Use of Epsilon Aminocaproic Acid in Perioperative Stabilization of Canine Spontaneous Hemoperitoneum

Abstract

Objective

To document the effects of epsilon aminocaproic acid (εACA) as a continuous rate infusion on the need for blood products and change in PCV during the perioperative period in dogs with spontaneous hemoperitoneum.

Design

Prospective, randomized, open-label controlled study.

Setting

Private practice specialty teaching hospital.

Animals

Eighteen client-owned dogs presenting with spontaneous hemoperitoneum.

Interventions

Dogs with a confirmed diagnosis of spontaneous hemoperitoneum secondary to an intraabdominal mass intended for surgical intervention were randomized to receive either εACA (50 mg/kg bolus, followed by a continuous rate infusion at 25 mg/kg/h for 24 h, n = 10) or standard therapy (n = 8).

Measurements and Main Results

PCV and total solids were obtained at presentation, preoperatively, immediately postoperatively, and at 24 h postoperatively. Six dogs, two in the control group and four in the εACA group, received blood transfusions (33%). There was no significant difference between the number of patients receiving transfusions in the control group compared with the εACA group (p = 1.0). The median volume of blood removed from the abdomen at the time of surgery and the difference in PCV and total solids at any time point were not significantly different between the treatment and control groups. Dogs taken to surgery sooner (surgery delay <265 min) had a significantly lower postoperative PCV compared with initial (p < 0.01) and preoperative blood samples (p = 0.047). There were no adverse events attributed to εACA in any patients.

Conclusions

Perioperative εACA was not associated with reduced requirement for blood product or blood loss at the time of surgery.