveness of the ad campaigns.
Which coagulation parameters does everyone prefer prior to liver core biopsy? Anyone use Vitamin K regularly before performing?
Which coagulation parameters does everyone prefer prior to liver core biopsy? Anyone use Vitamin K regularly before performing?
Comments
PT/PTT, platelet count. If
PT/PTT, platelet count. If PT/PTT abnormal then plasma transfusion prior to biopsy. Do not use vitamin K routinely prior to biopsy.
PT/PTT, platelet count. If
PT/PTT, platelet count. If PT/PTT abnormal then plasma transfusion prior to biopsy. Do not use vitamin K routinely prior to biopsy.
I will bx fibrous
I will bx fibrous presentations like cah in a liver or ugly ln not near any vasculature up to 20% elevated but go with fna if elevations in a lipidotic cat liver for example. I will use 25 g fna in coag elevations up to 30-40% if I feel we need a dx asap and run the risk. yes on plasma and I will use vit k but maybe more to make me think I am doing something in coag elevation scenarios only though
I will bx fibrous
I will bx fibrous presentations like cah in a liver or ugly ln not near any vasculature up to 20% elevated but go with fna if elevations in a lipidotic cat liver for example. I will use 25 g fna in coag elevations up to 30-40% if I feel we need a dx asap and run the risk. yes on plasma and I will use vit k but maybe more to make me think I am doing something in coag elevation scenarios only though
Will you retest the PT/PTT
Will you retest the PT/PTT after the plasma transfusion or does it make a difference at that point?
Will you retest the PT/PTT
Will you retest the PT/PTT after the plasma transfusion or does it make a difference at that point?
Ideally yes anytime you treat
Ideally yes anytime you treat for abnormal coag values a recheck before sampling is necessary to assess if it worked or not and if it is technically safe to sample.
Ideally yes anytime you treat
Ideally yes anytime you treat for abnormal coag values a recheck before sampling is necessary to assess if it worked or not and if it is technically safe to sample.
Would agree with Eric.
Would agree with Eric.
Would agree with Eric.
Would agree with Eric.
One final question. If you
One final question. If you experience a serious bleed in general practice, what steps do you take to help get the patient stablized or what products do you recommend having on hand (ex. colloids?) before you can get the patient transported somewhere for blood or plasma transfusion and possible surgery?
One final question. If you
One final question. If you experience a serious bleed in general practice, what steps do you take to help get the patient stablized or what products do you recommend having on hand (ex. colloids?) before you can get the patient transported somewhere for blood or plasma transfusion and possible surgery?
Sorry, one more. If there is
Sorry, one more. If there is ascites present, will you biopsy the liver via ultrasound? I think I heard somewhere in a lecture that it is contraindicated as the fluid will wash away the clot trying to form.
Sorry, one more. If there is
Sorry, one more. If there is ascites present, will you biopsy the liver via ultrasound? I think I heard somewhere in a lecture that it is contraindicated as the fluid will wash away the clot trying to form.
This is long response have
This is long response have to get to it tonight
This is long response have
This is long response have to get to it tonight
Serious bleed: I always have
Serious bleed: I always have the tech apply direct pressure after bx for 3 minutes. If theres a bleed i check crt and cardiac ultrasound to monitor contractility and shock, hetastarch bolus and belly wrap and transfuse if necessary. I bx cautiously in clinics that are less prepared and bx more aggressively in clinics that are very very attentive. If I am doing scans on multiple animal;s I will scan and bx the sampling case first then do the others while i check an ooze if need be.
Re ascites. If the ascites is portal hypertension form cirrhosis/fibrosis these, with proper needle placement, usually dont bleed anyway because tough for a scar to bleed. You can tap the belly first and if transudate, then sample and it becomes hemorrhagic transudate you know there is a problem. yes a bit more risk but things that do this are usually bad anyway so its the owner to decide with our informative support does the sample justify the risk. Other things like portal vein velocity and support for end stage liver failure (low bun, cholesterol, albumin…) may as a group be more informative to the outcome than the actual bx. But yes i do bx these and have never had an issue (knock on wood).
Serious bleed: I always have
Serious bleed: I always have the tech apply direct pressure after bx for 3 minutes. If theres a bleed i check crt and cardiac ultrasound to monitor contractility and shock, hetastarch bolus and belly wrap and transfuse if necessary. I bx cautiously in clinics that are less prepared and bx more aggressively in clinics that are very very attentive. If I am doing scans on multiple animal;s I will scan and bx the sampling case first then do the others while i check an ooze if need be.
Re ascites. If the ascites is portal hypertension form cirrhosis/fibrosis these, with proper needle placement, usually dont bleed anyway because tough for a scar to bleed. You can tap the belly first and if transudate, then sample and it becomes hemorrhagic transudate you know there is a problem. yes a bit more risk but things that do this are usually bad anyway so its the owner to decide with our informative support does the sample justify the risk. Other things like portal vein velocity and support for end stage liver failure (low bun, cholesterol, albumin…) may as a group be more informative to the outcome than the actual bx. But yes i do bx these and have never had an issue (knock on wood).
Thanks Eric and
Thanks Eric and Remo
Preparing for a liver biopsy today
Thanks Eric and
Thanks Eric and Remo
Preparing for a liver biopsy today