NC State Clinicians Testing New Treatment for Severe Bleeding

An ongoing clinical trial at the NC State Veterinary Hospital could significantly advance care for dogs suffering from traumatic injuries.

For the study, clinicians are exploring whether using the blood clot-stabilizing drug tranexamic acid, or TXA, can help dogs that are severely bleeding after an injury. Early use of TXA can be life saving for humans with injuries that cause massive bleeding.

The study, the first prospective evaluation of TXA’s effectiveness in treating canine traumatic injury, is funded by the United States Special Operations Command to standardize care for military working dogs, but the information could impact companion animal treatment as well.

To be eligible for the trial, dogs must arrive at the veterinary hospital within 24 hours after experiencing bleeding from a severe injury or rupture of tumors in the abdominal cavity. Dogs must weigh between 9 and 165 pounds. Attending emergency clinicians evaluate eligibility and request a dog’s blood sample from owners, who will earn $2,500 towards the cost of care at NC State should their dog meet the study enrollment criteria and they elect to participate.

“Expansion of our understanding of best practices in animal trauma care will no doubt result in lives saved among both pet and working dogs,” said Erin Long, a postdoctoral emergency and critical care resident.

Long, who has experience as a military veterinarian, is one of primary investigators working on the trauma dogs study, along with small animal emergency and critical care clinicians Bernard Hansen, Sarah Musulin and Alessio Vigani. The NC State Veterinary Hospital is leading the effort and is collaborating with veterinary hospitals at Cornell University, University of Pennsylvania and Tufts University.  

TXA blocks the natural process of a blood clot breakdown, or fibrinolysis, which becomes excessive after a trauma and leads to massive blood loss and higher chance of death. Traumatic injuries for pets and military dogs include car accidents, falls from high elevations, biting or crushing wounds, as well as injuries caused by weapons such as guns, knives or explosions.

Though the study may help refine treatment for pets, it is of particular interest to the United States military, which has about 2,500 working dogs spread out among its branches according to Department of Defense estimates. Military dogs, most commonly German shepherds and Belgian Malinois, can locate landmines and explosives and serve as sentries or assist law enforcement procedures.

Long said that during military operations in Iraq and Afghanistan from 2003 to 2009, there was a 62 percent mortality rate for working dogs wounded by ballistics. Quickly administering tranexamic acid in the field may drastically help.

“Since canine blood products are not readily available for resuscitation in austere environments, there is a critical need to identify pre-hospital therapies that can reduce working dog death following trauma,” she said.

Long said the most common treatment for dogs experiencing hemorrhages from trauma is plasma or red blood cell transfusions. About half of dogs with a trauma need either minor or major surgeries, she said, and most receive pain medication and antibiotics after injury. Long said trauma accounts for about 12 percent of urban veterinary hospital admissions and death from trauma is common, especially for young dogs.

“Both human and veterinary trauma practitioners, whether military or civilian, will benefit from this contribution to an underexplored area,” she said.

For more information on the trauma dogs study and more details about eligibility, go here.

~Jordan Bartel/NC State Veterinary Medicine