During Japan’s recovery from World War II, Dr. Utako Okamoto and her husband worked to reduce mortality from hemorrhage. In 1962, they reported the invention of epsilon-aminocaproic acid, which inhibits the breakdown of fibrin by plasmin. Later, they developed the more potent tranexamic acid, which was not fully recognized for its potential until decades later. These antifibrinolytic agents have now been used for over 30 years to manage bleeding and reduce blood loss in a multitude of clinical situations. In this issue’s Practical Pharmacology article, Dr. Alex Lynch reviews antifibrinolytic medications. In human medicine, antifibrinolytic drug therapy has been used extensively for the treatment of intraoperative hemorrhage, particularly in cardiac, liver transplantation, spinal, and orthopedic surgeries. In veterinary medicine, these medications appear to be primarily utilized in critically ill dogs and cats diagnosed with neoplasia, bleeding disorders, and trauma.1 However, its use is expanding. A recent study documented that the use of intraoperative tranexamic acid was effective in reducing bleeding and facilitating operative visualization in dogs with disk herniation undergoing spinal surgery.2 As data from additional trials become available, the full spectrum of applications for antifibrinolytics should become more apparent.
What We’re Reading
In each issue, a member of our Editorial Advisory Board will share a recent open access publication of interest.
Characterization of the Dissemination of Canine Cancer Misinformation on YouTube
Richartz ER, Hodgkiss BA, Black-Ocken NC, Fuentes RA, Looper JS, Withers SS.
https://doi.org/10.1111/vco.12977
What was investigated? This study evaluated the misinformation levels of 99 canine cancer videos on YouTube, a frequent source of information for pet owners. This study explored the quality and usefulness of video content utilizing the validated DISCERN criteria for consumer health information and the Patient Education Materials Assessment Tool (PEMAT).
What was found? The median DISCERN quality score for the videos evaluated was 3 (out of 5) while the median PEMAT understandability score was 72%. Nearly two-thirds (61%) of videos contained little to no misinformation. Videos created by veterinarians had significantly higher quality and understandability scores.
Take-home point: The findings show similar levels of misinformation in canine cancer videos compared to those reported for various human cancer topics. The data are a reminder of the importance of guiding clients to reliable and understandable sources of information.
— Chad M. Johannes, DVM, DACVIM (SAIM, Oncology)
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References
- Kelley M, Sinnott-Stutzman V, Whelan M. Retrospective analysis of the use of tranexamic acid in critically ill dogs and cats (2018-2019): 266 dogs and 28 cats. J Vet Emerg Crit Care (San Antonio). 2022;32(6):791-799. doi:10.1111/vec.13237
- Ferrarin DA, Schwab ML, Wrzesinski MR, et al. Tranexamic acid in reducing intraoperative bleeding in dogs undergoing thoracolumbar and lumbar hemilaminectomy and intervertebral disc fenestration. Top Companion Anim Med. 2024;58:100820. doi:10.1016/j.tcam.2023.100820