Companion Animal Hospital in Ithaca, NY for cats, canine, exotics, and wildlife
Equine and Nemo Farm Animal Hospitals in Ithaca, NY for horses and cattle
Cornell Ruffian Equine Specialists, on Lengthy Island for each horse
Ambulatory and Manufacturing Drugs for service on farms inside 30 miles of Ithaca, NY
Animal Well being Diagnostic Middle New York State Veterinary Diagnostic Laboratory
Cornell College School of Veterinary Drugs Ithaca, New York 14853-6401
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Overview
Vitamin Okay is a fat-soluble vitamin important for the post-translational processing of the prothrombin group of coagulation components (Elements II, VII, IX, and X). Vitamin Okay deficiency causes extreme bleeding on account of failure of regular fibrin clot formation. Medical indicators of bleeding rely on length and severity of vitamin Okay deficiency and embrace extended bleeding from minor wounds, spontaneous hematoma formation, intracavitary hemorrhage, and loss of life on account of blood loss and acute hemorrhagic shock. Anticoagulant rodenticide poisoning is the most typical explanation for extreme, acute vitamin Okay deficiency in canine and cats.
Extreme SQ bleeding in a canine attributable to vitamin Okay antagonism (anticoagulant rat poison toxicity).
Vitamin Okay Metabolism and Actions – “vitamin k for dogs”
Vitamin Okay Absorption and Recycling
Dietary Vitamin K1 (phylloquinone) is excessive in inexperienced leafy vegetation. Vitamin K2 (menaquinone) can be produced by fermentation and intestine microbiota. As a fat-soluble vitamin, Vitamin Okay is absorbed after bile salt and pancreatic-dependent solubilization and uptake of lipid micelles into enterocytes. After intestinal uptake, Vitamin Okay undergoes intra-hepatic recycling the place it acts as a cofactor for post-translational carboxylation of vitamin Okay-dependent proteins. Vitamin Okay participates in these reactions by way of oxidation of vitamin Okay hydroquinone (KH2) to vitamin Okay epoxide (KO). The KO type of vitamin Okay is regularly recycled to replenish KH2 by the enzyme KO reductase.
Vitamin Okay-Dependent Proteins
The glutamate residues on proteins that endure vitamin Okay-dependent carboxylation are known as “Gla-domain” and the group of proteins that endure this modification, together with coagulation components, are generally known as “Gla proteins”. The Gla residues on these proteins are required for protein interplay with calcium. Along with intra-hepatic modification, some Gla proteins endure vitamin Okay-dependent carboxylation within the vasculature. Extreme Vitamin Okay deficiency manifests clinically as a bleeding diathesis, nevertheless vitamin Okay is required for purposeful exercise of extra proteins with quite a lot of physiologic roles.
Analysis of Vitamin Okay-dependent Coagulopathy
Coagulation Assessments and Pattern necessities
Coagulation screening exams and particular assay of the vitamin Okay-dependent coagulation components are direct measures of the reason for bleeding in vitamin Okay deficiency states. Citrate plasma, drawn antemortem, is the one acceptable specimen-type for these assays. See hyperlinks for extra sampling info and the Vitamin Okay-Deficiency panel.
Vitamin Okay Deficiency Illness Differentials
Anticoagulant and Non-anticoagulant Rodenticides
Anticoagulant Rodenticide Toxicity
Anticoagulant rodenticides act by blocking hepatic vitamin Okay recycling (see picture above). Ingestion of those merchandise by pet canine and cats is quite common and persistently within the prime 10 calls to the ASPCA poison management heart. New federal rules on the sale of those poisons are aimed toward lowering exposures of pets and wildlife. Many merchandise will stay extensively out there, nevertheless, and early recognition and remedy with Vitamin K1 are essential for profitable administration.
Administration Protocol
Non-anticoagulant Rodenticides
Some rodenticides in dwelling and business use don’t have any anticoagulant motion. These merchandise embrace bromethalin (neurotoxin), cholecalciferol (hypercalcemic renal failure) and zinc phosphide (phosphine fuel induced pulmonary edema). Coagulation testing will NOT determine these toxicities and Vitamin Okay is NOT indicated within the administration of those poisons. See Toxicology for added info on prognosis and remedy.