Pilot evaluation of point-of-care viscoelastic coagulation monitoring in Asian elephants (Elephas maximus) at two institutions and retrospective application in one elephant endotheliotropic herpesvirus case

Elephant endotheliotropic herpesvirus (EEHV) is a significant contributor to morbidity and mortality in young Asian elephants (Elephas maximus) through hemorrhagic disease (EEHV-HD). To continue improving clinical management of EEHV and EEHV-HD cases, research efforts are being focused on identifying and developing new diagnostics and treatments. The viscoelastic coagulation monitor (VCM) VetTM is a point-of-care, patient-side monitor that can evaluate hypo- and hypercoagulable states in animals. This study sought to evaluate the VCM Vet in 14 Asian elephants (6 males and 8 females, 1.5–54 yr old) housed at two zoological institutions. All animals were determined to be clinically healthy or to have minor health concerns unlikely to impact coagulation. Venipuncture samples were collected from the auricular (n = 11) or saphenous (n = 3) vessels. The VCM Vet analysis was performed in duplicate by using two machines within 3 min of collection for each elephant. The following median (range) values were determined: clot time, 462.5 (234–701) s; clot formation time, 141.5 (78–266) s; α angle, 55.5° (37–69°); amplitude at 10 min, 39.5 (25–54) VCM units; amplitude at 20 min, 47.5 (35–59) VCM units; maximum clot formation, 49.5 (37–60) VCM units; lysis index at 30 min, 100% (99–100%); and lysis index at 45 min, 98.5% (95–100%). Resultant VCM Vet values were retrospectively compared with values from a 2-yr-old female Asian elephant treated for clinical EEHV-HD. Clinical values from this case supported a hypocoagulable state compared with the values from this study. This point-of-care coagulation monitor shows promise as a diagnostic tool for EEHV and EEHV-HD management in E. maximus.