Retrospective Evaluation of the Safety and Efficacy of Tranexamic Acid (Hexakapron®) for the Treatment of Bleeding Disorders in Dogs

Kelmer, E. 94 IntRoduCtIon Bleeding is commonly encountered in critically ill veterinary and human patients. Blood products are increasingly used in veterinary medicine, however their use is not risk-free, and is often limited by low availability and high cost of blood components. Potential adverse effects of blood component therapy include immune and non-immune transfusion reactions, such as hemolysis, infectious agent transmission, bacterial contamination, microembolism, volume overload, acute lung injury and electrolyte abnormalities (1).To date, several drugs are used to decrease blood loss and requirements of red blood cell transfusion in human medicine, including ε-aminocaproic acid (EACA), tranexamic acid (TXA) and aprotinin. EACA is a synthetic derivative of lysine, with antifibrinolytic effects, primarily through reversible blocking of lysine binding sites on plasminogen, thereby inhibiting fibrinolysis, and, to a lesser extent, through promoting antiplasmin activity. Tranexamic acid has a similar mechanism of action, but is 10-fold more potent. Aprotinin is a natural serine-protease inhibitor, inhibiting plasmin, kallikrerin and trypsin, resulting in attenuation of inflammatory responses, fibrinolysis, and thrombin generation (2-4). In clinical trials of bleeding human patients, all three drugs were shown to effectively reduce blood transfusion requirements compared with placebo (5-7). Antifibrinolytic therapy in human medicine is indicated in cardiovascular (8) and pediatric surgery (9), heavy menstrual or post-partum bleeding (10), orthopedic surgery, such Retrospective Evaluation of the Safety and Efficacy of Tranexamic Acid (Hexakapron®) for the Treatment of Bleeding Disorders in Dogs